Inspection on 11/01/07 for Reinwood Avenue

This inspection was carried out on 11th January 2007.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 11 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Reinwood Avenue 31/10/07

Reinwood Avenue 23/02/06

Reinwood Avenue 21/02/05

Reinwood Avenue 20/08/04

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

The Cornerstone

John Street Nursing Home

Pennine Camphill

Whitwood House

Whitwood Hall

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

CARE HOME ADULTS 18-65 Reinwood Avenue 26 Reinwood Avenue Leeds West Yorkshire LS8 3DP Lead Inspector Sue Dunn Key Unannounced Inspection 11th January 2007 12:45 DS0000001401.V321470.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 DS0000001401.V321470.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. DS0000001401.V321470.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Reinwood Avenue Address 26 Reinwood Avenue Leeds West Yorkshire LS8 3DP 0113 273 0083 0113 2730083 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) www.c-i-c.co.uk. Community Integrated Care Mrs Lynda Whitehead Care Home 3 Category(ies) of Learning disability (3) registration, with number of places DS0000001401.V321470.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 23rd February 2006 Brief Description of the Service: The home is a large detached bungalow owned by South Yorkshire Housing Association. It is situated in a residential area close to the Oakwood area of Leeds. The house and gardens are well maintained and indistinguishable from other house in the street. Local shops and amenities are nearby. A regular bus service into the city centre passes the end of the road. The home has its own car use of which is dependant on staff who can drive being on duty. Bedrooms are of a good size with ample communal space for the 3 people the home can accommodate. The house and garden have facilities for service users who use wheelchairs. DS0000001401.V321470.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The purpose of the inspection visit was to ensure the home was operating and being managed for the benefit and well being of the service users. One inspector undertook the inspection, which was unannounced. The inspection started at 12.45pm and finished at 16.05pm. A pre-inspection questionnaire had been completed and returned by the manager and was used to support judgements made during the inspection visit. Judgements are based on the outcomes for the people using the service. The report is based on information received from the home since the last inspection in February 2006, observation and conversation with service users, staff and an advocate, examination of documentation including 2 care files (which were tracked), and an inspection of the premises. Survey forms had been completed, with the assistance of independent advocates, and returned by all the people living in the home. Details of the weekly fees for the home were awaited from the organisations head office. The services not included in the fees are hairdressing, personal clothing and toiletries, social activities, holidays and transport. Work had been done to meet requirements from the last inspection report but the record keeping continues to let down the good care practices seen during the inspection visit. More work is required for a satisfactory standard to be met. The inspector would like to thank the people living in the house and the staff for their assistance and helpful comments during the inspection visit. DS0000001401.V321470.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: The contract between the home and service user or the service user guide should state what is not included in the fees to avoid misunderstanding. The organisation and quality of the written records varied and did not provide evidence to show that care was consistent and person centred. Care files were poorly organised making information difficult to find and confusing as it was scattered throughout the file. DS0000001401.V321470.R01.S.doc Version 5.2 Page 7 Staff appeared to be relying on verbal methods of communication and not keeping up with written evidence to show that care needs were being reviewed. This could lead to the risk of some care needs being overlooked. Examples of this were that factual information could not be found in one file, and in house reviews of care meetings were not up to date. Some of the writing in daily records was illegible and a weight-monitoring chart had not been completed. Care files could be improved by showing more planning for the social and recreational aspects of life. For example, a holiday was being arranged but this was not recorded in the care file. Risk assessments should be supported by a clear risk management plan to show how risk is to be reduced. Accident records must be stored in an orderly manner and show evidence that they are audited to identify any trends so that appropriate action can be taken. A copy of the pictorial complaints leaflet developed by the manager should be available to the service users. Shortfalls identified could be overcome by allowing the manager to concentrate her time on overseeing training, supervision and monitoring of the care files and storage systems in the home. The present system of management is too thinly spread when the home needs clear leadership to develop its new staff team. 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. The summary of this inspection report can be made available in other formats on request. DS0000001401.V321470.R01.S.doc Version 5.2 Page 8 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 DS0000001401.V321470.