CARE HOME ADULTS 18-65
Sefton Street, 132 132 Sefton Street Southport Merseyside PR8 5DB Lead Inspector
Mrs Joanne Revie Unannounced Inspection 27th September 2006 10:00 Sefton Street, 132 DS0000005227.V309666.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 Sefton Street, 132 DS0000005227.V309666.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. Sefton Street, 132 DS0000005227.V309666.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Sefton Street, 132 Address 132 Sefton Street Southport Merseyside PR8 5DB 01704 530329 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) www.peterhouseschool.org Autism Initiatives Stephen Halewood Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Sefton Street, 132 DS0000005227.V309666.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Service users to include up to 3 LD Date of last inspection Brief Description of the Service: 132 Sefton Street is an older, semi-detached property providing care and accommodation for three adults with learning disabilities, specifically with Autism. It is situated in a residential area of Southport, close to public transport and the amenities that the town has to offer. The home provides accommodation over two floors with the service users’ individual bedrooms situated on the first floor. There are two bathrooms for service users to share with one including a shower facility. The communal space includes a large dining/kitchen area and a lounge. The home has a pleasant rear garden including decked area including garden furniture suitable for service users and their visitors. This is easily accessed. The home is part of a Voluntary Organisation known as Autism Initiatives. Sefton Street, 132 DS0000005227.V309666.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The visit was unannounced and took place over four and a half hours. On the day of the visit two service users were at home. A discussion was held with one of the service users. Brief discussions were held with two staff members. The manager was present throughout the visit and discussions were held with him. A variety of documentation was viewed during the visit, which is detailed in the evidence section of the report. What the service does well:
Each service user has a detailed plan of care, which is very individual to their needs. This means that staff have clear written instructions to follow. The service users within the home are supported to lead as independent lifestyle as they are able. This means that the service users take part in the usual activities of daily living with or without support. The staff support the service users to eat a healthy diet and staff understand the importance of offering choice and supporting service users to make appropriate choices which affect their lives. Each service user is supported to stay healthy. This includes support with diet, exercise and attending health professional’s appointments. General checkups also take place according to the service users age. The staff recognise the importance of treating service users as individuals and will support service users to make and achieve chosen goals. This means that service users progress to become as independent as possible. This includes recognising if a service user would benefit from further education. Service users are encouraged to continue relationships, which are important to them, and families are welcomed at the home. Service users are supported to have overnight stays at the family home if desired. Service users are encouraged to undertake activities on a daily basis, which are both useful and enjoyable. The home has strong adult protection procedures and robust staff recruitment procedures. This minimises the risk of a vulnerable adult being abused. The home is clean and tidy and in parts is nicely decorated with good quality furnishings. It has the appearance of a domestic house and photographs of service users undertaking activities helps to promote this. Each service user has their own bedroom and they are encouraged to furnish it according to their personal taste, which helps to make the bedroom “ their own”
Sefton Street, 132 DS0000005227.V309666.R01.S.doc Version 5.2 Page 6 A large proportion of staff have achieved a recognised NVQ qualification in care and have undertaken other training which is appropriate to the service users needs. The staff team is lead by a manager who is an experienced carer and is suitably qualified to carry out his role. What has improved since the last inspection? What they could do better:
A requirement was made following the last inspection that service users should be offered copies of contracts in a language, which they understand. The manager has started work on this project but the timescale has expired and the work is not completed. This must be addressed to show compliance with the Care Home Regulations 2000 and to ensure that service users are fully aware of their rights. The service needs to make sure that original assessment documentation is held on the service users file and that staff have access to a policy which details what steps to take regarding admitting a new service user. The manager stated his intention to discuss the provision of homely remedies to service users (i.e. giving of over the counter medicines) with each of their G.P’s. This must be followed through to ensure that the service users health is not compromised. Some areas of the building require attention such as exposed pipe work to shower room. This room was also in need of redecoration.
