Inspection on 18/08/05 for St Anne`s Alcohol Services - Leeds

This inspection was carried out on 18th August 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

St Anne`s Alcohol Services -... 06/11/08

St Anne`s Alcohol Services -... 15/01/07

St Anne`s Alcohol Services -... 05/01/06

St Anne`s Alcohol Services -... 06/10/04

St Anne`s Alcohol Services -... 24/06/04

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Oakmount Hostel

Ark House

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

CARE HOME ADULTS 18-65 St Annes Alcohol Services - Leeds Ashton House 186 Woodhouse Lane Leeds LS2 9DX Lead Inspector Sue Dunn Announced 18th August 2005 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 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 Stationary 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. St Annes Alcohol Services - Leeds 20051018 St Annes Alcohol Services AN Stage 4 S1352 V181918 J52.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service St Annes Alcohol Services - Leeds Address Ashton House, 186 Woodhouse Lane, Leeds, Yorkshire, LS2 9DX 0113 2434486 0113 2451526 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) St Anne`s Community Services Mr Jonathan Philpott Care Home 28 Category(ies) of Past or present alcohol dependence (28) registration, with number of places St Annes Alcohol Services - Leeds 20051018 St Annes Alcohol Services AN Stage 4 S1352 V181918 J52.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 06/10/04 Brief Description of the Service: Leeds Alcohol Service provided by St Annes is situated in St Marks House, a large two storey detached Victorian house Three of the 20 beds are to be used for acute detoxification and 17 for rehabilitation. This has been a reduction in the overall service due to the withdrawal of funding by the PCT. Offices, medication room and training rooms will remain in the adjoining Ashton House. The purpose of the service is to provide acute nursing care and a structured programme of rehabilitation for people with alcohol related illnesses and associated problems. The care home is well located in the university area of Leeds within walking distance of the city centre. A fence around the property creates safe sitting areas for the service users. There is a small area for visitor parking in front of the building. All bedrooms are below the minimum size requirement but all offer single accommodation and are regarded as fit for purpose. St Marks House has two lounges, dining room and a games room, which offer communal space. A ‘bedsitting’ unit offers a ‘stepping stone’ for people preparing to move back out into the community.Meals are provided from a central kitchen in St Marks House with facilities to enable people to make their own drinks and snacks.The service is managed and staffed by employees of St Anne’s. The home is currently recruiting nursing staff to provide 24 hour care for people who are going through the programme of detoxification. The registered manager has overall responsibility for the service. St Annes Alcohol Services - Leeds 20051018 St Annes Alcohol Services AN Stage 4 S1352 V181918 J52.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The announced inspection was carried out by one inspector between 9.45am4.15pm. Comment cards/questionnaires were provided for residents, visitors and other professionals to give people the opportunity for anonymous feedback. The purpose of the inspection was to make sure the home was operating and being managed to a satisfactory standard and in accordance with the National Minimum Standards for a Care Home for Younger Adults. One person who returned a comment card wanted to express strong disapproval about the withdrawal of Health Trust funding which has had implications for the service and facilities the home can provide. Service users have written and spoken to the inspector since the inspection to express their concerns and disappointment that decisions are being made which reduce the provision in the area and about which they have not been consulted. It is appreciated that such decisions have also been beyond the control of the organisation which is having to make compromises in order to maintain some services during this difficult time. In order to retain a detoxification service the home has had to adapt three beds in St Marks House for this acute service. The position and layout is far from ideal from the point of view of access to facilities, privacy and dignity and the overall amount of shared communal space in the home. A group of agency nurses have been employed on a block contract to maintain the nursing service. They have done this well under the supervision of a clinical manager skilled in the treatment of alcohol abuse and associated problems . The clinical manager, employed by the Health Trust has been responsible for the leadership and management of the nursing team and provided stability and development of the service, group therapy for service users and support for the doctor. Since the inspection the Health Trust have terminated the clinical manager’s contract leaving the home without a nurse manager or anyone with the skills to continue the valued group therapy sessions. Service users are extremely upset about the way in which this was done and feel badly let down. It must be said that this was again beyond the control of the organisation which is in the process of looking at how to provide the necessary knowledge and expertise to manage the nursing service and provide a group therapist. The quality of service and provision and impact on service users is being closely monitored over the coming weeks by St Anne’s, Social Services and the CSCI. What the service does well: A Statement of Purpose and Function, Service user Guide, and information St Annes Alcohol Services - Leeds 20051018 St Annes Alcohol Services AN Stage 4 S1352 V181918 J52.doc Version 1.30 Page 6 leaflet for referrers gives