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 4 and 5 Quality in this outcome area was good. This judgement was made using available evidence including examination of documentation, information provided by the manager on the pre inspection questionnaire, discussion with staff and the manager. Service users and their families have the opportunity to visit the home and become familiar with staff and prospective housemates before moving into the home. There should be more detail in the information about facilities and services to advise people about the services not included in the fees. EVIDENCE: The Statement of Purpose and Service User Guide had been re written. The Guide was particularly good, being produced in clear print and pictures making it easier to be understood by people with poor reading skills. The contract between the home and one of the service users was examined. This was in a basic format, which allowed space to insert the fee and the room to be occupied. The contract did not give details of services and facilities not included in the fees. This information should be in the Statement of Purpose or in the Contract so that people are clear about who is responsible for what. The contract examined had been signed by an advocate. Evidence in care files showed information gathering and forward planning took place before admission. DS0000001401.V321470.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8 and 9 Quality in this outcome area was adequate. This judgement was made using all available evidence including examination of documentation, discussion with staff and observation of service users. Care files were poorly organised making information difficult to find. Staff were relying on verbal methods of communication and not keeping up with systems to show evidence that care needs were being reviewed. This could lead to the risk of some care needs being overlooked. EVIDENCE: The staff were familiar with the ways in which each service user communicated their needs. This was also recorded in the two care files inspected. Each person had a sectioned file. One file was more difficult to follow than the other, as information in each section was stored in a plastic sleeve. In order to find the relevant information it was necessary to remove the whole bundle of papers out of the sleeve. This could lead to information being mislaid and out of sequence particularly as a number of documents were undated and unsigned. DS0000001401.V321470.R01.S.doc Version 5.2 Page 11 The home had a system of reviewing care plans formally through monthly keyworker meetings. However, the most recent notes of a key-worker meeting for one person were dated October 2006. Staff could describe each service users preferences and care needs in detail but the written evidence to show their response to changing care needs was being overlooked. Factual information in one file was easy to find inside the front of the file. But to find information, which may need to be found quickly in an emergency, in the other file involved a search, as information was scattered throughout the file. More work was still needed to improve the second file, which included a clear and easy to follow plan, described as a ‘service specification,’ done by staff before the service user moved to the placement. The service specification was unsigned and undated but was laid out to show needs on the left and how needs were to be met on the right of the sheet. There were records of keyworker meetings in September and January to review progress and set goals. It was apparent on the morning of the visit that goals set at the last meeting had been met. Risk assessments had been done but the plans to manage identified risks were not clear. There was some evidence of reviewing and updating but information was scattered throughout the file. The manager agreed that overall, files were not up to standard. DS0000001401.V321470.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16 and 17 Quality in this outcome area was good. This judgement was made using all the available evidence including examination of documents, observation of service users and discussion with staff. The people living in the home had individual weekly programmes for social and recreational activity. There should however have been more written evidence in the form of care plans to show how and why activities were arranged to satisfy the diverse needs of people in the home. EVIDENCE: Care files included some personal background history but did not include a specific plan of care to show social and recreational interests. Two service users were out on the day of the visit, both attending the TACT centre for people with learning difficulties at different parts of the day. One of the two had been shopping for items as arranged at a review meeting. The other person was in his room listening to the radio and later sitting in front of the TV. Staff said his parents visit regularly and telephone every night and DS0000001401.V321470.R01.S.doc Version 5.2 Page 13 he goes for outings in the car. Recent health and mobility problems have restricted his activities but arrangements were being made to organise a holiday at a holiday camp. This information was not recorded in the care file but obtained by overhearing a telephone conversation. A diary of weekly activities for each person was listed on the wall in the office. The home has a car but not all staff were able to drive. Taxis were used to ensure people continued to attend activities if there was nobody to drive the vehicle. Staff were relaxed and caring in their contact with service users, using their knowledge of each persons preferred method of communication to respond to their needs. It was clear that service users were able to move about the house freely and could relax in the lounges and their own rooms. The kitchen was well stocked with fresh and frozen food and food stored in the fridge was well dated. Drinks and snacks were available. DS0000001401.V321470.