Inspection on 18/07/05 for Wakeling Court

This inspection was carried out on 18th July 2005.

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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Wakeling Court 01/11/06

Wakeling Court 09/01/06

Similar services:

Townley Road, 2-3

Foxley Lane (121a)

Tudor Lodge

Stacey Street Nursing Home

Delrose House Ltd

Clovelly House Residential Home Ltd

Abbey Road [53]

Cherry Tree House

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

CARE HOME ADULTS 18-65 Wakeling Court 96A Halley Road Forest Gate London E7 8DU Lead Inspector Anne Chamberlain Announced Inspection 18 July 2005 at 10:00am th The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Wakeling Court G57 G06 S63897 Wakeling Court V237983 120705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Wakeling Court Address 96A Halley Road, Forest Gate, London, E7 8DU Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 020 8472 9648 020 8471 8839 East Living Limited Josephine Deighton Care Home 22 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (22), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (10) Wakeling Court G57 G06 S63897 Wakeling Court V237983 120705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24 and 25th February 2005 Brief Description of the Service: Wakeling Court is a 22 bedded residential home which provides personal care and support to service users with mental health issues. Placements are funded by Social Services and East London City Health Authority (ELCHA). The home is situated in Forest Gate close to local amenities and with public transport links. The home is purpose build and modern. It has been managed by Springboard Housing, however on 1st July 2005 the management transferred to East Living. There are 16 studio flats and six bedrooms. The home has a rehabilitation unit which has three bedrooms. There is a rehabilitation programme which offers intensive support towards independence and currently three people are participating in the programme. In addition to the manager there are twenty-one support staff including an adminstrator, cook, cleaner and general assistant. The home is staffed twenty four hours with one senior and two support staff on duty during the day and one waking senior and one support staff at night. Wakeling Court G57 G06 S63897 Wakeling Court V237983 120705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection and took place over eight hours on one day. The inspector interviewed the manager and two members of staff and spoke with several service users although only one was willing to enter into discussion. Four randomly selected service users files and three staff personnel files were viewed. The premises were also inspected, including the garden. It is acknowledged that the take-over by the new provider East Living was delayed by three months and therefore the home’s response to some of the requirements of the previous inspection has been affected. The manager has advised that she is involved in a series of meetings with the new provider and there is an acceptance that the home is currently in a situation of change. What the service does well: What has improved since the last inspection? The inspector was advised by a member of staff that in the last year it was difficult to get things done by the outgoing provider. The service has now been transferred to the management of the new provider East Living and the manager and staff have expectations of improved support. A number of outstanding inspection issues, for example the home environment, can and are being addressed. However it is acknowledged that the manager has, since the last inspection, achieved a number of improvements herself. Wakeling Court G57 G06 S63897 Wakeling Court V237983 120705 Stage 4.doc Version 1.40 Page 6 There is now a system for noting and updating service user plans with the action points from reviews. Risk assessments have been updated. Referrals have been made to specialist services for individuals who have impaired vision. A standardised consent to medication form has been produced and is being used. A form has been designed to capture the views of service users regarding Afterlife arrangements. A proper cupboard for storing controlled drugs has been installed within the main medication cupboard. A noticeboard has been mounted on the wall in the lobby where families and visitors will see it. The home now has a business plan and an expectation of regular person in charge, quality assurance visits. What they could do better: The inspection resulted in 9 legal requirements and 1 recommendation being made. Service users should become more involved in the running of the home. This will provide mental stimulation, increase self-esteem, and generate a sense of ownership and greater respect for the home environment. The manager now needs to work with the new provider to ensure that documentation (including statement of purpose and service user guide) meets the requirements of the regulations. Individual paperwork like assessment forms could be more up-to-date and signed by service users, giving a better picture of needs and involving people more in their own care. It is understood that a major refurbishment of the premises is planned. This should address various issues related to the environment and provide service users with a safer and more comfortable home. The level of direct one to one staff supervision is a concern as it falls below requirements. Staff would benefit from more regular, intensive individual supervision. The manager will benefit from more direct support by the senior management of the new provider. Service users will benefit from more and better opportunities to express their views regarding their service. Wakeling Court G57 G06 S63897 Wakeling Court V237983 120705 Stage 4.doc Version 1.40 Page 7 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. Wakeling Court G57 G06 S63897 Wakeling Court V237983 120705 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Wakeling Court G57 G06 S63897 Wakeling Court V237983 