Inspection on 16/05/06 for The Cedars

This inspection was carried out on 16th May 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 no outstanding requirements from the previous inspection report, but made 7 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Cedars 30/06/09

The Cedars 22/03/07

The Cedars 03/11/05

The Cedars 30/06/05

The Cedars 05/01/05

The Cedars 01/07/04

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Sutton Lodge Nursing Home

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

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

CARE HOME ADULTS 18-65 The Cedars The Cedars (2 - 4) The Old Grove Surrey GU26 6BW Lead Inspector Suzanne Magnier Key Unannounced Inspection 16th May 2006 10:00 The Cedars DS0000013588.V294577.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 Cedars DS0000013588.V294577.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 Cedars DS0000013588.V294577.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service The Cedars Address The Cedars (2 - 4) The Old Grove Surrey GU26 6BW 01428 608726 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) Robinia Care South Limited Victoria Johnston Care Home 14 Category(ies) of Learning disability (14), Physical disability (14) registration, with number of places The Cedars DS0000013588.V294577.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The age/age range of the persons to be accommodated will be: 18-50 years Four Service users to be aged between 18 - 65 Years Date of last inspection 3rd November 2005 Brief Description of the Service: The Cedars consist of three bungalows, numbered 2, 3 and 4, that provide care and accommodation for fourteen adults with a learning disability and a physical disability. A garden area has recently been landscaped and surrounds the three bungalows. A fence surrounds the garden area and this provides a safe environment for service users. Each of the bungalows provides single service user bedrooms and offers a communal lounge, two bathrooms or shower rooms, a large kitchen and a laundry room. Bungalow 2 provides accommodation for four service users, and also accommodates the office facility for the service. Bungalows 3 and 4 each provide accommodation for five service users. All bungalows are suitably equipped for wheelchair users. The Cedars DS0000013588.V294577.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place over five and a half hours and was conducted with the manager. The main focus of the inspections was to ascertain that the previous requirements made during the unannounced inspection in November 2005 had been met. The inspector met with the majority of the residents during the inspection period. Due to the complexity of the residents needs it was difficult to obtain direct feedback from the residents. Therefore, observations of behaviour and ways of communicating were noted during the inspection. A tour of the premises took place and several documents and records were examined, including an individual care plans, risk assessments, menus, medication administration records (MAR), staff training and recruitment files, several policies and procedures and reporting of incidents and accidents. The organisation’s homes in Surrey have been subject to a review by the CSCI, a number of the matters have now been resolved or are nearing completion. These matters are now noted here more fully. 1. Resident’s finances from February 2002 to January 2005 had been of concern. The organisation has agreed with the CSCI and under Surrey County Council multi-agency procedures that recompense will be paid to all the service users in residence during that time. Payments will be dealt with on an individual basis and may take into account pro-rata amounts. 2. Payments for holidays, meals out of the home and any other additional staff costs have ensured that; (a) Holidays are either part funded by Robinia Care South or that each prospective resident will have £500 toward the cost of an annual holiday included in his or her fee. See Standard 14.4 of the National Minimum Standards for Young Adults (18-65). (b) Additional staffing costs will not be taken from resident’s own monies. (c) Residents will not fund meals out for staff nor will they pay the full cost of the meal. This as the cost of meals is inclusive in the fee; the difference will be funded directly by the resident. 3. Residents through their mobility benefits were paying for transport provision. This method had not clearly been agreed with local authorities or families and or residents. This matter has been resolved and individual agreements made with appropriate persons completed to ensure that any payment made is agreed and recorded clearly. 4. The organisation has introduced a new policy and procedure for dealing with resident finances in order to ensure that members of staff follow The Cedars DS0000013588.V294577.R01.S.doc Version 5.1 Page 6 consistent guidance. Members of staff have received training on this matter, as have the managers of the homes. 5. The organisation has provided each home with a clear chart informing staff of what to do and what not to do in the event of an allegation of adult abuse. The organisation has agreed to revise their policies and procedures in relation to the protection of vulnerable adults to ensure they are clear, easy to follow and are in line with local guidelines. This matter has not been confirmed as being finalised as yet. 6. Further training for members of staff was also agreed as part of the service review. The organisation has employed a specialist service to train Robinia Care South members of staff to communicate and engage with their residents more effectively. In particular engaging with individuals who have non-verbal communication needs. At the time of this visit the staff team of The Willows reported that only the manager had received this training and had provided the team with information from the course. The inspector wishes to thank the residents and staff for their hospitality and assistance during the inspection. What the service does well: What has improved since the last inspection? The manager showed the inspector a copy of the reviewed terms and conditions (titled Service User Placement Agreements). The document included clear guidance of additional costs and transport costs/arrangements, and holiday costs. New menus had been implemented and menu planning included healthy eating options. On the 16th June 2006 Robinia Care South confirmed with the CSCI that recompense payments had been made to all the service users resident with Robinia Care South during the specified period. The amount provided by the The Cedars DS0000013588.V294577.R01.S.doc Version 5.1 Page 7 organisation was pro-rata to the amount of time the service user had been resident. 