Inspection on 13/11/06 for Twyford Lane (7)

This inspection was carried out on 13th 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 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Twyford Lane (7) 17/12/09

Twyford Lane (7) 31/10/07

Twyford Lane (7) 16/12/05

Twyford Lane (7) 25/06/05

Twyford Lane (7) 29/09/04

Twyford Lane (7) 23/05/04

Similar services:

Flint House

The Cotswold Home

Fairways

Treloar College

Rush Court

The Maypole Nursing Centre

Fir Tree Lodge

Chilmington House

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

CARE HOME ADULTS 18-65 Twyford Lane (7) 7 Twyford Lane Browns Wood Milton Keynes Bucks MK7 8DE Lead Inspector Chris Schwarz Unannounced Inspection 13 November 2006 09:30 th Twyford Lane (7) DS0000015074.V300334.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 Twyford Lane (7) DS0000015074.V300334.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. Twyford Lane (7) DS0000015074.V300334.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Twyford Lane (7) Address 7 Twyford Lane Browns Wood Milton Keynes Bucks MK7 8DE 01908 639086 Telephone number Fax number Email address Ú,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) The Disabilities Trust Mrs Sandra Jane Stevens Care Home 3 Category(ies) of Physical disability (3) registration, with number of places Twyford Lane (7) DS0000015074.V300334.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16th December 2005 Brief Description of the Service: 7 Twyford Lane is a care home registered to provide rehabilitative care and accommodation for three younger people with an acquired brain injury. The home is administrated by The Brain Injuries Rehabilitation Trust, which is part of The Disabilities Trust. 7 Twyford Lane is situated on the Browns Wood development, which is to the south of the new town of Milton Keynes. The home is close to the local shopping districts of Old Farm Park and Walnut Tree and the more accessible and diverse Milton Keynes shopping centre. The home is close to a direct bus route that enables service users to have easy access to the towns of Bletchley and Milton Keynes as well as to main line train stations. The home is one of three properties built in a complex of small homes, all of which are administrated by The Brain Injuries Rehabilitation Trust. 7 Twyford Lane is a bungalow, which has been carefully adapted to provide for the needs of the service users who live there. Service users’ accommodation consists of single bedrooms with adjacent en-suite facilities. Communal areas consist of a lounge and kitchen/diner. The home shares a communal car park and garden with the other two properties on the complex. Fees range from £1785 to £1899 per week, according to information supplied by the manager in the pre-inspection questionnaire. Additional charges are made for personal items such as toiletries and outings. Twyford Lane (7) DS0000015074.V300334.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was conducted over the course of a day and covered all of the key standards for younger adults. Prior to the visit, a questionnaire was sent to the manager alongside comment cards for distribution to service users, relatives and visiting professionals. Any replies that were received have been taken into consideration and contribute to evidence of practice at the home. The inspection consisted of discussion with the house leader and individual meetings with some of the staff team plus discussion with the clinical psychologist. There were opportunities to observe care practice and to meet with service users to gain their views. A tour of the premises and examination of some of the required records was also undertaken. At the end of the inspection, feedback was given to the house leader and registered manager. Staff and service users are thanked or their co-operation and hospitality during this inspection visit. Overall, the inspection concluded that this is a well run service providing a good quality of care to service users in a homely and well staffed environment. What the service does well: Thorough assessment is undertaken of prospective service users’ needs, to ensure that care needs are ascertained prior to providing a service. Needs arising from equality and diversity are well met, ensuring that the needs of each person’s individual situation are addressed. Care plans have been produced for all service users, ensuring that needs have been identified and can be met. Service users are enabled to make decisions and be as independent as possible, providing them with choice and involvement. Service users are enabled to take responsible risks, ensuring that their independence is promoted. Service users take part in appropriate activities and make use of the local facilities, providing stimulation and variety. Service users are enabled to keep in contact with friends and family, maintaining important social links. The rights of the individual are respected, promoting fulfilment and affording service users respect. Twyford Lane (7) DS0000015074.V300334.R01.S.doc Version 5.2 Page 6 Meals are appropriately managed to ensure that service users receive the nutrients they require to keep them healthy. Personal support needs are recorded in care plans to ensure that service users receive the assistance they require. Physical and emotional health care needs are well managed to ensure that service users keep well. Medication practice is generally safe and ensures that service users receive the medicines they require. Effective complaints procedures are in place to listen to the views of service users and their representatives. Adult protection is well managed with appropriate policies, procedures and staff