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Inspection on 01/11/05 for Selwyn Road (1-3)

Also see our care home review for Selwyn Road (1-3) for more information

This inspection was carried out on 1st November 2005.

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

The inspector found no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Selwyn Road has a history of being a well managed service and the new manager and the deputy are keen to build on the high standards already achievedThe level of knowledge, skills and expertise among the staff group is high and the needs of the service users are well understood. The staff feel well supported and the organisational goals have been clearly communicated to them. They set no limits on the potential of service users and rejoice with them in their achievements. The service provides the structure and consistency which gives service users security but staff embrace change and service users are encouraged to try new things.

What has improved since the last inspection?

A new manager is in post and is getting to know the service users and staff. She and the deputy appear to have forged a good working relationship. The the deputy is being supported with her personal development. Some essential decorating works have been done.

What the care home could do better:

The inspection resulted in four legal requirements and one recommendation. The permanent manager now needs to be registered with the commission and key documents need to be updated to reflect the appointment. There are some shortfalls in the decoration of the home. Staff at the home have accepted the need to obtain the views of service users around the sensitive subjects of ageing, illness and death. They have prepared to do this task. They now need to put theory into practice and ensure that the views are sought and recorded appropriately.

CARE HOME ADULTS 18-65 Selwyn Road (1-3) 1-3 Selwyn Road Bow London E3 4PX Lead Inspector Anne Chamberlain Unannounced Inspection 1st November 2005 10:45 Selwyn Road (1-3) DS0000010303.V261733.R01.S.doc Version 5.0 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 Selwyn Road (1-3) DS0000010303.V261733.R01.S.doc Version 5.0 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. Selwyn Road (1-3) DS0000010303.V261733.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Selwyn Road (1-3) Address 1-3 Selwyn Road Bow London E3 4PX 020 8983 0036 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) Outward *** Post Vacant *** Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Selwyn Road (1-3) DS0000010303.V261733.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st June 2005 Brief Description of the Service: Selwyn Road is situated in the vicinity of Roman Road, off the Mile End Road. The area has good public transport connections with buses and underground trains going west to the centre of London and east past Stratford. Selwyn road is a residential home for 5 adult women with learning disabilities and some challenging behaviours. It comprises two adjoining houses. House number 1 has a ground floor bedroom with en-suite facilites, lounge kitchen and conservatory. On the second floor there are a further two bedrooms with hand basins and a shared bathroom/toilet, also the office/sleep in room. House number 3 has a kitchen and lounge with doors on to a small garden shared with number 1. On the first floor are a further two bedrooms with hand basins and a shared bathroom with separate toilet. The home has a manager in post who is not yet registered. Selwyn Road (1-3) DS0000010303.V261733.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the second inspection of the year. The inspector inspected the two standards which were the subject of requirements at the last inspection. She also inspected remaining non-key standards. She looked at some parts of the home, the garden and viewed documentation and files. The inspector discussed with the manager and deputy their response to an incident which had occurred since the last inspection. The inspection took place over three hours on one day. The inspector was assisted by the new manager and her deputy. The inspector met with one service user who was at home at the time of the inspection. The inspector would like to thank the service user, manager and deputy manager for their assistance and co-operation with the inspection. What the service does well: Selwyn Road has a history of being a well managed service and the new manager and the deputy are keen to build on the high standards already achieved Selwyn Road (1-3) DS0000010303.V261733.R01.S.doc Version 5.0 Page 6 The level of knowledge, skills and expertise among the staff group is high and the needs of the service users are well understood. The staff feel well supported and the organisational goals have been clearly communicated to them. They set no limits on the potential of service users and rejoice with them in their achievements. The service provides the structure and consistency which gives service users security but staff embrace change and service users are encouraged to try new things. What has improved since the last inspection? What they could do better: The inspection resulted in four legal requirements and one recommendation. The permanent manager now needs to be registered with the commission and key documents need to be updated to reflect the appointment. There are some shortfalls in the decoration of the home. Staff at the home have accepted the need to obtain the views of service users around the sensitive subjects of ageing, illness and death. They have prepared to do this task. They now need to put theory into practice and ensure that the views are sought and recorded appropriately. Selwyn Road (1-3) DS0000010303.V261733.R01.S.doc Version 5.0 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. Selwyn