Inspection on 02/12/06 for 39 Silverbirch Road

This inspection was carried out on 2nd December 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 no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

39 Silverbirch Road 07/02/06

39 Silverbirch Road 22/08/05

39 Silverbirch Road 24/01/05

39 Silverbirch Road 23/08/04

39 Silverbirch Road 17/02/03

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Aston Court Nursing Home

Polesworth Group 70 Long Street

Breme

Ravenhurst

Polesworth Group 64 Long Street

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

CARE HOME ADULTS 18-65 Silverbirch Road (39) Erdington Birmingham West Midlands B24 OAR Lead Inspector Kerry Coulter Unannounced Inspection 2nd and 8 December 2006 09:00 th Silverbirch Road (39) DS0000039326.V321687.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 Silverbirch Road (39) DS0000039326.V321687.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. Silverbirch Road (39) DS0000039326.V321687.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Silverbirch Road (39) Address Erdington Birmingham West Midlands B24 OAR 0121 250 2067 F/P 0121 250 2067 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) New Outlook Housing Mr Leon Smith Care Home 6 Category(ies) of Learning disability (6), Physical disability (6), registration, with number Sensory impairment (6) of places Silverbirch Road (39) DS0000039326.V321687.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Residents must be aged under 65 years. The home can continue to accommodate one named service user over 65 years. 7th February 2006 Date of last inspection Brief Description of the Service: 39 Silverbirch Road is registered to provide personal care and support to six adults with a learning disability/visual impairment, who have been assessed as requiring full assistance with daily living tasks. The home is staffed 24 hours a day including waking night and a sleeping in member of staff. Service users would be admitted to the home following a full assessment that would determine the level of support they require. The full range of medical services, leisure and social activities are provided for the service users. A number of adaptations have taken place within the home in order to meet the assessed needs of the service users. Service users are encouraged and supported to maintain links with their families and the local community. The care needs of the service users are monitored and reviewed and action is taken to address any concerns. The home is situated in Erdington, a residential area of Birmingham and has ready access to local amenities. The fees charged to each service user are between £784 to £1397 per week. The CSCI inspection report is available in the home for visitors to read if they wish to. Silverbirch Road (39) DS0000039326.V321687.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Prior to the fieldwork visit taking place a range of information was gathered to include notifications received from the home and a pre-inspection questionnaire. This was the homes key inspection for the inspection year 2006 to 2007. One inspector carried out the unannounced fieldwork visit over seven hours. This was spread over two days as a return visit was needed when the Manager was on duty so that staff records could be looked at. The staff on duty were spoken to. The inspector met with all of the service users and time was spent observing care practices, interactions and support from staff. A tour of the premises took place. Care, staff and health and safety records were looked at. What the service does well: The staff team are enthusiastic and committed in meeting the needs of service users’. Service users enjoy a variety of leisure activities in the community. They said that they enjoy going out often to the places they want to go to. Each service user has a care plan so that staff know how to support the person to meet their needs and achieve their goals. Service users’ are at the centre of decisions made about their daily lives. Service users said they choose what they want to eat and that the food is good. Service users are supported to keep in touch with their family and friends. Service users are supported to keep healthy and have regular health check ups. Staff notice when residents are unwell and make sure that they go to the doctor. Staff have training in how to meet the needs of the service users so they can support them well. Silverbirch Road (39) DS0000039326.V321687.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Silverbirch Road (39) DS0000039326.V321687.R01.S.doc Version 5.2 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 Silverbirch Road (39) DS0000039326.V321687.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 and 4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users have the information they need to make an informed choice about whether or not they want to live at the home. Prospective service users individual needs and aspirations are assessed to ensure that these can be met at the home. EVIDENCE: The statement of purpose and service users guide were looked at and contained all the relevant and required information. This would help prospective service users have the information they need so they can make a choice about whether or not they want to live there. As required at the last inspection the service user guide had been updated to reflect staff changes and qualifications. It was not possible to fully assess current practice regarding admissions to the home as no new service users have moved in since the last inspection. The home does have an admission procedure and this records that prior to a new service user moving in a full assessment would be completed and the views of other social and healthcare professionals would be sought. Trial visits would be offered and where individuals are unable to make informed decisions for themselves advocacy services would be sought. Silverbirch Road (39) DS0000039326.V321687.