Inspection on 20/06/07 for The Grange

This inspection was carried out on 20th June 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

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 The Grange The Green Benenden Cranbrook Kent TN17 0DN Lead Inspector Christine Grafton Key Unannounced Inspection 20th June 2007 10:30 The Grange DS0000069368.V339432.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 Grange DS0000069368.V339432.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 Grange DS0000069368.V339432.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Grange Address The Green Benenden Cranbrook Kent TN17 0DN 01580 240118 01580240270 cg@hotmail.uk 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) Mrs Linda Joyce Fennell Mrs Linda Joyce Fennell Care Home 21 Category(ies) of Learning disability (21) registration, with number of places The Grange DS0000069368.V339432.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. One service user over the age of 65 years may be accommodated. Date of last inspection N/A – new provider. Brief Description of the Service: The Grange is a large three-storey detached house standing within its own grounds, located just off the village green. It provides personal support for up to 21 people who have a learning disability. The home provides spacious accommodation with a variety of communal rooms, including a large lounge, a dining room, two sitting rooms with kitchenettes and dining areas, an activities room and there is a computer and a pay phone for residents’ use. There is one double bedroom and the rest are singles. There are shower and bathing facilities and some ensuite facilities. The front of the property is reached from The Green via a driveway leading to a car parking area and the rear of the property has extensive grounds that include a large lawned area, trees, vegetable plot and tennis court. Local village shops, amenities and bus stops are close by. The staff team consists of management staff, administrative staff, ancillary staff and a team of support workers, who work a rota that includes one waking staff member on duty at night and one person on sleeping in duty. Information provided in June 2007 indicates that the weekly fees range between £500.22p to £1,232.48p per week, with some additional charges that are specified within the pre-admission information pack. The Grange DS0000069368.V339432.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first inspection of this home since the ownership changed in February 2007. The report takes account of information accumulated since then, including a visit to the home. An unannounced visit took place on 20th June 2007 between 10.30 hours and 16.00 hours. The visit included talking to the provider/manager, staff and a number of residents, looking round the home and reading some records. At the time of the visit there were 18 residents living at the home. Prior to the visit, surveys were sent to a sample number of residents, their relatives and care managers. There was a very good response to these and the feedback contained has been used to inform the judgements made throughout this report. The provider completed an annual quality assurance assessment for the home. The findings of this inspection indicate that the people living in this home enjoy a good quality of life. What the service does well: Residents have been involved in writing their own care plans that show their wishes for the future and how they like things to be done when they need support from staff. Residents are encouraged to make decisions about their lives and to develop their independence. They have lots of opportunities to take part in a variety of activities. They have fun doing things in the home, such as ‘keep fit’ and crafts. Some people do outdoor activities, such as gardening. All residents go out a lot into the wider community, doing things they have chosen. Residents live in a clean, homely environment where their comfort is assured. They are proud of their home and work together with staff to keep their bedrooms looking nice, the way that they want them. Staff are well-trained and understand residents’ needs well, working with residents in a way that ensures they receive the right support and healthcare. Residents are involved in what goes on in the home and are relaxed in their surroundings, with each other and with staff. The Grange DS0000069368.V339432.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. The Grange DS0000069368.V339432.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 Grange DS0000069368.V339432.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): 1&2 People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Prospective residents can expect to be provided with information about the home and have their needs fully assessed before moving in. However, the information pack is still at the development stage and some of the current information is out of date. EVIDENCE: There is an up to date statement of purpose. The pictorial brochure is out of date. The provider indicated that a new admission pack is being devised that will include a pictorial brochure written in a format suitable to the needs of people for whom the home is intended. There have been no new residents admitted since the change of ownership. Evidence in residents’ records indicates that the home undertakes a full assessment of needs and obtains a copy of the care management assessment. Care plans contain detailed information about individual needs and aspirations that has been gathered over time and written in a ‘person centred’ way. Residents have been fully involved in writing their care plans. The Grange DS0000069368.V339432.