Inspection on 09/03/06 for The Brandles Residential Care Home

This inspection was carried out on 9th March 2006.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Brandles Residential Care... 09/12/08

The Brandles Residential Care... 08/01/08

The Brandles Residential Care... 04/10/06

The Brandles Residential Care... 04/02/05

The Brandles Residential Care... 15/06/04

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

CARE HOME ADULTS 18-65 The Brandles Residential Care Home 23/25 Birks Drive Bury Lancs BL8 1JA Lead Inspector Kath Smethurst Unannounced Inspection 9th March 2006 10:00 The Brandles Residential Care Home DS0000008426.V285466.R01.S.doc Version 5.1 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address The Brandles Residential Care Home DS0000008426.V285466.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Brandles Residential Care Home DS0000008426.V285466.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service The Brandles Residential Care Home Address 23/25 Birks Drive Bury Lancs BL8 1JA 0161 797 6367 0161 763 3833 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) Mr Rufus Fagbadegun Mrs Christine Fagbadegun Mrs Brenda Byrne Care Home 7 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (7) of places The Brandles Residential Care Home DS0000008426.V285466.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The home is registered for a maximum of 7 service users, to include: Up to 7 service users in the category of MD (Mental Disorder under 65 years of age). The service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. The registered person must ensure that all staff working in the home have training in mental disorder that equips them to meet the assessed needs of the service users. 25th August 2005 Date of last inspection Brief Description of the Service: The Brandles is a small care home providing long term support to people with mental health needs. It is situated in Brandlesholme, a residential area of Bury, and consists of two adjoining (semidetached) properties that have been converted into one house. The home provides seven places, all in single bedrooms (three on the ground floor, four on the first floor). There are gardens to the front and back, with open fields to the rear. The home is near to bus routes and local amenities, including several shops and a pub. There is onstreet parking available. The Brandles Residential Care Home DS0000008426.V285466.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over four hours during the morning and afternoon. The inspector looked around some but not all of the home and some records were looked at. To get more information about the home the inspector spoke to three residents, the acting manager and one carer. What the service does well: What has improved since the last inspection? What they could do better: Information about the help and support residents want and need must be kept up to date; making sure that everybody is working together (and in the same way); that residents feel listened to and that staff get the guidance and support they need to do their job. Staff need to weigh residents regularly to make sure they don’t lose weight and are eating enough. Although risk assessments are completed the staff need to review them more often to ensure any potential risks are monitored. The Brandles Residential Care Home DS0000008426.V285466.R01.S.doc Version 5.1 Page 6 A review of the number of care staff working at the home needs to be undertaken to make sure residents get the support and care they need. To help staff do a better job, ways of helping them learn more about mental health issues should be looked at. 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 Brandles Residential Care Home DS0000008426.V285466.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Brandles Residential Care Home DS0000008426.V285466.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Systems are in place to ensure assessments are completed prior to admission. EVIDENCE: One new resident has been admitted since the last inspection. Inspection of this residents record showed that relevant professionals had completed a comprehensive assessment of care needs. The assessment covered all areas of care needs. This assessment formed the basis of the care plan produced by the homes staff. Discussion with this resident indicated he was happy with the placement and felt his health had improved since being admitted. The Brandles Residential Care Home DS0000008426.V285466.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6 The care planning system needs to be improved as some records had not been completed or updated which, meant some important information had not been documented which could result in residents needs not being met. EVIDENCE: Three care plans were examined. Each of which contained details of personal history, activities, physical health, care needs, goals and aspirations. While residents goals and aspirations are documented, the recommendation to include details of the actions the resident and staff team were going to take to achieve identified short and long term goals has still to be addressed. Good practice was noted in that the acting manager had arranged for independent reviews to be undertaken by local authority review officers. Some shortfalls were noted. In one care plan staff were instructed to monitor weight monthly but the last record of this being done was dated 4/10/05. While the majority of risk assessments had been reviewed at appropriate intervals one risk assessment had been last reviewed on the 23/5/05. Examination of the progress notes of one residents indicated they were experiencing continence difficulties but there was no indication of what action The Brandles Residential Care Home DS0000008426.V285466.R01.S.doc Version 5.1 Page 10 had been taken, even though the acting manager had sought advice. All this needs to be addressed to ensure information detailed in plans is up to date. Individual progress notes are maintained. It was also noted