CARE HOME ADULTS 18-65
Renwick Dragon Lane Manningford Bruce Pewsey Wiltshire SN9 6JE Lead Inspector
Elaine Barber Unannounced Inspection 8 January 2007 10:30
th Renwick DS0000028214.V298461.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 Renwick DS0000028214.V298461.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. Renwick DS0000028214.V298461.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Renwick Address Dragon Lane Manningford Bruce Pewsey Wiltshire SN9 6JE 01672 563026 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) Steven@StevenAbbott.wanadoo.co.uk Mr Steven Abbott Mrs Jane Abbott Mrs Carol Bottoms Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Renwick DS0000028214.V298461.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 1st March 2006 Brief Description of the Service: Valued Lives is a private organisation, which operates five care homes for adults with learning disability. All are small establishments, intended to offer a normal domestic lifestyle. The main lead for the organisation is taken by one of the registered persons, Mrs Jane Abbott. She is supported by other senior colleagues, including family members. Each of the Valued Lives homes is situated in Pewsey, or nearby small villages. Pewsey itself offers a range of amenities. The market towns of Marlborough and Devizes are within 15 minutes’ drive and the larger towns of Salisbury and Swindon are easily accessible. The organisation provides a number of vehicles for people who live in the homes and they contribute towards the costs. Valued Lives also operates Harlequins, which is a day service used by most people who live in the homes for at least part of each week. They pay a small weekly sum towards this. Renwick is in the small village of Manningford Bruce. The home is registered for up to three service users, but has only one at present. The bathrooms and bedrooms are upstairs. Shared living rooms and the kitchen are on the ground floor. The fees are £1336. Renwick DS0000028214.V298461.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection included an unannounced visit to the home on 8th January 2007. During the visit information was gathered using: • • • Observation Discussion with the manager Reading records. Other information and feedback about the home has been received and taken into account as part of this inspection: • • The owner provided information prior to the inspection about the running of the home. The person who lived in the home was met with on two occasions whilst visiting other homes run by the organisation. The judgements contained in this report have been made from all this evidence gathered during the inspection, including the inspection visit. What the service does well:
The person who lived in the home had had their needs assessed over time to ensure that these needs were met. Their abilities, needs and goals were reflected in their individual plan to ensure that these needs were met. People could make choices and decisions in their daily lives. They chose the activities they followed, the colours of the rooms in their house and where to spend their time. They were supported to take risks so that they could remain as independent as they were able. People were provided with a range of activities and opportunities, offering access to their local community. These included holidays, shopping trips, going to the cinema, bowling, the pub and out for meals. People were able to maintain and develop appropriate relationships with family and friends. People were involved in planning the menu, which reflected their choices. People were offered a healthy diet and enjoyed their meals. People had detailed support plans so that they received support in ways they preferred and required. They had access to a range of health care professionals and their physical and emotional health needs were met. Medication was appropriately stored and people had their medication reviewed regularly. People were protected by the home’s policies and practices about medication. There was a complaints procedure and this was in pictorial format so as to be easily understood and people knew how to complain. There was information
Renwick DS0000028214.V298461.R01.S.doc Version 5.2 Page 6 about the local vulnerable adults procedures and staff had received training about protection of vulnerable adults. This ensured that people were protected from harm. The accommodation was in a cottage and had a cosy feel to it. There was a lounge and separate sitting room with small kitchen. The bedrooms were individually decorated and there was a small bathroom with a shower. The person who lived there said that they liked their room. There were laundry facilities in the kitchen to meet the laundry demands. The home was clean and tidy. People lived in a comfortable, clean and safe environment, suitable to their needs. People were supported by suitable numbers of appropriately trained staff. One member of staff was on duty at all times that the person was at home. There was a range of training. No new staff had started work in the home since the last inspection. The staff had had all the appropriate checks before starting work so that people were protected by effective recruitment practices. The manager was appropriately qualified to run the home. She was supported by the owner and other senior managers in the organisation so that people were benefiting from a well run home. A quality assurance system had been developed and views of people who used the service, their relatives and visiting professionals had been obtained. People’s views underpinned all self-monitoring, review and development by the home. What has improved since the last inspection? What they could do better:
The care plans could be improved by signing and dating them to show when they were developed and by whom. People or their representatives should sign their plans to show that they have been involved in developing them. Any changes to the care plans following a review should also be dated. This will ensure that staff know which information is the most up to date so that they can meet people’s changing needs. The house felt cold on the day of inspection. However, the person who lived there had been staying in another home for a few days so the house had not been lived in. The house had storage radiators and the temperature was not