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents benefit from having their own individual care plan that fully reflects all their needs and aspirations and ensures they are supported to make their own decisions and choices to develop their life experiences. EVIDENCE: Since the change of ownership in February, staff have worked hard to introduce new ‘person centred’ care plans that have been developed with the residents’ full involvement. Each resident keeps their own care plan in their bedroom that has been written in their own words, with pictures and symbols to aid communication. The care plans include personal details that describe the individual, their likes and dislikes, their needs and choices and show how staff should support them to achieve their goals. They include weekly planners, a pictorial agreement, risk assessments and a pictorial complaints procedure. The Grange DS0000069368.V339432.R01.S.doc Version 5.2 Page 10 The care plans are very informative and provide a good insight into each resident’s strengths, support needs and aspirations for the future, showing when goals have been achieved. Key workers described how the home is trying to encourage residents to become more independent. Risk assessments have been completed for this; for example, three residents are currently doing a bus training programme. Another resident’s training programme for ‘shadowing’ them to the village forms part of their personal development plan. Discussion with the resident indicated their increased confidence and sense of achievement from going out alone. Residents and staff have daily informal meetings each morning when residents choose their daily activities, including involvement with some household chores. Key workers encourage their involvement in decision-making and monitor activities. Residents are supported to manage their own money and they have individual bank accounts from which they draw their weekly spending money. Where money is held on a resident’s behalf, appropriate records are kept showing expenditure, balance and two signatures. Staff spoken to had good understanding of the residents’ needs. The Grange DS0000069368.V339432.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 & 17 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents are supported and enabled to live fulfilling lifestyles both within the home and in the wider community. The involvement of families and friends is positively encouraged. Meals and mealtimes are enjoyable. EVIDENCE: Residents participate in a range of activities throughout the week, attending various day centres, colleges and clubs in surrounding towns and taking part in a variety of in-house activities. They go out to the village and neighbouring towns, some individually, some with staff support, or in small groups. Care plans contain details of activities such as: shopping, visiting pubs, bowling, swimming, keep-fit, discos, day trips and holidays. One resident does voluntary work at a local nursery. The Grange DS0000069368.V339432.R01.S.doc Version 5.2 Page 12 Residents spoke with enthusiasm about their favourite activities, including: horse riding, gardening, or interests such as football and motor racing. Skilled sessional workers are employed, in addition to the support staff, to lead some of the in-house activities. A person does gardening with residents twice a week; a keep fit instructor visits once a week and a reflexologist/craft worker was at the home at the time of the visit. Two residents were very pleased with the necklaces they had made during the craft session. Two of the staff spoken to have done a signing course and indicated how they can communicate with residents who do not use verbal language. Observation indicated good practice in this respect. Feedback from relatives in their surveys indicates that residents’ family contact is supported. The home has an active group of friends called ‘The Friends of The Grange’ which has recently become a registered charity. The committee also includes one resident representative and one staff member. The Friends are currently organising a summer barbeque. Residents are fully involved in the home routines doing such things as their own laundry and cleaning their bedrooms. A small group of residents are learning to be more independent and are managing their own housekeeping budget with support from a staff member. They do their own budgeting, food shopping, menu planning and cooking. Pictorial menus and a kitchen rota are displayed. Residents helping in the kitchen said they like to be involved in this activity. Residents spoken to said that they have nice food and that they sit down and choose menus with staff in the evenings. In addition to the well-equipped main kitchen there are two additional kitchenettes that residents can use to make drinks and snacks. The Grange DS0000069368.V339432.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents receive personal support in a way that ensures their dignity and privacy is respected. Residents’ benefit from the good health care support given to them in this home. A review of the way medications are managed could provide the opportunity to improve safety and develop residents’ involvement. EVIDENCE: Residents’ care plans contain a section entitled ‘How to Support Me’ covering such things: as communication, how to help with eating and how to assist with toileting. The way they are written demonstrates that key workers have a high level of awareness of the important things to ensure residents’ are treated with sensitivity and their dignity and privacy are ensured. This was confirmed in discussion with staff when they described how they support residents with their personal care. The Grange DS0000069368.V339432.R01.S.doc Version 5.2 Page 14 The provider indicated that