CARE HOMES FOR OLDER PEOPLE
Martins The Vinefields Bury St Edmunds Suffolk IP33 1YA Lead Inspector
Mary Jeffries Announced 17 August 2005
th 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 Older People. 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. Martins I54-I04 S24443 The Martins V234046 050817 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Martins Address The Vinefields, Bury St Edmunds, Suffolk, IP33 1YA 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) 01284 753467 01284 701892 Methodist Homes For The Aged Post Vacant Care Home 40 Category(ies) of Old Age (OP)28, Dementia Over 65 (DE)E 12. registration, with number of places Martins I54-I04 S24443 The Martins V234046 050817 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 25/02/05 Brief Description of the Service: The Martins was rebuilt in l998, to an extremely high standard. The Martins stands in its own beautifully kept grounds, which are frequently used by residents. The main view from the Home is towards Bury St. Edmunds town centre. Many rooms look on to the historic Abbey Garden ruins, with the River Lark running between the ruins and the home. All community facilities are available in the town centre but only the most active of resident would make the trip regularly on foot. The purpose built home is constructed on an incline, therefore has a lower ground floor, which is Lark Close, a ground and first floor that are the main part of the home. The Home has 40 single rooms, each with en-suite WC facilities. All rooms have a front door style entrance.Communal areas in the main home comprise a large sitting room and dining room, both of which have entrances onto the veranda and a second lounge on the ground floor. There is an additional sitting room on the first floor equipped with tea making facilities. There is a purpose built hairdressing salon and a small courtyard in the middle of the Home. Lark Close is more compact, designed in a simple ‘L’ shape. It has a kitchen/diner and two lounges for communal space as well as individual bedrooms. It also benefits from a secure sensory garden containing sculptures, seating and scented plants. The home is planning to develop its facilities for dementia care, within the same overall numbers. Martins I54-I04 S24443 The Martins V234046 050817 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection took place on one day in August 2005. The home provides care for 40 service users, 28 frail elderly, 12 elderly with special needs. 38 service users were living at the home at the time of the inspection, there were 2 vacancies on the frail elderly unit. 2 of the 12 service users on the special needs unit, Lark Close, were in hospital. The Inspector sat and spoke with a group of service users in a lounge on the special needs unit, as well as observing daily life on the unit. Two of these service users were spoken with individually, and showed their rooms to the Inspector. Two service users from the frail elderly unit were also spoken with. The acting manager took part in the inspection. Carers, activity and domestic staff participated. A visiting general practitioner and the visiting continence nurse were spoken with briefly. What the service does well: What has improved since the last inspection?
A registered managers application had been submitted, and a fit persons interview conducted by the CSCI. Good progress had been made on all the requirements made at the previous inspection. The home’s atmosphere and staff morale were noticeably good. Communication had improved in the home. The presentation of the home had improved: fresh flowers were in evidence around the home, information was readily available, drink making facilities had been located in the reception area, photographs of a recent social event were displayed.
Martins I54-I04 S24443 The Martins V234046 050817 Stage 4.doc Version 1.40 Page 6 Staff recruitment procedures had improved and were compliant with the regulations. 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. Martins I54-I04 S24443 The Martins V234046 050817 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Martins I54-I04 S24443 The Martins V234046 050817 Stage 4.doc Version 1.40 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,3, All service users will be assessed prior to being admitted into the home. EVIDENCE: The Statement of Purpose had been revised to meet the requirements of the previous inspection. The acting manager advised that they had completely reworked the document. It was therefore to be put to the next service users meeting for consultation. Domiciliary assessments were seen to have been carried out by the assistant acting manager prior to admission. The organisation had a system whereby applicants from another area would be assessed by a local service. Martins I54-I04 S24443 The Martins V234046 050817 Stage 4.doc Version 1.40 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9,10 Service users can expect to be treated with respect and sensitivity, and to have a care plan based on their assessment. Record keeping and record keeping practices require improvement to ensure privacy is fully respected, risks assessed and anticipated, and all needs addressed. EVIDENCE: Six care plans were inspected. Work had commenced on reviewing the care planning in use. The basic care plan format was quite brief. All service users files inspected had been recently reviewed, and additional sheets added. Service users risk assessments were in a folder in the main office, rather than on file. Risk assessments usefully contained information on risk to service user, risk to other service users, risk to staff. All service had falls risks assessments, but they were otherwise somewhat patchy. Two service users who had bedsides were seen to have a risk assessment in place that had been signed by a family member of the service user. Two service users who were spending some time on bed rest and who had pressure relief mattresses had not had