Renwick DS0000028214.V298461.R01.S.doc Version 5.2 Page 7 easily regulated. The system of heating should be reviewed to ensure that a comfortable temperature is maintained when people are at home. Further work needs to be done to complete the quality assurance process. The report about the findings of the surveys needs to be published by sending a copy to the Commission and by making copies available to people who use the service. 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. Renwick DS0000028214.V298461.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 Renwick DS0000028214.V298461.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 and 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The person’s individual needs were assessed so that their needs could be met. The person had a written contract with the home. EVIDENCE: This standard was met at last inspection and no new people had been admitted to the home since then. Renwick was supporting one person, who was admitted as an emergency in 2005, following the breakdown of their previous placement. Their needs had been assessed at this time. This person had a contract with the local authority and the home. They had signed the contract to confirm their agreement with it. Renwick DS0000028214.V298461.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7, 9 Quality in this outcome area is good. This judgement has been made using available evidence including visits to this service. People’s assessed needs were reflected in their individual plans. People made decisions about their lives with assistance as needed. People were supported to take risks and given opportunities for independence. EVIDENCE: The person who lived in the home had a detailed care plan. This included all aspects of personal and health care, safety issues, communication, preferred routines, contact with family, community and leisure activities and spiritual needs. There were also sections on developing independence and social skills. There were weekly review sheets in the personal notes to show that the care plan was reviewed and updated when needed. However the plan was not signed or dated by a member of staff or the person concerned to show when it
Renwick DS0000028214.V298461.R01.S.doc Version 5.2 Page 11 was developed and by whom. Changes to the plan were not dated. The person also had a social work care plan and a detailed behavioural support plan agreed with the community nurse. Examples of how the person exercised choice and decision making were recorded in the care plan and daily records. They had a choice of activities, TV programmes and food and they chose where to spend their time. They had chosen to spend Christmas in another home owned by the organisation, which had a vacancy. There were plans to redecorate the home and the person had been involved in choosing colours. They had also decided that they preferred to stay in the other house whilst the decorating took place. The manager reported that there was a range of risk assessments for this person. These were not available for inspection. However, there was written evidence in the personal notes that the person was supported to take risks to promote their independence. There were examples of participating in activities, which may pose a risk, with support such as household tasks and going out. A new risk assessment format was to be introduced and the manager said that new assessments would be done. The new format included the benefits to the person of taking risks. Renwick DS0000028214.V298461.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16, 17 Quality in this outcome area was good. This judgement has been made from evidence gathered during the visit to the home. People were provided with a range of activities and opportunities to go out into their local community. Activities were suited to their individual needs and preferences. People were able to maintain and develop appropriate relationships with family and friends. People’s daily lives had an appropriate balance between necessary routines, and individual choice. People were offered healthy, nutritious and enjoyable meals, in line with individual needs and choices. Renwick DS0000028214.V298461.R01.S.doc Version 5.2 Page 13 EVIDENCE: The person who lived in the home attended the day service run by the organisation on weekdays. They had a weekly programme showing their choice of activities at the service. They also had a record of community activities in their daily notes and care plan. Staff supported them to access community facilities including the shops, pub, café, garden centre, post office and restaurants. They went bowling or to the cinema once a month and to a social club once a fortnight. At home they enjoyed watching television or videos, sewing, helping around the house and walks. They also participated in outings including to London and Longleat. They had a holiday in the caravan owned by the organisation. The manager reported that staff supported the person to maintain contact with their family. They assisted the person to make phone calls and visit relatives. At the time of the inspection they said that they were looking forward to visiting their mother later in the week. They also said that they enjoyed visiting people who lived in other houses run by the organisation. They were met with on two separate occasions visiting people in different houses. The manager reported that people chose the menus by looking at recipe cards. They were also involved in buying ingredients. Healthy eating was promoted. At the time of the inspection the person was staying in another house and had chosen their meals at this house. There was a varied menu and the person said that they enjoyed the meals. Renwick DS0000028214.V298461.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People received support in ways they preferred and required. People’s physical and emotional health needs were met. People were protected by the home’s policies and practices about medication. EVIDENCE: The person’s preferred daily routines were recorded in their care plan. These included how they liked staff to support them. Personal care was provided in private. They chose their own clothes and hairstyle. They had specialist support when needed. Details about support with health care were recorded in the care plan. Contacts with a range of health care professionals were recorded. These included the GP, dentist, optician, community nurse, psychologist, psychiatrist and speech and language therapist. The person had an annual health check and their health was actively promoted by staff.
