Inspection on 01/02/06 for Summerlands

This inspection was carried out on 1st February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 11 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Summerlands 17/07/08

Summerlands 20/07/07

Summerlands 29/06/06

Summerlands 08/07/05

Summerlands 06/01/05

Summerlands 12/07/04

Similar services:

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

Pinta

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

CARE HOME ADULTS 18-65 Summerlands 9 Villiers Road Southsea Portsmouth Hampshire PO5 2HG Lead Inspector Liz Normanton Unannounced Inspection 1st February 2006 11:15 Summerlands DS0000011856.V254179.R01.S.doc Version 5.1 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 Summerlands DS0000011856.V254179.R01.S.doc Version 5.1 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. Summerlands DS0000011856.V254179.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Summerlands Address 9 Villiers Road Southsea Portsmouth Hampshire PO5 2HG 023 9283 0682 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) Mrs Francesca Bilsland Miss Joy Michelle Tremayne Care Home 23 Category(ies) of Learning disability (23) registration, with number of places Summerlands DS0000011856.V254179.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Service users in the category LD must be at least 40 years of age One current, named, service user over 65 years of age can be accommodated. One current, named, service user in the category MD can be accommodated. 8th July 2005 Date of last inspection Brief Description of the Service: Summerlands is a Grade 2 listed building designed by the architect Thomas Owen and built in the 19th century. The interior and exterior of the home have numerous features of architectural interest. It has been converted to provide accommodation for 23 service users who have a learning disability. The home is close to Southsea shopping centre as well as the sea front, promenade and beach. The service is set over four floors and has five single rooms and nine doubles. There is a stair lift between two floors, but as this does not extend to the floor with the sitting room and dining room, the service could not be said to be suitable for people with mobility needs. Mrs F Bilsland privately owns the service. Summerlands DS0000011856.V254179.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, which took place on the 1st February 2006 and was the second inspection of the inspection year. The inspectors spoke with the manager, three care workers, several service users and a visitor. A full tour of the home was undertaken to ascertain that previous environmental requirements had been met. While there had been some improvements the outcome was that furnishings in a majority of bedrooms were showing serious signs of wear and tear. Additionally, staffing levels were not considered to be appropriate to meet the needs of the service users. Care workers are well supported by the manager. The overall view of this home was that there has been very little financial investment into the environment, and staffing. A letter of serious concern was issued following the inspection and CSCI is meeting with the registered provider to discuss concerns identified. What the service does well: What has improved since the last inspection? What they could do better: Summerlands DS0000011856.V254179.R01.S.doc Version 5.1 Page 6 Opportunities should be made available for service users to have more input into the day-to-day running of the home. The maintenance and refurbishment plan needs to be followed and priority needs to be given to updating service users’ bedrooms. The number of staff on duty needs to be increased to allow service users greater opportunities to undertake activities and learn independent living skills. Service users would benefit from staff having training relevant to learning disabilities and challenging behaviour. The home should implement systems to gather feedback from service users and stakeholders as part of self-monitoring quality assurance. 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. Summerlands DS0000011856.V254179.R01.S.doc Version 5.1 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 Summerlands DS0000011856.V254179.R01.S.doc Version 5.1 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): 5 Service users have been provided with a contract of their placement which details the terms and conditions. While they have signed their contracts it is clear that a number lack the capacity to understand the concept of the content of the contract. EVIDENCE: The inspectors looked at a sample of three residents’ files and found all three to contain a contract of the placement, which sets out the terms and conditions of the home. It was noted that service users had signed these contracts. The manager confirmed that it had been practice for service users to sign their contracts but recognised that not all had the capacity to understand the content of the document. Summerlands DS0000011856.V254179.R01.S.doc Version 5.1 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): 7 and 8 Service users are able to make daily choices about how they wish to spend their time. However, they are not consulted/not offered opportunities to participate in the day-to-day running of the home. EVIDENCE: The home has a policy on choices, which was seen by the inspectors. The manager stated that service users are able to make choices about what time they get up and go to bed and what clothing they wish to wear. The inspectors observed that service users were dressed age appropriately and had individual hairstyles and clothing to reflect their personalities. They were also seen engaging in independent activities, which included knitting, listening to the radio, watching television and dozing in the lounge. The inspectors spoke with several service users