that the language used in one care plan was inappropriate. This was discussed with the acting manager who indicated this had already been addressed with the member of staff responsible. Staff need to carefully consider the language used in records to ensure residents dignity is maintained. The Brandles Residential Care Home DS0000008426.V285466.R01.S.doc Version 5.1 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 16 & 17 Residents took part in activities that reflected their choices and capabilities. However, due to staff ratios opportunities for reaching personal development goals and for one to one social activities outside the home were limited, potentially resulting in such needs not being met. Within agreed restrictions daily routines promote residents independence and individual choices. Mealtime arrangements are satisfactory offering variety and choice for people living in the home. EVIDENCE: Several residents continue to attend a range of weekly art therapy classes and cookery and support groups. In addition one resident commenced a welding course in September 2005. None of the residents currently have a job, although one resident showed some interest in volunteering at a charity shop, but had decided against taking up an offer of employment. While it is acknowledged such a situation can be The Brandles Residential Care Home DS0000008426.V285466.R01.S.doc Version 5.1 Page 12 discouraging it is important these opportunities continue to be offered in the future. As previously recommended, a visit to Bury’s supported employment agency (BEST) would be beneficial, in enabling staff to gather information about local opportunities and support available for people with mental health needs wanting to work. Residents are supported to maintain a range of personal and practical life skills. As identified in previous inspections staff usually work alone and therefore the opportunity for them to undertake rehabilitative work and support residents in the community is limited. Extra staff are made available when residents need support to attend appointments or social outings. For example on the day of the visit a resident had a hospital appointment and an additional member of staff was provided to accompany this resident. While some residents lead independent lives and are able to use local transport, shops, pubs and churches others are unable to leave the home without staff support. For example on the day of the visit one resident was able to travel to his college course unsupported, while another resident was able to go shopping alone. However as previously mentioned those residents unable to leave the home unsupported lead more restrictive lives due to the current staffing ratios. Interactions between staff and residents were observed to be very friendly. Several examples of resident’s rights being respected were observed. Staff were seen to respect residents privacy when entering bedrooms. Residents receive their mail unopened. During the visit some residents chose to spend time in their bedrooms while others preferred to be in the shared lounges. All bedrooms have locks fitted however discussion with two of the residents indicated they did not have a key. The acting manager advised this was through personal choice. However this information was not reflected in the care plans. This is an area staff should review regularly, in order to determine whether residents continue to be content with this arrangement. Mealtime arrangements are flexible enough to accommodate individual preferences and the activities residents take part in. The home does not have a fixed menu system but details of what meals residents have had are recorded afterwards. Residents have a choice of cereals and toast for breakfast, sandwiches for lunch, with the main meal served in the evening. The majority of the food is home cooked. No special diets are currently required. Meals are decided by consensus on a daily basis. During the visit a member of staff was observed discussing with residents what they would like for their evening meal. Residents were seen to be actively involved in the decision making process until agreement had been reached. Residents spoken with expressed satisfaction with the quantity, quality and choice of food available. One resident described the food, as being “very good” and that there was The Brandles Residential Care Home DS0000008426.V285466.R01.S.doc Version 5.1 Page 13 “more than enough to eat”. The minutes of the last residents meeting held on the 27/1/06 indicated residents had been consulted about the meals provided and were happy with the food offered. The Brandles Residential Care Home DS0000008426.V285466.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 20 The systems for the administration of medication were in the main satisfactory, but policies and procedures need to be reviewed to ensure all relevant areas are covered in order to minimise risks. EVIDENCE: On the 16 December 2005 the CSCI pharmacist inspector undertook an inspection. In the main medication procedures were on the whole found to be satisfactory although some improvements were needed. The requirements and recommendations resulting from the pharmacy inspection were followed up during this visit. Progress had been made on improving the management of medication in the home. During the inspection visit undertaken by the pharmacist it was noted that medicines had been pre-potted into named medicine pots ready to be taken to residents rooms, which is not considered to be a safe practice. It was evident during this visit this practice had ceased. Residents were seen to come to the office for their medication. The acting manager was also observed completing the Medicine Administration Sheets (MARs) after each resident had taken their medication. In the previous visit it was also noted that on one occasion medicines received into the home had not been documented which is a requirement. This has now been satisfactorily addressed with medicines received and leaving the home being