Inspection on 31/10/07 for Reinwood Avenue

This inspection was carried out on 31st October 2007.

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

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Reinwood Avenue 11/01/07

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 Valerie Francis Key Unannounced Inspection 31st October 2007 09:30 Reinwood Avenue DS0000001401.V354276.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 Reinwood Avenue DS0000001401.V354276.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. Reinwood Avenue DS0000001401.V354276.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 reinwoodavenue@c-I-c.co.uk www.c-i-c.co.uk. Community Integrated Care 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) Mrs Lynda Whitehead Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Reinwood Avenue DS0000001401.V354276.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11th January 2007 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 look like other houses on the street. The home has its own car. Bedrooms are of a good size with ample communal space for the 3 people who live there. The garden also suits people who use wheelchairs. The charges at the home on 31st October 2007 are £1108.92 to £1189 per week. Additional charges are made for toiletries, some leisure activities, holidays and taxis. Reinwood Avenue DS0000001401.V354276.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection report is divided into separate sections for each outcome group for example Choice of Home. An overall judgement is made for each outcome group based on the findings of the inspection. The judgements reflect how well the service delivers outcomes to the people using the service. The judgements categories are “excellent”, “good”, “adequate” and “poor”. The judgements are recorded within the main body of this report. More detailed information about these changes is available on our website – www.csci.org.uk One inspector carried out an unannounced inspection, which started on 31 October and was completed on 5 November 2007 with feedback to the manager and the senior support worker. Some feedback was given to the senior support worker who was the person in charge of the home on the first day of the inspection. The purpose of this inspection was to make sure the home was providing a good standard of care for the people living there. The term people who use the service will be used throughout the report when referring to the people who live at the home. No arrangement had been made with the home to carry out the inspection. The home had been sent an Annual Quality Assurance Assessment (AQAA) self-assessment form to complete. This form gives the home and the organisation an opportunity to put forward their views on how they provide their service to people using it or wanting to. The methods used at this inspection included looking at care records, observing working practices and talking with people who live there and staff. Information gained from a pre-inspection questionnaire and the home’s service history records were also used. Before the visit, comment cards were sent out to service users, relatives and visiting professionals to the home. Two of these have been returned and this information has also been used in the preparation of this report. There were no visitors to the home on the day of the visit. Thank you to everyone for the pre-inspection information, returned comment cards and for the hospitality and assistance on the day of the visit. Requirements and recommendations made during this visit can be found at the end of the report. Reinwood Avenue DS0000001401.V354276.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? Each person now has a care plan which sets out the full range of needs. It is acknowledged that some work had been carried out to organise and make information easy to find. The process has started to record people’s physical and emotional health care needs and any identified risk in a care plan. The manager said the accident records are monitored as part of the regulation 26 monthly visits by the operation manager. This helps them look for any patterns in behaviour and links between incidents. Since the last inspection the source of the odour had been identified and floor covering and furniture replaced. The manager and staff said they have monthly supervision, and that monthly key worker meetings take place with the manager or senior support worker. From discussions with staff it was clear that they understood their role within the home and the service they deliver to people. The information for people who live at the home and their relatives/advocates now shows details of the services not included in the fees. A new house number plate has been fitted to the front door. Staff have had training and are supported to maintain care files and records. Reinwood Avenue DS0000001401.V354276.R01.S.doc Version 5.2 Page 7 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. The summary of this inspection report can be made available in other formats on request. Reinwood Avenue DS0000001401.V354276.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 Reinwood Avenue DS0000001401.V354276.