Inspection on 26/02/07 for The Annexe

This inspection was carried out on 26th February 2007.

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 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Annexe 24/09/07

The Annexe 11/09/06

The Annexe 16/11/05

The Annexe 11/11/04

The Annexe 26/04/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 The Annexe 161 Wootton Road Kings Lynn Norfolk PE30 4BU Lead Inspector Mrs Lella Andrews Unannounced Inspection 26th February 2007 09:30 The Annexe DS0000027605.V332169.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address The Annexe DS0000027605.V332169.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Annexe DS0000027605.V332169.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Annexe Address 161 Wootton Road Kings Lynn Norfolk PE30 4BU 01553 673194 01553 674395 onesixone@bt.openworld.com 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) One-Six-One Limited Mr Andrew Orford Care Home 3 Category(ies) of Learning disability (3) registration, with number of places The Annexe DS0000027605.V332169.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 3 people, of either sex, with a Learning Disability, may be accommodated. 11th September 2006 Date of last inspection Brief Description of the Service: The Annexe is a care home providing care to three people with learning disabilities. It is situated within the grounds of One-Six-One another residential care home owned by the proprietors. The Annexe is in a residential area of Kings Lynn, within approximately a mile of the town centre. There are local shops, library and other amenities within the immediate vicinity of the home. The premises consist of accommodation on two floors accessed by the stairs. There is a lounge, kitchen, dining area, utility area, bathroom and one bedroom on the ground floor. Two further bedrooms are located on the first floor in addition to the staff sleep-in room. There is also a patio and garden area. The home provides care for ambulant people who may require consistent support for their behavioural needs. The fees range for current service users from £1263 to £1903. The Annexe DS0000027605.V332169.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report contains information about the Home that has been gathered since the last Inspection which includes a random inspection (Nov 06) and an unannounced visit to the Home by two Inspectors on the 26th February 2007. During the visit the Inspector was shown around the communal areas of the Home, staff, looked at records and spent time discussing issues with the management team. Feedback following the Inspection was provided to the management team at a separate meeting three days after the visit to the Home. The report also includes information gathered from comment cards completed by two of the relatives and a health professional. There were only two clients at Home at the time of the visit and it was not possible to obtain information directly from them due to communication difficulties. The Home next door which is also owned by the company was also inspected at this time. In general, the Home has made improvements in lots of areas since the last key inspection. They have been assisted to do so by the appointment of a consultant. These improvements need to be maintained and further areas of development identified so that the Home continues to improve. What the service does well: The Home provides comfortable accommodation for the clients and has an ongoing redecoration and maintenance programme. The clients are supported to take part in a range of activities and to access local facilities. The care plans contain good information about the clients needs. The clients are offered healthy meals and choices about what they eat. Staff appear to enjoy working with the clients. The Annexe DS0000027605.V332169.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. The Annexe DS0000027605.V332169.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Annexe DS0000027605.V332169.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The Home has appropriate procedures for the assessment and admission of a new client. EVIDENCE: The Home has not admitted any new clients for over a year. The Home has appropriate procedures in place for the assessment and admission of prospective clients. The Annexe DS0000027605.V332169.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. The care plans and risk assessments now contain improved information for staff about how to meet the clients needs. The clients are supported to make their own decisions in range of daily living situations. The Annexe DS0000027605.V332169.R01.S.doc Version 5.2 Page 10 EVIDENCE: A sample of care plans were seen. These have been improved and contain more detailed information about the needs of the clients and how these should be met. They would benefit from further detail about the action staff should take if the use of physical restraint is not successful. Additional risk assessments have also been completed, particular with regard to clients behaviour and the use of physical restraint. These would benefit from being more detailed consideration of the risks of using physical intervention rather than merely the risks of not using it. The care plans and risk assessments need to maintained, reviewed on a regular basis to identify any change in need and updated as necessary. The staff who spoke to the Inspectors were aware of the care plans and new members of staff said that they have discussed these within their induction and been given time to read them. Some of the clients have relatives who are very involved in their care. The relatives comment card states that they feel that they are kept informed of important issues affecting their relative. The staff gave examples of how the clients are offered choices and supported to make their own decisions on a daily basis despite communication difficulties. Staff were seen to offer choice. There are situations in which the clients are not able to make their own decisions or those decisions are not able to be responded to in the way in which they may like. These situations and the reasons for this are starting to be recorded within the care plans which is an improvement. This needs to be continued and further developed. The Annexe DS0000027605.V332169.