Martins I54-I04 S24443 The Martins V234046 050817 Stage 4.doc Version 1.40 Page 10 pressure area risk assessments on file. One service user who self medicates by injection did not have a specific risk assessment on this. A recommendation made at the previous inspection that the content of daily records is developed had not yet been implemented. The acting manager advised that staff require care planning training first. This had been arranged to take place in September. The acting manager advised that following this, she intends to do monthly reviews with the key workers. Service user’s dependencies were closely monitored and recorded, and service user’s files showed evidence of appropriate medical referrals. Service users have a number of different General Practitioners. A visiting G.P. advised that they did not have many patients at the home, but had been visiting regularly for 4-6 weeks and that they were quite happy with what they had seen. They commented that the attention to care at the home seemed good. A visiting continence nurse advised that she was seeing six or seven service users to promote continence. Two service users had been referred to the local NHS Mental Health Trust Wedgewood Unit for assessment. The controlled drugs cupboard contained one controlled drug, and the amount accorded with the register. Four service users are diabetic, and one service user’s diabetes is controlled with insulin. Insulin Syringes, made up by the District Nurse, were in a container, within a locked medication fridge. The care advised that these are used by the service user: the acting manager confirmed this and that the home is clear that they do not administer made up medications. Eye drops kept in the fridge were found to be dated when opened. An acting senior advised that medicated creams were kept in service users rooms on the frail elderly unit, but for those on the special needs unit, they were kept in the medications trolley. A prescribed cream was , however, found on an en-suite bathroom shelf in the room of a service user with dementia. The administration of medicine on the frail elderly unit was observed and good practices were seen. The acting senior doing this confirmed that they always checked tablets had been taken before signing for them, and that they always double checked the record and the blister packet before administering medicine, even if they had been on duty for several days in a row. They confirmed that they had received Boots training, foundation and advanced. The Medical Administration sheets for the ten service users on the special needs unit were checked , and no errors were found over the previous three weeks. Each contained service users photographs. A group of service users were enjoying an exercise session in the communal lounge on the morning of the inspection. A half hour session is provided every morning.
Martins I54-I04 S24443 The Martins V234046 050817 Stage 4.doc Version 1.40 Page 11 During the day, two service users on the special needs units were seen to be upset. Carers knew what they were upset about, and responded very well. One carer who responded very gently and appropriately, described how and why they had dealt with the situation as they did. Key worker are allocated to service users, however, as one service user said of the carers, “ They all seem to take a special interest.” Seventeen of the nineteen service users responding to the pre inspection survey confirmed that their privacy was respected, and two said sometimes. The previous staff meeting had reminded staff that they must always knock on service users doors before entering. All those replying to this questionnaire said that they felt well cared for. Martins I54-I04 S24443 The Martins V234046 050817 Stage 4.doc Version 1.40 Page 12 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,15 The home’s environment offers a number of opportunities to support service users in keeping their spirits up, and maintain their interest in life. Service users can expect to receive a balanced well presented diet, and for their preferences and satisfaction around food to be taken into account on an on-going basis. EVIDENCE: Service users on both the frail elderly and special needs unit were well dressed. A group of service users were seen having their hair done in the hair dressing room; one of these was not a resident service user, but attended for day care. (The home has two places a day for day care.) All of nineteen friends or relatives replying to the pre inspection questionnaire said that they felt welcome in the home and could visit their friend or relative in private. Religious observance is a valued part of the home’s life. A notice board in the home advertised a weekly mid week worship meeting, and worship and prayers on the first Monday of the month. Service users confirmed that there is a weekly religious service held at the home. Prayers are said before meals, and a service user did this on the day of the inspection.