120705 Stage 4.doc Version 1.40 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 standard(s) 1,2,3 and 4. The existing information about the service does not adequately support an informed choice by a prospective service user. Individual needs and aspirations are assessed and met. There are opportunities for prospective service users to visit the home to help them decide whether to move in. EVIDENCE: The manager explained that she had not considered it worthwhile to amend the existing statement of purpose or service user guide as both will be reproduced with the new provider East Living. The manager expects that the new documentation will be corporate in style, produced to a high professional standard, and tailored specifically to Wakeling Court. The manager must work with the new provider to produce a statement of purpose and service user guide which meets the requirements of the regulations. This is a restated requirement. The home currently has three vacancies and three prospective service users. One person has been referred from hospital and two from East Living supported living projects. The manager explained that the prospective service users will be fully assessed using the new East Living assessment tool and Wakeling Court G57 G06 S63897 Wakeling Court V237983 120705 Stage 4.doc Version 1.40 Page 10 taking into account information from other professionals. The individuals will have opportunities to visit the home before deciding to move in. Upon moving into the home a more in-depth assessment of needs will be undertaken and a service user plan and daily support plan developed. A personal information sheet was noted in some service user files but not all. The manager must ensure that this completed sheet appears at the front of all of all the files. This is a requirement. The home is able to meet quite complex individual needs. There was documentary evidence of a range of medical referrals made on behalf of individuals. Wakeling Court G57 G06 S63897 Wakeling Court V237983 120705 Stage 4.doc Version 1.40 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7, 8 and 9. The changing needs of service users are reflected in their individiual support plans. They are encouraged to express their views and to take decisions about their lives. They are also supported through careful risk assessment, to be as independent as possible. There is scope for service users to become more involved in the running of the home EVIDENCE: The manager was able to give a good example of a change in care plan. The service user appeared to have lost interest in cooking but in discussion with her keyworker, was able to express that she did not like eating the dishes she was preparing. The care plan has been ‘tweaked’ and the service user is now cooking some of her Mum’s recipes from home, enjoying the activity and the results. The home is still experiencing difficulties in obtaining the minutes of reviews. Before reviews they complete an evaluation sheet which feeds into the process. They attend reviews and evidence this in the clinical review book. Any decisions which affect care are recorded on a continuation sheet and the support plan is updated. The daily action plan is also amended. A staff Wakeling Court G57 G06 S63897 Wakeling Court V237983 120705 Stage 4.doc Version 1.40 Page 12 member informed the inspector that the support plan is rewritten afresh every year. This was not evidenced however in the files which the inspector viewed. The manager agreed that assessment forms, support plans and evaluation sheets in the files are generally out of date. The manager must ensure that assessment forms, support plans and evaluaion sheets are brought up to date and signed and dated by staff members completing them, and if possible the service users themselves. This is a requirement. Service users are encouraged to make decisions about their lives. A staff member told the inspector she felt it was very important to listen carefully to service users. She spoke of one individual who had been able to say that although he enjoyed attending a certain club, he did not wish to travel there with a particular person. The travel arrangements have now been changed to reflect this choice. The home has regular weekly residents meetings. However the manager stated that she feels there is much scope to improve the level of participation by residents in the running of the home. It is anticipated that there will be a major refurbishment programme of the home by the new provider and the manager is hoping to involve service users fully in this project. Risk assessments were evidenced on files. They are updated every six months. There will be a new risk assessment tool in use with the new provider. This comprises a set of four forms, positive risk management form, initial risk assessment screening tool and risk assessment and monitor and review form. Staff will be trained in the new assessment framework. Wakeling Court G57 G06 S63897 Wakeling Court V237983 120705 Stage 4.doc Version 1.40 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13 and14. The home supports service users to take part in a range of appropriate local educational and leisure activities Service users are part of the local community. EVIDENCE: Service users take part in a range of activities. One service user enjoys further education courses but needs support to assess the impact on his health of the stress involved in challenging academic work. Two service users are experiencing difficulties in accepting the social boundaries in place at clubs they attend. The manager is negotiating with these services to avoid losing their places. A priest calls at the home twice a week to support spiritual needs. Service users engage in local community recreational and leisure activities including out and about group, deaf club, lunch club, leisure centre, church and cinema. The inspector noted a flyer in the residents meeting book for a day outing. Wakeling Court G57 G06 S63897 Wakeling Court V237983 120705 Stage 4.doc Version 1.40 