Road (1-3) DS0000010303.V261733.R01.S.doc Version 5.0 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 Selwyn Road (1-3) DS0000010303.V261733.R01.S.doc Version 5.0 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): 1,3,4 and 5. Prospective service users would have full information and a chance to test drive the home in order to make a decision about whether to move in. They could be assured that the home would have the capacity to meet their needs. Service users have individual written contracts which state terms and conditions. EVIDENCE: The statement of purpose and service user guide have not yet been updated to include the name and qualifications of the new manager. The manager advised that she will be updating the documents as soon as she is registered with the commission. The inspector advised the manager to study the lists of specified information in the National Minimum Standards when she updates the documents, and ensure that they will meet the requirements. The manager must update the statement of purpose and service user guide to show the change in registered manager. This is a requirement. The inspector asked the new manager of her first impressions of what the home can offer. The manager said that she has observed that the staff work together as a team and they are knowlegeable. Also that they apply their Selwyn Road (1-3) DS0000010303.V261733.R01.S.doc Version 5.0 Page 10 training to their practice. The deputy manager had experience of running the home for five months when she was acting up as manager and this has added to the expertise of the team. The inspector observed an example of health needs being well met as a diabetic service user was having her blood sugar carefully monitored that day, due to a change in medication. The inspector was satisfied that prospect service users would not be offered a place at the home unless staff believed they could meet their needs and aspirations. No new service users have been admitted to the home for three years. The inspector discussed with the manager and deputy their approach to offering a placement to new service users. They agreed that the key to successful placement is sound assessment. They stated that although things might match on paper the reaction of prospective service users to the home could not be assumed. New service users would be offered a weeks trial of the home before deciding whether they would like to move in. The deputy manager stated that all service users have a contract. The inspector viewed in the file of a service user a licence agreement and a core service agreement. The licence agreement states the fees, which were up to date. The core service agreement describes what is provided. It was updated in September 2004. There is also a list of fixtures and fittings. Selwyn Road (1-3) DS0000010303.V261733.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 8 and 10 Service users are fully consulted and participate in all aspects of running the home. Confidences are kept and information is sensitively and appropriately handled. EVIDENCE: The inspector saw the minutes of the house meetings. These are held once a week on a Sunday evening. The content of the meetings appeared useful. One resident chooses not to attend the meeting because she visits her family on Sundays. The inspector also saw a guide to house meetings which gives staff helpful advice on how to ensure house meetings are well run and empowering to service users. In addition to house meetings the organisation runs a service users forum quarterly. Service users also have a keyworker session once a week. They also have a one to one session which they can choose to have in the house or to go out somewhere of their choice. The deputy manager advised that it is often on Selwyn Road (1-3) DS0000010303.V261733.R01.S.doc Version 5.0 Page 12 these one to one sessions in some neutral environment, for example a café, that service users confide in workers. The organisation has a confidentiality policy. The manager and deputy manager stated that all staff are aware of rules and boundaries of confidentiality. They said that if staff need to discuss something of a sensitive nature, they will go to the office or excuse themselves for a few moments out of earshot. They ensure that service users do not overhear staff discussing them. Computer information is password protected and files are locked away in a cupboard within a cupboard. Logs and other records are also locked away. The inspector had a discussion with the manager and deputy around the Freedom on Information Act and was satisfied that they are aware of it, and are taking it into account in all recording. Selwyn Road (1-3) DS0000010303.V261733.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11 and 14. Service users at this home benefit from changing opportunities for personal development. They engage in a range of educational, recreational and leisure activities. EVIDENCE: The inspector viewed the various programmes of service users. Within the activities scheduled there are further alternatives, for example a session at home can be used in several different ways. One service user who has a car often chooses to go out somewhere with her worker. The Coburn Centre which is attended by some service users has a trip out every Thursday, which provides more recreational opportunities. The manager reported that they have made out a case for additional funding for one service user who now needs 2 to 1 support in the community. She is finding it hard to secure this and the inspector advised that rather than asking for a regular increase she might start by asking for one-off amounts to support specific activities, for example Christmas shopping. This will demonstrate the need and will hopefully lead to a permanent, regular increase in funding for the service user. Selwyn Road (1-3) DS0000010303.V261733.R01.S.doc Version 5.0 Page 14 The inspector was satisfied that service users at the home engage in appropriate leisure activities and that they exercise individual choice. The manager advised that one service user is able to see events like a concert advertised, and bring them to the attention of staff as events she would like to attend. Arrangements are then made to facilitate this. This is rewarding for the service user and encourages her to access community information. Selwyn Road (1-3) DS0000010303.V261733.