who confirmed that they were able to make choices. The manager said that while one service user was able to manage her own money the home took responsibility for safeguarding others. The integrity of the system employed by the home was checked and found to be satisfactory. Service users have varying levels of communicating their needs. While some have the support of their family it was noted that none had support from the advocacy service. Summerlands DS0000011856.V254179.R01.S.doc Version 5.1 Page 10 The manager stated that service user meetings are held monthly but no minutes of the meetings were available for inspection. In discussions with the manager it became evident that service users are not involved in the day-today running of the home and do not contribute to reviewing and updating the home’s policies and procedures. They do not sit in on interview panels for new staff even though some would have the ability to contribute, and this might be considered for the future. Summerlands DS0000011856.V254179.R01.S.doc Version 5.1 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): The above standards were assessed at the last inspection and were all met. EVIDENCE: Summerlands DS0000011856.V254179.R01.S.doc Version 5.1 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 20 This standard was assessed at the previous inspection and fell short of meeting the standard. The requirements have now been met. EVIDENCE: The inspectors spoke with the manager about the medication procedures and she was able to show them an updated policy and explained that the pharmacist is now dispensing medication separately for lunch time dosage when service users attend the day-centre. Summerlands DS0000011856.V254179.R01.S.doc Version 5.1 Page 13 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 The home treats residents’ complaints seriously and responds appropriately. The home’s policies, procedures and practices ensure that residents are safeguarded from abuse. Procedures for responding to evidence or suspicion of abuse are robust. EVIDENCE: The inspectors viewed the home’s complaints policy and procedure, which was reviewed in March 2005. The complaints procedure had details of how to contact CSCI and informed service users that complaints would be dealt with in 28 days. The manager confirmed that there had been no complaints about the service since the last inspection and the complaints log evidenced this. Details of how to complain are also written into the service user’s contract. One visitor confirmed that they had been given information on how to complain and were satisfied with the care being provided to their relative. In talking with service users it was clear that the issue of poor television reception had been raised with the manager. This was discussed with the manager and it transpired that the home does not have an antennae fitted to the roof and relies on portable aerials attached to individual televisions. One service user told inspectors they had sold their television due the poor reception in her room. The home has a copy of the Hampshire Adult Protection policy and procedure in place. The manager is aware of Protection of Vulnerable Adults Legislation (POVA). She stated that there had been no allegations from service users and there has been no “whistle-blowing” within the staff team. The majority of the staff team have completed National Vocational Qualifications ( NVQs ) level 2 Summerlands DS0000011856.V254179.R01.S.doc Version 5.1 Page 14 or 3 and have completed the module on adult abuse. Certificates were on display in the entrance hall. With regard to understanding physical and verbal aggression from service users, details are provided in care plans. The manager explained that no specific training had been provided in the management of challenging behaviour. Summerlands DS0000011856.V254179.R01.S.doc Version 5.1 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, 26 and 27 There is little evidence of investment in the environment. Furnishings and fittings appear worn. EVIDENCE: The inspector noted the ceiling was cracking above the stairwell. The communal areas are situated on the ground floor and consist of a spacious dining room and lounges. While the main lounge is generally light, airy and well furnished it was noted that the adjoining lounge had a mismatch of furnishings and was not inviting in appearance. There was a selection of uncoordinated seating, a white melamine kitchen cupboard unit, which looked wholly out of place, a bookshelf and an out of tune piano. The dining room is not well lit and has an institutional feel, with large wooden tables and chairs laid out in rows. The lounges have sliding patio doors to a pleasant well stocked garden, which has herbaceous borders. It was noted that the lock on one patio door was broken. Service users stated that the television in the main lounge was not working, as the picture was poor. The manager said she was not aware of this. Radiators around the home have been fitted with protective covers. However, none have been painted and as a result some have become badly stained Summerlands DS0000011856.V254179.R01.S.doc Version 5.1 Page 16 where people have put drinking cups on them. They also give bedrooms and communal areas an unfinished look. Service users’ bedrooms were seen to be personalised but the majority had furnishings, which showed serious signs of wear and tear due to their age. Mattresses had lost their springing and were not providing postural support. One bed also had a collapsed base. In one bedroom the base was smaller than the mattress. Some beds had headboards missing while others had badly stained headboards. Pillows had lost their plumpness and were lumpy. Some bedrooms did not have bedside lamps. A mirror was not available in one bedroom. A number of double rooms were only fitted with one double electrical