residents’ choice of key worker has been respected. Staff demonstrated good understanding of the diverse needs of individual residents. Responses in surveys from relatives and care managers indicated that staff treat residents well and provide the support necessary to ensure their healthcare needs are met. Care plans contained good records of involvement with health care professionals, such as doctors and district nurses, including any advice and subsequent action. There was evidence that health needs are monitored and followed up. Care plans and discussion with staff indicated good understanding of specialist health care needs. Care plans have not yet been reviewed, but have only been in place since the change of ownership. Formal reviews are held with care managers either annually or six monthly. Eleven staff were attending a medication-training course being held at the home at the time of the visit. None of the residents currently manage their own medications. Medications are stored in locked cupboards in the laundry. Residents go to the laundry with their drinks to receive their medications. Two staff give out the medications and sign the medication administration sheets. It was discussed with the provider and two senior staff that the proximity of the medication storage to the area where soiled articles are handled could pose a risk of infection. It was recommended to review the way medications are managed in the home to see if any changes could be made to improve safety and to promote more resident involvement. The Grange DS0000069368.V339432.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents are listened to and their views acted upon. The home has appropriate procedures in place to protect them from abuse. EVIDENCE: All of the relatives’ surveys returned indicated they know the home’s complaints procedure and one stated that they could approach the staff and owner with any concerns, which are dealt with sympathetically and successfully. Each resident has a copy of a pictorial complaints procedure. Responses in residents’ surveys returned indicated they know how to make a complaint. Residents are encouraged to speak to their key workers if they have any worries and they can air any complaints at residents meetings. Records of residents’ meetings indicated that residents talk about how they feel about certain situations in the home affecting them. Staff then support them to address the issue to achieve an acceptable outcome. Residents were confident in their approaches to staff and those spoken to said that they like living at the home. Two staff were very much aware of the procedures to safeguard people from abuse. They described how they observe residents’ behaviours and follow up any changes that could indicate an underlying cause for concern. The provider stated that there had been no The Grange DS0000069368.V339432.R01.S.doc Version 5.2 Page 16 complaints, or protection referrals, since she took over the running of the home. The personnel manager indicated that six staff have attended adult protection training and that another course is being planned. The Grange DS0000069368.V339432.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 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The standard of the environment within the home is good providing residents with an attractive and homely place to live. EVIDENCE: All bedrooms and communal areas are well decorated and well furnished. The majority of bedrooms are very spacious and they are all highly individual, reflecting residents’ interests and tastes. A number of bedrooms have ensuite facilities. Since the change of ownership, the home has been divided into two cluster groups known as The Robins and The Blackbirds. Residents were fully involved with this and chose the names at a residents’ meeting. Within The Blackbirds cluster area, the top floor has been arranged into a flat where residents are learning to be more independent. This has an attractive lounge/diner with kitchenette. Residents take a pride in their environment and several commented on how much they like their rooms. The Grange DS0000069368.V339432.R01.S.doc Version 5.2 Page 18 There are a variety of communal areas within the home, all comfortably furnished and the extensive grounds have separate areas for residents to relax, or pursue various outdoor activities. The provider indicated that there is an as ongoing maintenance programme in place for the home. The personnel manager monitors this as part of his responsibility for health and safety and confirmed that maintenance certificates are up to date. The provider spoke of plans to redecorate communal areas and residents’ bedrooms next year and to involve residents in the choice of décor. The home was very clean throughout, with plentiful hand washing facilities and well stocked supplies of liquid soap and paper towels in all places where needed. This reduces the risk of cross infection and protects residents and staff. There is a well-equipped laundry that was clean and spacious. Residents occupying an area of the home in The Blackbirds cluster group, known as The Lodge, also have their own washing machine, which they use independently. Residents do their own washing in the main laundry with support from staff. The Grange DS0000069368.V339432.