Inspection on 28/04/05 for The Swallows

This inspection was carried out on 28th April 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 15 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Swallows 13/07/06

The Swallows 02/11/05

The Swallows 09/11/04

The Swallows 03/06/04

The Swallows 11/02/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 The Swallows 183-189 Hanworth Road Hampton Middlesex TW12 3ED Lead Inspector Louise Phillips Unannounced 28 April 2005 9:20am 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 Swallows G54-G04 S17369 the Swallows V224240 280405 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service The Swallows Address 183-189 Hanworth Road, Hampton, Middlesex TW12 3ED 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) 020 8783 0354 020 8783 0354 Owl Housing Limited Mr Dion Allen Care Home only (PC) 6 Category(ies) of Learning Disability (LD) registration, with number of places The Swallows G54-G04 S17369 the Swallows V224240 280405 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 9th November 2004 Brief Description of the Service: The Swallows is a purpose-built single storey care home. The home is set back from the main road and has a wheelchair accessible well-maintained garden to the rear of the property. The home is registered to accommodate six service users with learning disabilities and is well-equipped for supporting individuals with physical disabilities or mobility problems. Each service user has their own bedroom which is specifically designed to cater for individual needs. The premises is owned by Thames Valley Housing and managed by Owl Housing. The Swallows G54-G04 S17369 the Swallows V224240 280405 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over one day and took approximately 5 hours. The inspection was carried out because the home has not been inspected since November 2005. A tour of the premises took place and care records were inspected. Two of the three members of staff on duty on the day and one of the six service users were spoken to. What the service does well: What has improved since the last inspection? What they could do better: There are significant number of staff shortages at the home which can lead to inconsistencies in the level of care provided. At the time of the inspection a lot of the documentation relating to service users was found to need improving. In particular the care planning documentation needs to be standardised so that a clear plan of the daily care The Swallows G54-G04 S17369 the Swallows V224240 280405 Stage 4.doc Version 1.30 Page 6 needs for each service user is in place, these also need to be reviewed regularly. The current risk assessment for service users need to be made clear as these were observed to be of two different formats in use at the same time at the home, each with different types of risk assessed. Record-keeping that indicates whether service users have received medication was poor in areas, especially where it was noted that staff had not signed the chart to demonstrate that the medication had be given. Staff training provided by the service was not clear and a requirement has been made to ensure that individual staff training needs are assessed and an annual plan devised from these. It is vital that all staff at the home undertake training in the Protection of Vulnerable Adults to ensure that they have an awareness of all types of abuse. It is also required that staff have the opportunity to discuss their work in a confidential supervision meeting with their manager at least six times a year. The service is required to implement quality assurance systems which demonstrate that service users, staff, relatives, professionals and anyone involved with the service has the opportunity to give feedback and that this is used to develop the service. The quality assurance system would also involve regular audits of the service to ensure that the areas identified above, in relation to record-keeping are picked up and managed. 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 Swallows G54-G04 S17369 the Swallows V224240 280405 Stage 4.doc Version 1.30 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 Swallows G54-G04 S17369 the Swallows V224240 280405 Stage 4.doc Version 1.30 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) 1, 2, 3, 4 and 5 There has been limited progress on developing the Service Users Guide to include the relevant information. There is good evidence of the assessment of service users prior to their moving into the home. EVIDENCE: The current Service Users Guide for the home was updated in January 2005. Further work is required on this to include information about the whole staff teams’ qualifications and experience. The deputy manager described that all service users have resided at the home since it opened in 1997. Three service user files were inspected and each were found to contain a comprehensive assessment of individual needs ranging from physiotherapy, dentistry, social work and speech and language services. Each service user file was seen to contain a written statement of terms and conditions for their accommodation. The Swallows G54-G04 S17369 the Swallows V224240 280405 Stage 4.doc Version 1.30 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, 9 and 10 The health needs of the service users are met however there are no clear care plans in place to identify the daily care needs of each service user. The documentation relating to the current risk assessments of service users is unclear. EVIDENCE: Three service user files were examined and each were found to contain a lot of information about the health needs of each service user. These included records of any hospital, GP and dental appointments plus guidance from physiotherapy services on dealing with service users’ physical health needs. One service user