Inspection on 07/01/08 for Salisbury Autistic Care Ltd

This inspection was carried out on 7th January 2008.

CSCI found this care home to be providing an Good service.

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 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Salisbury Autistic Care Ltd 14/08/07

Salisbury Autistic Care Ltd 30/05/06

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 Salisbury Autistic Care Ltd 28 Holt Road North Wembley Middlesex HA0 3PS Lead Inspector Andreas Schwarz Unannounced Inspection 7th January 2008 09:00 Salisbury Autistic Care Ltd DS0000063728.V354790.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 Salisbury Autistic Care Ltd DS0000063728.V354790.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. Salisbury Autistic Care Ltd DS0000063728.V354790.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Salisbury Autistic Care Ltd Address 28 Holt Road North Wembley Middlesex HA0 3PS 020 8908 1760 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) maynard@salisburyautisticcare.com Salisbury Autistic Care Ltd Ms Glenis Mary Castillo Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Salisbury Autistic Care Ltd DS0000063728.V354790.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14th August 2007 Brief Description of the Service: Holt Road is a five bedded home in Wembley and trades under the name of Salisbury Autistic Care Ltd. Mrs Glenis Randall manages the home and the Registered Individual is Mr Maynard Harry. The home was registered under the Care Homes Act 2001 in October 2005. The home is specialising in providing care for young adults who are within the autistic spectrum disorder and present some challenges to the service. The building is a detached property on a quite residential street in North Wembley, close to public transport, shops and other amenities. There is a large garden, spacious open plan kitchen and dining room on the ground floor. The home is providing separate rooms for activities, relaxation or cool down times for people using the service. There is off street parking for approximately three cars and unrestricted street parking. The home is providing a people carrier, which can be used for outings; shopping and other activities. The home has currently three vacancies. Fees and charges can be obtained on request from the registered manager. Salisbury Autistic Care Ltd DS0000063728.V354790.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This was the second unannounced key inspection for the inspection year 2007/08. This key inspection took seven hours and I visited the home on two days. The registered manager was not available during the first day of this key inspection. I assessed all care plans and other records relating to the care of people using the service. A support worker assisted me confidently during the first day of this key inspection. I met the registered manager during the second day of this inspection and viewed staffing files and quality assurance records. People using the service are non verbal and are not able to tell about me the care they receive at Holt Road, but I observed staff interacting with people during this visit. I would like to take this opportunity thanking all involved in this annual key inspection. What the service does well: The registered manager has good knowledge of Autism. Care plans and risk assessments are of very high standard and have great detail. The home is providing tailor made activities, which can be in-house or community based. The large number of requirements regarding damage to the environment has been dealt with and redecoration was undertaken to high standard. Salisbury Autistic Care Ltd DS0000063728.V354790.R01.S.doc Version 5.2 Page 6 The home has good links with Brent Learning Disabilities Partnership and can access Psychology, Psychiatry and the Challenging Behaviour Team to support people using the service and staff. People using the service settled in well and appeared very comfortable. The service is providing a homely and safe environment for people with Autism and Challenging Behaviour. What has improved since the last inspection? What they could do better: While the home has undertaken work on the Statement of Purpose and Service users guide, more work is required on both documents to fully meet National Minimum Standards. Once both documents are completed the home must forward copies of these documents to the Commission for Social Care Inspection. Carpets in the hallway and living room must be replaced to prevent people tripping and injuring themselves. The loose and missing tiles in the upstairs bathroom must be repaired to protect people using the service from injuries. Salisbury Autistic Care Ltd DS0000063728.V354790.R01.S.doc Version 5.2 Page 7 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. Salisbury Autistic Care Ltd DS0000063728.V354790.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 Salisbury Autistic Care Ltd DS0000063728.V354790.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): People using the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The service has developed a statement of purpose, which sets out the aims and objectives of the home, and includes a service user’s guide, which provides basic information about the service and the specialist care the home offers, both documents need more work to fully meet National Minimum Standards. Admissions are not made to the home until a full needs assessment has been undertaken. The assessment is conducted professionally and sensitively and involves the individual and their family or representative, where appropriate. EVIDENCE: The home has reviewed their Service Users Guide and Statement of Purpose, I discussed both documents in detail with the registered manager and pointed out that a copy of the most recent inspection report and a standard form of the contract must be included in the Service Users Guide. During the second day of this key inspection I viewed an updated copy of the homes statement of purpose, which requires some minor adjustments as stated in Schedule 1 of Care Homes Regulations 2001. The home did not have any further admissions since the last key inspection. I found detailed needs assessments in both care plan files during this key Salisbury Autistic Care Ltd DS0000063728.V354790.R01.S.doc Version 5.2 Page 10 inspection. Assessment information gathered during the assessment process are included in peoples care plans. Assessments viewed are clear and informative and pictures are used to make it accessible to a wider audience. Due to their disability people using the service have not been involved within the assessment process. Salisbury Autistic Care Ltd DS0000063728.V354790.