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7, 8 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff generally have the information in individuals care plans so they know how to meet individuals needs and help them achieve their goals. Service users are supported to make decisions and are consulted on what goes on in the home. Arrangements are in place to ensure that service users are supported to take risks within a risk assessment framework so helping them to keep safe. EVIDENCE: Three service user records were sampled. Records included an individual care plan that detailed how staff are to support the individual to meet their needs and achieve their goals. They included short and long- term goals recognising that due to the individual’s ability and resources available some goals may take longer to achieve. Care plans had recently been reviewed and updated to reflect any changes. Guidelines were available to enhance information in the care plans. These covered areas such as mobility, meals, likes and dislikes, cultural needs, behaviour, personal care and activities. For two individuals the guidelines were up to date. For one, some guidelines were overdue for review. Silverbirch Road (39) DS0000039326.V321687.R01.S.doc Version 5.2 Page 10 This must be done at least six monthly to ensure service users receive the care they need. Service users’ are at the centre of decisions made about their daily lives. Each service user has an annual review. Service users’ are involved in the whole process with assistance from the staff group. Where appropriate service users have the support of an advocate, for example where one service user is planning to move to another home. Service user meetings take place weekly where a variety of issues are discussed to include activities, staffing, pets, CSCI newsletters and anything they wish to discuss about the home. Service user records sampled included individual risk assessments. These were detailed and had recently been reviewed and updated where necessary to reflect any changes. They included the action that staff needed to take to minimise the risks due to manual handling, their behaviour, using the stairs, the laundry and kitchen and going out in the community. Silverbirch Road (39) DS0000039326.V321687.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Arrangements are in place so that people living in the home experience a meaningful lifestyle. EVIDENCE: Each service user has a schedule of activities. These are varied and include opportunities to go shopping, for meals out, to Church, music, pubs, walks, the gym and participation in household chores. Service users spoken with were happy with the activities on offer and said they could choose what they wanted to do. During the visit one service user went out with a friend to watch a football match, others were going out to watch a pantomime. One service user was playing his electronic keyboard in his bedroom, he said this was one of his favourite activities. For one service user records showed that he spent much of his time relaxing in the home. However, records also detailed that staff try and engage this individual in activities but that he chooses not to participate. Service users also have the opportunity to go on holiday. This is done on an Silverbirch Road (39) DS0000039326.V321687.R01.S.doc Version 5.2 Page 12 individual basis, the Manager said that one service user had chosen a holiday to Spain this year. Records sampled and service users said that staff support them to keep in contact with their friends and family through visits to them, visits to the home or by telephone. One service user has a friend that goes with them to watch Birmingham City Football Club. During the visit one service user had a visit from his wife. She said that staff always made her feel welcome when she visited. Service users rights were respected, for example where individuals wished to have a lie in bed this was observed to be respected by staff. Records stated and service users were observed taking part in household tasks encouraging them to be as independent as possible. All service users spoken with said they liked the food. After the lunchtime meal one individual was overheard to say to staff ‘compliments to the chef’. Food records sampled showed that a variety of food is offered that is culturally appropriate and that includes fresh fruit and vegetables. Fresh fruit was observed to be available on dining room tables, readily accessible to service users. Silverbirch Road (39) DS0000039326.V321687.