detailed information about the service. It is the policy of the home to consult with service users and their ideas have been included in the information. The managers of the service are constantly looking at ways to change and improve the quality and effectiveness of care and respond to the needs of service users. The restructuring of the rehabilitation programme last year tightened up the pre admission assessment process and time limited the very structured and goal centred rehabilitation period. Service users have benefited from a positive and focussed approach and the group and individual support systems built into the programme. Ex service users have become an important and valuable part of the education and recovery process. The home makes good use of community facilities in directing people towards personal development and lifestyle changes. Staff are valued and given opportunities for personal development What has improved since the last inspection? What they could do better: The home should place more emphasis on training for staff which focuses on approaches to Alcohol treatment. The regular turnover of people using the service causes wear and tear on furnishings and fittings. The furniture must be maintained to a satisfactory standard. The cleaning of paintwork throughout the home appears to be overlooked creating a shabby uncared for appearance in parts of the building. St Annes Alcohol Services - Leeds 20051018 St Annes Alcohol Services AN Stage 4 S1352 V181918 J52.doc Version 1.30 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. St Annes Alcohol Services - Leeds 20051018 St Annes Alcohol Services AN Stage 4 S1352 V181918 J52.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection St Annes Alcohol Services - Leeds 20051018 St Annes Alcohol Services AN Stage 4 S1352 V181918 J52.doc Version 1.30 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 standard(s) 1,2,3,4,5 The home provides clear written information about the service it provides. The licensing agreement is discussed within the first few days of admission as part of the admission process to ensure service users know what to expect and what is expected. The assessment process is appropriate for the service users. EVIDENCE: The Statement of Purpose setting out what the home does and how it does it is very informative and includes a guide for each of the two service users groups. Some of the people spoken with described their different routes into the service. One had received a leaflet about the service from a counselling agency, one had self referred after a period in hospital and another had heard about the service, made a telephone call which served as an initial assessment of need and was admitted within a few days. Service users stated that that have to show a willingness to participate in the rehabilitation programme to be admitted Because of the nature of the service a fuller assessment is carried out when people are well enough to be involved and can agree to the programme of treatment. All service users receive a licensing agreement which they sign after it is explained to them. As the service is the only one of its type in the area service users have limited choice if they need support to stop drinking. St Annes Alcohol Services - Leeds 20051018 St Annes Alcohol Services AN Stage 4 S1352 V181918 J52.doc Version 1.30 Page 10 Pre admission details are taken by telephone and a more detailed assessment undertaken with the service user on admission. St Annes Alcohol Services - Leeds 20051018 St Annes Alcohol Services AN Stage 4 S1352 V181918 J52.doc Version 1.30 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 standard(s) 6.7,8,10. Care plans and supporting records provided clear and detailed information agreed with each service user and which gave a clear structure to each day. The programme of treatment provided staff and peer group support to help people take responsibility for their own recovery. Residents were treated with respect and their privacy upheld. The home should ensure that service users receive the information they need to maintain their independence EVIDENCE: All the people going through the detoxification process go through a standard care plan programme. Once on the rehabilitation programme everyone works through a structured 13 week programme which helps each person to confront the underlying problems which lead them to drink, helps people to manage their time and offers support systems within the group. The programme involves making decisions about changing lifestyles. The most difficult activity was said to be the one which involved people managing time on their own but one person was very proud to have read three books during this time. One person felt that it would be helpful to have a timetable in each bedroom so that new people knew what to do each day. An information leaflet had only St Annes Alcohol Services - Leeds 20051018 St Annes Alcohol Services AN Stage 4 S1352 V181918 J52.doc Version 1.30 Page 12 just appeared in the bedroom though the person had been in the home for over a week One person said that ‘staff don’t give you the answers, you have the answers and staff help you to find them’. People valued the clinical manager’s ‘straight talking’ approach and felt that she was a key element in the success of the service. It was very helpful to be able to admit to having a problem and to learn what damage alcohol was doing to your body. A member of staff sits in on ‘in touch‘ group meetings during which service users and volunteers who have been through the unit discuss their week and their plans for the future. Current and ex service users felt it was really helpful to be able to share thoughts and plans with ‘people who had been there’. St Annes Alcohol Services - Leeds 20051018 St Annes Alcohol Services AN Stage 4 S1352 V181918 J52.doc Version 1.30 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 standard(s) 11,14,15,16,17 The home