Martins I54-I04 S24443 The Martins V234046 050817 Stage 4.doc Version 1.40 Page 13 Social events at the home are open to service users from both the frail elderly and the special needs unit. The most recent large social event had been a ‘D Day’ Celebration; photographs of this were displayed in the home. A classical/operatic event was advertised to take place on 4th November. Twelve of 18 service users answering the pre-inspection survey had indicated that the home provided suitable activities, two said not, 4 said sometimes. It was established that the activities coordinator had been off sick for two months, but was now back at work. The activities worker advised of the initiatives that the acting manager was developing with her. There was a very pleasant atmosphere on the special needs unit. A newly appointed worker was acting in a supernumerary capacity on the frail elderly unit, and was involving the service users in singing to a guitar. This worker advised that they had previously attended the home to play music for the service users during the evenings. Later in the day, some service users were dancing to music. A member of staff advised that the acting manager is concerned to know that service users have some opportunity for singing each day. A register of activities was seen, and staff were able to say which service users, who might other wise be somewhat isolated, were encouraged to attend the sessions provided by the activities coordinator. The atmosphere was more sedate on the frail elderly unit, and lunchtime was a quiet occasion. Two service users spoken with said that they liked this. The lunch menu was written on a blackboard in the home, and a communication system for service users who cannot see well was in place. A taped message, giving the events of the day and the daily menu was placed over a telephone receiver if lifted. The lunch served on the day was appetizing and healthy. Service users had a choice, and vegetables were served separately in covered dishes. Table were attractively laid. Some dissatisfaction with food had recently been expressed, through internal complaints and through the pre inspection survey, although one of these specifically commented that it had improved recently. Martins I54-I04 S24443 The Martins V234046 050817 Stage 4.doc Version 1.40 Page 14 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16,18 Service users can expect to have clear information available about the complaints procedure, and to have complaints responded to appropriately. They can also expect to be protected through the home’s recruitment procedures. EVIDENCE: A poster about the home’s complaints procedure was prominently displayed. 18 relatives replied to the pre inspection questionnaire. 17 of them were aware of the complaints procedure, none had ever had to make a complaint. A summary of service users’ complaints was available on the units for service users to see, however these, nor the camion complaints file contained a main summary log showing clearly which complaints had been upheld, not upheld or were found to be unproven. Complaints in the folder were mainly around food. This had been recognised an area which required improvement, and changes made to the menus with the involvement of a dietician. Criminal Records Bureau checks had been undertaken for all members of the committee, who may have unsupervised access to service users. Similarly staff recruitment practices seen offered appropriate protection to service users. Martins I54-I04 S24443 The Martins V234046 050817 Stage 4.doc Version 1.40 Page 15 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 22, 23, 24, 25, 26 Service users can expect to live in an very attractive and well- maintained safe environment, and that aids and adaptations will be provided to meet their needs. EVIDENCE: The home was clean bright and very attractive, yet still homely. It was a very warm day, fans were on in the home, and cool drinks were served to service users. Service users pointed out that a number of dead flies had collected in two glass lamp shades: otherwise the home was spotless. One carer suggested that the lounge would benefit from a small occasional table: this opinion was supported as a service user in the special needs unit had been observed to put his drink down on the floor. The gardens were well maintained. One service user pointed out that they Martins I54-I04 S24443 The Martins V234046 050817 Stage 4.doc Version 1.40 Page 16 could hear the children playing in the gardens next door, and that they enjoyed this. The home’s gardens had been awarded the first prize in the category of communal housing of Bury in Bloom this year. Aids were seen through out the home. A number of chairs had risers on them, raised toilet seats and rails were seen in W.C.’s., and two service users who had periods of bed-rest had pressure care mattresses. Two service users on the special needs unit took the inspector to see their rooms, which were personalised and attractive, with all appropriate furniture and fittings. Water temperatures were checked at a hand-basin and found to be 43 degrees Celsius. A certificate of fire equipment maintenance was seen. Martins I54-I04 S24443 The Martins V234046 050817 Stage 4.doc Version 1.40 Page 17 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,29,30 Some recent pressures on staffing have been alleviated, and the home had sufficient staff on duty to meet service users needs. Good recruitment practices, now in place, offer protection to service users. The staff group, which is evidently caring and sensitive, require some further training to ensure all needs and risks are fully identified and met. EVIDENCE: Staffing was adequate on the day of the inspection. The staff compliment is for 3 carers on the special needs unit. On the day of the inspection there were 2, plus a supernumerary worker on one shift, but only 10 service users in residence as two were in hospital. A worker spoken to said that it had happened that the home had been a carer short on this unit occasionally, if someone had telephoned in sick on the day, and they had been unable to get an agency worker. This staff member said that they had now agreed they would come in at short notice if required, and were happy to, so that this had not been a problem recently. Also 5 workers had been recruited and were due to commence the following week. PoVA firsts had been obtained, and the supervisory arrangements for these workers were discussed. The files for the two most recently recruited members of staff were inspected and found to contain all the required documentation, and to have started their 6 weeks induction courses. A recently appointed carer was able to confirm and demonstrate that they were aware of the homes policies. They explained the