training in place. A clean, comfortable and homely environment has been created for service users, ensuring that they have appropriate surroundings in which to live. Competent and qualified staff work at the home, ensuring that service users are cared for by people with the skills and knowledge necessary to meet their needs. Thorough recruitment practices are undertaken, to ensure that service users are protected from unscrupulous persons working with them. Training is undertaken by staff to ensure they are equipped to meet the needs of service users. The home is managed by a competent and qualified person, ensuring continuity of care and that needs are met. There is effective monitoring by the provider to ensure that standards of care meet the needs of service users. Health and safety is well managed overall, ensuring that staff, service users and visitors are not placed at risk of harm. What has improved since the last inspection? No action was required at the last inspection as all standards were met. Twyford Lane (7) DS0000015074.V300334.R01.S.doc Version 5.2 Page 7 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. Twyford Lane (7) DS0000015074.V300334.R01.S.doc Version 5.2 Page 8 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 Twyford Lane (7) DS0000015074.V300334.R01.S.doc Version 5.2 Page 9 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 the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Thorough assessment is undertaken of prospective service users’ needs, to ensure that care needs are ascertained prior to providing a service. EVIDENCE: Two new service users had been admitted since the last inspection. Both were present during the inspection and contributed to discussions and assisted with a tour of the premises. Detailed written information regarding care needs had been ascertained prior to admission and one of the service users confirmed that she had been given opportunity to visit the service, meet staff and service users and move in following an unrushed introduction. Documentation submitted with pre-inspection material included the home’s statement of purpose, which clearly outlines the scope and philosophy of the service. Signed contacts were in place on both files. Twyford Lane (7) DS0000015074.V300334.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Care plans have been produced for all service users, ensuring that needs have been identified and can be met. Service users are enabled to make decisions and be as independent as possible, providing them with choice and involvement. Service users are enabled to take responsible risks, ensuring that their independence is promoted. EVIDENCE: Care plans were in place for each person living at the home. These provided evidence of multi-disciplinary assessment and focussed on re-teaching or enabling service users to further develop independent living skills following acquired brain injuries. There was evidence of regular review and updating where necessary. Risk assessments were in place to promote independence and encourage service users to do as much for themselves as possible such as using public transport and accessing local shops. Procedures were in place in Twyford Lane (7) DS0000015074.V300334.R01.S.doc Version 5.2 Page 11 the event of anyone going missing from the service, with a photograph on each file and descriptions already prepared. The money of one service user was being held for safekeeping and appropriate records were in place to log credits and debits. A check was made of the actual balance, which tallied with the recorded balance. Records showed that the home holds regular service user meetings with opportunities for service users to raise issues and to contribute to discussion about the service. Twyford Lane (7) DS0000015074.V300334.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Service users take part in appropriate activities and make use of the local facilities, providing stimulation and variety. Service users are enabled to keep in contact with friends and family, maintaining important social links. The rights of the individual are respected, promoting fulfilment and affording service users respect. Meals are appropriately managed to ensure that service users receive the nutrients they require to keep them healthy. EVIDENCE: A daily programme was in place for each of the service users incorporating inhouse tasks such as preparing meals and doing their laundry as well as external activities such as going to the cinema, taking it in turns to go the local Twyford Lane (7) DS0000015074.V300334.R01.S.doc Version 5.2 Page 13 shop to buy milk and attending groups such as relaxation and discussion forums. Use is made of public transport and one person was attending a numeracy course at the library. Each person had their own cupboard and fridge space and prepared their choice of breakfast and lunch with a communal evening meal prepared and service users taking it in turns to cook, which they thought was a good idea. Information on healthier eating was provided for one service user and lots of fresh fruit was evident in the kitchen and lounge. Occasional takeaways were part of the menus. Service users keep in contact with family and friends by using their own or the house telephone and are supported to see their relatives. The routines within the home were seen to be flexible, such as meal times, and based around each person’s daily programme. Staff did not enter service users’ rooms whilst they were out and asked permission if they needed to enter, such as checking the smoke detector. Twyford Lane (7) DS0000015074.V300334.