socket, leading to the use of trailing leads, which are a health and safety issue. All rooms should have at least two double sockets. In one bedroom it was noted that the wardrobes were fitted with padlocks, giving an unsightly and institutional feel to the room. A bed without a headboard was butted up against the wardrobes, which were effectively being used as a headboard. The bed mattress smelt of urine and the bedroom in general had an unpleasant odour. The manager explained that one of the service users sharing this room presented with behavioural problems, which had led to the need to padlock the wardrobes. This practice impacts on the other service user sharing the room and needs to be addressed. One bedroom had a chest of drawers, with damaged veneer, and in another a chest of drawers had mismatched drawer knobs and flaking paint. There is a bedroom on the ground floor with frosted glass windows. The occupants have asked that these be changed so that they can look out. The television reception in this room was noted to be very poor, due according to the manager, to the lack of an external antenna. One service user told an inspector that they have sold their television due to the poor reception. Bed linen on a bed in one room was found to be heavily soiled with faeces, and had been remade ready for use that night. The manager dealt with this matter immediately. Armchairs in the majority of bedrooms were also showing signs of serious wear and tear due to their age, with cushions being flat and lattice supports broken. There are no en-suite facilities in residents’ rooms. There are seven bathrooms in the home, all tiled from floor to ceiling in white tiles. The combination of white walls, commercial grade, impermeable flooring and lack of curtains at the windows gives them a cold institutional feel. Only one bathroom had a blind at the window and this was in need of replacement. One wash hand basin was cracked. One bathroom had paint peeling of the windowsill and the sealing had black mould growing on the paintwork. One bath had paint flaking off the bath panel and the sealant was in need of replacing around the bath. The majority of toilets did not have lids. One bath Summerlands DS0000011856.V254179.R01.S.doc Version 5.1 Page 17 had two small chips in the enamel, one chip having sharp edges which posed a health and safety risk to service users. There were soap bars and cloth towelling being used for the purpose of hand washing in all communal areas, which does not meet with infection control standards. It was noted that a service user bathing in the late afternoon had their privacy compromised with the bathroom door ajar. This individual could be seen by others who used the adjacent toilet. Summerlands DS0000011856.V254179.R01.S.doc Version 5.1 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 35 and 36 While the staff team generally has years of experience of caring for service users with learning disabilities and have qualifications in care, they would benefit from some service specific training in the management of challenging behaviour. Again at this inspection staffing levels fell well below those recommended in the Residential Forum Guidance and were not adequate to meet service users’ needs. The staff team are well supported by the manager and receive regular supervision. EVIDENCE: The manager stated that all but one of the staff have completed National Vocational Qualifications at level 2 or 3 in care. Certificates were seen on display in the hallway. At the time of the inspection there were two care workers, two cleaners, a cook and the manager on duty. Duty rotas showed that two care staff was the norm during the day throughout the week. Additionally, on Fridays and Saturdays another carer is brought in to assist between the hours of 10:00 and 14:00. The home currently accommodates 21 service users. The manager told the inspectors that one service user has high needs, twelve have medium Summerlands DS0000011856.V254179.R01.S.doc Version 5.1 Page 19 needs and eight low needs. The Residential Forum Guidance produced by the Department of Health advises the provision of 683 hours care per week for this service user group. Excluding management hours current staffing hours provide approximately 340 hours per week. There was little evidence of individual activity with service users during the visit. In discussion with the manager inspectors were told that should additional staff be required – for example when a member of staff is supporting a resident who has high support needs – she would step in, or the owner would be called. This appears to the inspectors to be a reactive approach and does not allow for planned activity, and enabling residents to be supported to maintain and develop living skills. This will be looked at in depth at the next inspection of the home. Higher staff ratios would provide the flexibility for the provision of activities such as trips out, independent living skills etc. In discussions with three care workers at the change-over they stated that they felt that there was sufficient staff on duty. The inspectors saw evidence that the home has a comprehensive induction programme, which met with training standards. The manager confirmed that there had been no specific training in learning disabilities and managing difficult behaviour. She is not responsible for the training budget. The manager ensures that care workers are suitably supervised and offers formal supervision every eight weeks. The inspectors saw evidence of the supervision notes, which had a clear agenda and related to service users’ needs. Summerlands DS0000011856.V254179.R01.S.doc Version 5.1 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 The manager is qualified and experienced to run the home and the service users benefit from the leadership she provides within the home. More could