Martins I54-I04 S24443 The Martins V234046 050817 Stage 4.doc Version 1.40 Page 18 process for working their way through these, and were able to describe the rest of their induction course. At the time of the inspection, care practices were not supported by good recording and reviewing practices. For example, a full range of risk assessments were not being used as the basis of care staff’s daily working, and the most recent reviews had been conducted by management, to address a lack of systematic thorough reviewing of service users plans. Communication amongst staff, and between staff and management was good. Care staff spoken to demonstrated a good knowledge of service users needs and current circumstances, and a good manner in their interactions with service users. Service users comments confirmed that they felt staff were personally concerned about them as individuals. A good sense of morale and interest in their work was apparent in the care staff, domestic staff and activities staff. A comprehensive training plan was in place. The plan addressed routine training matters and identified areas of need, for example care planning. The acting manager confirmed that individual’s training needs had been analysed. Three members of staff, including a domestic worker confirmed that they had received manual handing training. Two confirmed that were up to date, a third that they were waiting for an update. At the last inspection, a requirement had been made that the Registered Persons develop a strategy to increase the percentage of staff with NVQs, with a view to the workforce target. The homes pre inspection questionnaire stated that 5 of 27 care staff, 14.4 have NVQ2 or above. The acting manager advised that 15 staff were doing or on line to do NVQ 2. Evidence of this will be sought at the next inspection. Martins I54-I04 S24443 The Martins V234046 050817 Stage 4.doc Version 1.40 Page 19 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 35, 37, 38 The acting manager has made a positive impact on the home in a short period of time. They have prioritised matters requiring their attention well, opened up channels of communication and kept service users and staff involved and informed. EVIDENCE: An application for Registration of the acting manager had been received by the CSCI and a fit persons interview undertaken. Evidence of the acting managers participation on the Registered Managers’ Award was provided. The acting manger had been in post since late February 2005. Staff regarded the acting manager as both caring and efficient. An energy and pride in their work was apparent amongst the staff group. Martins I54-I04 S24443 The Martins V234046 050817 Stage 4.doc Version 1.40 Page 20 Communication in the home is good. Staff confirmed that they thought it had much improved and that this was one of the strengths of the acting manager. A group of three members of staff described how they now try to relate to each other throughout their shifts, and also to senior staff. A staff handover book had been recently started, and there was also a daily communications folder which contained notes of a staff meeting held in July. An open surgery for staff is held by the acting manager once a week. Service user meetings were held on a monthly basis, and there were suggestion boxes throughout the home. A notice of the inspection was displayed. One partially sighted service user said that they did not bother with “the button” (the device to hear a taped message of the days events to come), “I knew you were coming”. The last Inspection Report was on display in the foyer. Another service user spoken with, when asked what they thought the home did well, said “the atmosphere is good, it’s relaxed, but positive, you can tell things are going to get done. It’s improved”. A domestic worker spoken with demonstrated on the special needs unit demonstrated a very good knowledge of Health and safety matters, including COSHH. No cleaning products were in evidence around the home, and the domestic advised that they were all stored in a locked cupboard upstairs, which also contained product sheets. They advised that a folder of product sheets were also kept in the main office, and this was found to be the case. One omission was found, in that there were no product sheets for two types of antibacterial hand-wash that were in screw top bottles, rather than wall mounted brackets, in the dementia unit. Service users files on the dementia unit were found to be accessible, in an unlocked office. A spot check of five service users personal monies held by the home was undertaken with the assistance of a committee member. Separate zip pockets held monies records and receipts for each service user that the home held monies for. They were found to be in order, with receipts provided for all transactions. Service users had a locked facility in each room. Regulation 26 reports had been provided regularly since the last inspection. A clear and comprehensive residents’ register had been set up and maintained. Martins I54-I04 S24443 The Martins V234046 050817 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 Older People 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3
COMPLAINTS AND PROTECTION 3 3 x 3 3 3 3 3 STAFFING Standard No Score 27 x 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 3 3 x 3 x 2 2 Martins I54-I04 S24443 The Martins V234046 050817 Stage 4.doc Version 1.40 Page 22 NO 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. 1. Standard 1 Regulation 4 Requirement Following consultation with service users, the Registered Persons must provide a copy of the revised Statement of Purpose to the CSCI. Service users plans need to be fully reviewed to ensure they include all relevant risk assessments. Prescribed creams must not be kept in unlocked cupboards in the rooms of service users with dementia. The Registered Persons must increase the percentage of staff with NVQs, with a view to the workforce target. Service Users files must be kept in accordance with the data protection act. Product information sheets are required for liquid hand washes in the dementia unit. Timescale for action 30/09/05 2. 7, 28, 37 13(4) 31/10/05 3. 9,38 13(4) Immediate and ongoing 31/12/05 4. 30 18(1) 5. 6. 10, 37 38 17(1)(b) 13(4) Immediate and ongoing 14/09/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. Martins I54-I04 S24443 The Martins V234046 050817 Stage 4.doc Version 1.40 Page 23 No. 1. 2. 3. 4. 5. Refer to Standard 7 16 20 26 Good Practice Recommendations It is recommended that the content of the service users daily record is developed. The complaints log should include outcomes and timescale. The lounge from would from a small occasional table. Light shades should be regularly cleaned. Martins I54-I04 S24443 The Martins V234046 050817 Stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection 5th Floor, St Vincent House Cutler Street Ipswich IP1 1UQ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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