Renwick DS0000028214.V298461.R01.S.doc Version 5.2 Page 15 There was a medication policy and staff received training about medication. Further training was planned in February 2007. The person was staying in another house at the time of the inspection and their medication was being stored in a locked cupboard there. Their medication was kept separately in a plastic box and they had a medication record book. The book and box went with the person when they moved between different houses. There were appropriate records of medication received, administered and returned to the pharmacist. A list of homely remedies had been compiled for the agreement of the GP but these had not yet been agreed. The psychiatrist reviewed their medication. There was a requirement at the previous inspection that guidelines must be available for the use of all ‘as required’ medications, to ensure that they are used within the prescriber’s instructions. The person no longer had any as required medication. The manager reported that guidelines had been drawn up for a previous as required medicine and guidelines had been developed for people living in the house where they were staying. Renwick DS0000028214.V298461.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People were safeguarded by the home’s policies and procedures for complaints and protection. EVIDENCE: There was information available regarding complaints. The procedure was last updated in September 2004. A pictorial version was available within the Service User Guide. Contact details for the CSCI were included. No complaints had been received. The aim was to minimise any likelihood of this, by having strong recording systems that make all staff accountable for the actions of each particular shift period. There was a wide range of information about adult protection issues. This included details about multi-agency procedures within Wiltshire. A ‘Protection’ section in the care plan gave information about the various safeguards in place. These included recruitment checks, staff training, and key individual abilities and relationships that contributed to upholding a person’s welfare. The person who lived in the home had a behaviour management plan and a restraint policy. This had been drawn up by all the staff with the involvement of the community nurse. Physical interventions were described and there were guidelines about which holds may be used and in what circumstances. Staff had received appropriate training in these techniques.
Renwick DS0000028214.V298461.R01.S.doc Version 5.2 Page 17 Staff assisted the person to manage their money and appropriate records were kept. The records for the previous year had been sent to be audited. Renwick DS0000028214.V298461.R01.S.doc Version 5.2 Page 18 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, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People lived in a comfortable, clean and safe environment, suitable to their needs. EVIDENCE: Renwick is a semi detached cottage in the village of Manningford Bruce and is in keeping with neighbouring properties. It is in a quiet rural location. Pewsey is approximately 3 miles away. The property is rented by Valued Lives. There was a living room and an adjoining sitting room, a small kitchen and a large hallway downstairs. Upstairs there were two bedrooms, a staff sleeping in room and a bathroom with a shower. The house was decorated in dark colours and was comfortably furnished. There was a plan to redecorate the whole house and the person who lived there had been involved in choosing colours. The house was heated by electric storage radiators and the manager
Renwick DS0000028214.V298461.R01.S.doc Version 5.2 Page 19 said that there were also some freestanding heaters but none were seen. At the time of the inspection the house felt quite cold. However the person had not been living there for a few days as they were staying at another house. The manager stated that the owner of Valued Lives was discussing the maintenance of the property with the owner of the house with a view to some changes. The house was clean and tidy. There was a domestic washing machine in the kitchen. Entries in the person’s care records showed that staff supported them with doing their washing. Renwick DS0000028214.V298461.R01.S.doc Version 5.2 Page 20 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): 33, 34, 35, Quality in this outcome area was good. This judgement has been made from evidence gathered during the visit to the home. People were supported by an effective staff team, who were appropriately trained, competent and qualified to meet their needs. People were protected by the home’s recruitment practices. EVIDENCE: Each home within Valued Lives has some staff specifically allocated to it. Cover is then made up by other staff, who work in more than one setting. The owner’s aim is to employ sufficient people so that, even if they are one staff member down, there are still enough to cover all the organisation’s services without needing to rely on external agencies. Cover at Renwick is usually provided by a member of staff who sleeps in at night. The staff member then spends the day at the organisation’s day service or undertaking community activities with the person. There were two regular staff members. However at the time of the inspection the person who lives at Renwick was staying at another home which had a vacancy and there were sufficient staff there to support them.
