Inspection on 30/06/05 for Tavistock Square (17)

This inspection was carried out on 30th June 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Tavistock Square (17) 18/11/08

Tavistock Square (17) 09/01/08

Tavistock Square (17) 07/12/06

Tavistock Square (17) 23/11/05

Tavistock Square (17) 25/01/05

Tavistock Square (17) 02/08/04

Tavistock Square (17) 17/03/04

Similar services:

22 Sandown Road

The Highlands

Dilston College Of Further Education

West View House

Prince Bishop Court

Park View (15)

Craigmore House

1 Lanark Close

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

CARE HOME ADULTS 18-65 Tavistock Square 17 Tavistock Square Silksworth Sunderland SR3 1DZ Lead Inspector Andrea Goodall Unannounced 30 June 2005 at 10.00 am 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. Tavistock Square B52-B02 S15736 Tavistock Square V217668 300606 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Tavistock Square Address 17 Tavistock Square Silksworth Sunderland SR3 1DZ 0191 5238250 0191 5239724 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) Northgate & Prudhoe NHS Trust Mrs Maria Jane Rennoldson Care Home 6 Category(ies) of LD Learning Disability (6) registration, with number of places Tavistock Square B52-B02 S15736 Tavistock Square V217668 300606 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 25 January 2005 Brief Description of the Service: The home at 17 Tavistock Square provides accommodation for 6 people with a learning disability, one of whom also has physical disabilities and uses a wheelchair. The home is a modern, purpose-built bungalow with level access at the 2 front entrances and good access around all areas for people with physical disabilities. It is sited in a cul-de-sac of similar modern housing and is set back with a large driveway and large back garden. The home provides personal care and is owned and operated by Northgate & Prudhoe NHS Trust. The bungalow provides 6 good-sized bedrooms, 2 lounges, 2 dining rooms, 2 bathrooms and an activities room.The home is within easy walking distance of various local shops, clubs, health centre and a church. It is also a short drive from main supermarkets and leisure clubs. Tavistock Square B52-B02 S15736 Tavistock Square V217668 300606 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over one day in June 2005. Most of the people who live here were either out on a day trip or were about to go out on a picnic, so only a short time could be spent with them. Residents find it very difficult to express their views due their disabilities, but a couple of people showed the Inspector their newly decorated bedrooms, and some time was spent observing staff interaction with residents. Some time was also spent with staff on duty discussing the progress of the service. The Inspector looked at a sample of care records, activity programmes, medication systems, and health & safety records. Most of the homes premises were examined. There have been no complaints received about the service since the last inspection. In keeping with the homes records, throughout the rest of this report the people who live here will be referred to as residents, and the Owner of the home (Northgate & Prudhoe NHS Trust) will be referred to as the Trust. What the service does well: The bungalow is very well decorated and furnished. It is a bright, comfortable and modern place for the residents to live. It is spacious and has lots of lounges and sitting areas for the people who live here to choose from. It also has good access for the person who has a physical disability. Residents have chosen their own colour schemes for their bedrooms so they are all different and individual. People here know that they can spend time in their own room whenever they want. Staff support residents to be included in choosing new furniture and pictures for their home. Staff understand the different needs of the residents and know how to support them in the right way. Staff keep care records that show what residents can manage themselves and exactly how to help them with the things that they cant manage. Staff said that it is a good home to work at and that the residents are the most important people here. There have been no staff changes since the last inspection. Tavistock Square B52-B02 S15736 Tavistock Square V217668 300606 Stage 4.doc Version 1.30 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. Tavistock Square B52-B02 S15736 Tavistock Square V217668 300606 Stage 4.doc Version 1.30 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 Tavistock Square B52-B02 S15736 Tavistock Square V217668 300606 Stage 4.doc Version 1.30 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 & 5. Prospective residents needs are assessed by appropriate professionals to ensure that the home can meet those needs. Each resident has a statement of the terms and conditions with the home, but should have support from independent representatives when signing up to these. EVIDENCE: Before anyone moves to this home a full assessment of their needs is carried out to make sure that the service is suitable for them. Since the last inspection one new resident has moved into the bungalow. Detailed assessment documents are stored in their care file that show how it was decided that the new residents needs could be met at the home. The people involved in the assessment included health professionals from the Trust, Social Workers, Tavistock staff, the prospective resident and their representatives. In this way, everyone involved in the residents care could help to decide if the service at Tavistock was right for that person. All the people who live here have been given a Residents Agreement which states the terms and conditions of their residence here. Some of this information