file contained a document titled ‘choice and responsibility’ which gave a snapshot of how the service user likes to be approached, appropriate phrases to use and areas where extra encouragement is required, eg. prompting to change clothes. Another service user file contained a plan for communication and the use of symbols, however this plan was seen to have been implemented in January 2004 and there were no records to indicate that this plan had been reviewed, discontinued or was ongoing. The same file also contained a bowel movement chart, the date of the last entry being April 2004 and there was no indication as to the reason for this no longer being monitored. The Swallows G54-G04 S17369 the Swallows V224240 280405 Stage 4.doc Version 1.30 Page 10 The third service user file contained a weight chart where records had been maintained monthly until December 2004. There was no record of why this monitoring was no longer being carried out. The file also contained details of the day centre services that is received by the service user, this was last reviewed in January 2004. On further inspection of the service user files it was found that there were no actual care plans in place detailing the daily support needs of the service users. Each of the three files examined contained an initial care plan devised by Richmond Social Services in June 2003, however there was no indication that these had been reviewed since they were implemented, or that they had been developed further as a record of the daily care needs of the service user. The service is required to implement a standardised care plan format that is easily accessible and gives a clear record of the daily support needs of each service user. A record should also be maintained of who is involved in the review of individual care plans. Risk assessments for daily activities carried out were found in two service user files. The risk assessment in one file was dated April 2002 and the other was dated August 2003, with no review of either having been carried out since this time. The deputy manager showed the inspector a file containing a different format of risk assessment for each service user, which he stated had been developed as a result of a recent review of all the risk assessments. These risk assessments were within date, however there was no indication that the existing ones contained in the service user files had been discontinued. It was very unclear to establish which risk assessment was in current use for each service user. The home has utilised the Owl Housing risk assessment strategy for use by staff when supporting service users on a one-to-one basis. This was seen to include such areas as what action to take when a service user goes missing or when medication is lost. The daily records are maintained through the use of an individual A4 ‘page a day’ diary for each service user. A record is maintained of the daily occurrences for each service user, with entries being made at the end of the morning, afternoon and night shift. The inspector observed that there were clear gaps between entries made and also the page left blank where the last entry had been made. The inspector discussed with the deputy manager that the use of this system of recording is bad practice. This is with particular reference to the leaving of gaps of blank spaces between entries, which can lead to fraudulent entries being made and it is recommended that the staff team be trained in accurate record-keeping techniques. The Swallows G54-G04 S17369 the Swallows V224240 280405 Stage 4.doc Version 1.30 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) 11, 12, 13, 14, 15, 16 and 17 Good positive relationships have been formed between the staff and service users. The staff have a good understanding of the service users needs and support with activities is offered in such a way as to promote individual needs and interests. EVIDENCE: The deputy manager discussed that service users were supported according to their individual needs and interests to develop their social, behavioural, emotional and independent living skills. Discussion with one service user indicated that they are supported to pursue individual interests such as going to the pub and watching football. During the inspection one service user was observed being supported by staff to do a jigsaw puzzle and there were other service users spending time watching the television. The service user files contain information on individual preferences such as swimming, shopping, going for walks and spending time with relatives. The deputy manager stated that the home has a minibus that is used to support service users to attend activities outside of the home, where during the The Swallows G54-G04 S17369 the Swallows V224240 280405 Stage 4.doc Version 1.30 Page 12 inspection one service user was observed being transported to the local day centre. The deputy manager discussed that the minibus is also used to take service users out for meals, trips to art exhibitions and to the any local events occurring in the community. The home has ‘Essential Lifestyle Plans’ that detail the likes and dislikes in photographic form of the activities that each service user likes to be involved in which are a good reference point for new staff coming to home. On the wall in the kitchen was displayed a weekly menu plan, with a choice of takeaway food for the service users on a Saturday night. The deputy manager discussed that the menu for the week is planned with service users. The cupboards, fridge and freezer were seen to contain a variety of fresh fruits, vegetables, dairy produce and other nutritious foods for consumption. Service users are supported to plan and go on holidays of their choice as a group or individually, depending upon their preference. The inspector observed that all interactions between