Inspection on 12/04/07 for The Avenue

This inspection was carried out on 12th April 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

The Avenue 16/02/06

The Avenue 22/06/05

The Avenue 15/12/04

The Avenue 03/06/04

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 The Avenue 72 Bates Avenue Cockerton Darlington County Durham DL3 0TU Lead Inspector Rachel Dean Unannounced Inspection 12th April 2007 11:00 The Avenue DS0000000783.V335588.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 Avenue DS0000000783.V335588.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 Avenue DS0000000783.V335588.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Avenue Address 72 Bates Avenue Cockerton Darlington County Durham DL3 0TU 01325 240452 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) john.leitch@tesco.net Mr John Michael Leitch Miss Sharon Elizabeth Keelan Miss Sharon Elizabeth Keelan Care Home 3 Category(ies) of Learning disability (3) registration, with number of places The Avenue DS0000000783.V335588.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16th February 2006 Brief Description of the Service: The Avenue is a small care home that provides personal care and accommodation for three adults who have learning disabilities. The Avenue is privately owned and is run by Mr. John Leitch & Ms. Sharon Keelan. The home is a semi-detached property that is located in the Cockerton district of Darlington. Each person living at the home has their own spacious bedroom and shares a communal bathroom, with a toilet, hand basin, bath and shower cubicle. Communal space in the house includes a large combined lounge and dining room, and a kitchen diner. There is off-street car parking in front of the property and a small courtyard garden at the back. The smallest bedroom upstairs is used as a staff office and out buildings provide storage and laundry facilities. At the time of this inspection the homes fees ranged from £404 to £612 per week. Items not covered by these fees include hairdressing, personal toiletries and additional holidays. Up to date information about fees should be sought from the home’s manager. The Avenue DS0000000783.V335588.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection of The Avenue that took place on 12th April 2007. The inspection focused on all of the key outcome areas for service users. During this inspection the inspector met two of the people living in the home. Unfortunately the third person living at The Avenue was in hospital at the time, so couldn’t meet the inspector. A selection of staff, relatives and professionals involved with the home were sent survey forms and invited to give their views as part of the inspection. This was important because the people living at the home can’t all communicate their views very easily. A number of records kept by the home were also inspected and the inspector made observations while she was in the home. Discussions were had with the manager throughout the inspection. What the service does well: The Avenue has provided care for the three people who live there for approximately thirteen years. Everyone has their own plan and record of the care they need. People were happy with the level of care and support provided at The Avenue. Comments made during the inspection included ‘excellent standard of care provided towards (name of person removed for confidentiality) at all times’, ‘always nicely dressed and well looked after’ and ‘every aspect of care – high quality, excellent care provider’. The Avenue provides a flexible lifestyle for the people who live there. People attend day centres and activities outside of the home according to their own wishes and abilities. Relationships with relatives and friends are also encouraged. Comments included ‘(my relative) has never had it so good, out and about shopping etc, meeting other people and socialising, (my relative) can go wherever she wants to, staff always support her in anything she chooses to do’, ‘ I visit on a weekly basis to see (my relative), this is always promoted, I always feel welcomed, the staff are very friendly towards me’ and ‘I am always informed with regard to any important issues…communication between both the home and myself is excellent, I have a very good relationship with staff’. The home itself is decorated comfortably and is a nice and homely place for people to live. Comments made by people who visit the home included ‘home is always very clean and tidy’. The staff who work at The Avenue have all worked there for some time. They were recruited safely and have been provided with training to help them do their jobs well. Staffing is provided in a flexible way to meet the needs of the people living in the home. Comments made about the staff working at The The Avenue DS0000000783.V335588.R01.S.doc Version 5.2 Page 6 Avenue included ‘excellent skills, staff are very confident and committed to their work as I observe regularly when I visit’ and ‘staff are excellent towards clients and myself’. The home is managed well, by an experienced and well qualified manager. Regular checks are undertaken to make sure that the home is safe and a yearly survey is undertaken. This survey gathers the views of the people living in the home, their relatives and the professionals who work with them. 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 Avenue DS0000000783.V335588.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 Avenue DS0000000783.V335588.