supports people to manage their leisure time with a programme of treatment which gives opportunity for development and lifestyle changes. This includes people learning to recognise that with rights go responsibilities. The home provides a range of healthy foods which allow for personal choice. EVIDENCE: Each day is clearly broken into time for the programme and time for leisure in the evenings. The television is not allowed during the day. Service users said that this encourages people to talk to each other. A concern was raised about health and safety in the allotment and about the use of cleaning products as people are expected to do cleaning chores within the unit. The manager stated that the home only uses ‘safe’ products which are locked in the COSSHE cupboard and supervised in and out. People are accompanied on their first session in the allotment where only manual tools are used. Service users can attend computer and other classes inside and outside the unit, some do voluntary work. St Annes Alcohol Services - Leeds 20051018 St Annes Alcohol Services AN Stage 4 S1352 V181918 J52.doc Version 1.30 Page 14 Contact with family and friends may be subject to restrictions if there are any identified risks. St Annes Alcohol Services - Leeds 20051018 St Annes Alcohol Services AN Stage 4 S1352 V181918 J52.doc Version 1.30 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 standard(s) 18,19,20,21 Staff were aware of the residents’ needs through a system of written and verbal communication between residents and each other. More work should be done within the staff team to ensure communication within the staff team is consistent and works effectively at all times for the benefit of service users. Residents are treated with dignity and their privacy maintained at all times. The homes policies and procedures on medication protect the service users. EVIDENCE: The care plans for two people going through detoxification were examined. One person completed detox, was discharged with a letter to the GP returning later for the rehabilitation programme. There is 24 hour nursing support for people going through detoxification. The quality of communication within the staff team was said to vary according to individuals The home is currently using a locum GP who is also a registrar at LGI therefore able to pick up underlying medical problems. Though not a specialist in addiction he was described as ‘very attentive’ to service users and willing to discuss care with the experienced nurses. There are ongoing discussions with the Primary Care Trust about their future medical input to the home. The home has changed medication prescribing habits by carrying out a base line assessment to see if all medication is really necessary. This has reduced St Annes Alcohol Services - Leeds 20051018 St Annes Alcohol Services AN Stage 4 S1352 V181918 J52.doc Version 1.30 Page 16 the amount of medication, such as sleeping tablets, being used. Self medication is not felt to be appropriate during the period of treatment therefore medication is managed by the nursing staff. The system of peer group support, staff support and counselling is aimed at meeting service users needs. St Annes Alcohol Services - Leeds 20051018 St Annes Alcohol Services AN Stage 4 S1352 V181918 J52.doc Version 1.30 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 standard(s) 22,23 Service users were aware of the complaints procedure and how to use it. Their views were listened to, taken seriously and action taken to resolve issues. Service users can be sure that their rights are protected and that they and their families are protected by the adult and child protection procedures. EVIDENCE: The home has been very open about handling complaints and gives service users the opportunity to express their views through regular meetings. There was however a concern expressed that people who complained would be disapproved of. The manager was aware and dealing with a complaint about the attitude of an agency worker. The staff have had training on the protection of vulnerable adults and children. St Annes Alcohol Services - Leeds 20051018 St Annes Alcohol Services AN Stage 4 S1352 V181918 J52.doc Version 1.30 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 standard(s) 24,25,27,28,29,30 Bedrooms do not meet the minimum size requirements but are considered as ‘fit for purpose’ in view of the short term care provision. However the use of 3 rooms in St Marks House to maintain a reduced detoxification service is regarded as a retrograde if necessary arrangement if this service is to continue over the coming months. The reduced communal space is not sufficient to compensate for the small size of the bedrooms. The situation is regarded as temporary and must be closely monitored in the interests of service users. Overall the building was clean but the paintwork and furniture must be maintained to a satisfactory standard. EVIDENCE: The inspection concentrated on the arrangements being made to accommodate the detoxification service in St Marks House. All are agreed that this is not an ideal arrangement but will provide a temporary solution to maintain the service. Discussions continue with PCT’s and local authorities over funding for a detoxification service. The bedrooms proposed for the detoxification programme may pose some privacy issues being close to the entrance to the building, which has been moved to provide ramped access to St Marks House. The inspector had several concerns which were discussed with the manager St Annes Alcohol Services - Leeds 20051018 St Annes Alcohol Services AN Stage 4 S1352 V181918 J52.doc Version 1.30 Page 19 and the assistant director for St Anne’s. Anyone entering the building will pass the bedroom doors and bathroom of people in the acute stage of detoxification. The walk in shower will be shared by all service users who require it. Access to medication will involve the nurse on duty having to go