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 20 and 21. The administration of medication is sound and appropriate steps are taken should an error occur. Ageing, illness and death are handled with respect but individual wishes need to be sought and recorded. EVIDENCE: A medication error was reported to the CSCI since the last inspection and the inspector discussed with the manager and deputy what their response has been to prevent recurrence. The support worker responsible for the error is not currently administering medication and will be retrained and monitored closely should she again administer medication. A third member of staff has been rostered for the early morning, doing a short 7.30a.m.-12.30p.m. shift. The manager also said that she tends to come in early on many days and this provides additional staff cover. The organisation has a code of good practice. In issue no 26 staff were encouraged to work with service users, planning funeral arrangements and considering saving for the associated expenses. The manager and deputy Selwyn Road (1-3) DS0000010303.V261733.R01.S.doc Version 5.0 Page 16 agreed a flexible approach to this would be needed, in accordance with individual wishes and financial means. The inspector is aware that the home has already done a deal of research work around the issue of ageing, illness and death. She had a discussion with the manager on the topic. The inspector found that the manager was convinced of the importance of giving service users the opportunity to express their preferences in this area, and have them recorded on file. Also to record on file if a service user had been given the opportunity to discuss the topic and had declined. The inspector felt that the home are now ready to undertake this work and the staff have the necessary skills and sensitivity to do it well. The manager must ensure that service users are given an opportunity to express their views and preferences regarding ageing, illness and death. The results of the discussions must be recorded on their files. This is a requirement. Selwyn Road (1-3) DS0000010303.V261733.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: Selwyn Road (1-3) DS0000010303.V261733.R01.S.doc Version 5.0 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, 28 and 29. The environment at Selwyn Road is homely, comfortable and safe. The shared areas provide additional pleasant accommodation for service users. One service user needs some specialised equipment which she has. EVIDENCE: The inspector viewed the new decorations which have taken place in the home. The bedroom ceiling in the ground floor bedroom has been redecorated. Unfortunately a little damp stain has come through again and the home are hoping that this will dry out and fade. The cracks under the stairs in No 3 have been repaired and this and other areas redecorated. The deputy manager advised that the only decorating work outstanding now is the two bathrooms. The toilet roll holder in the downstairs toilet has been repaired. The new curtains needed in the lounge of house No 3 have not yet been fitted. The manager said that she has found the process of acquiring them through the organisation unsuccessful and is going to purchase some from a shop instead. Selwyn Road (1-3) DS0000010303.V261733.R01.S.doc Version 5.0 Page 19 The manager must ensure that the two bathrooms are brought up to a good standard of decoration. She must fit new curtains to the lounge in No 3 house (or have the old ones cleaned and relined). This is a requirement. The home has a number of shared spaces:- the conservatory in No 1 house, two lounges, two kitchens, two laundry rooms and the garden. The indoor spaces are pleasant and homely. The garden is in need of tidying up for the winter. One service user likes to assist with gardening and home has bought some bulbs to go in for the spring. The manager should ensure that the garden is tidied ready for the winter. This is a recommendation. There is no specialised equipment needed by the service users apart from the ground floor en-suite bathroom which has a walk in shower and shower chair used by the occupant. There are no moving and handling needs in the home and no-one has sensory loss. Selwyn Road (1-3) DS0000010303.V261733.R01.S.doc Version 5.0 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): 31, 32, 33 and 36. Staff are clear about their roles and responsibilities and service users benefit from this understanding. The staff are competent and generally well qualified. The staff team supports the service users effectively enabling them to grow in independence and have a satisfying quality of life. EVIDENCE: In discussion with the manager and deputy the inspector was convinced that staff have a good understanding of their roles. The deputy manager has been a support worker and as previously mentioned acted up as manager. She was able to describe all three roles and the differences between them. The manager had observed that relationships with outside agencies are good and staff recognise when specialised in-put is needed. The example of referral to a speech therapist was given. The staff group in the home are qualified to a substantial level. The manager has completed NVQ 4 and is currently undertaking her registered manager training. She has