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 & 36 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents benefit from the well-trained, enthusiastic staff team who work positively with them to improve their quality of life. Residents are protected by the home’s thorough recruitment procedures. EVIDENCE: Staff on duty included four support workers and a deputy manager, plus someone for cooking and a sessional worker. Rotas indicate that these staffing numbers are maintained throughout the day during the week, with additional staff to cover management, administration, cleaning and maintenance. Three staff are on duty during the day at weekends and there is one waking person and one person sleeping in each night. Staff demonstrated good attitudes towards residents, who were clearly comfortable with them. Two staff said that there has been a drive to provide more staff training since the change of ownership and that it feels good to work at the home now. All staff spoken to commented on the high morale in The Grange DS0000069368.V339432.R01.S.doc Version 5.2 Page 20 the home now and said they felt well supported to do their jobs in the best way for the benefit of the residents. The provider said that one staff member is a qualified counsellor for people with learning disabilities and does group work and individual work with residents. This was supported in a relative’s survey that indicated excellent support was provided to a resident at a time of family bereavement. Staff files were well ordered and contained all the required information, indicating that thorough recruitment checks are completed before the new person starts work at the home. Residents are involved in staff interviews and complete their own interview records in pictorial and symbol format. Residents grade the person on a scale of 1-10 and the personnel manager indicated that the decision to employ takes full account of this. A new induction workbook has been introduced that is linked to the Skills for Care specification. Five staff have achieved their National Vocational Qualification (NVQ) in care level 2 and two are currently working towards it. Two staff have their NVQ level 3. A wide variety of short courses are undertaken including learning disabilities training and behaviour management. The personnel manager does formal staff supervision with staff and records indicate this is done approximately every three months. He agreed to implement two monthly sessions in future. The Grange DS0000069368.V339432.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 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents can be confident that the home is well-run and managed in their best interests, promoting and protecting their health, safety and welfare. EVIDENCE: The provider/manager has many years experience working with people with learning disabilities and has a qualification in social care that was achieved some time ago. When she took over the home, she indicated she would update her knowledge by enrolling on a National Vocational Qualification (NVQ) level 4 in management. Discussion with the provider at this visit indicated that she has improved her knowledge of the national minimum standards and care home regulations and The Grange DS0000069368.V339432.R01.S.doc Version 5.2 Page 22 has developed a system for keeping up to date with the latest good practice guidance. She stated that she has enrolled on a ‘Registered Managers Course’ that she aims to start in September. The deputy manager and head of care have also enrolled on this course and their actions and discussions indicated their competence in their senior roles. The provider has introduced a quality monitoring system that includes monthly visits by an independent consultant and questionnaires for residents, their families and staff that were completed in March 2007. As a result of the feedback, key workers sent individual letters to families, with their photograph, introducing themselves. A pictorial staff tree was devised as a result of residents’ feedback. Staff spoken to said that standards at the home have improved since the change of ownership and that residents are more involved in what goes on now, being more relaxed and happy. A relative’s survey reflected upon the changes over the past eighteen months and that “The Grange is more settled and back to a secure setting.” Information provided by the manager prior to the inspection indicates that the home’s equipment has been serviced within the recommended timescales. This was confirmed in discussion with the personnel manager responsible for health & safety, who does monthly walking route checks of the building and annual health and safety reviews. There were no obvious health and safety hazards observed around the home. Staff attend training courses to ensure safe working practices, including fire safety, first aid and moving and handling. The Grange DS0000069368.V339432.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 2 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 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 3 33 x 34 3 35 3 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x 3 x 3 x x 3 x The Grange DS0000069368.V339432.R01.S.doc Version 5.2 Page 24 N/A Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 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 YA20 Good Practice Recommendations It is recommended to review the way medications are stored and managed in the home to see if any changes could be made to improve safety and to promote more resident involvement. It is recommended that staff have recorded supervision meetings at least six times a year with their senior/manager. It is recommended that the registered provider/manager completes a qualification in management and care to update and develop her knowledge, skills and competence for managing the home. 2 YA36 3 YA37 The Grange DS0000069368.V339432.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Grange DS0000069368.V339432.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. Re-publishing this information is in breach of the terms of use of that website. 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