is in pictorial form but due to the severity of their disabilities, the people who live here cannot fully understand the Residents Agreement. Some residents have signed the document, but there is no indication that their representatives have seen the document to know the terms of the service. Tavistock Square B52-B02 S15736 Tavistock Square V217668 300606 Stage 4.doc Version 1.30 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, 7 & 10. Clear support planning systems ensure that staff work consistently in support of residents individual goals and needs. Residents are encouraged to make everyday decisions about their lifestyle. Residents do not have information in a suitable format about their right to access their own records. EVIDENCE: Support plans are in place for 5 of the people who live here. These provide staff with very good information about peoples individual specific needs and show exactly how staff should support them. Review intervals are set (usually 3 or 6months) to show the progress for each long-term goal. For a small number of goals, reviews had not been recorded at the set timescale so it was difficult to know what progress residents had made in these areas. Support plans have not been signed by residents or their representatives, and there is no written record to demonstrate how residents have been included in drawing up their plans. The plans are written in plain language but the residents have severe learning disabilities and there are no pictorial clues in the plans to help residents understand them. Residents care files also contain detailed daily records and a monthly summary of each residents well being in terms of health, activities, behaviour Tavistock Square B52-B02 S15736 Tavistock Square V217668 300606 Stage 4.doc Version 1.30 Page 10 and relationships. In this way, shorter-term goals can be set and monitored by staff e.g. support to arrange holidays. Daily living skills assessments are still being carried out with the new resident, and this will help to decide on a plan of how best to support them with their goals and needs. The assessment documents are very informative but are not dated and this would make it difficult to refer back to at future reviews. The residents are encouraged by staff to make their own choices wherever their capabilities allow. Residents make menu choices, choose what to wear each day, decide where to go on their holidays, and all have chosen their own colour schemes in their bedroom. These decisions are recorded within the daily and monthly records so it can be seen what people have chosen to do. The Trust has an Access to Information Policy, but this is still not available to residents in a suitable format that they could understand. As a result residents do not have information about their rights to access their own records. Tavistock Square B52-B02 S15736 Tavistock Square V217668 300606 Stage 4.doc Version 1.30 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) 12, 15 & 17. Residents have good opportunities to take part in a range of activities. Residents who have relatives are supported to keep in contact with their families, but some people do not have independent representatives. Residents are offered a varied, nutritional diet and enjoy their meals. EVIDENCE: Since the last inspection an Enabler has been appointed whose specific role is to help residents access community-based activities. Staff stated that since then there have been much improved opportunities for residents to try different activities. Residents care records indicated that people are offered a range of activities everyday, and these have included swimming, canoeing, horse riding, cinema and day trips. Also the some of the homes budgets have been combined and this has led to more money being available for activities that have a charge. For one resident, activities are a particularly important goal and this is reflected in their support plan. The staff and Enabler make sure that this person gets plenty of chances to try different activities. Staff are developing a photoboard of this persons activities programme so that he can see what activities he will be doing. For another resident social and leisure events can be Tavistock Square B52-B02 S15736 Tavistock Square V217668 300606 Stage 4.doc Version 1.30 Page 12 distressing so staff support this person with activities that dont involve busy places. Two people have frequent contact with relatives and go to the family home for holiday breaks. Two people have only occasional telephone contact with distant relatives, and 2 people have no relatives. There are no advocacy services involved with residents at this home, so some people have no independent representation. Staff stated that menus are designed around the known likes and dislikes of the people who live here, and are used as a shopping list rather than for rigidly set meals. Meal choices include healthy, varied and nutritional foods. Residents can choose what they want for breakfast everyday and all the residents enjoy occasional meals out where they can choose from restaurant or pub menus. Staff stated that only one resident enjoys going grocery shopping at supermarkets with staff, although other residents do use local shops for sweets and snack foods. There are 2 dining rooms, one on either side of the kitchen, so that residents can sit in small groups and be supported by staff at mealtimes. Three people can make their own drinks but must be supervised at all times in the kitchen due to their behavioural needs. None of the residents are able to be involved in preparing meals due to their disabilities, and the kitchen is kept locked at times when it is not being used to support the safety of the people who live here. There are appropriate risk assessment