Inspection on 19/07/05 for The Lodge Dovercourt

This inspection was carried out on 19th July 2005.

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

Other inspections for this house

The Lodge Dovercourt 04/11/08

The Lodge Dovercourt 08/11/07

The Lodge Dovercourt 30/11/06

The Lodge Dovercourt 23/03/06

The Lodge Dovercourt 29/03/05

The Lodge Dovercourt 08/09/04

The Lodge Dovercourt 25/02/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 The Lodge - Dovercourt 16/18 Beach Road Dovercourt, Harwich Essex CO12 3RP Lead Inspector Sara Naylor-Wild Unannounced 19 July 2005 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 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 Stationary 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 Lodge - Dovercourt I56-I05 S17969 The Lodge Dovercourt V239579 190705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service The Lodge - Dovercourt Address 16/18 Beach Road Dovercourt Harwich Essex CO12 3RP 01255 503678 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) The lodgecarehome@aol.com Mrs Nowranee Sookun Mrs Nowranee Sookun Care Home (CRH) 8 Category(ies) of Learning disability over 65 years of age registration, with number (LD(E)), 1 of places Learning disability (LD), 7 The Lodge - Dovercourt I56-I05 S17969 The Lodge Dovercourt V239579 190705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. Persons of either sex, under the age of 65 years, who require care by reason of a learning disability (not to exceed 7 persons). 2. One named person, aged 65 years and over, who requires care by reason of learning disability. Date of last inspection 29/03/2005 Brief Description of the Service: The Lodge is situated near the seafront at Dovercourt. The home changed its category of care from elderly people to people with learning disabilities in 2001. Prior to this it had been operating as a small home. The home is registered for one elderly person and 7 people with a learning disability (one of whom is over 65). Mrs Sookun has remained the registered manager during the lifetimes of both registrations and has a background in nursing. The accommodation is comprised of a converted family home, with 8 single rooms, one of which is on the ground floor. There is no lift. There are two bathrooms with toilets and additional separate toilets on the ground and first floor. Catering and laundry facilities are at the back of the house on the ground floor. Communal areas consist of a lounge and dining room. The dining room has patio doors opening up onto the rear garden, which is accessed via steps and is mainly laid to lawn with some flowerbeds. The small front garden is paved. The Lodge - Dovercourt I56-I05 S17969 The Lodge Dovercourt V239579 190705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out on 19th July 2005 and took 5 hours to complete. The information gathered for this report was taken from discussions with the manager, staff and service users, as well as observation of practice. In addition records such as care plans were sampled. The inspection was scheduled to encompass the consideration of a formal complaint received by Essex Social Services, the concentration on standards that provided evidence of the home’s performance in respect of the complaint led the planning for this visit. 24 of the 43 standards were assessed at this visit. 10 of these complied with the standard, with 14 assessed as almost meeting the standard. Of these, 5 have been repeated as requirements since 2002 and one since March 2005. What the service does well: What has improved since the last inspection? The activities initiatives seen at this inspection are more appropriate to the service user group and appear to be focused on their personal abilities and interests. The inspector was particularly impressed with the artwork that all service users had participated in to one degree or another. The overall atmosphere of the home has become more relaxed and service users appeared calmer and more engaged with their environment and their participation in daily tasks. The Lodge - Dovercourt I56-I05 S17969 The Lodge Dovercourt V239579 190705 Stage 4.doc Version 1.40 Page 6 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 Lodge - Dovercourt I56-I05 S17969 The Lodge Dovercourt V239579 190705 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection The Lodge - Dovercourt I56-I05 S17969 The Lodge Dovercourt V239579 190705 Stage 4.doc Version 1.40 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 standard(s) 2 and 3 The home does not hold full needs assessments for all the service users. EVIDENCE: Whilst the documentation used by the home to record their assessment of service users’ needs is a comprehensive format that includes all the areas identified in the NMS, these were not present for a number of service users living at the home. This included the provision of placing authority assessments. Therefore, the evidence as to the suitability of the admission and the considerations made in deciding whether the home could meet the needs of the service users was not present. Additionally there was not basis from which to collate information into a plan of care. The service’s capability in meeting service users’ needs is impaired by the staff and training issues mentioned later in this report. The Lodge - Dovercourt I56-I05 S17969 The Lodge Dovercourt V239579 190705 Stage 4.doc Version 1.40 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 standard(s) 6, 7, 8 and 9 Care plans were varied in their completion and the detail of information they contained. Those plans that were completed gave details of how service