Inspection on 24/11/06 for Twyford Lane (9)

This inspection was carried out on 24th 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 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Twyford Lane (9) 16/07/07

Twyford Lane (9) 16/12/05

Twyford Lane (9) 17/08/05

Twyford Lane (9) 10/12/04

Twyford Lane (9) 02/09/04

Twyford Lane (9) 18/02/04

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 (9) 9 Twyford Lane Browns Wood Milton Keynes Bucks MK7 8DE Lead Inspector Chris Schwarz Unannounced Inspection 24 November 2006 07:20 th Twyford Lane (9) DS0000015075.V300339.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 (9) DS0000015075.V300339.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 (9) DS0000015075.V300339.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Twyford Lane (9) Address 9 Twyford Lane Browns Wood Milton Keynes Bucks MK7 8DE 01908 639087 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) The Disabilities Trust Mrs Sandra Jane Stevens Care Home 3 Category(ies) of Physical disability (3) registration, with number of places Twyford Lane (9) DS0000015075.V300339.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. This home is registered for 3 people with a physical disability. Date of last inspection 16th December 2005 Brief Description of the Service: 9 Twyford Lane is a care home providing rehabilitative support to up to three service users with an acquired brain injury. At the time of this announced inspection three male service users were resident at the home. The home, which is part of the Brain Injuries Rehabilitation Trust, is situated on the Browns Wood development in the south of the new town of Milton Keynes. The home is close to the local amenities of Bletchley and Milton Keynes. Transport to both towns is very regular and service users are orientated to access local transport into these areas as part of their rehabilitation plans. The home is one of three properties situated on the development. All properties share a communal garden, which is centrally situated and there is also a communal car park with adequate parking facilities for up to eight vehicles at the front of the development. All bedrooms provide single room accommodation and are fitted with adjacent en-suite facilities. Bedrooms are situated on both floors of the property. There are communal living areas situated on the ground floor. Fees for the service range from £1106.35 to £1207.22 per week. Service users need to pay for personal items such as toiletries and sundries, plus outings in addition to the fee. Twyford Lane (9) DS0000015075.V300339.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 the morning shift and covered all of the key standards for younger adults. Particular attention was paid to how the home meets needs arising from equality and diversity. 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 from the comment cards have helped to form judgements about the service. The inspection consisted of discussion with the staff on duty and there were opportunities to observe care practice and to meet with all of the 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 registered manager. Staff and service users are thanked for their co-operation and hospitality with this visit. What the service does well: The needs of prospective service users are assessed prior to admission, to ensure that the service does not offer a placement to someone whose needs it cannot meet. Needs arising from equality and diversity are well met, ensuring that each persons individual circumstances are taken into account. 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 (9) DS0000015075.V300339.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 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 to reduce the risk of harm to service users. 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. What has improved since the last inspection? What they could do better: A clean, comfortable and homely environment has been created for service users but there is evidence of structural movement of the building which is awaiting remedial action to ensure that the premises are safe and then appropriately maintained. 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, ensuring that service users are adequately protected against the risk of harm. Twyford Lane (9) DS0000015075.V300339.R01.S.doc Version 5.2 Page 7 A record of core food temperature checks is to be established, to ensure that sufficient heat has prevented the growth of food poisoning bacteria. Staff need to ensure that hot water temperatures do not exceed 43° Celsius to ensure that service users are not placed at risk of harm. The fire based risk assessment needs to be revised to ensure that staff, service user and visitors are not placed at risk of harm. 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 (9) DS0000015075.V300339.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 (9) DS0000015075.V300339.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. The needs of prospective service users are assessed prior to admission, to ensure that the service does not offer a placement to someone whose needs it cannot meet. EVIDENCE: The home has a comprehensive statement of purpose that adequately describes the scope of the service. Each person living at the home had been assessed prior to admission with involvement from a multidisciplinary team, outlining care needs and aims of the placement. Copies of contracts and current fees were included on each file and signed by the service user. Twyford Lane (9) DS0000015075.V300339.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: A care plan was in place for each person, with information such as a detailed assessment of needs, a photograph of the individual, weekly planner, rehabilitation goals, risk assessments to support the goals and individual missing person’s procedure. There was evidence of regular reviewing to monitor progress against set goals and documentation on files showed that each person has support from a multidisciplinary team. There was evidence of service users signing documentation. A relative commented, “We’re very Twyford Lane (9) DS0000015075.V300339.R01.S.doc Version 5.2 Page 11 pleased with all aspects of care that our relative receives. He views it as his home and everyone there his friends.” All service users said via comment cards that they feel safe and well cared for at the home. Regular service user meetings are held with minutes kept of matters discussed. All of the service users were able to participate in the inspection and contribute to discussions about their home. In respect of decision making and choices, each placement is subject to a structured routine and some prompting and checking was needed to ensure that service users had completed morning tasks safely and effectively. There was free movement around the premises and individuals helped themselves to breakfast and drinks, one person went outside to smoke. One of the service users was managing his medication with an accompanying risk assessment to support this. The home manages some aspects of service users’ finances. Lockable tins and individual record books, signed by the service user, were in place, with receipts to verify expenditure. Recorded balances tallied with actual balances. Twyford Lane (9) DS0000015075.V300339.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: Each person had a structured weekly planner of community activities and household tasks to further develop their daily living skills. Use is made of public and community transport as well as walking. Service users use local Twyford Lane (9) DS0000015075.V300339.R01.S.doc Version 5.2 Page 13 shops and facilities as well as those in the city centre. Contact with family and friends is enabled through telephone calls and visitors to the home. Routines within the home are structured when part of service users’ weekly programme and may necessitate some prompting by staff, as observed during the visit. Staff did not enter service users’ rooms without their permission and were respectful when speaking with them. Records showed that service users enjoy a range of meals and are involved in shopping and cooking. There were useful cookery books to refer to and some wholesome and nutritious meals had been prepared such as home made soup. Fresh fruit was available in the home and the kitchen was reasonably stocked. Twyford Lane (9) DS0000015075.V300339.