records in place about this restriction. Tavistock Square B52-B02 S15736 Tavistock Square V217668 300606 Stage 4.doc Version 1.30 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 & 20. Residents physical and health care needs are met. The homes procedures for dealing with residents medication are suitable and meet the needs of the residents, but records of medication received are not sufficiently completed. EVIDENCE: Residents have access to all relevant health care services in the community, such as GP, opticians and dentists so that their general health care needs are met. Some residents also have input from specialist healthcare services for their individual health needs. One person has a severe physical disability and is visited by an Occupational Therapist to make sure that he has adaptations and equipment to meet his needs. He has recently received a new electric wheelchair and a new shower chair. Staff support this person to transfer to alternative seating to relieve any pressure areas, and there are clear guidelines in place so that staff know how to move and assist this person. A Speech and Language Therapist is involved with another resident and this helps staff to support this persons language skills. Another person has specialist health care input for their swallowing problems and this helps staff to know how to support this person when eating. Tavistock Square B52-B02 S15736 Tavistock Square V217668 300606 Stage 4.doc Version 1.30 Page 14 At this time none of the residents have been assessed as capable of managing their own medication. Medication is supplied to the home from a pharmacist in a blister pack Monitored Dosage System. Medication is securely stored in a suitable metal medication cabinet. Records of incoming medication were not completed for several medications that had been recently prescribed; and the required code had not been used to gaps in the medication administration records where a resident had been away from the home. Tavistock Square B52-B02 S15736 Tavistock Square V217668 300606 Stage 4.doc Version 1.30 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 23. The homes procedures and staff training ensure that residents are protected from abuse. EVIDENCE: As with all homes for adults in the City of Sunderland, the home has adopted the MAPPVA (Multi-Agency Panel for the Protection of Vulnerable Adults) policy and procedures. These are robust procedures for responding to suspected abuse. The Manager and the majority of staff have had training in the MAPPVA Alerter procedures so that they know what to do if they suspected any abuse or neglect of the residents or of any other vulnerable people. Staff are clear about their responsibilities in this area. Some people do need verbal support and supervision to manage their behavioural needs. Staff have had some training in breakaway and diversionary techniques. Staff do not carry out physical interventions to support residents behavioural needs. Tavistock Square B52-B02 S15736 Tavistock Square V217668 300606 Stage 4.doc Version 1.30 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 26 & 30. The home provides a safe, comfortable, accessible place for people to live. Residents bedrooms promote their independence, individuality and choice but do not protect their privacy. The home is clean and hygienic. EVIDENCE: There have been significant and much-needed improvements to the quality of decoration and furnishings within the home over the past couple of years, and the home now offers a very good standard of accommodation for the people who live here. The home is modern, bright, well furnished, contemporary and cheerful. The bungalow is well maintained and is accessible for residents or visitors with a physical disability. The residents bedrooms are being redecorated to individual tastes, so residents have been fully involved in choosing their own colour schemes. Residents can use their bedrooms for privacy and for hobbies whenever they wish. Currently, none of the people who live here have been assessed as Tavistock Square B52-B02 S15736 Tavistock Square V217668 300606 Stage 4.doc Version 1.30 Page 17 capable of keeping their own key for their bedroom door, so they need staff support to keep their doors closed when appropriate. However all bedroom doors were propped open during this visit even though 4 residents were out for the day, so their bedrooms and personal possession were not being kept private for them. Staff carry out daily household tasks in support of the residents. They encourage and help residents with their domestic skills, but most residents choose not to be involved in cleaning. Those areas of the home that were examined were very clean and tidy. The home has a well-equipped utility room where staff support residents with washing clothes. In one of the bathrooms there was an open box of latex gloves left out, which does not protect the dignity of the residents, and the contents could become contaminated. Tavistock Square B52-B02 S15736 Tavistock Square V217668 300606 Stage 4.