be done in the area of quality assurance, gathering information from service users/relatives and stakeholders to underpin the development of the home. There are policies and procedures in place to promote the service users’ health and welfare and overall service users are protected. There were concerns about infection control procedures, which have been highlighted earlier in the report. EVIDENCE: The manager has completed the NVQ at level 4 in care and has also completed the Registered Managers Award. She has many years’ experience of working with people with learning disabilites. The manager supports the staff team and ensures that they receive regular supervision and attend staff meetings. Summerlands DS0000011856.V254179.R01.S.doc Version 5.1 Page 21 In discussions she stated that they do have service user meetings but she was not able to provide records. She explained that there are no other monitoring systems in place. The inspectors saw evidence of health and safety policies and procedures. Safety notices were posted in areas where there were potential hazards. Fire safety equipment was provided and fire records showed that tests are done weekly. The home was in possession of a fire safety certificate. Records indicated that the boiler had not been serviced for two years. The manager believed that this work had been done and thought that the proprietor might have put the certificate elsewhere. Materials hazardous to health are stored appropriately and the manager was in the process of updating the home’s generic risk assessment. There was a certificate of insurance on display. The use of bars of soap and cloth towels in communal hand washing areas did not meet with infection control standards. The kitchen was clean. However, the microwave was broken and a cupboard door had broken laminate. Fridge and freezer temperatures are checked daily and records kept. Two cleaners were present in the home during the inspection and the home was seen to be kept clean and hygienic. Summerlands DS0000011856.V254179.R01.S.doc Version 5.1 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 x 2 x 3 x 4 x 5 3 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 1 25 x 26 3 27 2 28 x 29 x 30 x STAFFING Standard No Score 31 x 32 3 33 2 34 x 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score x 3 2 x x LIFESTYLES Standard No Score 11 x 12 x 13 x 14 x 15 x 16 x 17 x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score x x 3 x 3 x 1 x x 3 x Summerlands DS0000011856.V254179.R01.S.doc Version 5.1 Page 23 Are there any outstanding requirements from the last inspection? Yes 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 YA24 Regulation 16 (2) (c) Requirement You are required to replace all worn mattresses and pillows, as listed in the serious concern letter. You are required to repair the chips to the bath in the first floor bathroom. You are required to make good the areas in bathrooms where paint is flaking off. Attention must be paid to the replacement of toilet lids. All bathrooms must be fitted with appropriate screening at the windows, which makes for a more homely appearance. The cracked sink basin must be repaired or replaced. The sealant around the bath must be resealed and mould on the bathroom ceiling should be eliminated. All beds must be fitted with headboards. These must be clean and fit for purpose. The stained headboards as identified must be replaced. You are required to remove all damaged armchairs from bedrooms and have them repaired or replaced. DS0000011856.V254179.R01.S.doc Timescale for action 20/02/06 2 3 YA24 YA24 23 (2) (c) & (d) 23 (2) (c) & (d) 20/02/06 06/03/06 3 YA24 16 (2) 06/03/06 4 YA24 16 (2) (c) 06/03/06 Summerlands Version 5.1 Page 24 5 YA26 23 6 YA30 13 (3) 7 YA33 18 (1) (a) 8 YA35 18 (1) (a) 9 YA39 24 (1) (a) (b)& 35 10 YA42 16 (2) (g) You are required to undertake a programme of work to ensure that all bedrooms are fitted with at least two double electrical sockets. Frosted glass in bedroom windows must be replaced by clear glass. A suitable television aerial must be provided by the given date and all residents must be able to have a clear picture on their own television. You are required to minimise the risk of cross infection by replacing towels and soap bars with liquid soap and paper towels. You are required to review staffing levels and to produce evidence that there are enough suitably trained staff on duty to meet the needs of the residents. This is outstanding from the previous three inspections of the home and has been referred to the inspectors line manager. You are required to forward a copy of your staffing level review to CSCI by the given date. You are required to provide staff with training in the area of learning disabilities and how to manage difficult behaviour. You are required to review service delivery on an annual basis as part of self-monitoring and developing the service to meet the needs of the service users. The broken microwave oven must be replaced. 30/04/06 20/02/06 31/03/06 30/04/06 31/03/06 20/03/06 Summerlands DS0000011856.V254179.R01.S.doc Version 5.1 Page 25 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 YA8 YA5 Good Practice Recommendations The home should offer those service users that have the capacity to become more involved in the day-to day running of the home. Consideration should be given to the capacity of service users to understand the content of their contract with a view to contracts being signed by a family representative or advocate on their behalf. Summerlands DS0000011856.V254179.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection Southampton, Portsmouth and Isle of Wight Ground Floor Mill Court Furrlongs Newport, IOW PO30 2AA 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 Summerlands DS0000011856.V254179.R01.S.doc Version 5.1 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!