Renwick DS0000028214.V298461.R01.S.doc Version 5.2 Page 21 There were appropriate recruitment practices and no new staff had been recruited since the last inspection. Over 50 of staff in the organisation had a National Vocational Qualification (NVQ). One of the regular staff had recently started NVQ level two. All staff in the organisation had received a range of training including health and safety, food hygiene, first aid, medication, including special methods of administration, and abuse awareness. There were also courses about epilepsy, challenging behaviour, person centred planning, physical intervention, autism, and dementia in people with Down’s Syndrome. This range of training ensured that staff could meet the diverse needs of the people who lived in the organisation. Refresher training was held in November for health and safety, food hygiene, first aid and administration of medicines by special methods. Training about Makaton and updates about protection of vulnerable adults, medication and food hygiene were planned. The provider reported that they also planned to introduce Learning Disability Award Framework training for all staff. Renwick DS0000028214.V298461.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 Quality in this outcome area was good. This judgement has been made from evidence gathered during the visit to the home. The registered manager was suitably competent and experienced, and was supported by senior colleagues, so that service users benefited from a well run home. People’s views underpinned all self-monitoring, review and development by the home although the report about these views needs to be published. People’s health, safety and welfare were promoted and protected by the health and safety measures. EVIDENCE: The registered person is Mrs Jane Abbott. She has lengthy experience of working with people with learning disability, and has owned and operated her own services for many years. She is supported by other senior staff within the
Renwick DS0000028214.V298461.R01.S.doc Version 5.2 Page 23 organisation. Together, they oversee all five services currently run by Valued Lives. Mrs Carol Bottoms is registered manager for Renwick, and for Roman Court in Pewsey. She had the registered managers award and kept her training up to date. Since the last inspection the registered person and registered manager had been working on their quality assurance for the service. The quality assurance framework was based on the systems in the house including policies and procedures, care plans, records and staffing. A consultant had provided advice and guidance about quality assurance. The views of people who used the service, relatives and visiting professionals had been collected. These had been collated into a quality assurance report for the whole service covering five homes. There was also a draft review report of the previous three years. Areas for improvement were identified. A copy of this report now needs to be sent to the Commission and made available to all people who use the service. There was a health and safety policy to comply with the relevant regulations. A number of general risk assessments and safe working procedures had been recorded. There were also individual risk assessments. There were arrangements for the training of staff in moving and handling, fire safety, first aid and food hygiene. A monthly ‘hazard’ inspection of the home was carried out. Hot water temperature regulators had been fitted to the taps. There were Control of Substances Hazardous to Health (COSHH) assessments, equipment was regularly serviced and portable appliances were tested annually. There was a fire risk assessment and records of fire safety checks. The radiators were not covered. The risk to the person of uncovered radiators had been assessed and no risk was identified. Information was available about what to do in the event of a heat wave. Renwick DS0000028214.V298461.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 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 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 X 33 3 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 x LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Renwick DS0000028214.V298461.R01.S.doc Version 5.2 Page 25 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA39 Regulation 24 Requirement The registered person shall establish and maintain a system for reviewing at appropriate intervals and improving the quality of care at the care home. The registered person shall supply to the commission a report in respect of any review conducted by him and make a copy of the report available to service users. In order to comply with this requirement the registered person must supply to the Commission a copy of the report about the quality assurance survey and make a copy of the report available to service users. Timescale for action 31/03/07 Renwick DS0000028214.V298461.R01.S.doc Version 5.2 Page 26 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 Good Practice Recommendations Care plans should be signed and dated when they are developed. All changes to the care plans should also be signed and dated. The service user or their representative should sign the care plan to show they have been involved in developing their plan. The system of heating should be reviewed to ensure that a comfortable temperature is maintained when people are at home. 2. 3. YA6 YA24 Renwick DS0000028214.V298461.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Chippenham Area Office Avonbridge House Bath Road Chippenham SN15 2BB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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