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): People using the service experience an excellent outcome in this area. This judgement has been made using available evidence including a visit to this service. Staff is committed in supporting individuals to lead purposeful and fulfilling lives as independently as possible. People using the service make their own decisions and have the right to take risks in their daily lives. EVIDENCE: I have viewed both care plans during this key inspection, which are now completed and very detailed. Care plans are reviewed regularly and formal reviews are undertaken every six-month, with the involvement of families and outside professionals. Care plans are available in pictorial form and are person centred. Autism specific needs such the Triad of Impairment is addressed and approaches are tailored around this. Guidelines are of great detail and support staff working with people using the service at Holt Road. This enables staff to provide a consistent approach when working with people. Salisbury Autistic Care Ltd DS0000063728.V354790.R01.S.doc Version 5.2 Page 12 The home is recording people using the service likes and dislikes to provide person centred support. Restrictions are clearly documented in guidelines and care plans. The registered manager is acting as an appointee for one of the person living at the home. Financial records were of good standards and the registered manager has supported the person to receive the correct benefits. Behaviour guidelines are in place, which provide reactive and pro-active approaches to challenging behaviours. Risk assessments are detailed and give clear guidelines to staff in how to minimise risk in the community, at home, in the car, etc. The registered manager informed me that risk assessments are reviewed if risks change. This was evident when viewing risk assessments during this key inspection. Salisbury Autistic Care Ltd DS0000063728.V354790.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): People using the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who use the service have the opportunity to develop and maintain important personal and family relationships, and are able to access information and specialist guidance about issues such as intimate relationships. People who use services are involved in meaningful daytime activities of their own choice and according to their individual interests and capability. The meals are balanced and nutritional and cater for the varying cultural and dietary needs of the individuals using the service. EVIDENCE: Peoples activities are clearly recorded in daily records, which are of excellent standard and provided information of what food was eaten, peoples behaviour, activity participation, interactions with staff and other people using the service, personal care, etc. People using the service are not in any paid or unpaid employment and do not access colleges; this is due to their ability and Salisbury Autistic Care Ltd DS0000063728.V354790.R01.S.doc Version 5.2 Page 14 challenging behaviour. The home is however using gyms, swimming pools; activity centres to access and facilitate community based activities. A pastor visits the home for regular church service. People using the service go regularly for drives in local parks for walks or to play football. Staff informed me that they are currently in process of exploring more suitable activities for people using the service. Since the last inspection there is a stronger focus of providing more structure and consistency. The registered manager told me that this is to reduce the challenging behaviour, which people can display. This was discussed with behaviour specialists who visited the home and assessed people using the service. The home is supporting individuals to maintain family relationships, by inviting relatives to meetings and encouraging visits. I have seen records of visits from family members over Christmas. One person is calling his parents weekly in the West Indies. Peoples sexuality is discussed in care plans and specialists are involved to provide support to people using the service and staff. People using the service have unrestricted access to communal areas and their bedroom. The office, bathrooms and food storage areas are locked to ensure peoples safety and reduce ritualistic behaviours due to their Autism. People are not issued with keys due to the risk of absconding; this is clearly recorded in care plans and separate guidance. I have observed staff interacting professionally and patiently with people using the service, during this key inspection. The home is providing a well-balanced and cultural appropriate diet. Meals are pre prepared by staff during waking night shifts; staff informed me that this is necessary, as both people have displayed challenging behaviour when meals are prepared in their presence. The home is recording food eaten by people using the service and menus are based on likes and dislikes, which have been documented by staff over the past. Salisbury Autistic Care Ltd DS0000063728.V354790.