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. People who use the service experience good quality outcomes in this area. There is sufficient information about the home available to people to make sure they can make a choice about living at the home. People are provided with enough information to enable them to make an informed choice about the home. The admission process is good and includes introductory visits. We have made this judgment using available evidence including a visit to this service. EVIDENCE: The Statement Of Purpose and Service User Guide have been produced in an easy read format, using large print and pictures. They give detailed information on what the service can provide. People have a contract with the organisation with all costs listed in them. Service users’ needs had been assessed before they moved into the home to make sure the home could meet their needs. Before people move in, the assessment process starts with a “getting to know you” document. This helps the home decide if and how people’s needs can be Reinwood Avenue DS0000001401.V354276.R01.S.doc Version 5.2 Page 10 met. Only then is a moving in date arranged. The two relatives who responded to surveys said they were quite happy with the process. Reinwood Avenue DS0000001401.V354276.R01.S.doc Version 5.2 Page 11 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 & 9. People who use the service experience good quality outcomes in this area. The home is good at meeting the care needs of the people who use the service but records do not consistently provide evidence of this. There are safe practices in handling Medication and people’s healthcare needs are met. We have made this judgment using available evidence including a visit to this service. EVIDENCE: Each person has a care plan, which in the main, are detailed. There were some good personal details about individual care needs documented. However, review and update of care was not always clear. Although care plans give staff specific instructions on care needs and they have been developed from assessments of people’s needs. They were in Reinwood Avenue DS0000001401.V354276.R01.S.doc Version 5.2 Page 12 several formats and needed to be organised, so that information is more accessible. All staff are involved in developing the care plans and updating them as needs change. It was apparent from observation, discussion with staff, survey information from relatives and health professionals that staff were very knowledgeable about the care needs of the people they were looking after. One relative said “ we are kept informed and told everything”, “at his review We sit and discuss what going on and make decisions about his future”. Risk assessments have been completed for people, and in some cases were part of the care planning process. Since the last inspection a format to record individual key worker meetings with people to evaluate their care has been put in place. However this is not effective as people have no verbal communication and cannot really participate in the process, to make sure that any change in their care needs in reflected in their care plan. Some work has started on people’s last wishes. The organisation has now put in place a document “ when I die “, a record sheet to record information on what things people would like to happen when they die. This, however does not provide staff with any information, that they can use to make a plan of care to support people in their last days. Reinwood Avenue DS0000001401.V354276.R01.S.doc Version 5.2 Page 13 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): 12,13,15 15 & 17. People who use the service experience good quality outcomes in this area. The home offers opportunities to people who use the service for their personal development and social and leisure activities. Effort is made to provide people with a balanced diet, but no nutritional risk assessments are carried out for people, to give staff information that would help them to identify people who are at risk. We have made this judgment using available evidence including a visit to this service. EVIDENCE: People are involved in a variety of activities, such as doing activities with other agencies, shopping, and meals out. People are supported and encouraged to meet up with friends and to keep in contact with their families. Reinwood Avenue DS0000001401.V354276.R01.S.doc Version 5.2 Page 14 Peoples’ relatives told us: • • • • One person said they have offered to bring my son me if I cannot get to visit him at the home. Two staff took my son away abroad on holiday, which was quite satisfactory. Staff brought my son to see me when I was in hospital, they also took him to see my father and took him the funeral. They take him out, so he meets other people and arrange things for him to do and take him on holiday. As well as outside activities people enjoy activities in the home as a group or individually. The inspector was told that there are plans in place for a sensory garden. The lack of drivers in the staff team has an impact on how often the home vehicle is used. However it was evident that use of taxis and public transport is encouraged. There is use of shared transport with another home within the organisation. There is a menu plan for four weeks at the home. However, if people wanted something different to what is on the menu, this can be done like “take away “ food which staff said depended on people’s choice. Staff appeared to know what people liked and did not like. Despite one person having some problems with eating and a dietician being involved in his care there was no evidence that people’ nutritional needs had been assessed and no regular review for risk such as overweight and underweight. People’s weights were not regularly recorded. It was evident from information in people’s assessments that they were at risk of choking, each had a risk assessment, but no clear plan of action to be taken to manage or minimise the risk. Reinwood Avenue DS0000001401.V354276.R01.S.doc Version 5.2 Page 15 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 & 20. People who use the service experience good quality outcomes in this area. People who use the service are supported with their personal and health care in a way that meets their individual needs. People are protected by the organisation’s policies and procedure for safe handling of medication. We have made this judgment using available evidence including