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 Cedars DS0000013588.V294577.R01.S.doc Version 5.1 Page 8 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 Cedars DS0000013588.V294577.R01.S.doc Version 5.1 Page 9 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): 1,2 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home has updated the Statement of Purpose and also reviewed the terms and conditions regarding residency and costs at the home. The home has undertaken a full pre admission assessment for a resident who has recently moved into the home. EVIDENCE: The Statement of Purpose had been updated and included pictorial as well as written guidelines for the reader. The inspector and manager discussed the complexity of the document, which may not be suitable for residents currently residing at the home. The inspector sampled one resident’s records admitted in May 2006. A care needs assessment had been completed by the Development Manager and contained a variety of assessments including the individuals communication skills, personal care needs, eating and drinking abilities, sleep patterns and environmental safety and mobility issues. Following previous inspections requirements had been made that the organisation review the statement of terms and conditions in order that residents, their relatives or representatives were clear about what the home could provide, what any additional costs were and the current the fee levels. The Cedars DS0000013588.V294577.R01.S.doc Version 5.1 Page 10 The manager showed the inspector a copy of the reviewed terms and conditions (titled Service User Placement Agreements). The document included clear guidance of additional costs and transport costs/arrangements, and holiday costs. A draft copy of the terms and conditions has been forwarded to the Commission for Social Care Inspection (CSCI). The inspector was advised that draft copies had also been sent to residents Care Managers. No terms and conditions were available in the file for the resident newly admitted to the home. The Cedars DS0000013588.V294577.R01.S.doc Version 5.1 Page 11 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): 6,7,9. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The standard of care planning and documentation of care plans was good. It is required that the home documents a risk assessment without delay when hazards to the welfare and wellbeing of the residents or staff have been identified. EVIDENCE: The inspector sampled a variety of care plans for the residents residing in all three bungalows. The standard of care planning was good and the inspector and registered manager discussed ways in which the residents could become more involved in their care plans and a recommendation for further improvement may be the use of photos (with consent) to show skills and goals for service users. The daily record keeping by staff was good in understanding the activities and occurrences throughout the day. Whilst sampling the care plan of a service user recently admitted to the home the inspector noted that no risk assessments had been completed for the management of various hazards identified in the service users care plan for The Cedars DS0000013588.V294577.R01.S.doc Version 5.1 Page 12 example choking and manual handling concerns. Immediate action is required that any activities and unnecessary risks to the health and safety of service users are so far as possible eliminated and documented risk assessments must be in place for service users to ensure their safety and welfare. The Cedars DS0000013588.V294577.R01.S.doc Version 5.1 Page 13 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): 12,13,15,16,17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home promotes residents to maintain significant friendships and access their community. New menus had been implemented and menu planning included healthy eating options. EVIDENCE: Five residents were at home during part of the inspection and the inspector met residents who were returning home from various activities. One resident returned home with a friend and there was a lot of excitement regarding cleaning the resident’s car. All the residents were calm and relaxed within the home and in the garden area. Rapport between the staff and residents was noted to be friendly and appropriate. The resident care plans indicated that several residents visit family and friends and there was clear evidence through documentation of telephone calls and visits by friends and relatives to the residents home. The Cedars DS0000013588.V294577.R01.S.doc Version 5.1 Page 14 It was observed that that the staff and residents had developed appropriate relationships and staff on duty were able to understand the needs of the residents with limited communication skills. The inspector did not observe a mealtime. New menus have been developed and include pictures and choices. The home was well-stocked food and fresh fruit and vegetables and the menu planning was centred in healthy eating options. The Cedars DS0000013588.V294577.R01.S.doc Version 5.1 Page 15 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): 18,19,20. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. . This judgement has been made using available evidence including a visit to this service. Agreed working practices to support residents with personal care were well documented and up to date. The home continues to have good regard for the health care needs of residents. An immediate requirement was made regarding shortfalls identified in the storage and administration of medication. EVIDENCE: The care plans sampled by the inspector included reviews of residents needs and a variety of healthcare reports for example manual handling assessments conducted by an occupational therapist, physiotherapist reports and speech and language reports. Additional records for each resident included daily notes including skills and abilities, diet and food eaten, continence issues, leisure and social activities, communication and behaviours which required additional support, monitoring charts for example epilepsy, night time records and an inventory and disposal of belongings. Records indicated that staff supported residents to a variety of other health care appointments including the dentist, eye specialists and the doctors. The The Cedars DS0000013588.V294577.R01.S.doc Version 5.1 Page 16 support guidelines and agreed working practices to support residents with their personal care were well documented and up to date. A continence advisor visited the home during the inspection and spoke favourably of the homes ability to work cohesively in the best interests of the residents. The inspector sampled Cedars 3 medication system and identified shortfalls, which included inadequate storage and recording of a controlled medication, which had been received into the home and incomplete recording of medication on the administration sheets. An immediate requirement was made that there are adequate arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the home (including controlled medications). The Cedars DS0000013588.V294577.R01.S.doc Version 5.1 Page 17 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): 22,23. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The home has a written complaints procedure. It has been required that the home must ensure that the revised policy and procedures for safeguarding vulnerable adults is in line with the local multi agency procedures for safeguarding vulnerable adults and that all staff receive training in the safeguarding vulnerable adults. EVIDENCE: The inspector sampled the homes complaints procedure, which the manager advised had been updated. It was noted that there was not a review date on the document. The inspector also sampled the resident’s complaint procedure, which was in each residents file. Following the previous inspection and the requirements made the inspector sampled a flowchart regarding the procedures for staff to use in the event of a ‘concern’. The flowchart refers to concern about suspected sexual or physical abuse and advises that the concerned person should contact their line manager immediately who will then instigate the Protection of Vulnerable Adults (Safeguarding Adults) procedure. The flowchart was viewed as a separate document and no links from the homes perspective were recognised regarding the local Surrey multi agency Safeguarding Adults from Abuse policies and procedures. The procedures sampled were unclear and confusing and it is required that the organisation refer to the local Surrey multi agency Safeguarding Adults from Abuse policies and procedures dated February 2005 which give a clear account of the procedures to be undertaken and which should be adopted by the home. The Cedars DS0000013588.V294577.R01.S.doc Version 5.1 Page 18 The manager told the inspector that the induction for staff includes one full day in the detecting and reporting of abuse. Records indicated that four staff out of twelve had received Safeguarding Adults training and a requirement has been made that all staff attend the training in order to ensure the safety and welfare of residents from abuse. The Cedars DS0000013588.V294577.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. This judgement has been made using available evidence including a visit to this service. The home was observed as clean and hygienic. The communal and areas and private rooms of the residents were tastefully decorated and individualised. It is required that carpets in the resident’s rooms which were soiled due to wear and tear must be cleaned or replaced. EVIDENCE: Overall the home was observed as clean and hygienic. The inspector looked at all the resident’s bedrooms all of which were tastefully decorated and contained appropriate furnishings and personal items including framed pictures, photos, music systems and other leisure items. The inspector sampled the homes bathrooms and toilets, which were also tastefully decorated. The specialist equipment used by resident’s for example portable and overhead hoists were well maintained and serviced. The inspector noted that the several carpets in resident’s rooms were soiled and it is required that the carpet is cleaned or replaced in order to reflect the high standard of decoration and cleanliness throughout the home. The Cedars DS0000013588.V294577.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35,36. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. . This judgement has been made using available evidence including a visit to this service. The staff recruitment and training files were evidenced as poorly managed which did not offer clarity regarding safe vetting practices and ongoing staff training. The staff files contained well-documented records regarding staff support and supervision. EVIDENCE: The inspector sampled several staff files, which were noted to be un manageable. Due to the disarray it was unclear if the home operates a safe vetting and recruitment practice. A requirement has been made that all staff files are revised and documents are stored and managed appropriately. One file contained a discrepancy regarding the references date and the application form date. The home is continuing to ascertain the equivalency of certificates of qualification achieved from several staff members from overseas against the National Vocational Qualifications (NVQ). The registered manager told the inspector that various staff had achieved NVQ awards from Level 4 to Level 2. and some staff were waiting to start at Level 3 through Godalming College. The Cedars DS0000013588.V294577.R01.S.doc Version 5.1 Page 21 The staff training files sampled by the inspector were also noted to be un manageable. Due to the disarray it was difficult to have an overview of the voids in training. It is required that the files are revised and documents are stored and managed appropriately in order to ascertain the current training needs of the staff. A list of organised training was submitted with the pre inspection questionnaire but does not include staff names for monitoring purposes. The staff files contained records regarding staff support and supervision. On the 16th June 2006 the CSCI received confirmation from Robinia Care South that recompense payments had been made to each service user resident during the period specified in the summary of this inspection report. The payments made were pro-rata to the amount of time the service user had been resident. The organisation stated that they had worked with the various social services departments funding those service users to ensure full agreement regarding the amounts paid. The Cedars DS0000013588.V294577.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There is an open and friendly atmosphere in the home, which reflects the competency of the staff in supporting residents in and efficient and effective manner. EVIDENCE: The home is well managed and staff moral is high. The inspector discussed the need for the manager to complete their registered manager application to the CSCI. The manager has achieved NVQ Level 4, Registered Managers Award, and is a NVQ Assessors and Internal Verifier. The duty rosters were discussed with the inspector and the manager advised that following the last inspection deployment of staff across the three homes has been re evaluated in order to ensure the safety and welfare of service users and no service users are now left alone with one member of staff. The inspector sampled the homes Health and Safety checks that demonstrated that all hoists have been serviced and fire extinguishers serviced. It was noted The Cedars DS0000013588.V294577.R01.S.doc Version 5.1 Page 23 that a request for hanging of service users pictures in bedroom had been requested several months ago and had not been attended. In addition the digital thermometers on showerhead not working and a record for the monthly bath water temps stated 44.c and shower temp 41.c. yet there was no evidence available at the home regarding the safety and repair of the items. A requirement has been made that all parts of the home to which residents have access are so far as reasonably practicable free from hazards to their safety. Robinia have developed an organisational QA system, which was sampled by the inspector. The manager explained that the current feedback from the service users and their representatives has not been obtained. The Cedars DS0000013588.V294577.R01.S.doc Version 5.1 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 3 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 2 ENVIRONMENT Standard No Score 24 2 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 2 33 x 34 2 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 2 3 LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 1 x 3 x 3 x x 2 x The Cedars DS0000013588.V294577.R01.S.doc Version 5.1 Page 25 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. 1 Standard YA9 Regulation 13.(4)(b-c) Requirement Timescale for action 05/06/06 2 YA20 13(a)(b)(c) The registered person must ensure that any activities and unnecessary risks to the health and safety of service users are so far as possible eliminated and documented risk assessments must be in place for service users to ensure their safety and welfare. The registered person must 05/06/06 ensure that there are adequate arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the home (including controlled medications). The registered person must ensure that the revised policy and procedures for safeguarding vulnerable adults is in line with the local multi agency procedures for safeguarding vulnerable adults. The registered person must ensure that all staff receive training for safeguarding vulnerable adults. DS0000013588.V294577.R01.S.doc 3 YA23 13.(6) 01/07/06 4 YA23 13.(6) 16/08/06 The Cedars Version 5.1 Page 26 5 YA24 6 YA34 7 YA42 The registered person must 16/08/06 ensure that residents carpets are cleaned or replaced in order that to reflect the high standard of decoration and cleanliness throughout the home. 17.(2)(3)(a- The registered person must 16/08/06 b) ensure that staff training and recruitment records are kept up to date and are available at all times for inspection. 13.(4)(a) The registered person must 01/07/06 ensure that all parts of the home to which residents have access are so far as reasonably practicable free from hazards to their safety. 23.(2)(d) RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations The Cedars DS0000013588.V294577.R01.S.doc Version 5.1 Page 27 Commission for Social Care Inspection Surrey Area Office The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN 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 Cedars DS0000013588.V294577.R01.S.doc Version 5.1 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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