brought to the post substantial experience in the field of learning disabilities. The deputy manager is undertaking NVQ 4 and has already completed Learning Disability Award Framework (LDAF). Three of the staff are qualified to NVQ level 3, three are currently undertaking NVQ 3 and two of them are undertaking LDAF also. One worker has not undertaken any Selwyn Road (1-3) DS0000010303.V261733.R01.S.doc Version 5.0 Page 21 NVQ training. The inspector was assured by the manager and deputy that they would be encouraging this member to undertake the training as soon as possible. The manager said that she had observed since taking up her post in the home, that the organisational training the staff have had is put into practice by them in their work. She said that they demonstrate an understanding of the needs of the individual service users and that they have a range of strategies for managing challenging behaviours. One service user in the home is autistic. The manager said she has found the level of understanding of autism within the staff group good. The deputy gave an example of supportive piece of work when a worker identified a college placement and also a place at a local day centre for a service user. The service user was very appreciative of this assistance. The manager said that the sickness level in the home is good. The new manager has her Criminal Records Bureau check in the name of Outward. She has applied to the Commission for Social Care Inspection for registration as manager of the home, but has not completed the process yet. The manager must ensure that she completes the process to become the registered manager of the home. This is a requirement. Selwyn Road (1-3) DS0000010303.V261733.R01.S.doc Version 5.0 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): 37,38,40 ,41 and 42. The ethos is good and the staff are well led by supportive management. The practice at the home is founded on sound organisational policies and procedures. Records are well kept. This home is well run and ensures that service users are comfortable and supported to achieve their individual goals. EVIDENCE: The manager stated that she has brought with her two years of managerial experience. She feels she has come into a well established home where good work has been done and can be built upon. The manager said that the budget situation is healthy. The manager said that she feels from the top downwards the ethos of Outward is well supported with all managers reflecting the same aims and objectives of continuous improvement in service. She feels that the organisation is not budget driven. The manager explained that she and the staff respect the fact that their workplace is firstly the service users home. She said she would never use her key to come into the house without knocking, even if she feels it Selwyn Road (1-3) DS0000010303.V261733.R01.S.doc Version 5.0 Page 23 is unlikely anyone is at home. In the mornings she would wait for a service user or staff to open the door to her and invite her in. She said that all staff do this. The home has a support and care manual which contains all the organisations policies and procedures. They are comprehensive and were audited on 10th August 2004. Service user files seen by the inspector are well kept. The deputy manager explained that all the folders which contain home records are numbered and indexed for quick reference. This is an Outward system. The deputy said that the IT systems are getting better. The inspector viewed the contents of the refrigerators in the two kitchens. She examined the record of fire and nurse alarm checks, which are done weekly. Fire drills are held quarterly and the inspector viewed the record of these. The inspector advised the home to have a fire drill when everyone has gone to bed, as a useful exercise. The fire extinguishers were maintained until March 2006. Selwyn Road (1-3) DS0000010303.V261733.R01.S.doc Version 5.0 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 x 3 3 3 Standard No 22 23 Score x x ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score x x 3 x 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x 3 3 x LIFESTYLES Standard No Score 11 3 12 x 13 x 14 3 15 x 16 x 17 Standard No 31 32 33 34 35 36 Score 3 3 3 x x 2 CONDUCT AND MANAGEMENT OF THE HOME x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Selwyn Road (1-3) Score x x 3 2 Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 3 3 x DS0000010303.V261733.R01.S.doc Version 5.0 Page 25 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA1 Regulation 4 and 5 Requirement The manager must update the statement of purpose and service user guide to show the change in registered manager. The manager must ensure that service users are given an opportunity to express their views and preferences regarding ageing, illness and death and have them recorded on their files. The manager must ensure that the two bathrooms are brought up to a good standard of decoration. She must fit new curtains to the lounge in No 3 or have the old ones cleaned and relined. The manager must ensure that she completes the process to become the registered manager of the home. Timescale for action 01/01/06 2. YA21 15 01/01/06 3 YA24 23 01/03/06 4 YA36 10 01/01/06 Selwyn Road (1-3) DS0000010303.V261733.R01.S.doc Version 5.0 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 YA28 Good Practice Recommendations The manager should ensure that the garden is tidied ready for winter. Selwyn Road (1-3) DS0000010303.V261733.R01.S.doc Version 5.0 Page 27 Commission for Social Care Inspection East London Area Office Gredley House 1-11 Broadway Stratford London E15 4BQ National Enquiry Line: 0845 015 0120 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 Selwyn Road (1-3) DS0000010303.V261733.R01.S.doc Version 5.0 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!