Inspection on 13/05/08 for Tramways Corner

This inspection was carried out on 13th May 2008.

CSCI found this care home to be providing an Poor service.

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

Other inspections for this house

Tramways Corner 15/09/09

Tramways Corner 21/10/08

Tramways Corner 08/08/07

Tramways Corner 19/07/06

Tramways Corner 03/11/05

Tramways Corner 17/05/05

Tramways Corner 25/01/05

Tramways Corner 11/08/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

Extracts from inspection reports are licensed from CQC, this page was updated on 28/09/2008.

CARE HOME ADULTS 18-65 Tramways Corner Tramways Corner 39 Trebarwith Crescent Newquay Cornwall TR7 1DX Lead Inspector Alan Pitts Unannounced Inspection 13th May 2008 10:00 Tramways Corner DS0000009094.V362593.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 Tramways Corner DS0000009094.V362593.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. Tramways Corner DS0000009094.V362593.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Tramways Corner Address Tramways Corner 39 Trebarwith Crescent Newquay Cornwall TR7 1DX 01637 872049 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Catherine Fogarty Mrs Mary V Musselwhite Position Vacant Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Tramways Corner DS0000009094.V362593.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Service users to include up to 8 adults with a learning disability (LD) of whom 1 may also have a physical disability. Total number of service users not to exceed a maximum of 8 Date of last inspection 8th August 2007 Brief Description of the Service: Tramways Corner is an end terrace property very close to the town centre of Newquay. Behind the property there is parking for two cars. Additional car parking is available in a near by pay at the metre car park. There is a courtyard to the back of the house accessed through the kitchen. In the courtyard there is seating, pots of plants and a barbecue. Accommodation is provided on three floors (there is no stair lift facility) to upstairs bedrooms. On the ground floor there is a large lounge/diner and a kitchen that also has dining space. The laundry is domestic in type but is separate to the kitchen. The home provides accommodation and personal care for up to 8 residents with a learning disability. Fees range from £300 to £450 per week. Tramways Corner DS0000009094.V362593.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 0 star. This means the people who use this service experience poor quality outcomes. This inspection took place on the 13th May 2008, over a period of approximately 6 hours. Two inspectors carried out the inspection, which included: discussion with the registered providers and staff, a tour of the premises, examination of relevant documentation, and the inspectors met with 2 of the people that live there. We also looked at the responses from 10 surveys received from the people that use the service and others, which were sent out prior to the inspection. The residents have lived at Tramways for a number of years and the registered provider’s and staff have a good understanding of their care needs, though this does not always correlate with the care documentation. The overall rating is primarily the result of the home’s lack of management systems and a lack of attention to record keeping. This results in a lack of attention to issues that are intended to protect residents. What the service does well: What has improved since the last inspection? What they could do better: The registered provider is slowly continuing with the Registered Managers Award training, and this should now have been completed. More importance should be placed on staff training, particularly NVQ training. The home must do more to ensure its records reflect the service provided. The home could be more proactive in protecting the interests of the residents. More importance needs to be attached to management systems and the home’s records. Tramways Corner DS0000009094.V362593.R01.S.doc Version 5.2 Page 6 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. Tramways Corner DS0000009094.V362593.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 Tramways Corner DS0000009094.V362593.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 - Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Information for residents is dated and needs reviewing. The registered providers endeavour to ensure that prospective residents will fit in with the existing residents, and obtain pre-admission assessment information to aid this. EVIDENCE: The home’s Statement of Purpose and Service User Guide are both old documents that need reviewing and amending to ensure compliance with the relevant regulations and also to ensure they are current and accurate and reflect the level of service offered (e.g. staffing levels available). Tramways has an established group of people living there. The most recent person to move in to the home visited on three occasions before the decision was made to progress the admission. The resident met with the existing people that lived at the home. Pre-admission assessment information was obtained. There have not been any new admissions to the home since the last inspection. Placements are initially agreed on a first month trial basis, and the home maintains good contact with referring agencies, family and representatives. Tramways Corner DS0000009094.V362593.R01.S.doc Version 5.2 Page 9 The registered provider is aware of the importance of a successful placement for the existing residents as well as the new person coming to the home. Tramways Corner DS0000009094.V362593.