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16 and 17 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Clients are supported to take part in a range of formal and more informal activities. Clients are supported to maintain contact with relatives. Clients are offered choice with regard to meals and drinks. The Annexe DS0000027605.V332169.R01.S.doc Version 5.2 Page 12 EVIDENCE: One of the clients attends formal day services for three days per week and the staff at the Home support the other two clients during the day. One of the clients used to have a member of staff who supported them to go for long walks during the week but this member of staff has just left. The Manager said that he is trying to replace them but that in the meantime the other staff are supporting the client to go for walks. Discussions with staff and a look at the records show that the clients are supported to access a range of leisure activities such as shopping, meals out, visits to local places of interest. The care plans contain information about how the clients like to spend their days. Concerns had previously been raised to the Commission about the fact that there was often only one member of staff on duty with the three clients in the Home which is not enough to meet the clients needs. Discussions with staff confirm the staffing rotas which show that for the last two months this has not happened. However, due to the fact that one of the clients often needs two staff to support them it is not clear how often clients are able to be supported to take part in activities away from the Home at weekends. The records were not clear enough to review this and neither was the information from the management team so it is recommended that the Manager review this situation to ensure that two staff on duty is enough to meet the needs of the clients at weekends. The Home has several cars which are for staff to use to provide transport for the clients that live at this Home and those who live at the Home next door (also owned by the company). The Home is situated close to local shops, library, pubs and the town centre. The daily routines of the Home are centred around the needs of the clients. For some clients this means that there is a lot of flexibility around when they get up and how they spend their time whilst for others there is less flexibility and staff are aware of the need for adherence to agreed times for routines to take place. The clients are supported to have a holiday if that is what they would like to do. These are arranged in small groups or individually, depending on the individual client. The Proprietors home in Spain has been used for some clients to have a holiday but there have been some concerns about the staffing support at these times and so this practice has stopped. One of the relatives comment cards states that they would like their relative to have a holiday. The Annexe DS0000027605.V332169.R01.S.doc Version 5.2 Page 13 The care plans contain information about the arrangements in place for supporting clients to maintain contact with relatives. The Home has a cook who prepares the main meal at lunchtimes. She is also responsible for ordering and purchasing food as well as preparing menus. Staff said that the clients are always able to have a choice at mealtimes. The kitchen in the Home has a gate which prevents the clients using the kitchen unless accompanied by staff due to the health and safety risks. The Annexe DS0000027605.V332169.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The health and personal care needs of the clients are met. The medication is managed in a safe and effective way. EVIDENCE: The information in the care plans about the health and personal care needs of the clients has improved. This needs to be maintained and regularly reviewed and updated as necessary. The care plans show that the clients are supported to attend appointments for general health care such as GP, dentist and optician as well as more specialised health care such as psychiatrists. The health professional who completed a comment card visits one of the clients with regard to a specific health need. Their comment card indicates that the staff work well with them, that they meet the needs of the client in this respect and that guidance is incorporated into the care plan. The Annexe DS0000027605.V332169.R01.S.doc Version 5.2 Page 15 There are always male and female staff on duty so that clients are able to be supported with personal care by staff of the same gender. This is an improvement on previous situations when there was not always a female member of staff to support female clients with personal care. The support that the clients need varies. The medication system was inspected. An additional communication book is kept for staff to record any changes to medication. This is good practice and enables staff to keep up to date more easily. Appropriate records are kept and the staff understand the procedures for managing medication safely. The Annexe DS0000027605.V332169.