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Arrangements are in place to ensure that individuals personal care and health needs are generally well met. The arrangements for the management of the medication are generally sufficient to protect service users. EVIDENCE: Care plans sampled detailed how staff are to support individuals to meet their personal care and health needs. One service user said he had a shower that morning as he preferred showers to having a bath. Service users were well dressed and this was appropriate to their age, gender, the weather and the activities they were doing. Staff were observed to offer appropriate support, for example supporting an individual to wipe his face after he had eaten. Another individual who was reluctant to move from his chair for his meal was supported by staff with encouragement and patience. One service user has had input from ‘Deafblind Uk’, a letter was observed from them complimenting the home on how staff communicate with the service user. Service users records included an individual Health Action Plan. This is a personal plan about what an individual needs to stay healthy and what Silverbirch Road (39) DS0000039326.V321687.R01.S.doc Version 5.2 Page 14 healthcare services they need to use. Health Action Plans clearly show that referrals have been made to the appropriate professionals for specialist help in meeting service users’ needs. Service users had regular check ups with dentist, chiropodist and optician. Records of all appointments were kept including the outcome with any action that staff need to take to ensure the individuals health needs are met. Medication is stored in a locked cabinet. The Medication Administration Records (MARS) sampled were signed appropriately. Written protocols to direct staff as to when to administer ‘as required’ medication were observed to be in place but needed further development. For example one protocol for medication prescribed to relieve constipation did not guide staff as to how they know when it should be given. Another protocol regarding the refusal of medication needed further clarification about when the GP should be consulted as it guides staff to contact the GP after four days. However the Manager stated the GP has said that staff should not contact him so frequently. Copies of prescriptions are retained so that staff can check the correct medication has been received from the chemist. The CSCI has been notified of one medication error in the home since the last inspection. Records showed this had been investigated and addressed with staff to prevent future occurrences. Silverbirch Road (39) DS0000039326.V321687.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The complaints and adult protection procedures available ensure that service users are protected from harm. EVIDENCE: The complaints procedure included all the relevant and required information and is available in written and audio format. The home or the CSCI had not received any complaints about this service since the last inspection. One service user spoken with said he had no complaints about the home, but if he did he would be happy enough to tell the Manager or Deputy. Staff had received training in adult protection and the prevention of abuse. Staff records sampled included evidence that a satisfactory Criminal Records Bureau (CRB) check had been undertaken before the individual started working at the home. This is to ensure that suitable people are employed to work with the service users. One service users financial records were sampled. Records showed that the individuals regularly receive their personal allowance and this is spent on personal items. Receipts are kept of all expenditure and these cross-referenced with individual records. Silverbirch Road (39) DS0000039326.V321687.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 26, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home was clean, warm and fit for its purpose and generally provides service users with a safe, homely and comfortable environment. EVIDENCE: The home was seen to be generally well maintained, homely, comfortable, and free from odour. Furniture, fixtures and fittings were generally of a good standard and well maintained. The lounge wallpaper was observed to require attention where damage had been done from attaching Christmas cards. The Manager was able to evidence he had gained several quotes for redecorating the home, this included the lounge area. It is a little disappointing however that the lounge has been in this condition for nearly eleven months. Bedrooms sampled were very personalised, service users are supported by staff to have a bedroom that reflects their gender, age and culture. One service user has recently had new flooring, bed and chair. Staff said this was due to the room previously having an unpleasant odour which the new floor and furniture had resolved. Silverbirch Road (39) DS0000039326.V321687.R01.S.doc Version 5.2 Page 17 People who live at the home have varying needs, to include sensory and mobility needs. The home appears to have suitable adaptations and equipment to meet individual needs. The home has a rear garden which is accessible via a ramp with handrails fitted. Service users who have increased mobility needs are accommodated on the ground floor. The upper floors of the home are reached by a passenger lift. The home also benefits from having a bathroom with an adapted bath that enables service users to have a bath instead of a shower if they prefer one. The home was observed to be clean with no unpleasant odours. Infection control arrangements were satisfactory to include good hand washing facilities in bathrooms, laundry and kitchen areas. Silverbirch Road (39) DS0000039326.V321687.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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 and 36. