Inspection on 16/02/06 for Shila House

This inspection was carried out on 16th February 2006.

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

Other inspections for this house

Shila House 13/10/08

Shila House 17/09/07

Shila House 22/06/06

Shila House 13/07/05

Shila House 08/11/04

Shila House 28/04/04

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

CARE HOME ADULTS 18-65 Shila House 49-53 Main Avenue & 1 Poynter Road Enfield Middlesex EN1 1DS Lead Inspector Mr Teferi Degeneh Unannounced Inspection 16th February 2006 11:00 Shila House DS0000010620.V271845.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 Shila House DS0000010620.V271845.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. Shila House DS0000010620.V271845.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Shila House Address 49-53 Main Avenue & 1 Poynter Road Enfield Middlesex EN1 1DS 020 8367 8774 020 8350 5361 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) Simiks Care Limited Mr Delroy Watson Care Home 14 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (14) of places Shila House DS0000010620.V271845.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 11 people with mental health needs of either gender at 49-53 Main Avenue and 3 people at 1 Poynter Road. 13th July 2005 Date of last inspection Brief Description of the Service: Shila House is a home registered to provide care to fourteen people with a mental disorder, excluding learning disability or dementia. The home is located at Main Avenue in Enfield and the annexe is over the road at Poynter Road. There are eleven places at Main Avenue and three at Poynter Road. Both homes are managed by Simiks Care Limited. Many of the service users have enduring mental health issues and have periods of time in hospital. The home was first registered in 1994.The main house was built partly above and behind a parade of shops. Poynter Road is a small end of terrace house. Next to the homes are a range of local shops and public transport. There are other leisure amenities in the local area. The annexe at Poynter Road is a semi-independent service where service users do their own cooking and other domestic chores. All the service users have their own bedrooms and at Shila House there is a wash basin and shower in each room. Shila House has two communal lounges and dining room areas. There are also two kitchens, one of which is for the service users to cook their own food if they wish. The home does not have a garden but does have a yard at the back of the home where service users can sit. The home has staff available 24 hours a day. Most of the service users spend their time doing domestic activities in the home or going out in the local area. Some attend a local day service one or two days a week. All the service users have access to a GP, psychiatrist and care manager. Some have input from a community psychiatric nurse. Shila House DS0000010620.V271845.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was conducted over a period of 5 hours, beginning at 11 am and concluding at approximately 4 pm. Ms Joanne Day, a Team Leader, who was in charge of the shift was present throughout the inspection. The inspection activity undertaken included a tour of the building, the examination of service users’ files including care records, the examination of health and safety records and the viewing of staff rotas. A member of care staff and six of the people who live at the home were spoken to. The inspection is also based on the information obtained through comment cards completed by people who live at the home and by their relatives and by professionals such as care-coordinators and health care staff. What the service does well: What has improved since the last inspection? What they could do better: The majority of the people who live at the home are not engaged. The registered person has a plan to improve this. Two members of staff have been asked to take the lead to identify suitable activities and support service users to take part in them. The carpets of the stairs by the office in Main Avenue need either replacing or cleaning. The practice of locking both kitchens in Main Avenue is not clear. This needs to be rectified and service users given the right Shila House DS0000010620.V271845.R01.S.doc Version 5.0 Page 6 to access them. The smoking policy needs to be specific and made clear to all people working and living at the home. Even though the complaints policy is clear some service users did not feel that they could talk about their concerns. The registered person must talk to find ways of enabling service users to share their concerns and worries with the management or relevant bodies including the CSCI. Service users’ care plans needs to be reviewed regularly. There is a need for the registered person to ensure that portable electrical appliances are tested once a year and that the fire drills take place and recorded consistently. 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. Shila House DS0000010620.V271845.R01.S.doc Version 5.0 Page 7 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 Shila House DS0000010620.V271845.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 There is a satisfactory admissions procedure which ensures that service users’ needs and aspirations are assessed by professionals and by the home before a decision is made about their admission. EVIDENCE: No new service users have been admitted since the last inspection. The responsible person explained the home’s admission procedure. She said the home receives completed assessments of prospective service users before a decision is made whether or not to offer them a place. Service users are then assessed by the registered person either at their present accommodation or at Shila House. It was evident in service users’ files that the home has received reports and assessments from social workers and health professionals. The six service users spoken to confirmed that they had visited the home before their admission and they are aware that their needs were assessed as part of their