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area was adequate. This judgement was made using all the available evidence including information from notifications, care files and observation and discussion with the manager and staff. Staff were able to describe how care was given to each individual but the organisation and quality of the written records varied and did not provide evidence to show that care was consistent and person centred. EVIDENCE: Information obtained from the methods shown above, showed that health care needs were being met. However, though staff were able to explain how they met the personal and health care needs of each person the written records were disorganised and in some cases illegible or unable to be found One file included completed behavioural monitoring forms to enable any challenging behaviour to be discussed with mental health professionals who were then able to offer support and advice on the best approach to reduce the behaviour. One person had a bruise on his face. Staff explained this happened during a relatives visit. The accident record log could not be found and a written report of the incident in the daily diary was so badly written as to be almost illegible. Copies of old accident forms were stored loose in the filing cabinet. These DS0000001401.V321470.R01.S.doc Version 5.2 Page 15 should be stored in date order and show evidence that the manager regularly checks and audits all accidents and incidents and takes appropriate action if any trends emerge. A weight chart in one file had not been completed since the person was admitted and there was no information to give an explanation why. Information about each person’s medication, its purpose and side effects was found in the files but was undated in one file therefore not clear if it was current. Guidance for staff on giving certain types of medication was clearly written but not held together with details of the rest of the medication therefore not easy for staff to find. Notes of a care planning review meeting with the Mental Health team showed that medication had been reviewed. The chronological records in both files, showing contact from health care professionals was good. There was clear guidance in one file showing how staff should apply an orthopaedic support device. A relative said staff had attended her son during a period of hospital admission. DS0000001401.V321470.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area was good. This judgement was made using all the available evidence including inspection of documentation, discussion with staff and the manager and a relative. Service users were protected by the home’s policies and procedures. EVIDENCE: There had been no complaints and no indication that people were expressing unhappiness through their behaviour. One person’s challenging behaviour had improved since admission to the home. A relative was confident that the manager would deal with any concerns if they were brought to her attention. The manager said she had produced a copy of the Complaints leaflet in pictorial form. This had been left in one of the other houses in the city. A copy of this document needs to be available for the young men with evidence that staff were regularly checking its contents with the service users. The staff training records showed that staff had had adult protection training. The manager was out of the home for most of the inspection visit giving adult protection training elsewhere within the organisation. DS0000001401.V321470.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27,28, 29, 30 Quality in this outcome area was good. This judgement was made using available evidence including information from the pre inspection questionnaire, a tour of the home and discussion with the manager and staff. The home was well maintained, comfortable and ‘homely’ with all the equipment required to support the care needs of the current group of service users. EVIDENCE: All areas of the building were clean, warm, free from clutter and in a good state of repair and décor. The appearance of the entrance to the house could be improved by repainting the house number plate, which let down the appearance of the entrance with its flaking paintwork. Bedrooms were large, allowing space for aids and adaptations. They contained photos and some personal possessions with some sensory stimulation equipment seen in one room. There was a very slight odour in one room, though it was clear that the carpet had been replaced since the last visit. The manager said the whole room and DS0000001401.V321470.R01.S.doc Version 5.2 Page 18 furnishings had been cleaned and underlay replaced and staff thought they had eliminated the odour. She said she would arrange to replace the chair in the bedroom, as that might be the source of the problem. The bathroom, fitted with moving and handling aids, and toilets, provided enough space for staff to assist service users as required. The home has had to stop keeping chickens as they were attracting vermin. Pest control specialists have eradicated the problem and the chicken run is to be removed. DS0000001401.V321470.