users should be supported in making choices and participate in their daily lives. EVIDENCE: The care plans for the two service users resident for the longest period at the home were comprehensive in their detail and provided good instruction to staff in how they should support. However, the remaining files were varied in their completion with the two service users on temporary stays having none at all. This is despite their complex needs. The care plans that were completed provided clear evidence of how service users should be supported in decision-making and there were risk assessments that detailed how this right should be limited. The involvement of service users in this process either directly or through advocates was evidenced at review. The Lodge - Dovercourt I56-I05 S17969 The Lodge Dovercourt V239579 190705 Stage 4.doc Version 1.40 Page 10 Service users were involved in the decision making process within the home and were actively involved in shopping, meal preparation and cleaning their own rooms. The two service users on respite stay had originally been placed in the home on a short term two week stay. In both cases this had been extended to more than four months at the time of inspection. The manager was not aware of an end date or how long the provision was planned. This practice did not appear to provide a strategy of care to meet these individuals’ needs and actually prevented them from participating in long term activities. The manager was asked to take this issue up with the placing authorities and ensure that strategies were shared with the service user and herself. The Lodge - Dovercourt I56-I05 S17969 The Lodge Dovercourt V239579 190705 Stage 4.doc Version 1.40 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 standard(s) 12, 13, 15, 16 and 17 The service users are provided with opportunities to participate in activities that promote their personal development both within the home and in the local community. Service users are encouraged to participate in the daily routine of the home and take responsibility for aspects of their daily life. Meals are provided from a planned menu. EVIDENCE: Service users’ daily records gave indication of their participation in activities that supported their personal development. These included responsibility for tasks inside the home that contributed to the daily routine, such as housekeeping, shopping and, for example, service users participated in a weekly rota for preparation of the lunchtime meal for the rest of the service users. The Lodge - Dovercourt I56-I05 S17969 The Lodge Dovercourt V239579 190705 Stage 4.doc Version 1.40 Page 12 Some service users also attended classes in IT, cookery, sensory skills, etc, at educational day centres, such as Jigsaw and the Community College. Within the home a range of activities was being developed to suit both the group and individual needs. A particularly good example of this is the artwork that had been undertaken by the whole group. A range of materials were used to create 3D pictures of local scenes and each of the service users had taken part in the process at a time and level to suit their abilities. A photo scrapbook record of how the project had been undertaken gave emphasis to their involvement and could be used even when the project finished. Other projects had also been undertaken and service users spoken with stated they had enjoyed the work. Routines within the home were based around programmed daily activities with flexibility to accommodate individual choices and preferences on a day-to-day level. Some service users had pictorial daily diaries, using the Makaton symbols, in their rooms that set out their individual routine. They included guidance in, for instance, when planned family contact would take place in the week, such as phone calls, etc. Meals were provided against a planned menu, based on service users’ preferences. This allows for flexibility to meet the changes in circumstances, i.e. hot weather. Service users appeared to enjoy their meal during the inspection day. The Lodge - Dovercourt I56-I05 S17969 The Lodge Dovercourt V239579 190705 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 The manager was aware of how individual service users preferred to be supported in their personal care, although care plans were not always present to support this. EVIDENCE: On the day of inspection Mr and Mrs Sookun and their daughter staffed the home. They were observed both directly and indirectly in their provision of personal support, which at all times appeared to be carried out in a sensitive and flexible manner that maximised service users’ privacy, dignity, independence and control over their own lives. It was noted that different approaches were taken in respect of communication with service users, which were appropriate to the recorded instruction in care plans of those individuals. On the completed care plans there was evidence of discussions with service users, their next of kin or their advocates in respect of preferences for later life. The Lodge - Dovercourt I56-I05 S17969 The Lodge Dovercourt V239579 190705 Stage 4.doc Version 1.40 Page 14 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 standard(s) 22 and 23 The complaints policy and procedure are appropriate to the standard. The home has adequate adult protection systems in place. EVIDENCE: A complaint had been received by Essex Social Services and passed to the CSCI in relation to the care management of service users at the home. In particular the complainant alleged that service users were not treated with respect and were bullied by the manager and other staff. This