recorded. The Brandles Residential Care Home DS0000008426.V285466.R01.S.doc Version 5.1 Page 15 One area still to be addressed is in regard to medication policies and procedures. It was unclear as to whether the policy had been expanded to include the safe handling of homely remedies. In order to clarify this issue a copy of the homes policy should be forwarded to the CSCI in order for the inspector to ascertain if this requirement has been met. Therefore the requirement is carried over with an extended timescale given. It was pleasing to note that the good practice recommendations made regarding the use of photographs and dividers (to segregate MARs) and a trained staff signature list had been acted upon. But some of the recommendations had not to date been actioned. As in the previous pharmacy inspection it was found that there were no blank MAR pro-forma, which results In any medicines not pre-printed having to be recorded on the footer. Once again it was noted that handwritten additions to the MAR had not been checked and countersigned. This is recommended to reduce the risk of transcription errors. Good practice was noted as one resident was supported to look after their own medication. Staff undertake spot checks to ascertain the resident can safely continue to self-administer. Records of these checks are maintained. The Brandles Residential Care Home DS0000008426.V285466.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 23 Policies, procedures and training to protect service users from abuse are in place. EVIDENCE: During the last inspection protection procedures were on the whole found to be satisfactory. However it was noted that there were no records of resident’s items (Watches & Jewellery) being kept for safekeeping. This issue has now been addressed. It was also recommended that ways should be looked at to support residents in managing their bank accounts. This still needs to be looked at and is once again recommended. No allegations of abuse have been made to the home or the CSCI. Procedures in respect to the protection of vulnerable adults are in place. Examination of staff records showed staff had undertaken vulnerable adults training in November 2004. The Brandles Residential Care Home DS0000008426.V285466.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 The Brandles provides residents with a comfortable and homely place to live. EVIDENCE: The Brandles was comfortable and homely. There is a satisfactory standard of décor and furnishings, which were domestic in style. Residents had the use of a small dining area, a kitchen, two adjoining lounges, a small smoking area and two bathrooms. There were gardens to the front and rear, with a paved patio area. Two residents showed the inspector their bedrooms, both of which were well personalised. The Brandles Residential Care Home DS0000008426.V285466.R01.S.doc Version 5.1 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 35 & 36 Staffing levels met previous minimum guidelines of the previous social services inspection unit guidelines, but need to be kept under review in order to ensure care needs are not compromised. Staff induction an ongoing training needs to be further developed to ensure staff are equipped with the skills and knowledge they need to meet the specialist care needs of people living in the home. EVIDENCE: Residents spoken with said staff looked after them well. Relationships between staff and residents seemed warm and friendly. Discussions with staff indicated they had a good understanding of residents support needs and enjoyed working at the home. One member of staff described the teamwork as being “very good”. A written duty roster is maintained samples of which were examined. Staff advised they met minimum guidelines set by the previous social services inspection unit. For the most part there is usually only one member of staff on duty at any one time but additional cover is provided to support residents to attend appointments. The current staff team consists of the acting manager and five carers. During the last inspection it had been identified that at times the acting manager had problems in covering the rota. Discussion with the The Brandles Residential Care Home DS0000008426.V285466.R01.S.doc Version 5.1 Page 19 acting manager indicated this situation had improved and there were currently no such difficulties. In this and previous inspections it has been identified that current staff ratios prohibit the time staff have to support residents in the community or in undertaking rehabilitative work. This is an area that needs to be addressed to ensure all care needs are met. The person responsible is asked to undertake a formal review of staffing arrangements in order to ascertain if ratios are adequate to meet all support needs. Two staff training records were examined. Each had received a range of training including food hygiene, medication, adult protection, falls and risks, schizophrenia. Following the last inspection the owner confirmed staff had undertaken training in purpose and role of the Care Programme Approach (CPA) system, fire safety and medication. Of the five carers three are in receipt of NVQ level 2. While residents said staff were looking after them well, staff development is an area, which still needs some attention. The induction records of one member of staff showed all areas were covered in one day. As noted in previous inspections the induction process needs to be staggered so that new staff can have sufficient staff to absorb information and for new staff to be assessed as being competent to work alone. Good practice was noted in that this member of staff had completed recent food hygiene and medication training. The need to also develop a training plan for the staff team remains. Discussion with the acting manager indicated that training planned for the coming year included fire safety and NVQ (National Vocational Qualification). However there was no indication of any plans for further training relating to the specialist needs of residents living