Inspection on 09/11/06 for Tregona

This inspection was carried out on 9th November 2006.

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

Other inspections for this house

Tregona 10/11/08

Tregona 05/01/06

Tregona 06/06/05

Tregona 09/12/04

Tregona 08/06/04

Similar services:

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

Pinta

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

CARE HOME ADULTS 18-65 Tregona 3 Edith Road Maidenhead Berkshire SL6 5DY Lead Inspector Mrs Rhian Williams-Flew Unannounced Inspection 9th November 2006 10:30 Tregona DS0000011271.V318282.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 Tregona DS0000011271.V318282.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. Tregona DS0000011271.V318282.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Tregona Address 3 Edith Road Maidenhead Berkshire SL6 5DY 01628 789433 / 62616 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) londonroad@tiscali.co.uk Milbury Care Services Limited Ms Annie McDermott Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Tregona DS0000011271.V318282.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 5th January 2006 Brief Description of the Service: Tregona provides care for three adults with learning disabilities, some of who may have associated physical disabilities. It is set in a residential area close to local amenities and the town centre. The home is a bungalow. There are a variety of aids and adaptations around the home to allow service users to be as independent as possible. All of the bedrooms are single and none of them have en-suite facilities. There are two communal toilets and one communal bathroom, this provides bathing and showering facilities. The Registered Manager has confirmed that the current weekly fees charged are £1923.66. There are additional charges for any other services provided such as, hairdressing; toiletries; holidays and outings. The home has a Statement of Purpose and Service User Guide and the Registered Manager has advised that there is a copy of the most current Commission for Social Care Inspection report available in the home for viewing. Tregona DS0000011271.V318282.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The accumulated evidence used to inform this report includes a pre-inspection questionnaire completed by the manager of the service; our inspection records held at the local office of CSCI; an unannounced site visit on 9 November 2006. The site visit took place between 10:30 hrs and 17:30 hrs and was conducted by one Inspector. During the unannounced site visit conversations were held with the members of staff on duty; a tour of the service was made; all of the case files were case tracked and some records concerning the management of the service were reviewed. The manager and deputy manager were present for the duration of the site visit. It was only possible to seek the views of one service user as the majority of service users do not converse verbally. CSCI did canvass the views of service users by asking them to complete a survey about their views of the care they receive, only one service user was able to partially participate. What the service does well: The home provides good information about the services it can provide. Some minor changes are required to reflect the current service. All prospective service users are assessed prior to being offered a place in the home. The care needs of all the service users are clearly identified in care plans. Other professionals are involved in the development of these care plans offering particular advice when required. Risk assessments are in place for each service user. Service users are offered a wide variety of activities and daytime occupation. These activities are individualised to the service user’s particular interests and wishes. The service users are supported to lead healthy lifestyles. Their health-care needs are well monitored. The medication policy and procedures within the home are administered and monitored effectively. The Registered Manager is proactive in responding to complaints. There are robust procedures in place for safeguarding the service users. The Registered Manager provides good leadership for the staff team. The deputy manager ably supports her in her role. The home almost has a full complement of staff. They are enthusiastic and motivated to provide individualised care. The service user who was able to converse commented positively about staff members and the support they have received from them. Tregona DS0000011271.V318282.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Tregona DS0000011271.V318282.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 Tregona DS0000011271.V318282.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. The home does have a Statement of Purpose and Service User Guide which details the care the home can provide as guided by the registration category. However, the Registered Manager and Responsible Individual will need to review whether the home is providing a service outside these criteria. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home does have a Statement of Purpose and Service User Guide. Minor revisions will be necessary to reflect staff changes and the contact address for the Commission for Social Care Inspection. The deputy manager gave an undertaking that these minor changes would be completed promptly. The Statement of Purpose indicates that the home is able to provide care for people with severe learning disabilities who may also have physical disabilities and communication needs. Since the previous inspection one new service user has been admitted to the home. There was good evidence that the Registered Manager had completed a full assessment of needs prior to the persons admission to the service and the Tregona DS0000011271.V318282.R01.S.doc Version 5.2 Page 9 persons care had been regularly reviewed throughout their stay in the home. It was evident that the needs of the person are complex. However, there was also evidence to indicate that the registered persons of the home should review whether they are providing a service outside that, which is stated in the Statement of Purpose and the registration category. It will be required that the Responsible Individual and Registered Manager review this matter as a priority. Tregona DS0000011271.V318282.