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is poor This judgement has been made using available evidence including a visit to this service. Relatives and clients said that they are aware of who to complain to. Procedures relating to the clients money have improved. The staff have attended training with regard to Safeguarding Adults and so have a better understanding of abuse and when to report concerns. EVIDENCE: The relatives comment cards both state that they are aware of the complaints procedure and that the staff do listen if they raise any concerns. The Manager sent a copy of the procedure to all relatives following the last inspection. It is difficult to see how two of the clients could effectively make a complaint due to the their communication difficulties. A concern was recently raised with the Commission by a relative about clothing and expenditure made on behalf of a client. The Manager will be addressing this situation directly with the relative concerned. The Annexe DS0000027605.V332169.R01.S.doc Version 5.2 Page 17 The Manager said that all staff have recently attended Safeguarding Adults training. New staff said that they had received this training within their induction. The staff who spoke to the Inspectors were clear about their responsibility to report concerns and aware of the whistle blowing policy. All of the staff, except for one, has attended training with regard to the use of physical interventions/restraint. The one member of staff works with one of the clients with whom restraint is used on a regular basis and so it is required that they attend the relevant training. The care plans are now clearer about the use of physical interventions with clients and about their individual behaviour and the need to try alternative ways of supporting them before any physical intervention is used. It is recommended, however, that the planning for the use of physical interventions is a multi agency approach eg. Involving social workers etc, and that the care plans reflect this. Following the last key inspection the requirements made about the need for improved policies relating to the looking after of clients money and of the additional charges that the clients are liable for have been met. The care plans include a financial care plan including details of how the clients money is looked after and how they are supported to make purchases. The team meeting minutes show that issues relating to the correct procedure for looking after clients money have been discussed with the staff. A sample of financial records were seen and these show improvements since the last key inspection. However, it was noted that receipts for expenditure on behalf of one of the clients living at the other Home actually included expenditure for staff beverages and also household items. The Manager said that he would address this immediately and reimburse the client. This took place several months ago and it is required that the Manager ensures that this situation is reviewed for all clients to ensure that they have not been paid for items they are not responsible for. In 2006 an allegation of abuse was made by one of the clients who lives at the other Home owned by the company, situated next door to this Home. The Criminal Prosecution Service decided against prosecution and the Commission are currently in the process of undertaking their own investigation and considering appropriate enforcement action to take, if any. A selection of staff files were seen during the visit and it was noted that there is a high level of staff (at least 6) employed with criminal records. The convictions are varied and the length of time elapsed also varies. The Manager said that he discusses the situation with staff prior to employing them and does consider the risks associated with employment. There is an appropriate procedure with regard to this situation. The Annexe DS0000027605.V332169.R01.S.doc Version 5.2 Page 18 However, there are no records of the detail of these discussions taking place and the seriousness of some of the convictions are of concern to the Commission. It is required that a record is kept of the discussions with staff and that an effective risk assessment is carried out prior to appointing a member of staff who has criminal convictions. The Annexe DS0000027605.V332169.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The Home provides a good standard of accommodation for the clients. EVIDENCE: The Home is attractively decorated and furnished. The Directors of the company have a maintenance and redecoration plan and work is continually carried out to improve the standard of the accommodation. The communal areas of the Home are fairly bare without ornaments or other items but this is due to the needs of the clients. The Annexe DS0000027605.V332169.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 and 36 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The standard and effectiveness of the staff induction and training has greatly improved so that staff feel more confident and able to undertake their roles more effectively. Improvements needs to be made to the recruitment system so as to provide better protection to the clients. Staff feel that the appointment of a senior member of staff has improved communication between them and the management team. EVIDENCE: The Home has greatly improved the induction and training provided to staff. Several new staff were recruited in January 2007 and those that spoke to the Inspectors said that they have received effective induction and support since starting work. The company has employed a consultant who is currently providing the induction and some ongoing training. The Annexe DS0000027605.V332169.R01.S.doc Version 5.2 Page 21 The Manager provided information which states that two staff have completed NVQ Level 2 and that two staff have enrolled for Level 2 and two for Level 3. Staff have received training in a range of mandatory subjects recently and said that they have enjoyed it and that it has been relevant to their role. As previously mentioned there is one member of staff who has yet to attend training with regard to the use of physical interventions. Staff also said that they are receiving regular supervision and have recently had appraisals. New members of staff said that they feel well