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&5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people who live in the home were assessed before admission and were admitted to the home in an appropriate way. People have written contracts, although these should be reviewed to make sure they contain all of the information that they should. EVIDENCE: The Avenue currently has three people living there. These three people have lived at the home since it was set up approximately thirteen years ago. There are no plans for these people to leave or for anyone else to be admitted. The three current residents were admitted appropriately when the home was opened, with their needs being assessed and the home being set up accordingly. Each person at The Avenue does have in place a written contract, which has been shared with the people themselves, or relatives and care managers where people are unable to understand them. However, the contracts would benefit from being reviewed, due to recent changes in the information that must now be included in such contracts. This was discussed with the manager The Avenue DS0000000783.V335588.R01.S.doc Version 5.2 Page 9 during the inspection and the manager agreed that the contracts would be reviewed as soon as possible. The Avenue DS0000000783.V335588.R01.S.doc Version 5.2 Page 10 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 & 9 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. All of the people who live at the Avenue have their own care plan and staff support them to make decisions about their own lives. The people living in the home are supported to have as independent a lifestyle as possible, according to their individual wishes and abilities. EVIDENCE: During this inspection a selection of the care records that are kept by the home were inspected. Each person living in the home has their own care plan, which is well organised and includes information about their needs and preferred routines of daily living. Risk assessments were also in place. The records included regular monthly reviews and daily and monthly reports. Two of the people living in the home had chosen to complete a person centred plan. These were inspected and found to contain detailed information about each person’s wishes and feelings, including photographs and information about their aspirations for the future. One person had not wished to contribute to a The Avenue DS0000000783.V335588.R01.S.doc Version 5.2 Page 11 person centred plan and their social worker had confirmed that this was the person’s choice in their records. Discussions with the home’s staff and observations made during the inspection indicated that the home is run around the individual wishes of the three people who live there. Staff are put on duty according to the needs of the residents and the activities they are taking part in. For example, when they are going out in the evening staff are put on duty until the activity finishes, rather that the service user having to come home at the time staff shifts change over. The home had in place good risk assessment and management systems to help identify what support people needed to live a fulfilling life and to help them achieve their goals. The home’s approach was very person centred, with goals identified according to each individual’s own personal abilities and wishes. For example one person loves animals and the home had helped him have guinea pigs and gold fish as pets, and helped him adopt a dog at a local animal sanctuary that he visits and takes for walks. Other good examples of this were available, including how the home sensitively helped one of the people living in the home to manage a complex health issue and were supporting another to safely make their own cup of tea. The Avenue DS0000000783.V335588.R01.S.doc Version 5.2 Page 12 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, 12, 15, 16 & 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home supports the people who live there to be part of the local community, to develop friendships and relationships, and to do activities and develop skills. The homes menus take into account the needs and preferences of the people living in the home and is flexible to accommodate their lifestyles. EVIDENCE: All of the people living at The Avenue have day centre placements or arrangements for social stimulation that have been arranged by the local authority and are part of their care plan. These placements provide access to training courses for those people who want and are able to do them. They also provide opportunities for suitable social activity, one to one staff support and work placements where these are appropriate. Comments made by people who are relatives or professionals working with people living in the home included ‘(my relative) has never had it so good, out and about shopping etc, The Avenue DS0000000783.V335588.R01.S.doc Version 5.2 Page 13 meeting other people and socialising, (my relative) can go wherever she wants to, staff always support her in anything she chooses to do’. The staff working in the home help the people living there to use local community resources as much as possible. All of the residents enjoy an active social life, including use of public transport, leisure centres, pubs, parks, football matches, beauty therapy and at least two holidays a year away from the home. These holidays are taken either together or individually depending on what they want to do and where they want to go. One of the people living in the home was able to show the inspector photos of the outings and holidays that they had been on and to tell her about their next holiday to a caravan park near Scarborough. The home encourages the involvement of family and friends and often has the friends and family of residents visiting the home. Where no family are involved the home encourages regular visits from the person’s social worker. The people living at the home have a busy social life and often have friends calling for visits and meals, meeting up to go on outings together, visiting each other for parties or simply socialising together. Comments included ‘ I visit on a weekly basis to see (my relative), this is always promoted, I always feel welcomed, the staff are very friendly towards me’ and ‘ I