in the home. This is an area, which needs to be considered to ensure staff receives the training they need to meet all aspects of residents needs. Regular staff meetings are now taking place on a regular basis the last two having taken place on the 9/1/06 and the 6/3/06. It was also pleasing to not that staff appraisals have now recommenced. However there was no evidence to suggest that regular individual formal supervision meetings having taking place at the required frequency. The acting manager is reminded that that it supervision should take place at least six times a year and cover aspects development, training and cares responsibilities. Records of supervision meetings need to be maintained and should be signed by both the carer and acting manager. The Brandles Residential Care Home DS0000008426.V285466.R01.S.doc Version 5.1 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37 & 39 The home is experiencing uncertainty regarding its leadership but this is minimised through the appointment of a known acting manager. Quality assurance systems are in place, but further development is needed to ensure the performance of the home is regularly monitored, and to provide evidence residents and other stakeholder’s views are sought and acted upon. EVIDENCE: The registered manager (Brenda Byrne) has been on long-term sickness absence since May 2005. The owner has been in correspondence with the registered manager but to date there is no indication of when she will be returning. The owner has kept the CSCI fully informed of the situation. As an interim measure a former manager (Ismet Shafiq) has been providing management cover. Discussion with the acting manager indicated she would continue to so. It is again recommended that the home purchase a photocopier to improve the effective use of staff time (regarding having to duplicate information). The Brandles Residential Care Home DS0000008426.V285466.R01.S.doc Version 5.1 Page 21 While some quality assurance systems are in place further development is needed. The home has a system for recording the complaints of those who don’t wish to complain formally. Residents are informed of CSCI inspections and inspection reports are available for visitors and residents to read. Residents and staff meetings are held regularly. Satisfaction surveys have been developed but have not been completed by residents or other stakeholders since 2003. Staff advised that the owner visits regularly, but no records were available in the home of these visits, which if documented would provide evidence the performance of the home is monitored and evaluated. All these areas need to be addressed to provide further evidence the home is run in the best interests of the residents. The Brandles Residential Care Home DS0000008426.V285466.R01.S.doc Version 5.1 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 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 X 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 2 33 2 34 X 35 2 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 X X X X LIFESTYLES Standard No Score 11 2 12 3 13 2 14 X 15 X 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X 2 X 2 X 2 X X X X The Brandles Residential Care Home DS0000008426.V285466.R01.S.doc Version 5.1 Page 23 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 2 3 Standard YA6 YA6 YA20 Regulation 15 12 & 15 13 Requirement Care plans and risk assessments must be regularly reviewed and up dated. To preserve residents dignity the language used in care plans must be carefully considered. In order to ascertain whether medication policies and procedures meet current guidelines regarding the administration of homely remedies a copy must be forwarded to the CSCI. The adequacy of current staffing arrangements must be reviewed (with regard to sufficient number), with any necessary action taken. A staff development programme must be developed to include a structured induction and specialist service specific training Formal staff supervision sessions must be undertaken at least six times a year. The responsible individual must visit the Home once a month and prepare and provide a written report as to the conduct of the Home in keeping with Regulation DS0000008426.V285466.R01.S.doc Timescale for action 30/04/06 30/04/06 30/04/06 4 YA33 12, 18 30/04/06 5 YA35 12, 18 01/08/06 6 7 YA36 YA39 18 26 01/08/06 30/04/06 The Brandles Residential Care Home Version 5.1 Page 24 26. 8 YA37 8,9 As previously agreed the temporary management arrangements must be kept under review (with CSCI informed of all relevant issues). 30/04/06 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 4 5 Refer to Standard YA20 YA20 YA20 YA6 YA12 Good Practice Recommendations Medication policies and procedures should be reviewed and expanded. The provision of blank MAR charts should be considered. Handwritten MAR entries should be independently checked and countersigned. Ways of helping residents to achieve/work towards their goals and aspirations (as detailed in their care plan) should be agreed, recorded and regularly reviewed. The acting manager or senior carer should visit Bury’s supported employment agency (BEST) to gather information about local opportunities and the support available for people with mental health needs wanting to work (in either a paid or unpaid capacity). Residents should be regularly consulted in regard to having their own keys to their bedrooms Ways of supporting residents to get more involved with their savings should be developed. A photocopying machine should be provided at the home. 6 7 8 YA16 YA23 YA43 The Brandles Residential Care Home DS0000008426.V285466.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Bolton, Bury, Rochdale and Wigan Office Turton Suite Paragon Business Park Chorley New Road Horwich, Bolton BL6 6HG 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 The Brandles Residential Care Home DS0000008426.V285466.R01.S.doc Version 5.1 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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