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35 and 36 Quality in this outcome area was good. This judgement was made using available evidence, which included discussion with support workers and the manager, examination of documentation and observation. Recruitment, selection and training met the care requirements of service users but staff required more support and monitoring to ensure care records included all the information to give staff guidance on the care of service users. EVIDENCE: A relative described staff as ‘marvellous’. The home has struggled since the last inspection visit to recruit a permanent staff team. The manager has tried to maintain continuity and stability for service users by employing a regular team of agency staff. Any temporary staff sign an induction checklist as previously recommended. The situation is now easing with two experienced staff transferred from other houses and a 30 hour vacancy soon to be filled when the CRB (criminal record bureau) check has been completed. The home will then be left with one 37.5 hours vacancy to be filled. The home follows the organisation’s recruitment procedure, which is good and thorough. DS0000001401.V321470.R01.S.doc Version 5.2 Page 20 The recruitment and selection records for a recently appointed support worker showed a well completed application form, two written references and POVA (protection of vulnerable adult) checks. Notes were available from the interview assessment and there was a questionnaire about attitudes and values completed by candidate. One support worker confirmed she had received induction training and the notes of another person were checked. One senior support worker had completed NVQ3 (National Vocational Qualification) another was still working towards the award and two had just applied for enrolment on an NVQ course. Training records showed that staff had done fire safety training and moving and handling. The community nurse gave staff training on Hydrocephalus, as this was relevant to the care needs of a service user. DS0000001401.V321470.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 40, 41, 42 and 43 Quality in this outcome area was adequate This judgement was made using all the available evidence including inspection of documentation, discussion with staff and the manager. The manager of the home did not have sufficient time in the home to ensure the documentation and records were orderly and information underpinning service users care easy to find. This could lead to service users needs being missed. EVIDENCE: In addition to staff shortages, due to vacancies and sickness, the manager has been responsible for the management of another home at the other side of the city, spending three days in the home one week and two the next. On day of visit she was doing Adult Protection training for a group of staff. She was registered for the NVQ 4 managers’ award but unable to proceed as the NVQ assessor had left and not been replaced. DS0000001401.V321470.R01.S.doc Version 5.2 Page 22 The operations manager was said to give good support but her duties had been extended to cover a much wider area, therefore there would be less time to continue the previous level of support. Overall management of the home is spread too thinly. Some work had been done since the last inspection to improve the layout of care files but these and the records were disorganised and not being monitored closely enough to maintain standards. The manager said she does supervision at beginning of the month assisted by a senior support worker. Key-workers meetings to review care plans followed supervision. It was clear from the records that this was not being done regularly. There had been a reorganisation of the storage of records in the office but both manager and staff had difficulty finding some of the records. All routine safety checks were held together in a maintenance book. The following records were checked and in order:– Weekly hazard checklist, last date 6.1.07 Water safety 18.12.06 Fire drill 9.1.07 Fire alarm check 10.1.07 4 staff had fire training 2.1.07 Annual fire risk assessments were due as seen by the records. The fire alarm panel was being replaced at time of visit after an inspection the previous day by the fire equipment contractor. DS0000001401.V321470.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 x 4 3 5 3 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 3 25 3 26 3 27 3 28 3 29 3 30 2 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 2 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 2 2 x 2 2 3 3 2 3 2 DS0000001401.V321470.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? Yes 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 YA18 Regulation 15,17 Requirement Each resident must have a care plan which sets out the full range of needs and is in a well organised format which makes information easy to find There must be a clear and prominent risk management plan for each area of identified risk Service users physical and emotional health care needs must be included in the plan of care Accident records must be available and managed in a way which shows they are regularly audited for any patterns of behaviour/incidents The manager must continue to take steps to eradicate any odours remaining in the home Timescale for action 30/04/07 2 3 YA9 13,15,17 15, 17 31/03/07 30/04/07 YA19 4 YA20 13,17 30/04/07 5. YA30 16 31/03/07 6 YA36 17,18 7 YA38 10 Staff must receive regular 30/04/07 support and monitoring of their work with service users to ensure the care they give is backed up by satisfactory written records The manager of the home must 31/03/07 communicate a clear sense of DS0000001401.V321470.R01.S.doc Version 5.2 Page 25 8 YA37 YA41 10,17 9 YA43 10 direction and leadership to ensure the records are in order and underpin the care being given The registered provider must 31/03/07 ensure the manager has enough time in the home to carry out her duties fully and ensure records are well organised and of a satisfactory standard Lines of accountability within the 31/03/07 home must be clearly understood RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 Refer to Standard YA5 YA24 YA35 Good Practice Recommendations The information for service users and their relatives/advocates should give details of the services not included in the fees. The appearance of the house number plate would benefit from repainting. Staff would benefit from more support and training to maintain care files and records. DS0000001401.V321470.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 DS0000001401.V321470.R01.S.doc Version 5.2 Page 27 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!