am always informed with regard to any important issues…communication between both the home and myself is excellent, I have a very good relationship with staff’. During the inspection discussions with staff, care records and observations showed that the people living in the home are encouraged to join in with tasks such as making drinks and other domestic arrangements. For example, one person has two guinea pigs which staff help and support him to look after. The people living in the home are also encouraged to join in with household tasks, such as being present and helping as much as possible when their bedrooms are tidied. The home has two pleasant dining areas, one located in the kitchen and a more formal one located in the large lounge/dining room. All of the staff employed at the home have completed food hygiene training. Menus are drawn up on a weekly basis, but because of the service users busy lifestyles these are used as a flexible guide. The menus are frequently changed to accommodate what people want and the outings that they are involved in, which often include eating out. The people living in the home are encouraged by staff to help and participate in the preparation of meals as much as their personal abilities allow. For example, from putting their plate away, helping make a drink or prepare food, to cooking simple meals with staff supervision. Records of what each service user has eaten for breakfast, lunch and dinner on each day are available. Comments made about the food included ‘ meal times are always well prepared and the food is delicious, there is always a good choice, there is always a nice atmosphere’. The Avenue DS0000000783.V335588.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 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Each person receives individual support and care, which meets their physical and emotional needs. Staff help people to take their medication safely and in accordance with their doctors instructions. EVIDENCE: All three of the people living at the home need help with their personal care. Discussions with the home’s manager, staff and observations of the way staff interacted with the service users showed that assistance is provided in sensitive and caring ways. All of the people living in the home appeared to be clean, nicely and appropriately dressed and appeared comfortable in their surroundings. Good information about each person’s personal care needs was available in their individual care plans and records. There was also evidence of special equipment, such as equipment to help people eat independently, being used. There was evidence of the involvement of other professionals, like occupational therapists and physiotherapists, where this was appropriate. Comments made by relatives or professionals working with the people who live in the home included ‘ excellent standard of care provided towards (name of The Avenue DS0000000783.V335588.R01.S.doc Version 5.2 Page 15 person removed for confidentiality) at all times’, ‘always nicely dressed and well looked after’ and ‘every aspect of care – high quality, excellent care provider’. Each of the people living at The Avenue is registered with their own doctor and the home uses two different doctor’s practices. The residents are also registered with opticians and dentists, with each person being registered with the service that is most appropriate for them depending on their past experience or needs. Records were available of all appointments and health checks. One person was in hospital at time of this inspection and the home was providing a staff member during the day, to stay with the person while they were in hospital. The manager saw the provision of this company and support as very important and in the best interests of the person in hospital. Only two of the people living in the home were on medication at the time of this inspection and both needed fully support with this. Medication was being appropriately stored in a lockable metal cupboard and records were available of all the medication that was taken. All of the home’s staff have completed training on ‘the safe handling of medication’. Medication was being handled safely. However, a couple of minor issues around the recording of ‘as required’ medication and the recording of regular competency checks (to demonstrate that staff are still competent to administer medication by invasive techniques) would benefit from being clarified and improved. This was discussed with the manager, who had already started to address these issues when this report was written. The Avenue DS0000000783.V335588.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 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People feel that they are listened to and know how to make complaints. Staff training, procedures and guidance help to protect people from abuse. EVIDENCE: The home has in place a formal complaints procedure and records of complaints. However, there have been no recent complaints made either directly to the home or to the CSCI. One relative commented that ‘I have a copy of the home’s complaints procedure and contact telephone numbers, never had any concerns’. The home has in place policies and procedures covering the recognition and reporting of abuse and staff have been trained in these areas. The policies and procedures are supplemented by additional information about the local muli-agency procedures and Department of Health guidance on ‘No Secrets’ and the Protection of Vulnerable Adults list (a list of people considered unsuitable to work with vulnerable people). Safe systems are in place to help people manage their own personal finances. Each person has their own bank account and records of financial transactions and receipts are kept. Staff provide the level of assistance that the person needs. The Avenue DS0000000783.V335588.R01.S.doc