service users and staff were respectful and positive, with a good friendly rapport between all parties. The Swallows G54-G04 S17369 the Swallows V224240 280405 Stage 4.doc Version 1.30 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, 19 and 20 Personal support is offered in a way that promotes and protects service users privacy, dignity and independence. There are no systems in place to audit the recording of medication administration so errors are not identified. EVIDENCE: The personal care needs are identified in service user files in the format of guidance procedures. The assistant manager discussed that staff offer support with personal care to service users to varying degrees dependant on individual abilities. The assistant manager stated that the times for waking are flexible, dependant on the wishes of the service user and their daily plan of activities. The medicine for each service user is kept in a locked cabinet in the office area. The medication administration record (MAR) sheets for two service users were observed to contain a number of discrepancies, where there was no signature to indicate that either service user had received their medication on a number of occasions. It is required that the Registered Persons implement a weekly audit of the medication administration system, including a weekly check of the MAR sheet, to ensure that any errors are identified and acted upon, and that unnecessary risks to service users health is minimised. The Swallows G54-G04 S17369 the Swallows V224240 280405 Stage 4.doc Version 1.30 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 home has a satisfactory complaints policy and procedure in place. Adult protection in this home is inadequate with the lack of staff training and understanding of adult protection issues potentially leaving the service users at risk of abuse or exploitation. EVIDENCE: The Swallows has a complaints policy and procedure in place that is satisfactory. The home has a whistle-blowing policy and the Richmond local authority Protection of Vulnerable Adults (POVA) procedures in place. The deputy manager stated that both he and the manager had received training in the Protection of Vulnerable Adults, but none of the remaining staff team had been trained in this. It is required that all staff receive POVA training to ensure that they have a thorough understanding of adult abuse issues and the action to take should they be aware of any such incidence. The Swallows G54-G04 S17369 the Swallows V224240 280405 Stage 4.doc Version 1.30 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, 25, 26, 27, 28, 29 and 30 The décor within the home is of a good standard and presents as an attractive, homely and comfortable environment for service users. EVIDENCE: On entering the home you are met with a hallway that is tastefully decorated and spacious. A tour of the building showed that there is a good standard of décor throughout with individually decorated bedrooms and a well-furnished comfortable lounge/ dining area. The kitchen has worktops that can move up and down to enable service users to prepare their own drinks and snacks when desired. There is a large garden to the rear of the home that is designed to enable easy access by wheelchair users. The accommodation within each bedroom was observed to be furnished with the necessary specialist equipment to support the individual service users in their daily activities and personal care needs. One service user spoken to stated that they were happy with their accommodation. The Swallows G54-G04 S17369 the Swallows V224240 280405 Stage 4.doc Version 1.30 Page 16 Discussion with the deputy manager indicated that the staff carry out the cleaning of the home as part of their duties. On the day of inspection the home was cleaned to a high standard throughout. During the inspection an external contractor was carrying out the water testing checks on the home, where he was observed stating that all the water supplied by the home is distributed at the appropriate temperatures. The fire records maintained by the home indicate that an evacuation occurs every three weeks and that a satisfactory fire system check was carried out in February 2005. The Swallows G54-G04 S17369 the Swallows V224240 280405 Stage 4.doc Version 1.30 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, 35 and 36 There is a staffing shortage at the home. There is no record of the assessment of the training needs of individual staff and there is also no annual training plan in place. Existing staff do not receive supervision on a regular basis. EVIDENCE: The inspector was informed that there are currently 5.5 vacancies for care staff from a complement of 12.5 posts at the home. The deputy manager stated that the home is currently hoping to fill some of these posts through a recent recruitment campaign. The file containing the training records for the staff team indicate that courses have been taken for moving and handling, basic food hygiene and first aid. There were no records to evidence that staff receive training in equal opportunities. There was no indication that a training needs assessment had been undertaken for the staff team, or that there is a training plan in place for the coming year. At the previous inspection it was recommended that 50 of care staff have achieved NVQ level 2 by April 2005. The inspector was informed by the deputy manager that two staff have obtained the NVQ level 2 in Care and that he is due to commence the NVQ level 4 in managing care in the next couple of months. Two other staff are newly appointed and are currently undertaking The Swallows G54-G04 S17369 the Swallows V224240 280405 Stage 4.doc Version 1.30 Page 18 the LDAF induction. This recommendation has not been implemented and is carried over for implementation by the Responsible Person. The previous