Sefton Street, 132 DS0000005227.V309666.R01.S.doc Version 5.2 Page 7 The Bathroom lacked homely touches and appeared dated in style. This would benefit from redecoration and should be addressed. The manager has developed some auditing systems since coming into post but not all of these were signed and dated. The Manager should sign and date all audits to evidence good practise. The manager had identified that one service user had become more involved in handling food and felt that this service user would benefit from food hygiene training. This should be followed through to reflect good practise. Although the manager carries out regular practise fire evacuations records were not available to support this event. These must be developed. One service users independence has improved over night with staff support but this may have compromised the fire safety of the home. This must be discussed with the local fire authority. The manager must also discuss the implications of both the back and front doors having to be unlocked with keys to exit the building. 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. Sefton Street, 132 DS0000005227.V309666.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 Sefton Street, 132 DS0000005227.V309666.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): The quality outcome in this area based on available evidence is adequate. Service users needs are assessed but the home does not have all the required written information to carry this out. Service users are not aware of their rights due to an outstanding requirement, which was made following the last visit. EVIDENCE: A discussion was held with the manager and two service users files were viewed. The most recent admission took place twelve months ago. The manager stated that the previous manager had undertaken the assessments. On viewing the file no documentation could be found to support this. The present manager was able to explain in detail the steps that would be undertaken to assess a new service users needs. The policy file was viewed but no policy could be found to support this. A requirement was made following the last visit, which stated that all service users must receive contracts in an appropriate format. The manager explained that some work has been undertaken to address this but that this had not yet been fully completed. Sefton Street, 132 DS0000005227.V309666.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 The quality outcome in this area based on available evidence is good. Each service user has a plan, which clearly reflects their goals and support required. Service users are supported to make decisions, which affect their lives Service users are encouraged to live as independent lifestyle as possible. EVIDENCE: Two service users plans were viewed. The plans identified the specific needs of each service user, which related to their health well being and safety. Each plan contained a variety of risk assessments, which had been developed specifically for the service users. Each of these assessments were signed which evidenced that the service had addressed a requirement which was made following the last visit. The risk assessments viewed had been developed around the usual activities of daily living including domestic chores Viewing the above documentation showed that the key worker reviews the plan monthly and writes a short summary detailing the service users progress. This reflects good practise. The manager explained that if service users needs change a full review of care and support takes places and if appropriate the
Sefton Street, 132 DS0000005227.V309666.R01.S.doc Version 5.2 Page 11 service user attends so that consolation can take place. The service has access to a practice support team that is made up of a speech therapist and communications specialist. They attend reviews also. One plan viewed showed input from the service user and the support that he would like to receive to meet his needs. A service user confirmed that he was aware of the plan Three plans were viewed which contained written information of goals that had been set with consultation with the service user. E.g. learn to cook, complete a shave etc. Each plan contained information about each individual’s preferences likes and dislikes. During a discussion with a service user it was confirmed that service user are supported to make choices and that staff respect the service users privacy and dignity. Pictures and symbols were viewed to enable one service user to make choices. One service user uses a computer programme to make his wishes known to staff. This was viewed in use in his bedroom. Sefton Street, 132 DS0000005227.V309666.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): 12,13,15,17 The quality outcome in this area based on available evidence is good Service users lead an active life style according to age and interest. Service user families are welcomed by the home and service users are supported to maintain relationships with them. Service users are supported to eat a healthy diet and are encouraged to take part in shopping and preparing food. EVIDENCE: Viewing the environment evidenced that lots of different activities take place outside the home. Photographs were displayed of various outings to evidence this. Viewing the three plans showed that each service user receives individual support according to their needs to lead an independent lifestyle. One service users plan was very structured for activities within and outside the home. Another plan was viewed of a service user is more independent and the structure of this plan reflected this. Viewing the plan and the services diary showed that one service user has chosen to attend two courses outside the home in the near future. It has been identified that one service user needs support with monetary skills and the
Sefton Street, 132 DS0000005227.V309666.R01.S.doc Version 5.2 Page 13 manager stated that the staff were exploring a maths course to develop this skill. On the day of the visit one service user visited the local shop to purchase items. Viewing plans showed that service user partake in activities in the local community such as bowling, visits to the pub, eating meals out, attending a local disco etc. Since the last visit the service users have enjoyed a short break holiday at Centre Parcs. During discussions one service user confirmed that he had really enjoyed the holiday and that he believed that the staff supported him to lead an independent lifestyle. Viewing the plans also evidenced that each service user had regular contact with their family. One service user confirmed that he could ring his sister when he liked. The manager stated that a telephone was available in the lounge for that purpose. Discussions with service users and viewing records evidenced that service users are supported to visit their family at home if they wish. One service user was observed returning home after food shopping with staff support. The serv9ice has developed a three week menu around service user choices. This was displayed and viewed. Photos are available for service user to make choices if needed. The kitchen was found to have a dining table, which is used at mealtimes. Choices were available on the menu and one service user confirmed that choices are available each day and detailed the choice, which he had made for his last meal. This was reflected on the menu. Viewing the menu and the food stores within the home it was evident that generally service users are supported to eat a healthy diet. The manager confirmed that he encourages service users to eat five portions of fruit and veg per day in line with government guidelines for health eating. Sefton Street, 132 DS0000005227.V309666.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 The quality outcome in this area based on available evidence is Service users receive personal care as they choose. Service user are supported to maintain their health Medications are not managed as safely as they could be. EVIDENCE: Three plans were viewed. Each contained details of the service user preferences regarding personal care. This information included usual routines. One service user confirmed that staff helped him when he needed it. Staff had identified that one service users independence could be developed around personal care and appropriate documentation had been developed to support this. Each plan contained information that showed those service users are supported to undertake well man checks. One service user had developed a tendency for high blood pressure. Support had been given to eat a healthy diet and to undertake regular exercise. This has reduced the service user blood pressure. . Staff record all doctors visits in detail including the service users reaction to visiting a health care professional. One service user was supported to undertake minor surgery. Evidence was also viewed that showed that service users had undertaken sight tests and visiting a chiropodist. Medications were viewed. One service user is being prompted to take medications and this was clearly identified within the care plan.