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. There are care plans for each resident, though these do not provide sufficient information. There is insufficient evidence to support the assertion that residents make decisions about their lives. The registered providers described practices that do enable some residents to take responsible risks. EVIDENCE: Care plans are not individual enough, and do not provide accurate up-to-date information. Those examined do not provide individual specific information such as dietary needs, medical conditions, and do not ensure continuity of care. One care plan made no mention of a medical condition relevant to the individual, another did not reflect the care interventions described by the registered providers at the time of the inspection. More information is needed to ensure that the individual’s needs and preferences are evident in the plan of care (e.g. current care plans do not indicate individual preferences for going to bed/getting up, bathing). Tramways Corner DS0000009094.V362593.R01.S.doc Version 5.2 Page 11 The registered provider and staff were knowledgeable of individuals’ capabilities, and have liaised effectively with the local community in one instance to protect a resident without limiting their lifestyle. The home maintains good links with one local day care service used by all but two of the people that live at Tramways Corner. There are risk assessments, but more could be done to show that issues are not dealt with in isolation (the decision made by Tramways staff alone), but that they are discussed openly with other agencies (social worker, GP). There is a need for the providers to alter the current financial arrangement whereby residents’ money is paid into the home’s bank account and then redistributed to the individual. More needs to be done to ensure that residents can manage their own finances, or have a representative do so for them, and the registered providers undertook to make arrangements for money to be paid direct to the individual. Tramways Corner DS0000009094.V362593.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, 15, 16, 17 - Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents are encouraged to have social relationships with family and friends, and lead active lives outside of the home. Risk-assessments help to identify where residents’ rights and responsibilities need to be respected. The meals provided in the home are satisfactory with healthy eating encouraged, though this needs to be better demonstrated. EVIDENCE: One resident works at a nearby garden centre, and another organises their own lifestyle. The remaining residents attend external facilities at varying frequencies during the week. All have a family member available, though contact varies. The home have been supportive in finding work placements for residents. Some of the residents access the local facilities, and two went out to the shops at the time of the inspection. The registered providers have liaised effectively with local businesses to support residents. Weekends are ‘free-time’ and residents relax with each other or with friends and family. Tramways Corner DS0000009094.V362593.R01.S.doc Version 5.2 Page 13 Relationships with family and friends are encouraged. Daily records evidence when the residents have had visitors. The people living at the home can receive their visitors in private in their room, or in the lounge. Residents can also telephone their family and friends or visit them at any time. Some of the residents go home at the weekend. Some go out unaccompanied, although it is expected that they inform staff where they are going and when they will return. Residents are free to decide if they want to be sociable or if they would prefer to spend time alone in their room. Residents assist with household tasks to varying degrees. The resident’s fall within a 20-year age group, and their activities and lifestyle are in keeping with this. The registered provider is aware of possible diversity issues presented by differing age groups. The registered providers and staff were seen to interact appropriately with residents. Residents have unrestricted access to the home and small rear garden. The registered providers are considering the arrangements possible to allow one resident a front door key. Bedrooms are not lockable, and more could be done to ensure privacy and individual wishes are respected. There is a tentative weekly menu. The registered provider has the food order delivered weekly. Some meals are provided at the day placement during the week. Staff decide what is for tea from the options available in the fridge and freezer. Care plans do identify specialised diets. The registered providers said that if residents don’t want what is on offer they would be offered another choice. Whilst there is no reason to doubt the suitability of the diet provided, there is insufficient evidence of this. The residents and the home would benefit from a more established menu with residents’ involvement in determining this. Tramways Corner DS0000009094.V362593.