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 good. Service users have clear and detailed care plans to ensure they receive the care they require. They are supported to lead independent lifestyles with due regard being given to risks that might occur. However, for one service user specific guidance is required to protect them and members of staff caring for them. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The care plans for all the service users were reviewed, discussions were held with various members of staff and observations were made of the delivery of care to the service users. From all the sources of evidence it was clear that the care plans reflected the needs of the service users and how these needs were to be met. All of the service users have a nominated key worker who is included in the review of their care needs. Only one of the service users was Tregona DS0000011271.V318282.R01.S.doc Version 5.2 Page 11 able to offer comment about their care and how they are cared for. Their comments were positive. All of the service users have very specific needs, which were clearly detailed in their care plans. For example, two service users are unable to use verbal communication and one of these service users has a significant visual impairment, another service user has very specific health care needs. There was good evidence to demonstrate support from the service users’ families to assist the service users in making decisions about how they wish to conduct their lives. The Registered Manager advised and, evidence was seen of each service user having a person centred plan being developed for and with them. Each of the service user’s care plans had up-to-date and detailed risk assessments in place. The risk assessments reflected the specific needs of the service users. For one service user with specific care needs the home were still awaiting specific guidance from identified professionals on how to manage a certain aspect of their care. The lack of these guidelines was a significant deficit for the staff. The Registered Manager will be required to ensure that guidelines are in place promptly to safeguard the service user and members of staff. Tregona DS0000011271.V318282.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 good. The service users led lifestyles that reflect their particular preferences. They lead inclusive lives and participate in local activities and facilities. The home has taken a pro-active stance about improving the menu choices available to the service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Registered Manager completed a pre-inspection questionnaire where she indicated that although the service users do not attend college or have employment they do participate in a wide range of community activities. These activities include attendance at day care services, social clubs, horse riding and visits to other community facilities. It could be evidenced from the service users’ care plans how many activities they participate in and gain enjoyment from. Tregona DS0000011271.V318282.R01.S.doc Version 5.2 Page 13 The home is situated within a residential street in Maidenhead. It is very close to community facilities and the service users are able to use all the facilities local to them with the assistance of staff. The home also has its own transport although its use is sometimes limited because of the small number of staff who can drive the vehicle. When this situation arises the service users are still enabled to use community facilities as taxis are used. During the inspection it was observed that all the service users were taken to participate in various activities in the local community. All of the service users have families who visit them regularly and are very involved in their care and how this is delivered. This is recorded in their care plans. Within the care plans there was clear evidence as to how the service users are to be supported in their daily routines to ensure their privacy and dignity. Members of staff were observed to be respectful of the service users when they entered their rooms or bathroom. None of the service users have locks on their rooms but there is clear evidence in their care plans that this has been risk assessed and agreed with their carers as appropriate. One of the service users has been provided, at her request, with a lockable box within her room to safeguard their possessions. All of the members of staff spoken with had a good understanding of the preferences of the service users. They understood their non-verbal communication and were able to clearly identify whether the non-verbal service users were happy or not when a specific event occurred. The Registered Manager provided information about the menu choices for the previous month. Within the service users’ care plans there was reference to their particular likes and dislikes with regard to food choices. Within the kitchen these preference were available for staff to refer to. The deputy manager was able to confirm that members of staff had recently attended training on diet and nutrition and the dietician who liaises with the home was due to provide them with information about providing more nutritious meals to meet the service users’ needs as the staff have recognised they need to provide more variety to the menu choices. One of the service users has particular dietary needs that the members of staff are receiving specific guidance on from a dietician. Tregona DS0000011271.V318282.