Inspection on 03/08/05 for Summerson House

This inspection was carried out on 3rd August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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

Summerson House 08/11/06

Summerson House 03/02/06

Summerson House 24/02/05

Summerson House 13/08/04

Summerson House 23/03/04

Similar services:

22 Sandown Road

The Highlands

Dilston College Of Further Education

West View House

Blenheim House

Prince Bishop Court

Park View (15)

Craigmore House

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

CARE HOME ADULTS 18-65 Summerson House 29-31 Stone Street Windy Nook Gateshead NE10 9RY Lead Inspector Lee Bennett Announced 3 August 2005 09:00am 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. Summerson House B52 B02 S7424 Summerson House V190906 3 Aug 2005 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Summerson House Address 29-31 Stone Street Windy Nook Gateshead NE10 9RY 0191 469 9611 0191 469 9611 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) Community Intergrated Care Care Home only 6 Category(ies) of LD Learning disability (6) registration, with number PD Physical disability (5) of places Summerson House B52 B02 S7424 Summerson House V190906 3 Aug 2005 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24/2/05 Brief Description of the Service: Summerson House is care home, providing personal care for up to six people with a learning disability related need. Nursing care is not provided, but District, Learning Disability and Psychiatric Nursing services can be arranged where necessary. It is a purpose built bungalow style care home, with level access throughout. There is a large enclosed garden to the side and rear of the home, which includes a smaller paved area. The home is situated in a quiet residential area near to local public transport links and a range of local facilities, including a doctors surgery, shops, pubs and places of worship. The shopping centre and community facilities at Felling are a short drive away. Summerson House B52 B02 S7424 Summerson House V190906 3 Aug 2005 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over a seven and a half hour period during the morning and afternoon, and was a scheduled announced inspection. A tour of the building took place and a sample of service users’ records was inspected. The inspector was able to chat with the service users and to observe life in the home. Medication storage facilities and administration records were inspected. As the prospective manager was absent on leave, a representative of the care provider assisted the inspection process. The judgements made are based on the evidence available to the inspector on the day of the inspection. The pre inspection questionnaire, returned to CSCI by a representative of Community Integrated Care (CIC), was not fully completed and was therefore returned during the inspection to CIC for completion. The completed form is still to be received by CSCI. What the service does well: Staff promote the independence of service users and encourage their community presence and involvement. There is an adapted vehicle available to enable this. There is a high standard of accommodation offered, and bedrooms have been personalised to suit individual tastes and needs. Staff have a good rapport with service users and are sensitive to their personal care and emotional needs. Staff have worked effectively, under the supervision of relevant healthcare professionals, to support a service user with significant medical needs to remain at the home. This work has enabled this man to remain in his own home environment, rather than staying in hospital or requiring nursing care. This represents a positive outcome for this man. Summerson House B52 B02 S7424 Summerson House V190906 3 Aug 2005 Stage 4.doc Version 1.40 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. Summerson House B52 B02 S7424 Summerson House V190906 3 Aug 2005 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Summerson House B52 B02 S7424 Summerson House V190906 3 Aug 2005 Stage 4.doc Version 1.40 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 standard(s) 2 and 3. Prospective and current service users have their needs assessed prior to moving to the home and periodically thereafter. This will help ensure that each service user’s needs are met at the home and inappropriate admissions avoided. Service users’ personal and social needs are met at the home. EVIDENCE: Each service user has a care managers’ (social workers’) assessment undertaken prior to their admission to the home. This details their abilities and needs. Staff in the home also complete periodic re-assessments, which outline each service users’ personal care, health care, social and psychological needs. From these assessments, care and goal plans are then developed to guide the practice of staff. These have been subject to a significant process of updating and review since the last inspection of the home. The information outlined within service users’ care plans and their progress notes, along with observed practice, demonstrates how the service is able to meet their needs. Staff have, in the past, received training relevant to learning disabilities and general care topics (however, see the comments below regarding training). Additional advice and guidance can also be sought from visiting professionals, such as the District Nurse, for health care needs, as well as other health care professionals from the Community Learning Disability team. Summerson House B52 B02 S7424 Summerson House V190906 3 Aug 2005 Stage 4.doc Version 1.40 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 standard(s) 6 and 7. Service users assessed needs are reflected within their individual plans of care. These provide guidance for staffs’ care practice. Decision making arrangements and safeguards regarding service users’ personal