Version 5.2 Page 17 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 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People have a safe, comfortable and homely place to live. The home is clean, tidy and appropriate arrangements are in place for doing laundry. EVIDENCE: The home’s aim is to provide a ‘normal’ domestic environment for the three people living there and The Avenue looks just like any other house located in the street. During the inspection the home was observed to be clean, tidy and there were no unpleasant smells. The communal areas of the home were well maintained and homely in character. The service users bedrooms were individually decorated and had been personalised with each person’s own possessions, including photographs of family and friends. There is one bathroom, which is shared by all three people living in the home and the staff. The bathroom is located upstairs and has a hand basin, toilet, bath and separate shower. Comments made by people who visit the home included ‘home is always very clean and tidy’. The Avenue DS0000000783.V335588.R01.S.doc Version 5.2 Page 18 An industrial style washing machine is been installed in the laundry and staff reported that this was very effective. Appropriate arrangements were in place for the storage and disposal of clinical waste, with a weekly collection service. Discussions with staff and the inspection of training records confirmed that training in ‘Infection Control’ had been provided. The Avenue DS0000000783.V335588.R01.S.doc Version 5.2 Page 19 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are supported by competent and stable staff team. Staff are recruited safely and are provided with training to help them do their jobs well. EVIDENCE: Staffing levels are provided flexibly to fit in with activities and day centre placements, with normal shifts being altered when necessary to fit in with outings and holidays. People often receive one-to-one staff time. The home has a small and stable staff team, with no staff members leaving the home’s employment since the last inspection. Two recruitment records were inspected and these showed that the staff had gone through a thorough recruitment process. This included Criminal Records Bureau (CRB) disclosures and written references. Staff have recently received refresher training in first aid and have been trained in safe handling of medicines, food hygiene, moving and handling and other areas. All of the care staff have a relevant qualification in care. Six of The Avenue DS0000000783.V335588.R01.S.doc Version 5.2 Page 20 the staff have achieved an National Vocational Qualification (NVQ), while the other member of staff is a registered nurse. However, regular up date training in manual handling should be considered. This is useful to staff even when they are not regularly handling people, such as in emergencies and when handing loads in the work place (for example, cleaning equipment). Comments made about the staff working at The Avenue included ‘excellent skills, staff are very confident and committed to their work as I observe regularly when I visit’ and ‘staff are excellent towards clients and myself’. The Avenue DS0000000783.V335588.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The Avenue is a well run home, which is run in the best interests of the people living there. Regular checks and maintenance take place to help keep people safe. EVIDENCE: The registered manager is very experienced and has achieved the Registered Managers Award and a National Vocational Qualification (NVQ) in Care. The Avenue has in place ways of monitoring its own performance and making sure the home is providing a good service. This includes checks that are done in the home on a regular basis and regular house meetings were staff and service users can voice their opinions. A yearly survey is undertaken, which The Avenue DS0000000783.V335588.R01.S.doc Version 5.2 Page 22 gathers the views of the people living in the home, their relatives and the professionals who work with them. Suitable arrangements, including policies and procedures and staff training, are in place at The Avenue to help keep staff and service users safe. Maintenance records were available and show that regular maintenance checks are completed, for example, monthly health and safety audits, regular fire alarm checks, water temperature checks and portable appliance testing. COSHH and RIDDOR files are available and records of accidents and incidents are kept. The Avenue DS0000000783.V335588.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 4 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 4 X 3 X LIFESTYLES Standard No Score 11 X 12 4 13 4 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X X 3 The Avenue DS0000000783.V335588.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? NO 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA5 Good Practice Recommendations It is recommended that the manager reviews the home’s contracts, to ensure they contain sufficient and clear information about fees. CSCI guidance about this was provided to the manager during the inspection. It is recommended that when ‘as required’ medication is not needed it is recorded on the MAR sheet as ‘not required’, rather than left blank. It is recommended that the manager checks on a regular basis that staff are still competent to administer rectal diazepam. These checks should be recorded. It is recommended that staff receive up date training in manual handling techniques. 2. YA20 3. YA35 The Avenue DS0000000783.V335588.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Darlington Area Office No. 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS 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 Avenue DS0000000783.V335588.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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