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 poor. This judgement has been made using available evidence including a visit to this service. There is insufficient evidence to show that the home provides sensitive and flexible personal support. Residents do not receive access to all the healthcare facilities available. Residents are not protected by the homes’ medicine practices. EVIDENCE: There is only one member of staff on duty at any time, and there have been instances when a resident has had to attend hospital unaccompanied. The home did not make additional staffing provision to support the resident. Times for getting up and going to bed are not reflected in the individual care plans. Although the home has sought appropriate professional advice where there is an identified need, not all residents are receiving access to the health care facilities they are entitled to (e.g. dental checks, eye tests). Guidance and support regarding personal hygiene is provided, and residents are assisted to choose their own clothes and appearance. The staff have undertaken medicine training via a local college. None of the residents self-medicate. Medicines are stored in a room that was very hot on Tramways Corner DS0000009094.V362593.R01.S.doc Version 5.2 Page 15 the day of the inspection. Medicines that require cool storage are placed with refrigerated foodstuffs. The home has an old copy of pharmaceutical guidelines. Two medicines were seen to be out of the original packaging and were not named. Medicine Administration Records are handwritten. The home’s medication policy and procedure was not available at the time of the inspection. The home administered a medicine that they did not have proof of prescription for, and made only one attempt to verify this with a telephone call to the GP surgery. Tramways Corner DS0000009094.V362593.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 adequate. This judgement has been made using available evidence including a visit to this service. There is a complaints procedure, which has been explained to the residents. More could be done to safeguard residents from abuse, though staff have received relevant training. EVIDENCE: There is a brief, but current complaints procedure, though the version contained in the Service User Guide is out of date. The registered providers and staff member confirmed that this has been explained to residents, and this is supported by the residents’ responses in the Commission for Social Care Inspection surveys received. One response from a relative said “I have had problems in the past and it has taken a long time for an outcome”. The complaints procedure does state that a response will be made within 28 days. An alternative format may be useful for residents. There has been one complaint made since the last inspection, which identified a number of issues. One of these was a safeguarding issue that should have been reported at the time, but has now been acted upon by the registered providers. More could be done to demonstrate adherence to robust safeguarding procedures. All the staff have attended training on safeguarding and the Mental Capacity Act. Tramways Corner DS0000009094.V362593.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 30 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a comfortable, homely environment, which is clean and hygienic. EVIDENCE: Tramway provides a homely environment with comfortable communal accommodation. The home is not suitable for wheelchairs as bedrooms are accessed by stairs with no stair lift or shaft lift facility, but the registered providers are aware of this and take this into account when assessing prospective residents. Bedrooms are available on the first and second floor. Each bedroom is individual and has been personalised. Six bedrooms are single with one double bedroom. Furniture and soft furnishings are satisfactory. Shared toilets and bathing facilities are available on each floor of the home. Bedroom doors do not have locks fitted. Tramways Corner DS0000009094.V362593.R01.S.doc Version 5.2 Page 18 Regular maintenance and testing of the premises is undertaken, to include; for example, gas safety; and hard wiring testing. The home was found to be clean on the day of the inspection. The laundry is small and domestic in nature, but sufficient for the residents’ current care needs. The communal dining and lounge areas are spacious and comfortable. There is a nurse call system, but this is not used at the moment. However, it was noted that some of these are not accessible should a resident have need and the registered providers undertook to ensure that all were accessible. Tramways Corner DS0000009094.V362593.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 - Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The registered provider must do more to encourage and promote staff training. The home adheres to a robust employment procedure. Staffing levels must be reviewed to provide flexible support to the residents. EVIDENCE: Only two members of staff have achieved the equivalent of NVQ Level 2 in care. This was discussed with the registered provider, who said that it was anticipated another staff member would commence NVQ training soon. One new member of staff was seen to be undertaking a National Training Organisation compliant induction programme. The registered provider has made suitable arrangements for staff to receive training in areas such as manual handling and 1st Aid. There is only one member of staff on duty at any time, and as has already been noted this has meant that a resident has had to attend hospital unaccompanied. There is no evidence of staffing levels being reviewed against Tramways Corner DS0000009094.V362593.R01.S.doc Version 5.2 Page 20 residents’ changing needs. The duty rota does not demonstrate the availability of additional staff should this be necessary. The personnel file for the newest staff member was inspected. This showed only one reference had been received; the application form did not reflect the employment history provided verbally by the registered providers; the application form does not make a statement in respect of the Rehabilitation of Offenders Act; there was no evidence of a Criminal Records Bureau or POVA 1st check, though the registered providers said that this was in the employees possession and they had seen it. Tramways Corner DS0000009094.V362593.