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): People using the service experience good outcomes in the area. This judgement has been made using available evidence including a visit to this service. Personal support is responsive to the varied and individual needs and preferences of the people who use services. People who use services have access to healthcare and remedial services. People using the service are supported in the administration of medication and procedures have improved and are now compliant with National Minimum Standards. EVIDENCE: I have viewed detailed personal care guidelines in both care plans I have assessed during this key inspection. Bathrooms can be locked to provide privacy. Both people living at the home are fully mobile and no technical aids and equipment is provided by the home. People using the service have an allocated key worker who is responsible for the maintenance of care plans, guidelines and any other issues relating to them. The home has access to Brent Learning Disabilities Partnership for clinical input such as psychiatrist, psychologist, Behaviour Specialists, etc. Brent behaviour intervention team is involved with both people using the service and supports staff to provide behaviour intervention guidelines. The registered manager informed me that Salisbury Autistic Care Ltd DS0000063728.V354790.R01.S.doc Version 5.2 Page 16 this work is ongoing and that the support is valuable in helping staff and people to minimise episodes of challenging behaviour. Both people using the service have health action plans in place. I have viewed one Health Action Plan, which was provided by the previous placement, and suggest incorporating this information in the current plan if still appropriate. People using the service are registered with their own General Practitioner and visits to health care professionals are clearly recorded. Staff assist people using the service to attend hospital appointments and records of these visits are in place. The home has changed their dispensing pharmacist and is now using the Monitored Dosage System. Medicines returned and received are recorded and signed by the pharmacist and staff. A list of staff authorised to administer medication is in the medication file and staff have received medication training. Medication is locked away and stored safely. None of the people living at the home is using controlled drugs. The General Practitioner has reviewed medication and any changes to medication are clearly recorded. The Medication Administration Sheets are of good standard and had no gaps. Previous inspections assessed the medication policy compliant with National Minimum Standards. Salisbury Autistic Care Ltd DS0000063728.V354790.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): People using the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The service has a complaints procedure that is clearly written and easy to understand. It is available on request in pictorial form to help anyone living at, or involved with, the service to complain or make suggestions for improvement. People using the service are protected through robust adult protection guidelines. EVIDENCE: The home has a complaints policy in place, which is available in the service users guide and on the notice board in the homes office. The home received one complaint since the last key inspection and actions and outcomes are recorded. All staff attended Protection of Vulnerable Adults training and staff spoken to demonstrated good understanding of reporting and recording adult abuse allegations. The home has a whistle blowing policy in place and staff has received Physical Intervention training. Previous inspections noted that one person paid for damages due to his challenging behaviour; the home has reimbursed the money to this person and updated the statement of purpose. The registered manager informed me that the home is planning a meeting with the care manager and family to discuss actions to be taken if further damages occur. The home has adult protection procedures in place and obtained guidelines from the funding and hosting borough. Salisbury Autistic Care Ltd DS0000063728.V354790.R01.S.doc Version 5.2 Page 18 Salisbury Autistic Care Ltd DS0000063728.V354790.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): People using the service experience adequate outcomes in this area. This judgement has been made using available evidence including a visit to this service. The physical environment does meet the specialist needs of the people who use the service. The home does have an on-going maintenance programme in place. People using the service live in a safe, clean and well-maintained environment. EVIDENCE: The home has done a substantial amount of work since the last key inspection. Bedrooms have been redecorated, loose wiring has been repaired and all requirements in regards to the environment have been met. The home has now an ongoing maintenance programme and the registered manager is monitoring maintenance issues monthly and reports to the proprietor for funding. I noted some areas, which require attention during this key inspection. Some of the tiling in the first floor bathroom came of the wall and must be replaced. The carpets in the home are very worn and loose in some areas, this could lead to people tripping and injuring themselves. The home is Salisbury Autistic Care Ltd DS0000063728.V354790.R01.S.doc Version 5.2 Page 20 decorated homely and meets the needs of people with Autism and Challenging Behaviour. The utility room is located on the top floor of the property and people using the service are able to use a washing machine and clothes dryer. The washing machine has a cycle for hot temperature. The home was clean and free of offensive odours during this key inspection. The home has Infection Control procedures in place and cleaning materials were stored safely. Salisbury Autistic Care Ltd DS0000063728.V354790.