Inspection on 23/02/07 for The Ranch

This inspection was carried out on 23rd February 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 found no outstanding requirements from the previous inspection report, but made 7 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Ranch 18/02/08

The Ranch 24/01/06

The Ranch 14/12/05

The Ranch 28/02/05

The Ranch 06/01/05

Similar services:

Southfields

Thorndene

Insight - Eastchurch

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

1 Marten Road

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

CARE HOME ADULTS 18-65 The Ranch Well Path, Well Lane Horsell Woking Surrey GU21 4PJ Lead Inspector Suzanne Magnier Unannounced Inspection 23rd February 2007 12.45 The Ranch DS0000059190.V327703.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 Ranch DS0000059190.V327703.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 Ranch DS0000059190.V327703.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Ranch Address Well Path, Well Lane Horsell Woking Surrey GU21 4PJ 01424 438813 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) Quest Haven Ltd Mr Isaac Tagoe Care Home 3 Category(ies) of Learning disability (3), Mental disorder, registration, with number excluding learning disability or dementia (3) of places The Ranch DS0000059190.V327703.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th January 2006 Brief Description of the Service: The Ranch is a detached Bungalow situated within a quiet residential area of Woking. The home provides 3 single bedrooms, bathroom, lounge, and conservatory, dining area, kitchen, office, utility room and a small rear garden. There is ample parking space to the front of the property. Local transport links provide access to Woking and surrounding areas. The current rate of fees are £1,300.00-£1,612.87 per week. The Ranch DS0000059190.V327703.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced visit formed part of the key inspection and took place over five and three quarter hours commencing at 12.45 and finishing at 17.30 at the registered care home. Ms S Magnier Regulation Inspector conducted the inspection with the registered provider/manager present. For the purpose of this report, the home has requested that people using the service are referred to as service users. The home is currently offering a residential service to 3 service users and employs 6 members of staff. The inspection process included the sampling of documents which consisted of service users care plans, risk assessments, daily records, medication records, several policies and procedures; staff training details, staff recruitment files and health and safety records. Comments from service users and staff have been included in the report. These were obtained during the visit. The Commission for Social Care Inspection have also received written comments from relatives and health care professionals. The inspector would like to thank the service users, staff and the manager’s for their assistance and hospitality during this visit. What the service does well: What has improved since the last inspection? What they could do better: The Statement of Purpose and Service Users Guide must be reviewed to ensure that all prospective service users have sufficient and appropriate information regarding the home. The Ranch DS0000059190.V327703.R01.S.doc Version 5.2 Page 6 The protocols and documentation in service users files must be reviewed and updated in order to ensure that the current care and support needs for service users are being met and service users have been involved in the development of their protocols. All risk assessments must be reviewed more frequently to ensure the safety and welfare of the service users and staff. The homes medication procedures must be further developed to ensure the safety and wellbeing of service users. The home must further develop the staff recruitment practices in order to ensure the protection of service users. All staff must receive mandatory training in order to ensure they have the skills and abilities to provide appropriate care and support to service users. The home is advised to publish and distribute the quality assurance findings to service users and their representatives in order to demonstrate that the home undertakes self-monitoring, development and improvement. 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 Ranch DS0000059190.V327703.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 Ranch DS0000059190.V327703.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): 1,2,3,4,5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users do not have sufficient information to make an informed choice if they would like to live in the home. Trial periods of stay in the home are available. The arrangements for a needs assessment for new service users ensure the needs of prospective service users are assessed and identified before admission to the home. Service users have a copy of their terms and conditions of stay in the home. EVIDENCE: The home had updated the Statement of Purpose in March 2006. It was noted that the document did not include staffing details for example, the number, relevant qualifications, and experience of staff working in the home. It has been required that these details are included in the document in order to ensure that prospective service users know that staff are suitably qualified and experienced to provide the care and support they need. The Statement of Purpose indicated that the home could provide care and support for people with diverse and cultural differences for example support to places of worship. The Ranch DS0000059190.V327703.R01.S.doc Version 5.2 Page 9 The inspector sampled the Service Users Guide, which had not been updated since 2004. It has been required that the document is reviewed and updated to include the changes in the Care Homes Regulations 2006 for example the arrangements for fees and the charging and paying for any additional