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 standard(s) 18,20 and 21 The staff at the home strive to provide services in a user led way. The home’s policies and procedures for the adminstration of medication are sound. Where appropriate service users administer their own medication. Ageing, illness and death are sensitively handled. An assessment tool to collect the views of service users has been developed and should be extended to all service users. EVIDENCE: A staff member advised that staff follow service user preferences. She said they work with service users “at a pace which suits them” and “have a discussion and find out what suits them”. One service user she said likes to have things written down. This staff member felt that although the approach of staff varies, the general view is that service should be tailored to service user’s needs. The arrangements for the administration of medication were inspected. Some service users are self-medicating and their medications are kept in their rooms in locked cupboards or drawers. Service users who are self-medicating sign a consent form and an example was viewed on file. Service users are assessed for competency in self-medication and one service user is currently being assessed. The assessment starts with coming to the office at the appointed times for medication. Random checks are made and if compliance with selfmedication is found to be poor the arrangement is terminated and medication is administered by staff. There are currently no service users taking controlled Wakeling Court G57 G06 S63897 Wakeling Court V237983 120705 Stage 4.doc Version 1.40 Page 15 drugs. The arrangements for the administration of medication were inspected including:- the recording of the receipt of medicines into the home, and the return or medicines to the pharmacy, the storage of medications, MAR sheets and dosett boxes within the main system and also in the room of a service user. Medications were checked and no discrepancies were found. It was noted that since the last inspection a lockable cupboard attached to the wall has been installed within the main medications cupboard for the storeage of controlled drugs. The manager stated that following the last inspection a training day was arranged for staff and attended by them. East Living medication policy and procedure which will shortly be adopted, was viewed. This allows for all staff to adminster medication and staff training will be provided. The home has introduced an Afterlife Arrangements assessment form to gather the views of service users views regarding death and dying. This has yet to be rolled out to all service users however, and the manager must ensure that the opportunity to express their views on the subject is extended to everyone in the home. This is a requirement. Wakeling Court G57 G06 S63897 Wakeling Court V237983 120705 Stage 4.doc Version 1.40 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 standard(s) These standards were not inspected on this occasion. EVIDENCE: Wakeling Court G57 G06 S63897 Wakeling Court V237983 120705 Stage 4.doc Version 1.40 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 standard(s) 24,25,26,27,28,29 and 30. The environment at Wakeling Court is clean,comfortable, hygienic and homely. Service users bedrooms are individualised and support the independent lifestyles of their occupants. There are adequate and private toilet and bathroom facilities and any necessary specialised equipment is provided. There are pleasant shared spaces where service users can relax. EVIDENCE: Following the last inspection the manager wrote to the maintenance department requesting repair of 7 malfunctioning storeage heaters. The premises were inspected and are generally is a reasonable state of repair, excluding the carpets which need replacement. The manager advised that a major refurbishment programme is underway which will include replacement of flooring. As the majority of service users smoke and the smoking room gets quite crowded, the manager has agreed with the provider that there will be a partitioning of the lounge to provide a larger smoking area. The room which has been awaiting refurbishment as a training kitchen will be fitted out as such and the present smoking room which is close by, will be a small dining area where the dishes produced can be eaten. Wakeling Court G57 G06 S63897 Wakeling Court V237983 120705 Stage 4.doc Version 1.40 Page 18 The inspector noted that bathrooms are not domestic in appearance and have disability equipment installed which is not needed for any current service users. Also light fittings are quite unsuitable for bathrooms, being unenclosed bulbs in sockets suspended from the ceiling, with lampshades. The manager advised that she expects bathrooms to be part of the revamping of the premises. There was a requirement at a previous inspection that an alarm call system be installed in the home. This has not been done but the manager expects it to be undertaken in the forthcoming works. The manager must ensure that an alarm call system is installed. This is a requirement. The inspector was able to speak with some service users in their rooms and noted that they were clean, pleasant and personalised and supported their individual lifestyles, having TV, music equipment, storeage space etc. Care plans pinned up in rooms assist service users to plan their days. The home has a sufficient number of toilets and bathrooms and is built for disability access with a lift and wide doorways. The current service users generally have good mobility but the inspector was satisfied that the home would be able to access any specialist equipment which might be needed for an individual. The home has quite spacious shared spaces including a pleasant garden. The garden pond needs attention. The water level has dropped and the liner is split. The manager must ensure that the pond is repaired and refilled. This is a requirement. The home is clean and hygienic in appearance with no sticky or dusty surfaces. The carpeting which has been mentioned previously is burned in many