a visit to this service. EVIDENCE: Staff supports people with their personal care needs in private and with dignity. It was noted on the day of the inspection, that people are well dressed in clothing appropriate to their age and needs. Staff have good knowledge of peoples preferences on personal care. Staff said that one person had a particular shirt, which he likes to wear when he went to the day centre. This was not recorded in the care plan. Staff surveys said the home supports people in meeting their needs. Reinwood Avenue DS0000001401.V354276.R01.S.doc Version 5.2 Page 16 Care plans also have details of any health professionals that people see. These included, GP, dentist, district nurse, and chiropodist. Records are kept of any health appointments and their outcome. Staff always accompany people on all their appointments. One health care professional said: “The home carers support people to appointments and activities which are offered to benefit, their health needs. However sometimes this is difficult due to staffing levels, but they seem to try to honour appointments”. One relative said “ I get telephone call or letters telling me how he is progressing”. The home uses a monitored dosage pre-packed system for medicines. All staff have had training on a twelve week course on safe handling of medication. There are good ordering and checking systems in place, with a clear audit trail for any unused medication returned to the pharmacy. The medication administration record (MAR) sheets were checked and showed no errors. Reinwood Avenue DS0000001401.V354276.R01.S.doc Version 5.2 Page 17 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 & 23. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People and their representative’s concerns are listened to and acted upon. People are protected from abuse by the home’s policies and procedures on adult protection. We have made this judgment using available evidence including a visit to this service. EVIDENCE: The home has a complaints procedure displayed in the entrance to the home. The complaint procedure has been produced in an easy words and pictorial format to make it more accessible to all. One relative who returned a survey card commented they did not know how to complain, but felt it was best to know, should the need arise. But felt they had not had any cause to be concerned to date. Another relative said if they had any concerns “ I phone and ask questions if they say they will phone back they do and reply”. Staff spoken to said they are aware of the complaints procedure, the procedure was displayed on the wall in the hallway. Reinwood Avenue DS0000001401.V354276.R01.S.doc Version 5.2 Page 18 Staff have received training on the protection of vulnerable adults. They were able to say what action they would take if they suspected abuse or had an allegation of abuse made to them. They were also able to describe the different types of abuse. People were quite clear of their awareness’ of the whistle blowing procedure and had no problem to use it if they had to. They were also aware of the named person in the organisation who they would contact. Staff have CRB checks every and three years there is ongoing training on dealing with aggression. Good records are kept of people’s finances and their monies are kept safe. Reinwood Avenue DS0000001401.V354276.R01.S.doc Version 5.2 Page 19 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 & 30. People who use the service experience good quality outcomes in this area. People live in a homely, comfortable and safe environment. We have made this judgment using available evidence including a visit to this service. EVIDENCE: The environment is comfortable and well kept there are communal sanitary facilities that allow for full assistance from staff. Peoples’ rooms are furnished and the addition of personal items makes the rooms homely to reflect the individual’s own tastes and interests. Although most areas of the home seen were well maintained there were several shortfall that needs to be addressed. The bathrooms were showing signs of wear and tear. Paint was peeling, seals around the bath were showing Reinwood Avenue DS0000001401.V354276.R01.S.doc Version 5.2 Page 20 signs of mould and although the bath itself was fully working this was again showing signs of age and wear and tear. Individual personal laundry is carried out, the laundry was organised and everyone has a personalised basket for their laundry. . The home was clean, no odour throughout. Staff have received training in infection control and were able to say what infection control measures are in place. Liquid soap and disposable towels was available at all sinks, to make sure of good hand washing hygiene. The home has a large garden, which the manager said plans were in place to create a sensory garden with seating so that people can make good use of, especially in the summer months. Reinwood Avenue DS0000001401.V354276.R01.S.doc Version 5.2 Page 21 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): 32,34 & 35. People who use the service experience good quality outcomes in this area. Overall, there were enough staff to meet the needs of the people living at the home. People are protected by robust recruitment procedures. We have made this judgment using available evidence including a visit to this service. EVIDENCE: There are staff on duty throughout the day and night. There are usually two staff on the morning shift, two staff on the afternoon shift and one additional staff member per day on occasions, depending on the needs and activities of people. During the night there is one member of staff available to people who use the service with an on call arrangement from the organisation. One relative said “ possible a little more staff sometimes during the weekend as it always seem to be