services to ensure that service users are aware of all charges related to their care and accommodation. It has been recommended that the Statement of Purpose and the Service Users Guide are developed to include pictures/photographs in order that the home promotes the understanding for service users with differing communication skills about their home. The home call care plans ‘protocols’. The inspector sampled one service users protocols, which clearly documented evidence that the home had undertaken a formal assessment, including visits to the day centre attended by the service user, prior to them moving into the home to ensure that the home could meet the needs and choices of lifestyle for the service user. The documentation also detailed that introductory visits had been encouraged and the service users had visited the home on various occasions. The inspector met and observed the service users who had recently moved to the home and noted that the person was calm, relaxed and moved freely around their home and enjoyed the company of one other service user and staff. The Ranch DS0000059190.V327703.R01.S.doc Version 5.2 Page 10 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. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home has protocols and risk assessments. Some documents were not current to ensure that the service users safety, wellbeing and personal goals were evidenced as being met. Service users make decisions regarding their lives and participate in the running of their home. EVIDENCE: The inspector sampled two service user’s protocols one belonging to a service user recently admitted the home and another to a person who had been resident for nine months. The protocol for the service user newly admitted to the home contained several assessments, which had included family and health care professionals. There was documentation regarding the anticipated needs of the service user to assist them to settle and daily records had been kept since their admission to the home. The manager explained that as the service user had not been resident at the home for long the home the protocols, which would included The Ranch DS0000059190.V327703.R01.S.doc Version 5.2 Page 11 personal care guidelines, some daily living skills, shopping, budgeting, and use of transport were still in the process of being developed. The protocols for the service user who had been resident in the home for nine months were in place but had not been updated or reviewed for several months. Several goals, including cooking and bathing had not been updated since September 2006 and there was no indication that the service user was currently engaged in pursuing these goals for personal development. Daily records were documented for each service user and the other documents within the files included personal belongings charts and a tick box system for activities attended. In discussion with the manager it was noted that the file sampled contained numerous documents, which were not relevant to the direct care and support needed by the service user. Due to these findings it was difficult to have a clear understanding of the current care and support needs for the service user and what support staff were offering as part of the persons care needs and achievements of personal goals. It is required that the protocols and documentation in service users files is reviewed and updated in order to ensure that the current care and support needs for service users are being met and service users have been involved in the development of their protocols. During the site visit it was apparent that all service users were able to make decisions and exercise their choice within the home and in their daily lives. Individual’s diversity and independence was encouraged and evidenced by one service user choosing to communicate through writing rather that speaking. The inspector sampled a behavioural risk assessment for the service user newly admitted to the home. Whilst sampling some other risk assessments it was not evident who had written the assessments and when the documents had been reviewed. It is required that all risk assessments are reviewed at least annually to ensure the safety and welfare of the service users and staff. It is recommended that all staff sign the risk assessments and protocols to confirm agreement of the working practices to safely support service users in their daily lives. The Ranch DS0000059190.V327703.R01.S.doc Version 5.2 Page 12 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): 12,13,14,15,16,17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home promotes and maintains service users involvement in their community, offers opportunities for personal development, appropriate activities and maintaining friendships. Service users are encouraged to be involved in the running of the home and improving daily living skills. The service users enjoy a healthy balanced diet provided by the home. EVIDENCE: The inspector met with one service user in their bedroom and later met with the other two service users when they returned home. One comment card received from a service user’s relative stated that they did not like their relative learning swear words from another service user. One service user told the inspector that they liked living in the home and liked being as independent as possible, which also included having a job. The inspector noted that all service users moved freely around their home. The Ranch DS0000059190.V327703.R01.S.doc Version 5.2 Page 13 A service user indicated by using signing and writing on a notepad that they did not like living in the home. On investigation and sampling the service users protocol it was noted that the service user has an advocate and was receiving support from their care manager to address their wishes and choice to move from the home and live in Sutton. It was evident during the inspection that the service user had difficulty accepting that a new person