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Personal support needs are recorded in care plans to ensure that service users receive the assistance they require. Physical and emotional health care needs are well managed to ensure that service users keep well. Medication practice is generally safe and ensures that service users receive the medicines they require. Some attention is needed where staff hand write medicines onto the record sheet. EVIDENCE: Service users did not require physical assistance in areas such as washing, dressing, showering or eating and thus the need for specialised equipment was not necessary. A multi-disciplinary care approach is undertaken with each service user and files provided evidence of input from specialists such as speech and language therapists, occupational therapists, physiotherapists and the clinical psychologist. Records were being maintained of medical appointments Twyford Lane (7) DS0000015074.V300334.R01.S.doc Version 5.2 Page 15 attended by service users and where possible, service users were being encouraged to manage their own medication. Where staff were managing medicines, the cabinet was secure and locked when not in use and a change to the Boots monitored dose system was better suiting the needs of the service. Medication administration records were in good order and accurate. Where staff had added a medication to the record sheet, there were no initials or signature of the person adding the information, which additionally should have been verified by a second person to ensure accuracy. A requirement is made to address this. Twyford Lane (7) DS0000015074.V300334.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Effective complaints procedures are in place to listen to the views of service users and their representatives. Adult protection is well managed with appropriate policies, procedures and staff training in place. Some revision is needed to the local adult protection policy to ensure that all agencies are notified of concerns, allegations and incidents of abuse. EVIDENCE: A copy of the complaints procedure was submitted with the pre-inspection questionnaire and contained all required information for anyone wishing to express views about the service. The Commission has not been made aware of any complaints about this service from service users or their representatives and none were indicated as being received by the home on the pre-inspection questionnaire. The log book in the service confirmed that no one has made a complaint. A service user described the range of people she would speak with if she had any concerns, which included the manager and external contacts. There are adult protection and whistle blowing procedures in place at the home and staff have undertaken Protection of Vulnerable Adults training last year, with an update course due soon. It was noticed that a local policy on adult protection did not refer staff to reporting concerns to Social Services and the Commission for Social Care Inspection. Whilst the organisational policy was detailed and contained satisfactory reporting details, to avoid Twyford Lane (7) DS0000015074.V300334.R01.S.doc Version 5.2 Page 17 misunderstanding by staff a recommendation is made to revise the local policy to state that both agencies are to be notified. The Commission is not aware of any adult protection concerns about the service. Twyford Lane (7) DS0000015074.V300334.R01.S.doc Version 5.2 Page 18 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 the following standard(s): 24 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. A clean, comfortable and homely environment has been created for service users, ensuring that they have appropriate surroundings in which to live. EVIDENCE: 7 Twyford Lane is situated on the Browns Wood development, which is to the south of the new town of Milton Keynes. The home is close to the local shopping districts of Old Farm Park and Walnut Tree and the more accessible and diverse Milton Keynes shopping centre. The home is close to a direct bus route that enables service users to have easy access to the towns of Bletchley and Milton Keynes as well as to main line train stations. The home is a bungalow, which has been carefully adapted to provide for the needs of the service users who live there. Service users’ accommodation consists of single bedrooms with adjacent en-suite facilities. One of the new service users confirmed that she had chosen the colour of paint in her room and that the room was comfortable and sufficient for her needs. Communal areas consist of a lounge and kitchen/diner. The home shares a communal car park and garden with the other two properties on the complex. Twyford Lane (7) DS0000015074.V300334.R01.S.doc Version 5.2 Page 19 The home was in a good state of repair and although some attention was needed to the inside of the microwave where food splashes had not been wiped up, the premises were overall clean and in good order. Service users’ daily programmes take into account their responsibilities for maintaining their rooms in a clean and hygienic condition and doing their laundry. Twyford Lane (7) DS0000015074.V300334.R01.S.doc Version 5.2 Page 20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Competent and qualified staff work at the home, ensuring that service users are cared for by people with the skills and knowledge necessary to meet their needs. Thorough recruitment practices are undertaken, to ensure that service users are protected from unscrupulous persons working with them. Training is undertaken by staff to ensure they are equipped to meet the needs of service users. EVIDENCE: Two staff were on duty at the time of arrival, one initially away from the premises escorting a service user to an activity. Rotas showed that appropriate staffing