admission. One service user stated that they are currently assessed by their social worker in order to move to a self-contained accommodation where they can live more independently. Shila House DS0000010620.V271845.R01.S.doc Version 5.0 Page 9 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, and 9 There are encouraging and commendable efforts regarding enabling people to take responsible risk and to carry out a range of independent activities. The risk assessments are adequate and up-to-date. However, the systems for reviewing care plans are not satisfactory. This means that service users’ needs are not identified and care for as is expected by service users. EVIDENCE: The responsible person said that the home reviews care plans every three months. There is a key working system and it was clear from discussions with the responsible person that key workers review care plans. An examination of service users’ files revealed that all service users have care plans. However, it was evident from the care plans that some care plans have not been updated for two or more years. Some care plans are not complete and some did not contain evidence of service users’ involvement. The responsible person stated that the home is aware of these issues and has advised all staff to ensure that care plans are updated and service users are involved. Each service user has a risk assessment in their files. Discussions and observation of service users showed that those service users who are assessed to be independent are able to travel on their own to places using public Shila House DS0000010620.V271845.R01.S.doc Version 5.0 Page 10 transport. Some service users are supported by staff to go to shops and appointments. A number of service users spoken to said they take responsibility to do their shopping, laundry, cleaning and cooking. The responsible person confirmed that those service users who are able to use have been given bedroom and front door keys. Shila House DS0000010620.V271845.R01.S.doc Version 5.0 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16, and 17 The meals provided are good and meet the needs of service users. However, the system of locking the kitchens is below the expectations of service users. This practice has inconvenienced both the service users and the staff. The arrangements for visitors are satisfactory and service users are able to see friends and relatives at the home. The home has not done enough to engage service users. Most service users spend time at the home doing hardly anything. EVIDENCE: At the last inspection the registered person was required to consult service users about their social interests, and make arrangements to enable them to engage in local, social and community activities. The responsible person stated that two members of staff have been allocated to consult with service users and identify and provide for them activities that meet their needs. It was stated that these tasks are yet to be implemented by the relevant staff. Discussions with service users and the responsible person indicated that staff support service users to access community based facilities such as cinemas, cafés, public houses and shops. Some service users were observed taking their Shila House DS0000010620.V271845.R01.S.doc Version 5.0 Page 12 personal allowances from the responsible person so that they can go out to various places. The responsible person stated that all service users are registered to vote on the electoral poll. The home supports some service users with the management of their finances. The records of the finances of all service users were checked and found to be correct. The cash tins of two service users with relatively a large sum of cash were checked and were found to be in order. At the last inspection a recommendation was made for the registered person to introduce a policy which ensures that there is a limited amount of cash kept at the home for each service user. The service users spoken to stated that they could go to bed or get up at a time of their choice. Service users were observed accessing most of the communal areas such as the lounge and the garden. However, both kitchens are kept locked and service users were seen looking for the staff for the keys. The reasons behind locking the keys were not explained in care plans or in risk assessments. The service users at Poynter Road are able to buy and cook meals of their choice. Service users who live at Main Avenue also said they are happy with the meals. Discussions with the responsible person showed that the food supplier has recently stopped trading and the home is looking into how and where to find a new supplier. There is a four weekly rotating menu and all staff who prepare meals have attended basic food hygiene training. Most service users are able to undertake their personal care. The staff spoken to demonstrated good understanding and knowledge of ensuring privacy, dignity and choice of service users when supporting service users with their personal care. It was evident from discussions with service users and the responsible person, and an examination of the homes records that service users are visited by families and friends. There is a pay phone which service users can use to contact friends and families. The relatives who completed comment cards confirmed that they can visit service users and that they are also kept informed of important matters affecting them. Shila House DS0000010620.V271845.R01.S.doc Version 5.0 Page 13 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): 19, and 20 There are satisfactory systems in place to ensure that service users receive appropriate health care. The systems for the administration of medication are good with clear arrangements being in place to ensure service users’ medication needs are met. EVIDENCE: Records and discussions with service users showed that service users have accessed health care. From the comments cars completed and returned to the CSCI it was evident that community and district nurses visit the home. Documents and discussion with the responsible person