had moved into their home and didn’t like the noise and sometimes the language used by a service user. During sampling the protocols and daily records it was evident that service users skills were promoted to maintain their independence and abilities for example their own personal care, being in the kitchen and assisting with meal preparation. The homes visitors book indicated that friends and family were free to visit service users at home. One service user told the inspector that they go out for meals, visit the leisure centre, pubs and day centres and also visit and stay with family members. The manager explained that the home had been closed over the Christmas season as all the service users had visited and stayed with their families. The home promotes the service users rights of independence, diversity and choice. The manager stated that one service user smokes cigarettes in the garden and another service user has tea- making facilities in their bedroom. The homes menu indicated that the service users have a variety of meals including vegetarian options. Records are maintained of meals taken by service users and food-serving temperatures were also recorded. The homes fridges and freezers contained, appropriately stored foodstuffs and fresh fruit and vegetables were also available. The Ranch DS0000059190.V327703.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has records and documentation to evidence that service users receive personal care and attend health care appointments to ensure their wellbeing and welfare. The homes medication procedures are generally robust although further development is required to ensure the safety and wellbeing of service users. EVIDENCE: Two protocols and daily records sampled demonstrated that service users receive personal care in the way they prefer and health care appointments were attended for example visits to the dentist, optician and general practitioner. Records to monitor the service users specific health care concerns were also documented and included weight charts. The records also indicated that the home had close working relationships with other health care professionals such as care managers, community psychiatric nurses and psychiatrists. Records indicated that care plan reviews had taken place and the home were active in seeking advice and support from healthcare professionals should the need arise to ensure the safety and well being of the service users. The Ranch DS0000059190.V327703.R01.S.doc Version 5.2 Page 15 The home has a medication policy and procedure regarding administration of medication. The home has a Monitored Dosage System (MDS) system, which is overseen by the manager and designated staff. The medication is stored in a locked cabinet in order to protect the service users from harm. No service users are self-medicating. The inspector sampled all the service users medication administration charts, which were generally in good order and medication administered in accordance with the general practitioners instructions. One entry of medication, given when necessary had been obscured by correctional fluid and the inspector noted that there was no records to indicate how many tablets were in stock. The manager acted promptly to rectify this shortfall and documented the amount of tablets in order to ensure an improved system of handling medicines in the home. The manager explained that staff seek advise from him before administering medication on a ‘as required’ (PRN) basis. It was noted that there were no written guidelines regarding this procedure. A requirement has been made that written procedures are developed in order to further ensure and safeguard the service users and staff. Staff training certificates indicated that staff had received training in the administration of medicines. The Ranch DS0000059190.V327703.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users were confident that their concerns would be listened to and acted upon. The arrangements in place for safeguarding protected service users from abuse, neglect and self-harm. EVIDENCE: The home has a complaints procedure and the manager explained that no complaints have been received by the home. During the site visit the inspector asked several service users what they would do if they had any concerns. The service users said they would go to their relatives, manager or staff and would feel confident that their concerns would be listened to and dealt with. The service users comment cards received by the inspector also indicated that service users knew how to complain or raise concerns. The home has not been subject to any safeguarding referrals since the previous inspection. The manager explained that he undertakes non-abusive psychological and physical intervention training for staff and this included the local authorities procedures and policies for safeguarding vulnerable adults. The Ranch DS0000059190.V327703.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, 27, 28, 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home offers a clean, comfortable and homely environment. Communal areas, including bathrooms in the home were spacious, well decorated and maintained to meet the current needs of the service users. EVIDENCE: The home continues to offer a homely, clean and comfortable environment. The lounge and dining areas were spacious and well decorated. The bathrooms and toilets were in working order, clean and well decorated. The Ranch DS0000059190.V327703.