places from cigarettes butts stubbed out on it and it is obvious that smoking takes place in communal areas outside of the designated smoking room. The manager stated that she and the staff constantly challenge this behaviour. The new flooring will provide a chance to reinforce to service users, the smoking policy and also the need to respect property. The inspector has suggested to the manager that she grasps the opportunity. This is a recommendation. Wakeling Court G57 G06 S63897 Wakeling Court V237983 120705 Stage 4.doc Version 1.40 Page 19 The inspector checked the main refrigerator in the kitchen and found food items which did not have ‘opened on’ dates on them. The manager must ensure that all food opened and placed within refrigerators is clearly marked with the date the container was opened. This is a requirement. Wakeling Court G57 G06 S63897 Wakeling Court V237983 120705 Stage 4.doc Version 1.40 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 34 and 36. The home’s recruitment policy and practice protect service users. Currently staff are not being supervised frequently enough. EVIDENCE: The practice with the previous provider was for certain staff records to be held at the head office. These records have not been transferred to the home as yet. At the last inspection standards of recruitment were found to be satisfactory and no new staff have been employed since then. New criminal records bureau (CRB) enhanced disclosure checks with East Living will be undertaken for all staff. There was evidence on file of staff appraisal, but supervision is not being undertaken six times per year. The manager must ensure that supervision of staff is undertaken not less than six times per year, including staff who are supervised by senior staff. This is a requirement. Wakeling Court G57 G06 S63897 Wakeling Court V237983 120705 Stage 4.doc Version 1.40 Page 21 Staff files were not divided up. Papers were stored loosely together. The manager must ensure that files are divided tidily into categories i.e. application, training, supervision etc., so that the information is readily accessible. This is a requirement. Wakeling Court G57 G06 S63897 Wakeling Court V237983 120705 Stage 4.doc Version 1.40 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39 and 43. Service users views underpin the quality assurance programme of the home, and the organisation. The management of the home is competent and accountable. EVIDENCE: A residents meeting is held every week and the minutes were viewed. Wakeling Court is now part of the East Living organisation and will access the service user annual forums. East Living have indicated to the manager that there will be regular unannounced person in charge visits. The inspector viewed the visit form which will be used. The recommendation made at the last inspection that a notice board be put up in the lobby for families, has been carried out. The board carried information about the inspection. Wakeling Court G57 G06 S63897 Wakeling Court V237983 120705 Stage 4.doc Version 1.40 Page 23 The inspector viewed the East Living comprehensive business plan which runs from 2005 – 2009. The manager has been given some information about her budgets and knows that a sum will be paid on a monthly basis into the home’s account, and that she will have a printed out list of amounts spent and balances Wakeling Court G57 G06 S63897 Wakeling Court V237983 120705 Stage 4.doc Version 1.40 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 3 2 3 x Standard No 22 23 ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 3 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 3 3 2 3 2 Standard No 11 12 13 14 15 16 17 x 3 3 3 x x x Standard No 31 32 33 34 35 36 Score x x x 2 x 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Wakeling Court Score 3 x 3 2 Standard No 37 38 39 40 41 42 43 Score x x 3 x x x 3 G57 G06 S63897 Wakeling Court V237983 120705 Stage 4.doc Version 1.40 Page 25 yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 1 Regulation 4 and 5 Requirement The manager must ensure that the statement of purpose and the service users guide fully meet the specifications of the regulations (previous timescale of July 2005 not met). The manager must ensure that assessment forms, support plans and evaluation sheets are brought up to date and signed and dated by staff members completing them, and if possible the service users themselves. The manager must ensure that the Afterlife Arrangements assessment is offered to all service users. The manager must ensure that an alarm call system is installed (previous timescale of September 2005 not met). The manager must ensure that the garden pond is repaired and refilled. The manager must ensure that all opened food containers stored in the refrigerator have opened on dates. The manager must ensure that staff files are divided tidily into categories i.e. application, Timescale for action 1 November 2005 2. 6 14 and 15 1 November 2005 3. 21 15 1 November 2005 1 November 2005 1 October 2005 1 November 2005 1 November 2005 Page 26 4. 24 23 5. 6. 28 30 23 (o) 13 7. 34 18 Wakeling Court G57 G06 S63897 Wakeling Court V237983 120705 Stage 4.doc Version 1.40 8. 36 18 9. 3 14 training, supervision etc., so that the information is readily accessible. The manager must ensure that supervision of staff is undertaken not less than six times per year, including staff who are supervised by senior staff. The manager must ensure that the completed information sheet appears at the front of all service user files. 1 September 2005 1 September 2005 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 30 Good Practice Recommendations The manager grasps the opportunity of the refurbishment to improve adherence to the smoking policy and general respect for the property. Wakeling Court G57 G06 S63897 Wakeling Court V237983 120705 Stage 4.doc Version 1.40 Page 27 Commission for Social Care Inspection Gredley House 1-11 Broadway London E15 4BQ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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