indicated that service users have seen opticians, dentists and chiropodists. All service users are registered with their own general practitioners. Consultant psychiatrists review service users health needs quarterly and records showed that there is close working relationship with the home and health care providers. Medication is administered by the staff. It was evident from a discussion with the responsible person and the assessment of staff files that all staff who administer medication have undergone relevant training. Medication is kept in a locked cabinet in a room on the ground floor. The temperature of the area where medication is kept is monitored and recorded daily. The recordings showed that the temperature has never been above 25°C. Shila House DS0000010620.V271845.R01.S.doc Version 5.0 Page 14 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, and 23 Despite the satisfactory complaints procedures some service users do not feel that they express their concerns. This has been evidenced by the response of some service users in comment cards. The policy and procedure of adult protection are satisfactory. This gives service users that they are protected from abuse. EVIDENCE: Six service users who were spoken to said they can go to the manager or staff to talk to them if they have concerns. However, three of the ten service users who completed and returned CSCI comment cards ticked “No” to the question which asked them if they knew who to speak to when they are unhappy. The home has a complaints procedure which contains details of how to make a complaint and the maximum period of time within which a response would be made. A coy of the complaint procedure is displayed on the wall by the main entrance. All the professionals and relatives who completed the CSCI comment cards confirmed that they did not have to make a complaint. The home has a policy on adult protection. A copy of the local authority’s policy and protection on the protection of vulnerable adults from abuse has been obtained by the home. The staff who were spoken to were able to give satisfactory description of how they follow the home’s procedures in dealing with incidents of real or suspected abuse. Staff records indicated that they have attended training on the protection of vulnerable adults from abuse. Shila House DS0000010620.V271845.R01.S.doc Version 5.0 Page 15 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, and 30 The registered person has done a good job in replacing the carpets and the sofas in Poynter Road. These have added to the comfort of service users who live at the home. There remains, however, more to be done at Main Avenue. The carpets of the stairs by the main office do not meet the expectation of service users. EVIDENCE: At the last inspection the registered person was required to replace the carpets and the sofas in the lounge of the building at Poynter Road. These have been satisfactorily complied with. However, the registered person is yet to replace or clean the carpets of the stairs by the office in Main Avenue. Shila house is located within a close proximity to the Cambridge Road in North London and service users have easy access to a range of shops, leisure and transport facilities. The home comprises two buildings, one at Main Avenue and the other across the Road at Poynter Road. All service users in both buildings have their own bedrooms and those who are able to use have been offered bedroom and front door keys. The communal areas in both buildings include sitting rooms, toilets, kitchens, dining areas and gardens. It has been mentioned above that the home keeps the kitchens in Main Avenue locked. A requirement is made regarding this. Shila House DS0000010620.V271845.R01.S.doc Version 5.0 Page 16 The common rooms in both Main Avenue and Poynter Road were clean and tidy. Shila House DS0000010620.V271845.R01.S.doc Version 5.0 Page 17 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, 33, and 34 The policies and procedures of staff recruitment and training are satisfactory and service users are supported by experienced and appropriately vetted staff. However, the staff ratio is inadequate to sufficiently meet the needs of service users. EVIDENCE: A member of staff was interviewed and three other care workers were informally spoken to. The files of the staff were inspected. It was evident from the discussions with the staff and assessment of the files that they have attended a number training programmes such as mental health awareness, basic food hygiene, first aid, medication administration, fire safety and adult protection. There is an induction programme which new staff are required to complete. The service users who completed the comment cards and who were spoken to confirmed that the staff treat them well. Three of the staff have completed NVQ level 2 care qualification. The responsible person said five other members of staff are due to start care training to achieve NVQ level 2 qualification. Two new members of staff have been recruited since the last inspection. Both have two written references in their files. One of the newly recruited care staff is waiting for the arrival of their CRB check before they can start work at the home. All members of staff who work at the home have successfully undergone CRB checks. The home has a recruitment policy which includes an Shila House DS0000010620.V271845.R01.S.doc Version 5.0 Page 18 equal opportunities policy. There is a probationary period of six month for newly recruited staff. The rota showed that there are three care staff at Main Avenue and one care staff at Poynter Road in the early shifts. The after noon shifts are covered by two care staff and one member of staff in Main Avenue and Poynter Road respectively. Night shifts are covered by three waking night staff. The duties of staff include helping service users with cooking, administering medication, prompting service users with cleaning and self-care and supporting with laundry. At the last inspection a requirement was made for the registered person to review the staffing level of the