expenditure (specifically in relation to their benefits to assist with their mobility) are not transparent. This may lead to service users’ financial interest not being best served. EVIDENCE: An adapted ‘mini-bus’ type vehicle is available for service users living at the home. This is funded through their personal benefits income, and allows for them to access a range of community services and facilities. There are individual agreements drawn up between the service user and Community Integrated Care (C.I.C.) in the form of a contract. However, a representative of C.I.C. has signed this agreement on behalf of the service users as well as on behalf of C.I.C. This appears to present a conflict of interest. In addition, all six service users contribute to the cost of the vehicle and it’s associated running costs. The arrangements that would take effect should one or more service users leave the home are not clear, and could result in increased payments not specified in the contract, or payments being required in excess of the collective benefits income of the remaining group of service users. The Summerson House B52 B02 S7424 Summerson House V190906 3 Aug 2005 Stage 4.doc Version 1.40 Page 10 decision making arrangements and individual liabilities being entered into need to be clarified, and are a requirement of this report. They would also benefit from further external scrutiny. Each service user has a personalised care plan file, developed by their key worker, that covers a range of need areas. These are linked to periodic monitoring of areas such as personal care and behaviour management. Service users’ abilities, strengths, and preferences, as well as areas of need are noted. Staff are also able to comment on and these strengths, abilities and needs. Summerson House B52 B02 S7424 Summerson House V190906 3 Aug 2005 Stage 4.doc Version 1.40 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 standard(s) 16 and 17. Service users rights are respected, but need to be more clearly expressed within the behavioural management plans. This can help ensure that staff consistently apply best practice. Service users are offered and receive a varied, wholesome, nutritious and wellpresented menu. This can contribute to their general health and wellbeing. EVIDENCE: The last two inspection reports have noted the need to develop specific guidance outlining acceptable forms of restraint (including the use of equipment, furniture and staff involvement) used in the home. Before her period of extended absence the prospective manager commenced work to update these plans. Further development of these plans is nevertheless still required, and must be explicit in respect of what are acceptable forms and techniques of restraint and the circumstances when they can be used. Guidance and instruction in this respect must also be built into the staff induction process. The inspector offered advice to the home’s representative present during the inspection regarding the level of detail needed, and the reasons for this, particularly in relation to adult protection arrangements. Further guidance and information is outlined within the Department of Health’s Summerson House B52 B02 S7424 Summerson House V190906 3 Aug 2005 Stage 4.doc Version 1.40 Page 12 guidelines on ‘physical interventions’. Individual instances where physical interventions are used must also be documented, preferably in a bound book with consecutively numbered pages. Individual instances of challenging behaviour are monitored through the use of ‘ABC’ charts. Staff interact and support service users in a positive and clear manner, and will take the time to identify what service users are trying to express. Service users have a range of dietary needs, which are outlined within their care plans. Staffs’ practice reflects the guidance and risk assessments provided. There is a record kept of the meals planned and provided. Where a service user’s dietary needs have a significant health impact, the input and oversight of medical professionals is in place. Summerson House B52 B02 S7424 Summerson House V190906 3 Aug 2005 Stage 4.doc Version 1.40 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 and 20. Staff help to ensure that the service user’s physical and emotional health needs are met. This can contribute to ensuring fair access to health services and the promotion of general health and welfare. Medication arrangements are appropriate for the needs of service users, and are managed in a safe manner. EVIDENCE: Regular access to primary and secondary health care services, such as GP and psychiatric services, occupational therapy and the dentist, is supported, and medical support is currently available .for a service user with specific dietary needs. Contact with health care professionals is documented within the service users care records. Locked storage has been installed for medications, with internal and external medicines being stored separately. The amount of storage is currently adequate. Printed administration records are kept, and a sample signature list is maintained to identify which staff are responsible for each medication administration. Due to their levels of need, staff assist service users in this area and they have undergone training in relation to medication administration. Audit arrangements do not allow accurate stock checks to be undertaken, and the implementation of clear recording arrangements are a requirement of this report. Summerson House B52 B02 S7424 Summerson House V190906 3 Aug 2005 Stage 4.doc Version 1.40 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 23. Local adult protection procedures have been implemented and instigated to help contribute to the protection of service users from abuse. EVIDENCE: An adult protection referral has emerged from the home over the past twelve months. This further highlighted the need to provide clear guidance for