into another part of the building when medication is required. Shared communal space for people on the detoxification programme and the rehabilitation programme has been reduced therefore there is less space to compensate for the undersized bedrooms throughout the home. The office will double as a room where people will be seen by the doctor. During such times the telephone will be put onto an answer machine The organisation is to monitor the new arrangements, with input from service users and social services. A brief tour of the building found wear and tear to some furniture, which it was said is to be replaced. The home employs a cleaner and service users do routine cleaning chores each morning as part of their rehabilitation programme. ‘Safe’ cleaning products are used and are supervised in and out of the store area. The building was clean overall but paintwork on doors and surrounds was marked and grubby. The industrial washing machine in Ashton House will continue to be used for people on the detoxification programme. St Annes Alcohol Services - Leeds 20051018 St Annes Alcohol Services AN Stage 4 S1352 V181918 J52.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,33,35,36 Staffing numbers and skills ensure that residents’ needs can be met. If the team is to be effective all staff should make sure they communicate with their colleagues at all times. The clinical manager is competent and skilled in her management of the staff team and the development of the treatment programmes. She is highly respected by the service users. EVIDENCE: Service users were very positive about the help and support received from staff, particularly the clinical manager who was described as ‘straight talking’. Care workers have recently been re graded to become Alcohol support workers which describes their role and responsibilities more clearly. There have been no changes in the team of Alcohol Support Workers since the last inspection. Since withdrawal of PCT nurses the home has been using agency nurses who have been employed for a 4 month block contracted period. The clinical manager works closely with the agency manager and is able to vet the suitability of the nurses. A recently employed nurse was able to describe her induction period, which was overseen by the clinical manager. The nurse stated there was some confusion about the roles and responsibilities of the alcohol support workers who work between both floors as some did not always communicate their whereabouts to the nurse. St Annes Alcohol Services - Leeds 20051018 St Annes Alcohol Services AN Stage 4 S1352 V181918 J52.doc Version 1.30 Page 21 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,38,39,41,42,43 The management team have the skills and knowledge to provide effective leadership. Staff are well managed and motivated. Service users are consulted and kept informed about all matters which remain within the control of the organisation. Decisions taken outside the organisation which have affected the service have left service users feeling excluded and let down. EVIDENCE: Service users described the manager and clinical manager as ‘a good team’. Staff felt that they set clear expectations and provided well-structured programmes of care. An issue raised by a service user about fire evacuation procedures had revealed that two staff had not followed procedures though they were able to St Annes Alcohol Services - Leeds 20051018 St Annes Alcohol Services AN Stage 4 S1352 V181918 J52.doc Version 1.30 Page 22 explain what the procedure was. The manager had dealt with the matter appropriately. Service users confirmed that there are regular meetings though some people do not always feel confident enough to express their views. The organisation and managers are doing what they can to maintain the service though funding of the nursing service has been withdrawn. Some service users expressed concerns that decisions have been made which affect the service by people who have not consulted with service users. They felt that this undermined the ethos of the organisation and the value of their views and opinions . St Annes Alcohol Services - Leeds 20051018 St Annes Alcohol Services AN Stage 4 S1352 V181918 J52.doc Version 1.30 Page 23 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 3 3 3 3 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 x 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 x 3 3 3 2 Standard No 11 12 13 14 15 16 17 4 x x 3 3 3 3 Standard No 31 32 33 34 35 36 Score 3 x 3 x 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 St Annes Alcohol Services - Leeds Score 3 3 3 3 Standard No 37 38 39 40 41 42 43 Score 3 3 2 x 3 3 3 20051018 St Annes Alcohol Services AN Stage 4 S1352 V181918 J52.doc Version 1.30 Page 24 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. Standard 24 28 Regulation 23 23.(2) e,g,h 23.(2)d 12.(2)(3) Requirement Timescale for action 31.10.05 3. 4. 30 39 Furniture throughout the home must be of a satisfactory standard There must be sufficient 31.03.06 communal space within the home to compensate for the size of the bedrooms Walls and paintwork throughout 31.10.05 the home must be kept clean PCT managers must be made 31.10.05 aware of the policies of the home and service users rights to be consulted about decisions which affect their lives 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 35.7 Good Practice Recommendations Staff training should place more emphasis on alcohol treatment St Annes Alcohol Services - Leeds 20051018 St Annes Alcohol Services AN Stage 4 S1352 V181918 J52.doc Version 1.30 Page 25 Commission for Social Care Inspection Aire House Town Street Rodley Leeds, LS13 1HP 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 St Annes Alcohol Services - Leeds 20051018 St Annes Alcohol Services AN Stage 4 S1352 V181918 J52.doc Version 1.30 Page 26 - 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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