arrangements are in place at the home during the day to enable service users to be supported in their programmes and with a member of staff sleeping in each night. Where cover had been needed recently whilst one person was on annual leave, staff known to service users from other projects had been deployed. Twyford Lane (7) DS0000015074.V300334.R01.S.doc Version 5.2 Page 21 The home has achieved its requirement for 50 of staff to possess at least National Vocational Qualification level 2 and training on mandatory courses was on-going with the majority of staff up-to-date and just needing to attend the Protection of Vulnerable Adults update session that is due soon. There had not been any new staff recruited from outside of the organisation. One person had transferred from a project run by the provider and copies of the references and a fresh application were available to see. This member of staff stated that when she had first joined the organisation she had undertaken a three stage induction programme, as had others according to the training records. It was possible to observe that the approach of a member of staff was picked up by the house leader and dealt with promptly to ensure that service users do as much for themselves as possible, rather than staff offering to intervene. The staff team is small, reflective of the size and nature of the service. Staff meetings have taken place three times so far this year according to minutes. There is frequent support from the registered manager, who is based off site but visits regularly, plus the clinical psychologist was working closely with the staff team. A copy of the General Social Care Council code of practice was pinned to the notice board in the kitchen/diner for both staff and service users to refer to. Twyford Lane (7) DS0000015074.V300334.R01.S.doc Version 5.2 Page 22 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home is managed by a competent and qualified person, ensuring continuity of care and that needs are met. There is effective monitoring by the provider to ensure that standards of care meet the needs of service users. Health and safety is well managed overall, ensuring that staff, service users and visitors are not placed at risk of harm. EVIDENCE: The home has a house leader, who is charge of day to day running of the service. The community support manager is registered as manager and she has undertaken National Vocational Qualification level 4/Registered Manager’s Award and has the necessary experience and skills to ensure that the service Twyford Lane (7) DS0000015074.V300334.R01.S.doc Version 5.2 Page 23 operates to a high quality and that service users receive the support and assistance they require. Reports of monthly monitoring visits by the provider have been forwarded to the Commission on a regular basis and provide good evidence of detailed monitoring. Copies were also available in the office at the home. Health and safety is well managed with a range of checks in place. There was a current gas safety certificate in place, testing of portable electrical appliances had been undertaken in December 2005 and satisfactory checking of the electrical installation was undertaken in May 2005. The home has domestic smoke and heat detectors in place which are tested regularly for efficiency. Extinguishers had been serviced in March of this year and regular drills had been undertaken to ensure that safe evacuation procedures are rehearsed. A daily register is kept and the means of escape are checked regularly. Accidents and incidents are appropriately recorded and any serious matters reported to relevant agencies, such as the police following a stone throwing incident by passers by. Checks are made of fridge and freezer temperatures and hot water temperatures and shower heads are cleaned regularly to prevent build up of limescale and bacteria. Core temperatures of cooked foods are also checked but not recorded by staff or service users. It is recommended that a record be established to ensure that sufficient internal heat is achieved to prevent the growth of food poisoning bacteria. Twyford Lane (7) DS0000015074.V300334.R01.S.doc Version 5.2 Page 24 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 x 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 3 23 3 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 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 3 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 3 2 x 3 x 3 x x 3 x Twyford Lane (7) DS0000015074.V300334.R01.S.doc Version 5.2 Page 25 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 YA20 Regulation 13(2) Timescale for action Initials or signature are to be 14/12/06 added where staff hand write medicines onto medication administration sheets. This should then be verified by a second person for accuracy. Requirement 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 YA23 Good Practice Recommendations The local adult protection policy is to be revised to state that both Social Services and the Commission for Social Care Inspection are to be notified of any adult protection concerns, allegations or incidents. The microwave is to be kept clean after use. A record of core food temperature checks is to be established. 2 3 YA30 YA42 Twyford Lane (7) DS0000015074.V300334.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Burgner House 4630 Kingsgate Cascade Way Oxford Business Park South Cowley Oxford, OX4 2SU 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. Extracts may not be used or reproduced without the express permission of CSCI Twyford Lane (7) DS0000015074.V300334.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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!