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32 & 33. Residents are supported by competent, qualified staff. There are sufficient staff on duty to meet the needs of the people who live here. EVIDENCE: The staff team consists of the Manager, Assistant Home Leader, 11 Support staff and one Enabler. There is a good mix of age and experience in the staff team. Also there are 6 male staff (including the Enabler) and this is a helpful gender balance for the support of the 4 men who live here. There are 2 vacant support posts and these hours are being covered by existing staff team to ensure the continuity of care of the people who live here. Of the 11 support staff, 9 have completed NVQ 2 and 2 support staff are about to commence training towards this qualification, and this demonstrates that staff are competent and skilled in their roles. It was very clear from discussions with staff that they understand residents individuality, capabilities and needs. The minimum staffing provided at Tavistock Square is 3 support staff on duty from 8am-8pm, and 2 night–time staff (one of whom is on waking duty). However staff are flexible and will provide extra time to help residents go to special events. For example on the evening of this visit some staff were Tavistock Square B52-B02 S15736 Tavistock Square V217668 300606 Stage 4.doc Version 1.30 Page 19 working until 9.30pm to support some residents who wanted to go to an evening social club. Also there is now an Enabler staff on duty for 5 days per week so there are more opportunities for residents to have 1:1 support with their individually preferred activities. Tavistock Square B52-B02 S15736 Tavistock Square V217668 300606 Stage 4.doc Version 1.30 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 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) 39 & 42. Residents benefit from a well run service. Residents views have yet to be gained to review the development of the service. Staff training and home procedures promote the safety and welfare of the people who live here, but some practices do not fully ensure fire safety. EVIDENCE: The Manager has been a Registered Manager at small homes operated by Northgate & Prudhoe NHS Trust for several years. She is a registered nurse and has many years experience of working with people with a learning disability in both nursing and community settings. She is engaged in further training in management, which will support her in her role. There are clear lines of accountability and management support within the organisation. In this way the residents, and staff, benefit from a well managed service. Tavistock Square B52-B02 S15736 Tavistock Square V217668 300606 Stage 4.doc Version 1.30 Page 21 The Trust has a quality assurance system (Total Quality Management) to monitor and review the services it provides, including the home at Tavistock Square. The Trust wants to include residents views in reviewing the home, so has designed a questionnaire that uses pictures and easy language to support the communication needs of the people who live here. The questionnaires have not yet been used and most people will need help from independent advocates in order to complete the questionnaires. Staff receive mandatory training in health & safety matters on an annual basis through the Trust. Staff carry out sleep-in duties overnight and in-house fire instruction is carried out every 3 months. However the instruction records do not currently include all members of staff, so it cannot be demonstrated that they receive the instruction at the correct intervals. All bedroom doors were propped open during this visit. Most bedroom doors are fitted with electronic holding devices that would close the door in the event of a fire. However one bedroom door is not fitted with such a device and was propped open with a piece of bedroom furniture. This practice presents a fire safety hazard. Tavistock Square B52-B02 S15736 Tavistock Square V217668 300606 Stage 4.doc Version 1.30 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x x 2 Standard No 22 23 ENVIRONMENT Score x 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x x 2 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x 2 x x x 3 Standard No 11 12 13 14 15 16 17 x 3 x x 2 x 3 Standard No 31 32 33 34 35 36 Score x 3 3 x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Tavistock Square Score x 3 2 x Standard No 37 38 39 40 41 42 43 Score 3 x 3 x x 2 x B52-B02 S15736 Tavistock Square V217668 300606 Stage 4.doc Version 1.30 Page 23 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 7 Regulation 15 Requirement Support plans should include written details of how the resident is involved and included in their care planning, or the reasons why this is not possible. Residents must have information in a suitable format about how they can access all their own records maintained by the home. Medication records must include details of any incoming medication, the date and quantity received; and the appropriate code must be used to denote why a resident has not received medication. Latex gloves and other personal care equipment must be safely and discreetly stored to prevent possible contamination and to uphold the dignity of the residents. In-house fire training records must include all members of staff. Previous requirementtimescale of 1.4.05 not met. Bedroom doors must not be propped open with furniture, as this could present a fire safety risk. Timescale for action 1.10.05 2. 10 17 1.9.05 3. 20 13(2) 1.8.05 4. 30 13(3) 1.8.05 5. 42 23(4)d 1.8.05 6. 42 23(4)a 1.8.05 Tavistock Square B52-B02 S15736 Tavistock Square V217668 300606 Stage 4.doc Version 1.30 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 5 7 26 Good Practice Recommendations Residents should be supported by relatives, advocates or representatives when signing the Residents Agreement. Daily living skills assessment records should be dated for future reference. Staff should support the residents to keep their bedroom doors closed when they are out of the home in order to safeguard their private space and possessions. Tavistock Square B52-B02 S15736 Tavistock Square V217668 300606 Stage 4.doc Version 1.30 Page 25 Commission for Social Care Inspection Baltic House Port of Tyne South Shields Tyne and Wear 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 Tavistock Square B52-B02 S15736 Tavistock Square V217668 300606 Stage 4.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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