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 - Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. This is a small home, which is managed by the day-to-day involvement of one of the registered providers. The views of residents and others have been sought. Residents benefit from a homely environment and a stable staff team. Relevant safety checks and maintenance is carried out. EVIDENCE: The registered providers’ progress in undertaking the Registered Managers Award has not changed since the last two inspections, and it is hoped that the successful completion of this training is not too far off. Either one of the registered providers has day-to-day involvement in the home. The management approach is relaxed, and the staff and people that live in the home would benefit from a more pro-active approach to training, Tramways Corner DS0000009094.V362593.R01.S.doc Version 5.2 Page 22 records, and managerial systems. The home does not have an annual development plan (environmental improvements, staff training). The registered provider said that a number of quality assurance questionnaires have been sent to families. One non-committal response was seen at the time of the inspection. This has not changed since the last inspection. More could be done and discussion took place around the options for this, such as comment/complaint forms being made available to visitors to the home. All but one of the staff have undertaken fire warden training, and the registered provider understands that the 3-monthly fire training provided needs to be maintained. Relevant training in respect of manual handling and 1st Aid is provided. The registered providers ensure that there is regular maintenance and safety checks of the equipment and premises. Tramways Corner DS0000009094.V362593.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 2 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 2 33 2 34 2 35 3 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 2 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 2 1 X 2 X 2 X X 3 X Tramways Corner DS0000009094.V362593.R01.S.doc Version 5.2 Page 24 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 4, 17 Requirement Timescale for action 01/07/08 2. YA6 15 3. YA7 20 The registered providers must keep documentation up-to-date and accurate. The Statement of Purpose and Service User Guide must reflect the service offered and must be reviewed and updated and be provided to all residents and/or their representatives. The registered providers must 01/08/08 ensure that care plans are current, regularly reviewed (with the resident or representative where possible), and provide sufficient information about the individuals’ capabilities and needs. The registered providers must 01/08/08 make arrangements for residents to receive their money into their own bank accounts. The registered provider must make arrangements to ensure that they do not act as agents (appointee) for the residents wherever possible. The registered provider must ensure that there is an accurate record of food provided and DS0000009094.V362593.R01.S.doc 4. YA17 16 01/07/08 Tramways Corner Version 5.2 Page 25 5. YA19 13 6. YA20 13, 16 choices made, and a written menu that offers choice at meals. The registered provider must 01/07/08 make arrangements to ensure that all the residents receive the health care services to which they are entitled. The registered provider must 01/07/08 ensure the home’s medicine practices adhere to the latest Royal Pharmaceutical Society guidelines (www.rpsgb.org.uk) in relation to the receipt, storage, administration, and disposal of medicines. The registered provider must provide a fax facility at the home (in this instance in order to receive or confirm medication changes). The registered providers must ensure adherence to a robust safeguarding procedure in a timely manner. The registered provider must make arrangements to ensure that at least 50 of the staff have NVQ Level 2 in care or equivalent qualification. The registered providers must ensure there are sufficient staff available to provide individual flexible support to the residents. The registered providers must ensure the duty rota reflects additional staff on duty/on-call in order to meet the needs of the residents. The registered providers must review the needs of the residents (and care plans) and the staffing levels needed to meet those needs. The registered providers must 01/06/08 DS0000009094.V362593.R01.S.doc Version 5.2 Page 26 7. YA23 13(6) 01/06/08 8. YA32 18 01/11/09 9. YA33 18 01/07/08 10. YA34 19 Tramways Corner ensure adherence to a robust employment procedure in order to protect the residents. 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 YA9 Good Practice Recommendations The registered providers should ensure that care plans include the residents’ capability and right to take responsible risks, including consultation with other professionals. The registered providers should make arrangements for residents’ rooms to be fitted with suitable door locks. Riskassessments should be recorded to enable residents that so wish to have a key to their room and to show where this is impracticable or not wanted. The registered provider should amend the complaints policy to ensure it is current. The registered provider should consider using alternative formats to ensure the understanding of the residents. The registered provider should complete the Registered Managers Award training being undertaken. The registered provider should be proactive in obtaining the views of others about the service provided, publishing a summary of the findings. 2. YA16 2. YA22 3. 4. YA37 YA39 Tramways Corner DS0000009094.V362593.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA 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 Tramways Corner DS0000009094.V362593.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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