Sefton Street, 132 DS0000005227.V309666.R01.S.doc Version 5.2 Page 15 Staff undertake a weekly stock check to ensure amounts of medications tally. Records were viewed of this. Staff record the amount of all medications received into the home and obtain a receipt from the pharmacist for anything that is no longer required. The home records homely remedies appropriately and one service user was observed receiving homely medication from the manager appropriately. The manager confirmed that he intends to get permission from the service user G,Ps to administer homely medication. Medication administration records were viewed. These were clear and contained all required signatures to show that medication had been given as pescribed. Sefton Street, 132 DS0000005227.V309666.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 The quality outcome in this area based on available evidence is good Service users have access to and are encouraged to use the services complaints procedure. Staff have the knowledge and skills to protect vulnerable Adults from abuse. EVIDENCE: No complaints have made about the service to the home or to CSCI since the last inspection. A copy of the services complaints procedure was displayed in the hallway of the home. This was written in plain English and was supported by pictures to explain the process. A discussion with one service user confirmed that he was aware of the complaints procedure and he confided that in the past when he had raised concerns to the staff they had supported him to make a complaint but he had declined. A copy of the services own abuse awareness and whistle blowing policy was viewed. The manager has displayed these on a notice board, as he believes they are particularly important policies. The service also has a copy of the local authorities own complaints procedure. Through discussion the manager showed that he understood what to do if abuse occurred. He explained that the service has their own Adult Protection officer who is familiar with both policies. Viewing staff records and the training plan confirmed that all staff have received training in the protection of vulnerable adults. Copies of the service user finances were viewed. A clear audit trail was viewed and the manager confirmed that each service user has their own bank account. A staff member was observed supporting a service user to access money.
Sefton Street, 132 DS0000005227.V309666.R01.S.doc Version 5.2 Page 17 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 30 The quality outcome in this are based on available evidence is adequate. The home is not as well maintained as it could be. The home is a clean place to live. EVIDENCE: A tour of the environment was undertaken. The home has a lounge which appeared clean and comfortable and was decorated and furnished to a good standard. All bedrooms were viewed. These were very personal to each service user. The home has a bathroom and a shower room. Both were viewed. The bathroom was clean and tidy but did not appear homely as would be expected in a domestic house. The shower room has had a new door fitted to meet the service user needs but exposed pipe work was viewed and the room required redecoration. The kitchen was clean and tidy and had pictures attached to doors and drawers so all service users were aware of where to find kitchen utensils. The manager explained that night staff have a cleaning rota to follow. This was viewed. The manager explained that service users are supported to carry out domestic tasks such as hovering.
Sefton Street, 132 DS0000005227.V309666.R01.S.doc Version 5.2 Page 18 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): 32,34,35. The quality outcome in this area based on available evidence is good Staff have the competencies and skills to support the service users. The service has robust recruitment procedures EVIDENCE: Copies of the homes off duty were viewed. These showed that the home has a stable staff team. 1 member of staff is available 24 hours per day with a a second member of staff coming on duty during the day according to which activities the service user are undertaking that day. The carer who works the night shift is a waking member of staff. A discussion with the manager revealed that five staff have achieved NVQ qualifications. One member of staff has yet to undertake this qualification. Viewing staff files supported this view. Viewing staff files showed that staff have also undertaken training in positive intervention (managing challenging behaviour) and communication in Autism and Aspergers syndromes. Staff have also undertaken training in medication awareness and mental health awareness, Infection control training and fire prevention. Training has been delivered around care planning and formulating and assessing risk The manager stated during discussion that he interviewed all potential new staff for the service. A copy of an induction programme was viewed which is followed by new staff. This is undertaken over a six week period and staff have to complete a questionnaire after each module is completed.