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. Service users’ healthcare needs are well monitored and members of staff are vigilant to changing needs. The members of staff ensure that service users have access to all healthcare services. The Registered Manager does need to ensure that if service users’ healthcare needs are beyond the level of care the home can provide then reassessment should occur and action taken. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The pre-inspection questionnaire indicated that all of the service users have complex but differing healthcare needs. The mobility of two service users is limited to within the home. When they use community activities they use wheelchairs, although they are able to transfer from sitting to standing with minimal assistance. These service users require considerable assistance with their personal care and making choices about their clothing etc. How this care is to be provided is clearly detailed in their care plans and when spoken with, all members of staff had a good understanding of these service users’ Tregona DS0000011271.V318282.R01.S.doc Version 5.2 Page 15 preferences. References to the service users’ wishes with regard to their religious and cultural preferences. All of the service users are women and so are the staff team. The most recently admitted service user has very specific healthcare needs. There was clear evidence that the Registered Manager and staff team have tried to gain support from suitably qualified professionals to ensure they can meet this person’s needs. Some of the advice they have been promised has not yet come to fruition, in spite of their efforts to acquire it. Other advice they have received the Registered Manager does not consider appropriate for the service they are registered to provide. All of the service users’ health records were up to date and if appointments had been cancelled there was good evidence that the staff team made every effort to re-arrange the appointment. The members of staff commented that the service users receive good support from the GP surgery they are registered with. The home has clear policies and procedures for the storage and administration of medication. The staff member who is responsible for this area of care delivery was able to demonstrate how the system works and the procedures to be followed. One service user has been assessed as being able to participate in the dispensing of their medication but not without staff supervision. There are no controlled drugs prescribed. Tregona DS0000011271.V318282.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. The home has a robust policy and procedure with regard to complaints. Concerns and complaints are dealt with promptly. Service users are supported by a staff team who have received up to date training in safeguarding adults. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The pre-inspection questionnaire indicated that there has been one complaint since the previous inspection, which was partially substantiated. The complaint investigation was reviewed and was found to have been dealt with promptly and appropriate action was taken. The complainant was reported to have been satisfied with the outcome. CSCI have received no complaint, concerns or allegations since the previous inspection report. The deputy manager confirmed that all members of staff (with the exception of the most recently recruited) had received training in safeguarding adults. The home had the most recent documents from the local authority with regard to this and at interview staff members were able to clearly demonstrate their knowledge of the subject and the actions they should take. In addition, they were all familiar with the “whistle-blowing” procedures. The provision for safeguarding service users’ monies complies with the policies and procedures of the provider of the service. Tregona DS0000011271.V318282.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, 29 & 30 Quality in this outcome area is good. The service users have a comfortable, clean and well-maintained home to live in. Suitably qualified professionals have assessed and provided any aids and adaptations the service users may require to promote their independence. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is a bungalow and all of the service users are able to access the rooms in the building. The Registered Manager completed the pre-inspection questionnaire and indicated that since the previous inspection all the service users’ bedrooms have been redecorated and have had new carpets. The lounge has had new carpet and other communal areas of the home have been redecorated. The home appeared to be clean, well maintained and decorated. Each of the service user’s rooms had been personalised to reflect their preferences. Tregona DS0000011271.V318282.R01.S.doc Version 5.2 Page 18 The Registered Manager has ensured that each of the service users who require specialist equipment to maximise their independence have been assessed by appropriate professionals. Any adaptations or disability equipment have been provided. The condition of a shower chair needs to be reviewed as it has areas of rust that could affect the health and safety of the service users. The Registered Manager gave an undertaking that she would have the provision of this equipment reviewed by the appropriate professionals. The home has a separate utility room where all laundry tasks are completed. The home has clear procedures to ensure that soiled laundry is not taken through the kitchen area in order to access this utility room. Tregona DS0000011271.V318282.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, 34 & 35 Quality in this outcome area is good. The service users are supported by a staff team who have received regular training and who are committed to providing individualised care. 50 of the staff team have achieved their NVQ level 2 in the delivery of care. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The majority of the staff team within this home are well established. The home has nearly a full complement of staff. The recruitment records for the two most recently employed members of staff were reviewed and found to contain all the required information. The Registered Manager confirmed in the pre-inspection questionnaire that 50 of the staff team have achieved NVQ level 2. There was also evidence within the home to confirm that staff members do receive the opportunity to attend relevant training. In discussions with 4 members of staff they all Tregona DS0000011271.V318282.R01.S.doc Version 5.2 Page 20 confirmed that the Registered Manager regularly encourages them to attend training that is relevant to their role. The Registered Manager is well supported by her deputy. Throughout the visit 5 members of staff were spoken to in private (including a member of staff who had been in the home for less than one week). Comments such as, the manager and deputy are very approachable and supportive; there are clear guidelines for us to follow; if I dont know something I always ask. The one service user who was able to offer comment was positive about how members of staff treat all of the service users. Tregona DS0000011271.V318282.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 good. This home is well managed by a competent and qualified manager. She ensures that the service is run to meet the needs of the service users. There are clear systems in place to support the running of the home. The registered Manager does need to remind members of staff to follow these procedures at all times. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Registered Manager is qualified, competent and experienced to run the home. Since the previous inspection she has achieved her Registered Managers Award. The Deputy Manager has achieved her NVQ 3 and hopes to achieve her Registered Managers Award in the future. Both managers ensure Tregona DS0000011271.V318282.R01.S.doc Version 5.2 Page 22 that they undertake periodic training to maintain their knowledge, skills and competence. The home does have quality monitoring systems in place. Inclusion of the service users’ families in this process is relevant as the majority of the service users are unable to express their own wishes and preferences. There is evidence within the home of the staff being responsive to the views of others in order to promote the well-being and care delivery to the service users. The home has clear policies and procedures, which reflect the good practice advice given with regard to the care of people with learning disabilities. The Registered Manager also ensures that actions are taken with regard to any requirements made by any statutory body to ensure the safety of the service users and members of staff. The Registered Manager confirmed (as did the members of staff spoken with) that all staff with the exception of the most recently employed have received their mandatory training to ensure the health and safety of the service users. The pre-inspection questionnaire confirms that regular checks are maintained with regard to the safety of systems used in the home for example, fire systems; maintenance of hoist; water checks; disposal of waste and the control of hazardous substances. On a random sample of compliance with the necessary health and safety safeguards two areas had deficits. Food was being stored in the refrigerator whose use by date had passed and the washing powders in the utility areas were not being stored as required by the home’s own risk assessment for the control of hazardous substances. The accident and incident records were reviewed. The Registered Manager was reminded to ensure that the health and safety executive guidance with regard to the recording of accidents, particularly with regard to recording the identifiable number of each accident, was followed. Tregona DS0000011271.V318282.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 2 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 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 2 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 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 2 3 X 3 X 3 X X 2 X Tregona DS0000011271.V318282.R01.S.doc Version 5.2 Page 24 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 YA2 Regulation 4 16(1) 23(1) Requirement Timescale for action 15/12/06 2 YA6 15 3 YA19 12 4 YA29 23(2)(c) The Responsible Individual and Registered Manager must review the service provided at the home as defined in the Statement of Purpose and the registration categories of the home particularly with regard to meeting the needs of service users. Decisions of the review must be actioned to ensure compliance with the regulations. The Registered Manager must 01/12/06 ensure that there are clear guidelines in place to support the care of one of the service users who has complex healthcare needs. The Registered Manager must 01/12/06 ensure that if service users’ healthcare needs are beyond the remit of the home then she seeks appropriate healthcare intervention. The Registered Manager must 31/12/06 ensure that all aids and adaptations provided for service users are in good working order. This is of particular relevance to the provision of a shower chair. DS0000011271.V318282.R01.S.doc Version 5.2 Tregona Page 25 5 YA42 13 (4) The Registered Manager must ensure that all members of staff comply with the health and safety guidance with regard to the storage of food and of hazardous substances. 01/12/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard YA1 YA42 Good Practice Recommendations The Registered Manager is to ensure that minor alterations are made to the Statement of Purpose and Service User Guide to reflect changes. The Registered Manager is to ensure that all members of staff followed the guidance given for completing accident records. Tregona DS0000011271.V318282.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Oxford Office Burgner House 4630 Kingsgate Oxford Business Park South, Cowley Oxford OX4 2SU 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 Tregona DS0000011271.V318282.R01.S.doc Version 5.2 Page 27 - 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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