supported by the staff team and that there is always more experienced staff on duty who they can go to for assistance if needed. Regular staff meetings have started to take place which enables the staff to discuss relevant issues and to ask questions. A senior support worker has been appointed for the staff team. Staff and the Manager said that this has improved communication between the management team and the care staff as well as ensuring that someone working in the Home is responsible for monitoring situations within the Home. One of the relatives comment cards states that staff have the right skills and experience, and the other states that they feel unable to comment on this. The health professionals comment card states that the staff have the right skills and experience and that staff communicate well with them. Observations of staff show that staff speak kindly and respectfully to the clients and that they genuinely appear to enjoy supporting the clients. The staffing rotas were seen and these are now, in general, accurate and so this requirement has been met. The Manager needs to remember to record his hours on the duty rota when he is working directly with clients as part of the staffing rota. The Home has recruitment procedures and, in general, these are effective. However, the Commission has concerns about the issue of employing staff with criminal records, (see previously in this report) and also one of the files sampled only had one reference. It is required that the information listed in Schedule Two is kept for all members of staff. The Annexe DS0000027605.V332169.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. There have been improvements to the management of the Home so that staff now feel that they are more involved and kept better informed about issues affecting the Home. The Home has completed its first quality assurance report and so have started to consider more effectively the quality of the service that they provide Staff are receiving more regular and appropriate training with regard to health and safety issues. The Annexe DS0000027605.V332169.R01.S.doc Version 5.2 Page 23 EVIDENCE: The company has three Directors, one of whom is the Registered Manager of the Home. The other two Directors have very little, if any, direct involvement with the clients at the Home. Since the last key inspection the company have appointed the services of a consultant to assist with making improvements to the service provided at the Home. The Home has a deputy manager but both she and the Manager spend little time at this Home and the majority of their time in the larger Home next door although staff said that they do call into the Home most days. The company has an office close by where the Manager spends some of his time. The Manager has not yet completed NVQ Level 4. Improvements have been made to the management style within the Home with staff feeling that they are included more in decision making and are kept better informed about what is happening within the Home. They said that the on call system is effective and that there is always someone available for support and advice. Monthly visits are being carried out by the consultant and reports sent to the Commission as per Regulation 26. The Home have recently carried out their own internal quality assurance process which involved sending questionnaires to clients, relatives and visiting professionals. The results of this have been collated into a report. This methods of continually reviewing the service that they are providing is positive and a process which should enable the management team to plan for further improvements. A selection of health and safety records were seen at the random inspection in November 2006 and found to be up to date so these were not seen again at this visit. Training records show that staff have attended, or are booked to attend, training in a range of health and safety issues such as Food Hygiene, Moving and Handling, Fire Safety and Health and Safety. There are still some concerns about the health and safety of the clients and these are detailed previously in this report. The Annexe DS0000027605.V332169.R01.S.doc Version 5.2 Page 24 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 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 1 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 1 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X X 2 3 X X 3 X The Annexe DS0000027605.V332169.R01.S.doc Version 5.2 Page 25 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 YA23 Regulation 13 (6) Requirement It is required that the Manager reviews all of the clients financial records to ensure that they have not paid for items that they are not responsible for. It is required that effective risk assessment is carried out with regard to employing staff who have criminal convictions and that a written record is kept of this. It is required that the information listed in Schedule Two of the Care Homes Regulations is kept for all staff. Timescale for action 30/04/07 2 YA34 13 (6) 20/03/07 3 YA34 19 26/02/07 The Annexe DS0000027605.V332169.R01.S.doc Version 5.2 Page 26 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 YA20 YA23 YA14 Good Practice Recommendations It is recommended that a record is kept of staff being supervised to administer medication as part of their induction records It is recommended that the care plans contain evidence of multi agency discussions and agreement about the use of physical interventions It is recommended that the Manager ensures that the staffing levels at weekends are sufficient to enable clients to go out if they wish to. The Annexe DS0000027605.V332169.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI The Annexe DS0000027605.V332169.R01.S.doc Version 5.2 Page 28 - 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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