short at this time”. Since the last inspection the home has employed a full time care support worker. The manager said she keeps staffing levels under review to make sure staff levels properly meet people’s needs. Reinwood Avenue DS0000001401.V354276.R01.S.doc Version 5.2 Page 22 Two files of the last staff employed at the home were look at. In the main recruitment is properly managed by the organisation. Interviews are held, references and CRB (Criminal Record Bureau) checks are obtained before staff start work and checks are made to make sure staff are eligible for work. The manager said the organisation carries out CRB checks every three years, however one staff said they have not had a CRB check since they have been employed. Staff training was up to date, records of staff training are held by the organisation’s training section. A training matrix was seen with updates of courses to make sure training doesn’t get missed. Staff said they are given a good range of training, which supports them in delivering care to people who use the service. Two members of staff have achieved an NVQ (National Vocational Qualification) in level 2 or above. Staff said they felt they have a good team with good support from the manager and senior support worker. They felt communication and teamwork within the home is good. Regular staff meetings are held. Staff receive supervision by the manager or the senior support worker and have an annual appraisal of their performance. Reinwood Avenue DS0000001401.V354276.R01.S.doc Version 5.2 Page 23 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): 37,39 & 42. People who use the service experience good quality outcomes in this area. The management structures the organisation has put in place in the home ensure, it is managed in the best interest of the people living at the home, people are safe. We have made this judgment using available evidence including a visit to this service. EVIDENCE: The registered manager has completed the Registered Managers Award and plans to start NVQ level 4 in January 2008. The manager also manages another small home in the organisation, she works two and half days at each home. Some of the management responsibility has been delegated to the senior support worker. This was a concern at the last inspection and this inspection. Reinwood Avenue DS0000001401.V354276.R01.S.doc Version 5.2 Page 24 This was discussed with the manager who said senior line management has made a decision to employ a part time senior support worker to also share responsibility to make sure that the home is well managed in the absence of the registered manager. People who live in the home are safe and staff have access to one of the home’s management staff during the day. Presently, the senior support worker has 16 hours supernumerary hours and there are plans in place to also give supernumerary hours to the part time worker. The manager said she works alongside staff to make sure of good practice. The senior support worker uses shift handover times to complete management tasks. Monthly visits are made by a senior line manager to the home to carry out regulation visits, which involve talking to people who use the service and staff about the home. A report of these visits is made showing details of any action to be taken to improve the service. In addition to this, annual questionnaires are sent out to families, staff and health care professionals. The manager said people’s care plan reviews are also used as quality audit be getting feedback from relatives about the service provided. Maintenance records were well kept, environmental risk assessments were completed and up to date. Fire training is carried out all staff according to the records seen. Staff have access to a range of comprehensive policies and procedures, which they have the opportunity to read and become familiar during their induction. Reinwood Avenue DS0000001401.V354276.R01.S.doc Version 5.2 Page 25 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 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 2 33 X 34 3 35 4 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 2 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 3 X 2 X 3 3 3 X X Reinwood Avenue DS0000001401.V354276.R01.S.doc Version 5.2 Page 26 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA17 Regulation 12 Requirement The manager must ensure that nutritional risk assessments are carried out and documented for all people who live at the home; this must be supported by regular weight checks. The registered provider must ensure that the areas identified in the environment as a shortfall is resolved to provide people with a home that is kept under good repair. Timescale for action 31/01/08 2. YA24 23 31/01/08 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 YA6 YA19 YA9 Good Practice Recommendations The registered manager should continue to make sure that any identified risks are documented within a plan how each risk will be managed, she should also continue make sure that people’s physical and emotional health needs are in a care plan and all care plans are in a format that is organised and accessible. DS0000001401.V354276.R01.S.doc Version 5.2 Page 27 Reinwood Avenue 2. YA36 YA38 The registered provide should make sure that the management arrangement at the home is kept under review. Having clear line of responsibility and accountable for management of staff, which will mean that people who live at the home will continue receive a good standard of care and information well documented. Reinwood Avenue DS0000001401.V354276.R01.S.doc Version 5.2 Page 28 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 Reinwood Avenue DS0000001401.V354276.R01.S.doc Version 5.2 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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