home. This requirement has not been satisfactorily complied with. Shila House DS0000010620.V271845.R01.S.doc Version 5.0 Page 19 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, and 42 The manager of the home is able, experienced and committed to improving the service. Service users have benefited from the knowledge and commitment of the manager. An encouraging work has been done regarding the quality assurance consultation process. Service users had an opportunity to express their views about the quality of the services. The precautions taken to ensure health and safety of the people at the home can be improved. Service users can benefit from the regular checking of portable electrical appliances and consistency in the implementation of the fire drills. EVIDENCE: The registered person was away on the day of inspection due to personal reasons. However, it was evident from previous telephone and written contacts that he is not only experienced and knowledgeable regarding management of care homes but also committed towards improving the quality of the services provided at Shila House. The service users, staff, relatives and professionals are positive about the management of the home. Many professionals and relatives stated in the comment cards that the home is well run. The manager is supported by a Team Leader. Shila House DS0000010620.V271845.R01.S.doc Version 5.0 Page 20 Two requirements were made at the last inspection regarding the monitoring of the quality of the services. Both requirements have been addressed. The registered person has distributed quality assurance questioners to service users, relatives and visitors. The outcome of the questioners have been summarized and action plans developed. As required at the last inspection, the registered person has implemented monthly visits to the home in line with Regulation 26 of the Care Homes Regulations. Copies of written reports following these visits have been received by the Inspector. The registered person has produced a certificate as evidence for the standard of the installation of the gas boilers. The gas boilers were satisfactorily checked and serviced on 29/09/05 and the fire equipment was checked on 13/02/06. Records showed that the emergency lights were inspected on 03/05/05. It was also evident from records that fire alarm points are tested and recorded weekly. Fire drills have taken place but records indicated that there have been inconsistencies in how often they had to be practiced. The home has a fire risk assessment. Portable electrical appliances were last tested on 12/9/04. The home has a non-smoking policy. However, this policy is incomplete in that it does not specify where people can and cannot smoke. Although a general statement is made in service users’ contracts regarding non-smoking policy in the kitchen, bathroom and toilet, there is no written advice for the people who live at the home if smoking is allowed in sitting room on the first floor or second floor in the building at Main Avenue. Shila House DS0000010620.V271845.R01.S.doc Version 5.0 Page 21 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 X 3 X X X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 3 X 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 X X X X X 3 LIFESTYLES Standard No Score 11 X 12 2 13 3 14 X 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X 3 2 3 3 X CONDUCT AND MANAGEMENT OF THE HOME 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Shila House Score X 3 3 X Standard No 37 38 39 40 41 42 43 Score 3 X 3 X X 2 X DS0000010620.V271845.R01.S.doc Version 5.0 Page 22 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 YA7 Regulation 15(2) Requirement The registered person must, as appropriate, consult service users and their representatives and revise care plans. The registered person must consult service users about their social interests, and make arrangements to enable them to engage in local, social and community activities. (The timescale of 30/09/05 not met.) The registered person must ensure that service users have access to the kitchen and suitable kitchen equipment for preparation and storage of food. Unless otherwise stated in care plans and risk assessments, the kitchen must be open for service users to use. It is required that the carpets of the stairs by the office in Main Avenue are replaced. (Timescale of 30/09/05 not met.) The registered person must, having regard to the size of the home, the statement of purpose and the number and needs of service users, ensure that at all times suitably qualified and DS0000010620.V271845.R01.S.doc Timescale for action 30/04/06 2 YA12 16(2)(m) 30/04/06 3 YA17 16(2)(g) 30/04/06 4 YA24 16(2); 23(2) 18(1)(a) 30/04/06 5 YA33 30/04/06 Shila House Version 5.0 Page 23 6 YA42 23(2)(4) 7 8 YA42 YA42 23(4) 13(4) competent persons are working at the home in such numbers as are appropriate for the health and welfare of service users. (Timescale of 31/08/05 not met.) The registered person must ensure that all portable electrical appliances are tested and safe to use. The registered person must ensure that fire drills are carried out and recorded regularly. The registered person must ensure that the current smoking policy and practice do not adversely affect the health of people who do not smoke. 31/03/06 31/03/06 31/03/06 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. Refer to Standard YA23 YA22 Good Practice Recommendations The registered person should introduce a policy which ensures that there is a limited amount of cash kept at the home for each service user. The registered person should look for ways of raising the awareness of service users and encouraging them to complain if they have concerns. Shila House DS0000010620.V271845.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Southgate Area Office Solar House, 1st Floor 282 Chase Road Southgate London N14 6HA 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 Shila House DS0000010620.V271845.R01.S.doc Version 5.0 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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