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 safe and ensures that service users receive the medicines they require. EVIDENCE: Care plans contained details of any assistance required by service users with their personal care. It was possible to see that detailed records were being maintained of one service user’s morning routine and whether prompts were needed by staff to ensure that all tasks were carried out. Monthly weights are recorded for all service users. Files contained records of health care appointments, showing that service users attend a range of appointments, including doctors and routine screening. Twyford Lane (9) DS0000015075.V300339.R01.S.doc Version 5.2 Page 15 Records showed that staff follow up on test results and actions from such appointments. A monitored dose system of medication administration is in use at the home and records showed that staff had received training from the supplying pharmacy in its use. Medication administration records were in good order and medicines were kept secure in a locked facility. Some homely remedies are kept on the premises with records showing infrequent use. One person was managing his own medication. A doctor commented, “Staff always present at consultations but will leave if requested. Don’t call unless necessary. Good working relationship.” Twyford Lane (9) DS0000015075.V300339.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 to reduce the risk of harm to service users. 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. The log book in the home confirmed that one person has recently made a complaint regarding the environment. There are adult protection and whistle blowing procedures in place at the home and staff have undertaken Protection of Vulnerable Adults training, 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 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 current adult protection concerns about the service. Twyford Lane (9) DS0000015075.V300339.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 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 poor. 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 but there is evidence of structural movement of the building which is awaiting remedial action. EVIDENCE: The home showed signs of structural movement which the provider is already aware of and a surveyor has examined. The premises were said to be safe although pieces of coving and a small amount of plaster had fallen down from ceilings around the premises and cracks of different depths were visible; the front door could not be used possibly due to altered alignment. These matters were of concern to some of the service users and staff were naturally wary. The registered manager gave assurance that the problem was being handled by insurers/loss adjusters and there was no immediate cause for concern. Her suggestion to keep the Commission updated on any developments is welcomed. 9 Twyford Lane is situated on the Browns Wood development in the south of the new town of Milton Keynes. The home is close to the local amenities of Twyford Lane (9) DS0000015075.V300339.R01.S.doc Version 5.2 Page 18 Bletchley and Milton Keynes. Transport to both towns is very regular and service users are orientated to access local transport into these areas as part of their rehabilitation plans. The home is one of three properties situated on the development. There is a communal garden, which is centrally situated and there is also a communal car park with adequate parking facilities for up to eight vehicles at the front of the development. All bedrooms provide single room accommodation and are fitted with adjacent en-suite facilities. Bedrooms are situated on both floors of the property. There are communal living areas situated on the ground floor and a very small staff sleeping in room and office. The home was clean with service users sharing household tasks to keep their home in good order. A significant part of the rehabilitation programmes is to undertake responsibility for doing domestic tasks such as laundry, shopping, cooking, ironing and cleaning and service users undertook their chores before going out. Twyford Lane (9) DS0000015075.V300339.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 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: The home has a small staff team with no newly recruited members since the last inspection. A check of recruitment records at that time showed that satisfactory recruitment checks are carried out for all staff and that Criminal Records Bureau checks are being repeated for those staff who have been in employment longer than three years. The home had one vacancy and had managed to maintain staffing levels through use of overtime and occasional input from other staff at Twyford Lane. During the course of the morning it was possible to see that staff from the Twyford Lane (9) DS0000015075.V300339.R01.S.doc Version 5.2 Page 20 other houses on the site help each other out with unexpected events to ensure that each of the homes is properly supervised at all times. Those staff met during the inspection had worked for the organisation for three and five years respectively and were effective in their work with service users, both acting as key workers to service users. Records showed that regular staff meetings take place to discuss and share practice issues and ideas. Training records showed that two of the three permanent team members have achieved National Vocational Qualification level 2 or above and there had been good attendance with mandatory and supplementary courses. One person needed to renew fire safety training and a Protection of Vulnerable Adults update for all staff was being organised. One service user volunteered that he thought highly of a member of staff. Twyford Lane (9) DS0000015075.V300339.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 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 adequate. 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 practice needs some attention to ensure 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 (9) DS0000015075.V300339.R01.S.doc Version 5.2 Page 22 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. A range of health and safety checks is in place at the home. There was a current gas safety certificate in place, testing of portable electrical appliances had been undertaken in January 2006 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. The home’s fire base risk assessment was undated and did not include a point from a health and safety audit about there being a potential fire evacuation issue for service users whose rooms are upstairs. A requirement is made to revise the assessment. Accidents and incidents were being appropriately recorded. 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. Several temperature records showed that hot water has been in excess of the maximum safe temperature of 43° Celsius around the building without remedial action being taken. A requirement is made to address this. 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 (9) DS0000015075.V300339.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 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 1 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 3 x 3 x 3 x x 2 x Twyford Lane (9) DS0000015075.V300339.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 YA42 Regulation 23(4) Timescale for action The fire based risk assessment is 15/01/07 to be revised and include the potential evacuation issue for service users whose rooms are upstairs. Hot water temperatures are not 01/01/07 to exceed 43° Celsius /- 2 degrees. Requirement 2 YA42 13(4) 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. A record of core food temperature checks is to be established. 2 YA42 Twyford Lane (9) DS0000015075.V300339.R01.S.doc Version 5.2 Page 25 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 (9) DS0000015075.V300339.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!