complaint was considered under the Protection of Vulnerable Adults Guidance by Essex Social Services, and the CSCI were asked to consider the issues raised in the complaint during their scheduled inspection of the home. There was not any evidence or indication of poor practice witnessed during the inspection, and documents relating to individual care needs supported the action taken in meeting these. The investigation by Essex Social Services had not been completed at the time of the writing of this report. The home had adequate adult protection policies and procedures, and records examined showed that training in relation to abuse was included in the LDAF induction training received by newly appointed care staff at the home. The Lodge - Dovercourt I56-I05 S17969 The Lodge Dovercourt V239579 190705 Stage 4.doc Version 1.40 Page 15 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 standard(s) 24, 27 and 25 The premises are adequate to meet the needs of service users living there. Service users’ rooms were suitable to meet their individual needs, although the number of changes to accommodation arrangements must be reviewed. EVIDENCE: The majority of the home has not undergone redecoration and is tidy and clean in appearance, although some issues relating to décor of bathrooms continues to be an issue. A kitchen area has been installed in a larger bedroom upstairs to provide prospective service users with a semi independent bedsit arrangement. This facility would need a risk assessment to ensure that both the prospective service user and other service users were not put at risk by the provision. The manager informed the inspector that the service user occupying this room at present was not remaining, as they would not be able to access this facility. This discussion and the noted other moves between bedrooms that had taken place or were planned were discussed with the manager, who was reminded that the service user’s terms and conditions of residency included the specific The Lodge - Dovercourt I56-I05 S17969 The Lodge Dovercourt V239579 190705 Stage 4.doc Version 1.40 Page 16 bedroom to be occupied. Therefore any changes to these arrangements must be negotiated and agreed with the service user or their representatives. The layout of the premises presents the need for consideration of mobility needs any prospective service users may have. In particular the narrow hallway and lack of lift to the first floor would limit the availability of accommodation on that floor to service users with full mobility. The Lodge - Dovercourt I56-I05 S17969 The Lodge Dovercourt V239579 190705 Stage 4.doc Version 1.40 Page 17 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 33, 34, 35 and 36 The staff numbers have not been reviewed using the residential forum calculation. Staffing numbers have not changed from previous inspections. Recruitment and retention of staff continues to be an issue. Staff files do not contain all the recruitment checking documentation required. The staffing team are not retained for sufficient periods to develop appropriate skills to meet service users’ needs. EVIDENCE: The numbers of staff on duty have not changed in response to the increase in service users living at the home. At all previous inspections there have been two staff including the person in charge on duty. This appears to indicate that a review of staffing requirements is not regularly undertaken using the residential forum calculation, although the manager reported this was not the case, a record could not be found at the time of inspection. This outcome of this calculation is provided according to the assessed needs of service users. The Lodge - Dovercourt I56-I05 S17969 The Lodge Dovercourt V239579 190705 Stage 4.doc Version 1.40 Page 18 Historically the home has had difficulty not in attracting staff to work at the home but in the retention of suitable staff for prolonged periods. The manager confirmed at this inspection that the longest period a staff member had been employed was five months. The outcome of this has been a stunted development of the service, as the staff team are not retained for sufficient period to develop their own or the service’s competence in delivering a quality specialist service. This is evidenced in the lack of development in care planning completion, which the manager has insufficient time available to commit to completing. This issue is particularly relevant to the care of service users with Autism Spectrum disorders, where change is the least desirable to their wellbeing. The manager stated that she had recently recruited two overseas workers and was hoping to have them in post by September. The nursing qualifications they are reported to hold will she hoped ensure a good standard of practice in the home. The transitional status of the staff group has meant that apart from undertaking the LADF induction, staff do not develop their competencies further in specific training in caring for service users with autism, and overall the training and development of the service is stunted by this. Staff supervision had not been able to be consistently established for the same reasons. Staff files sampled at the inspection did not all contain the documents required by Regulation 19, Schedule 2 in relation to safe recruitment practice. The Lodge - Dovercourt I56-I05 S17969 The Lodge Dovercourt V239579 190705 Stage 4.doc Version 1.40 Page 19 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37 and 42 The manager had developed her understanding of the best practice the service aims to maintain. The manager’s style is forthright and directional. Ongoing