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): People using the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Staffing rotas take into account the needs and routines of the people using the service. The service recognises the importance of training, and tries to deliver a programme that meets any statutory requirements and the National Minimum Standards. The manager is aware that there are some gaps in the training programme and plans to deal with this. The service has a good recruitment procedure that clearly defines the process to be followed. EVIDENCE: Staff spoken to have different skills and experiences of working with people with Autism. I observed staff who were professional and demonstrated skill when working with people who can challenge the service. The home does not employ staff under the age of 18. Both assessed staff files had proof of relevant training in care in place. Staff told me that they worked with similar clients in the past. All staff hold or is in the process of obtaining relevant qualifications in care. Staff informed me that they feel supported and appropriate staffing is on shift to support people using the service. Salisbury Autistic Care Ltd DS0000063728.V354790.R01.S.doc Version 5.2 Page 22 I have assessed two staffing files during this key inspection; both files contained a Criminal Records Bureau check, passport photo, three references, induction records, and application forms. Staff spoken to told me that they had an interview prior to being offered a post in the home. All records viewed contained training records and a training and development plan. Training and development is addressed in supervisions, which are provided monthly. Staff working in the home over a year has received an annual appraisal. Staff attended training such as Protection of Vulnerable Adults, Autism, Loss and Bereavement, challenging behaviour, Food Hygiene, First Aid, Health and Safety, Breakaway, etc. The home is providing induction to new staff and records of this has been viewed during this key inspection. Salisbury Autistic Care Ltd DS0000063728.V354790.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): People using the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The Manager has the required experience and is competent to run the home. The manager of the home is currently obtaining qualifications in care and management. People who use the service are protected by safety checks and procedures, from Health and Safety hazards. EVIDENCE: The registered manager is very experienced in care and has been working with people with Autism for a number of years. Staff spoke very positive about the registered manager and told me that she is very supportive and listens to all problems. The registered manager informed me that she is currently in the process of obtaining her Registered Managers Award. Staff told me that the team was working well during the absence of the registered manager. The Salisbury Autistic Care Ltd DS0000063728.V354790.R01.S.doc Version 5.2 Page 24 manager is currently part time, but will resume the full time post by February 2008. I have seen a copy of the homes annual development plan, which was judged of good standard and detailed. Staff informed me that the staff group meets every four to six weeks for meetings to discuss people using the service and their progress and any other issues relating to the home. The registered manager informed me that these meetings could be used as training sessions. I viewed the Landlords Gas Safety Certificate (expires September 08), Portable Appliances Test Certificate (expires December 08). The fire risk assessment is up to date and the fire equipment was last serviced in December 2007. Fire drills are recorded and undertaken monthly. The home has purchased boxes to store fire extinguishers safely. Salisbury Autistic Care Ltd DS0000063728.V354790.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 2 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 X 3 X LIFESTYLES Standard No Score 11 X 12 4 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 Salisbury Autistic Care Ltd DS0000063728.V354790.R01.S.doc Version 5.2 Page 26 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 YA1 Regulation (4)(5)(6) Schedule1 Requirement The home must update the Statement of Purpose and Service Users Guide to ensure new prospective people using the service receive satisfactory information about the home prior to moving in. A copy of the Statement of Purpose and Service Users Guide to the Commission for Social Care Inspection once updated. (Timescale of 01/10/07 not met) 2. YA24 23(2)(d) Carpets in the hallway and living room must be replaced to prevent people tripping and injuring themselves. 01/03/08 Timescale for action 01/03/08 3. YA24 23(2)(c) The loose and missing tiles in the 01/03/08 upstairs bathroom must be repaired to protect people using the service from injuries. Salisbury Autistic Care Ltd DS0000063728.V354790.R01.S.doc Version 5.2 Page 27 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 YA19 Good Practice Recommendations The home should include information from previous health action plans in care plans. The home should provide a separate sheet for staff to sign when involved in the administration of medication. It is strongly recommended to provide paid National Vocational Qualification in Care training to managers and care staff. 2. YA20 3. YA37 Salisbury Autistic Care Ltd DS0000063728.V354790.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Harrow Area office Fourth Floor Aspect Gate 166 College Road Harrow HA1 1BH 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 Salisbury Autistic Care Ltd DS0000063728.V354790.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. 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