Sefton Street, 132 DS0000005227.V309666.R01.S.doc Version 5.2 Page 19 Three staff files were viewed. Each contained the information required by the care home regulations 2001. Sefton Street, 132 DS0000005227.V309666.R01.S.doc Version 5.2 Page 20 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 The quality outcome in this area based on available evidence is good. The manager is experienced and qualified to manage the home. The home requests the opinion of others about the service offered. EVIDENCE: Since the last inspection the manager has achieved registered managers status with CSCI. Through discussion and through viewing this application it was evidenced that the manager is an experienced carer who has developed through the organisation. He has achieved an NVQ level 3 and 4 in care and plans are in place for him to undertake the registered managers award. The manager has developed some auditing tools for monitoring performance of the service one of these was viewed, which related to staff training. This is good practise but the manager had not signed or dated the work he had undertaken. Sefton Street, 132 DS0000005227.V309666.R01.S.doc Version 5.2 Page 21 Copies of competed questionnaires were viewed. These had been completed by service users where appropriate and by the service users families and representatives. The manager confirmed that this undertaken annually. The organisation undertakes quality audits on the actual house and the systems in place. A copy of this is forwarded to the manager to action. Viewing staff training files evidenced that staff have undertaken appropriate training to maintain the service users health and safety. This included first aid, fire prevention, food hygiene and cross infection. The manager stated that one service user is involved in preparing food and intended to explore the possibility of this service user undertaking food hygiene training. Records were viewed which showed that regular checks are undertaken on the fire alarm system and emergency lighting. The manager stated that a practice fire evacuation occurs each time the alarm is tested but no records were available to support this although a service user did confirm that this takes place. Records also showed that water temperature tests are carried out and that the manager undertakes a monthly health and safety audit. Records also showed that the manager attends an organisational monthly health and safety meeting. A discussion took place with the manager regarding concerns he had surrounding fire safety. The manager revealed that by attempting and supporting one service user to be more independent this had resulted in a bedroom door being wedged open over night. The service has one waking staff member. The manager also expressed his intention to discuss escape routes with the fire officer as both the front and back doors require keys to unlock them to leave the building. An up to date gas safety and electrical safety certificate were viewed. Portable appliance testing was carried out earlier this year. Sefton Street, 132 DS0000005227.V309666.R01.S.doc Version 5.2 Page 22 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 2 3 X 4 X 5 2 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 3 3 x 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 3 X X 2 X Sefton Street, 132 DS0000005227.V309666.R01.S.doc Version 5.2 Page 23 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 YA5 Regulation 5 Requirement Contracts of residency must be in an appropriate format to meet the needs of residents. Outstanding 30/06/07 Contracts of residency must be signed by independent representatives where residents are unable to sign. Outstanding 30/06/06 The manager must ensure that assessment documentation on each service user is made available and that a policy is in place, which details what steps to take for the admission of a new service user to the home. The manager must follow through his intention to discuss the provision of homely remedies with the G.P s of the service users who live in the home. The responsible person must ensure that the exposed pipe work and décor of the shower room is addressed. The manager must ensure that he keeps records of any practice fire evacuations that occur including who takes part
DS0000005227.V309666.R01.S.doc Timescale for action 31/12/06 2. YA5 5 31/12/06 3 YA2 14 a 1 a b cd 31/12/06 4 YA20 13 2 31/12/06 5 YA24 12 1 b 23 1a 24 c iii 31/12/06 6 YA42 30/11/06 Sefton Street, 132 Version 5.2 Page 24 7 YA42 23 4 a The manager must seek advice form the fire authority regarding wedging open bedroom doors at night time and escape routes when both doors to the house require keys to exit. 30/11/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 Refer to Standard YA24 YA37 YA42 Good Practice Recommendations The bathroom should be redecorated to reflect a domestic home. The manager should ensure that he signs and dates any audits that he undertakes. The manager should carry through his intention for one service user to undertake food hygiene training. Sefton Street, 132 DS0000005227.V309666.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Knowsley Local Office 2nd Floor, South Wing Burlington House Crosby Road North Liverpool L22 0LG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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