inspection required that the staff files contain the documentation specified in Schedule 2 of the Care Homes Regulations 2001. The report indicated that recent photographs of some staff are required. The staff files are no longer held at the home and so this was not inspected on this occasion. This Requirement is carried over for the next inspection. The deputy manager showed records to demonstrate that one supervision session had taken place for the each of the two new staff, however there is no supervision provided to the existing staff team. The Swallows G54-G04 S17369 the Swallows V224240 280405 Stage 4.doc Version 1.30 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) 39 and 41 There are no adequate systems in place to seek the views of the service users or staff. The home does not demonstrate that the views of relatives, professionals or any stakeholders of the service are sought. EVIDENCE: The deputy manager described that the home holds a group meeting with service users approximately once a month where service users are informed of changes and trips are planned. The format for the recording of individual responses is through the use of a photo of the service user and a written record of their contribution to the items discussed. The records of these indicate that the most recent meeting occurred on the 23rd April 2005 and the one previous to this on the 29th January 2005. The home should ensure that service user meetings are held weekly, and a record maintained of the issues discussed. The record for the most recent staff team meeting was 21st February 2005, with them being held monthly up until this time. The deputy manager The Swallows G54-G04 S17369 the Swallows V224240 280405 Stage 4.doc Version 1.30 Page 20 discussed that these meetings are used to discuss issues and any plans regarding the service users. The Registered Persons should ensure that these meetings are carried out monthly to ensure that staff have an opportunity to be involved with any plans for the service. The deputy manager stated that there are currently no quality assurance systems in place to seek feedback from service users, family, friends, professionals, advocates, etc. about the service. As stated earlier in this report there is no auditing carried out of the service to ensure that records are maintained in relation to medication administration or ensuring that the care plans are up-to-date. These are the subject of Requirements 2 and 4. The Swallows G54-G04 S17369 the Swallows V224240 280405 Stage 4.doc Version 1.30 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 2 3 3 3 3 Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 2 x 2 2 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score x 2 2 x 2 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Swallows Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score x x 1 x 2 x x G54-G04 S17369 the Swallows V224240 280405 Stage 4.doc Version 1.30 Page 22 YES 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 YA1 Regulation 5(1) & (2) Requirement The Service User Guide must contain all information detailed in Standard 1.2 of the National Minimum Standards for Older People. A copy of the guide must be supplied to the Commission. The Registered Persons must ensure that the current service users plans are of a standardised format and are accessible. The service user plans must be reviewed at least every six months and a record maintained of the people involved in the review. The Registered Persons must ensure that specific, up-to-date risk assessments are carried out for all activities undertaken by each service user The Registered Persons must ensure that a weekly audit of the medication administration system, including a weekly check of the MAR sheet, is carried out. All staff working at the home must receive training in adult protection. The Registered Persons must ensure that documents specified Timescale for action 31/05/05 2. YA6, YA39 and YA41 15 (1) & (2)(b) 31/05/05 3. YA9 & YA41 13(4) & (6) 31/05/05 4. YA20, YA39 & YA41 13(4)(c) 31/05/05 5. 6. YA23 YA31 & YA41 13(6) 19(1)(b) 30/06/05 31/05/05 Page 23 The Swallows G54-G04 S17369 the Swallows V224240 280405 Stage 4.doc Version 1.30 7. YA35 18(1)(c) 8. YA36 18(2) 9. YA39 24(1) in Schedule 2 of the Care Homes Regulations (2001) are obtained in respect of all staff. The Registered Persons must carry out an assessment of the training needs of the staff and implement an annual training plan to ensure that staff are appropriately trained for their work. All staff must receive supervision at least six times a year. A record is to be maintained of all supervision sessions. The Registered Persons must implement a quality assurance system to review the quality of the service and seek feedback from service users, their representatives and all parties involved with the service. 30/06/05 31/05/05 31/07/05 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. 3. 4. 5. 6. Refer to Standard YA10 & YA41 YA32 YA33 YA35 YA39 YA39 Good Practice Recommendations The Responsible Person should ensure that staff training in accurate record-keeping techniques. The Responsible Person should ensure that 50 of care staff have achieved NVQ level 2 by 31/12/05. The Responsible Person should ensure that there is a full complement of staff to ensure consistency of care to service users. All staff should receive training in equal opportunities. Service user meetings should be held weekly, and a record maintained of the issues discussed. The Responsible Person should ensure that staff meetings are held monthly. The Swallows G54-G04 S17369 the Swallows V224240 280405 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection Ground Floor 41-47 Hartfield Road Wimbledon London SW19 3RG 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. 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