staff on physical interventions, and for this to form part of the induction process. The staff member concerned has been suspended from duty, and staff followed the appropriate procedures. Summerson House B52 B02 S7424 Summerson House V190906 3 Aug 2005 Stage 4.doc Version 1.40 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 standard(s) 24, 25, 26, 28, 29 and 30. Service users benefit from well maintained, homely and clean accommodation. This can help promote a positive image for service users, and ensure they remain comfortable and safe. Service users bedrooms are furnished to a good standard. This can contribute to their comfort during their stay at the home. Aids and adaptations have been provided to promote service users’ independence and safety. Some fire escape routes are not designed to enable easy exit from the building. This may place service users and staff at risk in emergency situations. EVIDENCE: Summerson House is a purpose built bungalow, and provides level access throughout. It is split into two halves, and communal areas consist of a lounge and a separate dining room. Domestic style furnishings and fittings are provided, and adaptations, such as ceiling tracking, a hoist, grab rails and Summerson House B52 B02 S7424 Summerson House V190906 3 Aug 2005 Stage 4.doc Version 1.40 Page 16 adapted baths, have been installed in communal / bathing areas and service users’ own bedrooms. Bedrooms have been decorated and furnished in line with each service users’ personal tastes. All of the bedroom exceed 12 square meters in size, although non have en-suite facilities. A regular, planned cycle of cleaning is implemented. Two fire safety issues need to be addressed (the internal fire door fitted with a ‘baffle’ lock, and the fire exit fitted with multiple locks). Further advice in this respect can be obtained for the Fire Safety Officer from the local Fire Brigade. Summerson House B52 B02 S7424 Summerson House V190906 3 Aug 2005 Stage 4.doc Version 1.40 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 34 and 35. Service users are supported by a large staff team, adequate in numbers to meet service users’ needs. This can help ensure that service users are supported in a safe manner. Recruitment records do not provide evidence that safe recruitment practices are consistently applied. This can allow unsuitable candidates to be employed in the home. Staff have received inconsistent levels of training covering health and safety topics, but not areas relevant to the purpose of the home. A comprehensive range of training can contribute to staffs understanding of service users needs. EVIDENCE: On the day of the inspection there was a minimum of six support staff on duty during the morning and early afternoon, dropping to five during the evening. Two members of staff are available through the night on a waking basis. The team is mixed in terms of gender, age, background and experience. The recruitment records for two recently recruited staff members provided no evidence that the significant gaps in their employment histories were discussed as part of the recruitment process. A written record that these gaps are discussed, represents good practice, and is a recommendation of this report. One of these employees had only one reference on file, and the Care Homes Summerson House B52 B02 S7424 Summerson House V190906 3 Aug 2005 Stage 4.doc Version 1.40 Page 18 Regulations 2001 require that two references are obtained prior to employment starting. Criminal Records Bureau ‘disclosures’ are held centrally by CIC, and are therefore not available for inspection, and must be. A separate inspection of the home will be undertaken to verify that these disclosures have been obtained. Staff receive a range of training relevant to health and safety issues. Training records were not fully developed at the time of the inspection, and need further work if the planning of future training for the staff team is to be undertaken in an effective manner. The training records for four staff indicated that they had received health and safety related training only, and none in relation to care practice, or the specific needs of service users. Summerson House B52 B02 S7424 Summerson House V190906 3 Aug 2005 Stage 4.doc Version 1.40 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 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, 39, 41 and 42. At the time of the inspection, there was inadequate management oversight of the home. This can lead to a lack of direction and supervision of the staff team. Quality assurance arrangements are poorly implemented, which can lead to little self-monitoring, review and improvement. Record keeping arrangements are patchy, and do not adequately safeguard service users interests. The home is generally safe and on the whole free from hazards to service users. EVIDENCE: The prospective manager was on an extended period of absence from the home at the time of this inspection. Periodic oversight was being provided by Summerson House B52 B02 S7424 Summerson House V190906 3 Aug 2005 Stage 4.doc Version 1.40 Page 20 the home’s line manager, and a manager from another home undertook some pre inspection work. There were no acting up arrangements instituted during this period, effectively leaving the home without a manager. An immediate requirement was made to prompt CIC to provide management cover for the home. The implementation of the providers quality assurance system is still to take place in the home and this has been noted in several previous inspection reports. Some internal procedures are used to check the quality of some aspects of the service, such as building and health and safety checks, and the progress and development for service users is outlined within individual care planning processes. The home’s policies and procedures are developed on a corporate basis and reflect good practice guidance