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. An effective staff team supports service users. Service users are protected by the home’s recruitment practices. Staff receive the appropriate training and support to meet the needs of individual service users and protect them from harm. EVIDENCE: It was noted that both staff and service users appear comfortable in each other’s company and enjoy a good general rapport. They give support with warmth, friendliness and patience and treat people respectfully. The composition of the staff team is reflective of the gender and cultural background of individuals in their care. Staff have the opportunity to complete the Learning Disability Award Framework and 50 of staff have achieved an NVQ in care. This ensures that staff have the right qualifications and knowledge to meet the needs of service users. Observation of the staff rota and discussion with the Manager and staff shows that there are enough staff on duty to meet the needs of service users. There had been some difficulties in staffing the home in the summer months when Silverbirch Road (39) DS0000039326.V321687.R01.S.doc Version 5.2 Page 19 agency staff had to be used to cover deficits. However the home now has a full compliment of staff which means that service users will be supported by people they know and who are aware of their individual needs. Since the last inspection staff are working a shorter day in place of working twelve hour shifts they will work seven hours. This can only be of benefit to service users’ and staff as staff will not be as tired towards the end of their shift. Three staff records were sampled. These included the required recruitment records. They included evidence that a satisfactory Criminal Records Bureau (CRB) check had been undertaken for staff before they started working at the home to ensure that suitable staff are employed to work with the service users. Staff records showed that when staff begin working at the home they have an induction to ensure they know what is expected of them, their job role and how to work with individual service users. Training records showed that staff receive training in food hygiene, infection control, first aid, physical intervention, moving and handling, adult protection, health and safety, medication and epilepsy. Recently several staff have attended risk assessment training. The Manager has also completed a course in healthy eating and nutrition, this will assist in ensuring service users have a healthy diet. Staff have received fire training and the Manager was able to evidence he was in the process of arranging refresher training. Staff spoken with were knowledgeable about the needs of the individuals in their care and enthusiastic about their jobs. They said they felt fully supported in their roles and had received the training they needed to meet the needs of service users. Staff confirmed they had received an induction to the home and had regular supervision. Silverbirch Road (39) DS0000039326.V321687.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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from a well run home. Arrangements are generally sufficient to ensure that the health, safety and welfare of service users are promoted and protected. EVIDENCE: The Manager has many years experience of working with people who have a learning disability and had been the Manager for several years. He has NVQ level 4 in Management and Care. Systems are in place to assure quality. The representative of the Provider undertakes monthly visits to the home to assess the quality of the service as required under Regulation 26. Reports of the visits were available in the home. In house audits and quality monitoring is also undertaken to include Silverbirch Road (39) DS0000039326.V321687.R01.S.doc Version 5.2 Page 21 medication, health and safety, condition of furniture, care planning, accidents, hygiene and meals. Fire records showed that staff regularly test the fire equipment to make sure it is working. An engineer regularly services the fire equipment. Regular fire drills are held so that service users and staff know what to do if there is a fire. The Manager is in the process of arranging refresher fire training for staff that will also include instruction on how to use the newly purchased fire evacuation chair. An electrician completed the five –yearly hard wiring test in 2002 and stated that it was in a satisfactory condition. An electrician tested the portable electrical appliances in May to make sure they are safe to use. A corgi registered engineer last completed the annual test of the gas equipment in October and said it was safe. Certificates also evidenced the servicing of the adapted bath and passenger lift. Staff test the water temperatures weekly to make sure they are not too hot or cold. Silverbirch Road (39) DS0000039326.V321687.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 3 2 3 3 X 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 3 27 X 28 X 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 3 X X 3 X Silverbirch Road (39) DS0000039326.V321687.R01.S.doc Version 5.2 Page 23 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. 2. 3. Standard YA6 YA24 YA20 Regulation 14 23(2) 13(2) Requirement Timescale for action 30/01/07 The Manager must ensure all service user guidelines are updated at least six monthly. The Manager must ensure the 28/02/07 lounge is redecorated where the wallpaper has been damaged. Medication protocols need 30/01/07 development to guide staff regarding the use of ‘as required’ medication and action to take if medication is refused. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Silverbirch Road (39) DS0000039326.V321687.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Birmingham Office 1st Floor Ladywood House 45-46 Stephenson Street Birmingham B2 4UZ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Silverbirch Road (39) DS0000039326.V321687.R01.S.doc Version 5.2 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. 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