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The home does not offer a good induction and training development programme to ensure that staffs are competent to support the needs of the service users. Further improvement is needed regarding staff recruitment practices to ensure the protection of service users. EVIDENCE: It was observed that the staff on duty were confident in supporting and encouraging the service users. Whilst sampling staffing records the inspector noted that the home has staff recruitment practices to include evidence of job descriptions and interview records, to promote the homes equal opportunities policies and procedures to ensure the protection of service users. Two of four staff files sampled contained a lack of sufficient evidence to demonstrate that safe staff vetting practices including Criminal Records Bureaux checks (CRB) or POVA first checks and confirmation of a visa status, The Ranch DS0000059190.V327703.R01.S.doc Version 5.2 Page 19 had been obtained. It has been required that the home must ensure that these checks are undertaken without delay prior to staff commencement of employment in order to ensure the protection of service users. The four staff training records evidenced voids in the mandatory training for example fire safety, first aid, moving and handling and food hygiene. The inspector also noted that there was no clear evidence to indicate that staff had received specialist training for example supporting people who ‘test’ the service, working with people with autism spectrum disorders or mental health awareness. The inspector requested a training plan to be sent to the Commission, which would demonstrate the full training programme offered by the home to ensure the skills and competency of staff. This had not been received at the time of writing the report. It is required that all staff receive training, including mandatory training, appropriate to the work they are to perform to ensure the protection, welfare and safety of service users in their care. The Ranch DS0000059190.V327703.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from a well managed home. Quality assurance is undertaken and service users and their representative’s views are considered yet must be published. Health and safety arrangements are in place to ensure the service users safety and welfare. EVIDENCE: It was evident during the site visit that the service users were able to voice their opinions about the service and attend home meetings if they chose to. The manager told the inspector that the home has a quality assurance process and service users and their representative’s views had been sought since the previous inspection. The manager was unable to locate any documents to evidence that a recent audit had taken place. The home is advised to publish The Ranch DS0000059190.V327703.R01.S.doc Version 5.2 Page 21 and distribute the results of the quality assurance surveys to service users, their representatives, care management, health care professionals and the commission (CSCI) in order to demonstrate that the home undertakes self monitoring, development and improvement. The inspector sampled a variety of health and safety records, which included water, fridge and freezer temperatures, accident and incident records, fire drills, practices and noted that the fire extinguishers had been serviced. The Ranch DS0000059190.V327703.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 2 3 3 3 4 3 5 3 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 3 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 2 33 X 34 2 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 2 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 Ranch DS0000059190.V327703.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA1 Regulation 4.(1c) Schedule 1 (3) Requirement The homes Statement of Purpose must include the number, relevant qualifications, and experience of the staff working in the care home in order to ensure that prospective service users know that staff are suitably qualified and experienced to provide the care and support they need. Timescale for action 23/03/07 2. YA1 5.(1) (bb) (bc) (bd) 3 YA6 15.(1) (2) (a-d) 4 YA9 13.(4)(b) The Service Users Guide must be 23/03/07 reviewed and updated to include the changes in the Care Homes Regulations 2006 for example the arrangements for fees and the charging and paying for any additional services to ensure that service users are aware of all charges related to their care and accommodation. The protocols and documentation 23/04/07 in service users files must be reviewed and updated in order to ensure that the current care and support needs for service users are being met and service users have been involved in the development of their protocols. All service users risk 23/04/07 DS0000059190.V327703.R01.S.doc Version 5.2 Page 24 The Ranch 5 YA20 13.(2) 6 YA34 7,9,19 Schedule 2 7 YA34 18.(1)c(i) assessments must be reviewed at least annually to ensure the safety and welfare of the service users and staff. Clear written procedures must be 25/02/07 developed with regard to the administration of ‘as required’ medication in order to safeguard the service users and staff. The home must ensure that 23/03/07 Criminal Records Bureau checks (CRB) or POVA first checks are obtained without delay and prior to all staff employment in order to ensure the protection of service users. All staff must receive training 23/04/07 appropriate to the work they are to perform, including mandatory training, to ensure the protection, welfare and safety of service users in their care. 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 YA1 Good Practice Recommendations It has been recommended that the Statement of Purpose and the Service Users Guide are developed to include pictures/photographs in order that the home promotes the understanding for service users with differing communication skills about their home. It is recommended that all staff sign the risk assessments and protocols to confirm agreement of the working practices to safely support service users in their daily lives. 2 YA6 The Ranch DS0000059190.V327703.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Surrey Area Office The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN 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 Ranch DS0000059190.V327703.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. 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!