in a number of areas. Progress in addressing outstanding requirements and recommendations identified in previous inspection reports is still necessary (see the requirements list below). The absence of the prospective management has resulted in some delays, as has the lack of action by the registered provider, and those acting on his behalf. The last inspection report noted that these items needed to be addressed as a matter of urgency, which remains the case. Gaps remain in the staffing records required under the Care Homes Regulations 2001. The home manager and registered person should refer to schedules 3 and 4 to ensure that all of the records required by regulation are all in place and accessible for inspection. An audit of service users personal allowances remains outstanding. At the time of the inspection, there were no observed hazards or risks to safety, with the exception of: • • The fire safety matters highlighted within an immediate requirements form (namely the use of a “baffle” lock on an escape route, and the use of multiple locks on a fire exit) The lack of evidence of maintenance checks for the bed rails used in the home. The use of bed rails must be kept under review, and advice was provided at the time of the inspection on the need to include maintenance and checking arrangements within the relevant risk assessments. Further guidance is available within the Medical Devises Agency publication, ‘Guidance on the Safe Use of Bed Rails’. The evidencing of bed rail safety checks undertaken by a competent person is a recommendation of this report. The appropriateness of this equipment has been independently assessed by an Occupational Therapist. Summerson House B52 B02 S7424 Summerson House V190906 3 Aug 2005 Stage 4.doc Version 1.40 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 3 x x Standard No 22 23 ENVIRONMENT Score x 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 1 x x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 4 3 x 3 3 3 Standard No 11 12 13 14 15 16 17 x x x x x 2 3 Standard No 31 32 33 34 35 36 Score x x 3 1 2 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Summerson House Score x 3 2 x Standard No 37 38 39 40 41 42 43 Score 1 x 1 x 1 2 x B52 B02 S7424 Summerson House V190906 3 Aug 2005 Stage 4.doc Version 1.40 Page 22 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA7 Regulation 13(6) and 20(1). Requirement The registered person must arrange for a full audit of service users personal allowances, that they have been entitled to and have received, to be undertaken, and for this to be documented and forwarded to the lead inspector for the home. (This is an outstanding requirement. The previous action plan dates for completion were 22/11/04 and 5/8/05) The registered peron must ensure that the decision making and liability arrangements entered into on behalf of service users, in respect of the minibus, are subject to external scrutiny and agreement, and best serve service users financial interests. (This is a new requirement) The registered manager must develop and implement guidance outlining:· the acceptable forms of physical interventions to be deployed in the home, · the types of equipment that are to be used, · the circumstances under which it can be used and · Timescale for action 12/11/05 2. YA7 12(3) and 13(6) 12/12/05 3. YA16 and YA23 13(7) and 13(8) 12/11/05 Summerson House B52 B02 S7424 Summerson House V190906 3 Aug 2005 Stage 4.doc Version 1.40 Page 23 4. YA16, YA23 and YA35. 13(6) 5. YA20 13(2) 6. YA24 and YA42. 23(4)(a) 7. YA37 8(1)(a) and 38(2) the limitations of the interventions. This must also include reference to the arrangements used to record all occasions on which a physical intervention or restraint is employed. (This is an outstanding requirement. The previous action plan dates for completion were 26/6/04, 21/11/04 and 5/5/05) The registered person must integrate training and guidance regarding control and restraint into the staff induction programme. (This is a new requirement). The registered person must ensure that an accurate medication stock control record is maintained. (This is a new requirement). The registered person must ensure that the fire safety issues identified during the previous inspection are dealt with. These include:· · The ‘baffle-lock’ fitted to the fire door between the two bungalows to be replaced by a type approved by the Fire Authority. (This is an outstanding requirement, although it is acknowledged that several other aspects of the requirement have been dealt with. The previous action plan date for completion was 5/5/05). The registered person must ensure that during the managers absence, suitable and sufficient management cover arrangements are put into place. (This is a new requirement.) 12/12/05 12/11/05 10/8/05 10/8/05 Summerson House B52 B02 S7424 Summerson House V190906 3 Aug 2005 Stage 4.doc Version 1.40 Page 24 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. 3. Refer to Standard YA16 and YA23 YA32 YA42 Good Practice Recommendations The registered person should implement the recommendations of the psycologists behavioural management plan for a specific service user. The registered person ensure all care staff receive a minimum of five days paid training per year (pro rata for part time staff). The registered person should include maintenance arrangements for bed rails into the relevant risk assessment, and evidence this within regular health and safety checks. Summerson House B52 B02 S7424 Summerson House V190906 3 Aug 2005 Stage 4.doc Version 1.40 Page 25 Commission for Social Care Inspection Baltic House Port of Tyne, Tyne Dock South Shields NE34 9PT 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 Summerson House B52 B02 S7424 Summerson House V190906 3 Aug 2005 Stage 4.doc Version 1.40 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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