maintenance and health and safety checks of equipment were in place and demonstrated compliance. EVIDENCE: Discussions were held with the manager regarding her insight into the reasons staff are not retained at the home. She was clear that in many cases this was due to the staff members inability to provide care to the standard she expected, and their retention was she felt not in the best interests of the service. The possibility of the manager’s expectations and forthright style contributing to the situation were also discussed and she commented that she expected staff to follow instructions as set out in care plans without digression or deviation, and felt that some staff had found this difficult to maintain. The Lodge - Dovercourt I56-I05 S17969 The Lodge Dovercourt V239579 190705 Stage 4.doc Version 1.40 Page 20 The manager appeared to have a good rapport with service users and was able to give examples of her understanding of their differing needs and how these should be communicated. The involvement of advocates for all service users is good practice. The health and safety certificates for fire systems, gas safety and electrical safety were seen and assessed as compliant. The Lodge - Dovercourt I56-I05 S17969 The Lodge Dovercourt V239579 190705 Stage 4.doc Version 1.40 Page 21 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 2 2 x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 2 2 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 2 x 2 x x x Standard No 11 12 13 14 15 16 17 x 3 3 x 3 3 3 Standard No 31 32 33 34 35 36 Score x 2 2 2 2 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Lodge - Dovercourt Score 2 x x x Standard No 37 38 39 40 41 42 43 Score 3 x x x x 3 x I56-I05 S17969 The Lodge Dovercourt V239579 190705 Stage 4.doc Version 1.40 Page 22 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA3 Regulation 12 (1)(a)(b) Requirement The registered person must develop further the elements which demonstrate the home’s capacity to meet specialised needs. Specifically the knowledge and skills of the staff in dealing with autism and challenging behaviour. This is a repeat requirement since 2002. The registered person must provide to the Commission a planned programme for refurbishment and ongoing maintenance of the home and its fabric. This is a repeat requirement since 2002. The registered provider must ensure that toilets and bathroom facilities are maintained in an acceptable state of repair. This is a repeat requirement since March 2005. The registered person must ensure that a staff training and development programme that meets Sector Skills Council I56-I05 S17969 The Lodge Dovercourt V239579 190705 Stage 4.doc Timescale for action 15/10/05 2. YA24 17,23 15/10/05 3. YA27 23(2)(b) 30/09/05 4. YA35YA32 18 31/10/05 The Lodge - Dovercourt Version 1.40 Page 23 Workforce training targets and ensures staff fulfil the aims of the home and meet the changing needs of service users is devised. This is a repeat requirement since 2002. The registered person must maintain staff files to a satisfactory standard in line with Regulation 19, Schedule 2 of the Care Homes Regulations 2001. This is a repeat requirement since 2002. The registered person must ensure that all staff receive regular support and supervision on a minimum of six occasions per year. This is a repeat requirement since 2002. The registered person must put in place an effective quality assurance system based on seeking the views of service users and other stakeholders in the home. 5. YA34 19, schedule 2 30/09/05 6. YA36 18 31/12/05 7. YA39 24(1-3) 31/12/05 8. YA2 9. YA6, YA7, YA8, YA9,YA18 This standard was not assessed at this visit and is therefore carried forward to the next inspection. 14 The registered person must ensure that an assessment of prospective service users needs is carried out prior to admission to the home. 12,,13,15, The registered person must 17 and ensure that a care plan is Schedule created for each service user 3 which identifies their assessed needs and how staff should address these. They should state the service users choices in the delivery of their care and identify I56-I05 S17969 The Lodge Dovercourt V239579 190705 Stage 4.doc 30/09/05 15/10/05 The Lodge - Dovercourt Version 1.40 Page 24 10. YA5 5 (1)(b) 11. YA33 18 the parameters for any restriction of these. The registered person must ensure that the service users agreed terms and conditions of residency are upheld and that any changes must be in the best interest of the service user and are negotiated with them, or their representative, prior to implementation. This specifically relates to room changes. The registered person must ensure that there are staff with sufficient skills and competence employed to support the assessed needs of service users. 30/09/05 31/12/05 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. Refer to Standard YA5 YA37 Good Practice Recommendations The registered person should ensure that statements of terms and conditions are signed by service users or their representative. The registered manager should complete the NVQ level 4 qualification. The Lodge - Dovercourt I56-I05 S17969 The Lodge Dovercourt V239579 190705 Stage 4.doc Version 1.40 Page 25 Commission for Social Care Inspection 1st Floor, Fairfax House Causton Road Colchester Essex, CO1 1RJ 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 Lodge - Dovercourt I56-I05 S17969 The Lodge Dovercourt V239579 190705 Stage 4.doc Version 1.40 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. 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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