Inspection on 09/01/06 for Wakeling Court

This inspection was carried out on 9th January 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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Wakeling Court 01/11/06

Wakeling Court 18/07/05

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 Unannounced Inspection 9th January 2006 10:00 Wakeling Court DS0000063897.V264608.R01.S.doc Version 5.0 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 Wakeling Court DS0000063897.V264608.R01.S.doc Version 5.0 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. Wakeling Court DS0000063897.V264608.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Wakeling Court Address 96A Halley Road Forest Gate London E7 8DU 020 8472 9648 020 8471 8839 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) 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 DS0000063897.V264608.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th July 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 twentyone 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 DS0000063897.V264608.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was carried out over one day. It was focussed on monitoring progress in meeting the requirements which had been made at the previous inspection, and on inspecting other key standards. The inspector interviewed the manager and spoke with one service user. She toured parts of the premises and viewed service user files, staff files, and key records and documentation. What the service does well: What has improved since the last inspection? What they could do better: The inspection resulted in four legal requirements and two good practice recommendations. The service user guide has been the subject of a requirement restated for the second time. The guide needs priority attention to make it useful to prospective and current service users. The premises are undergoing a significant refurbishment programme and the home is currently quite disrupted by the presence of teams of workmen. It is envisaged that this inconvenience will continue for some time. In the meantime the staff are managing to continue to support individuals to Wakeling Court DS0000063897.V264608.R01.S.doc Version 5.0 Page 6 progress. There is still fall out from the change of provider. Springboard policies and procedures have not been fully cleared out. This situation can lead to confusion and should be remedied as quickly as possible. As soon as the major works are completed, the home needs to work with care managers and other professionals to review service users care and to set goals of rehabilitation, working towards these with creative care planning. The level of staff supervision is key to service delivery and staff should be supervised regularly and frequently, in line with East Living policy. 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 DS0000063897.V264608.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Wakeling Court DS0000063897.V264608.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 3 Information is provided to assist service users in making an informed choice about whether to live in the home. It needs some improvement. The home works to meet the needs and aspirations of service users. EVIDENCE: The inspector viewed the statement of purpose which was the subject of a requirement at the pevious inspection. The document has been amended and now meets the specifications of the regulations. The inspector recommends that the statement of purpose would be improved by an index. This is a recommendation. The inspector viewed the service user guide which was also the subject of a requirement at the previous inspection. The guide is a different one which has been produced by East Living. It has a number of shortcomings:The contact details for the Commission for Social Care Inspection (CSCI) are given in the section on complaints. However they are located under a heading If you are still unhappy also they are not the local contact details. The manager must ensure that the local contact details are given, and it is made clear that CSCI can be approached direct at any time with complaints. Wakeling Court DS0000063897.V264608.R01.S.doc Version 5.0 Page 9 The inspector was not able to find any reference to the inspection report in the guide or how to access it. The inspector has suggested to the manager that the most recent inspection report be displayed on the notice board in the foyer. The guide should explain where the report can be accessed. The guide gives no information regarding individual accommodation or communal space. It does not say how many places are provided. It does not give the qualifications and experience of the manager and provider and staff. There is no information regarding the rent/fees and what they cover. Service users views of the home are not given. The inspector suggested to the manager that as the East Living guide is quite generalised most of the above information could be included by the addition to the guide of a supplement, which refers specifically to Wakeling Court. The manager must ensure that the service user guide fully meets the specifications of the regulations. This is a restated requirement. The previous inspection required the manager to ensure that a completed information sheet appears at the front of service user files. The inspector noted from viewing files that this has been achieved. Wakeling Court DS0000063897.V264608.R01.S.doc Version 5.0 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 The individual plans of service users reflect their assessed needs. EVIDENCE: The manager stated that apart from in two cases, all the service users care plans had been brought up to date. The inspector viewed three service user files. She noted that the support plans have been superseded by care plans. which were up to date, also that reviews had been recorded. Most of the paperwork was properly signed and dated. The inspector noted that daily information sheets had not been filed up to date in the service user files and recommends that this is routinely done. This is a recommendation. A service user interviewed by the inspector advised an aspiration he has. When asked if he believed his keyworker would progress this for him he said he thought this quite possible. Wakeling Court DS0000063897.V264608.R01.S.doc Version 5.0 Page 11 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): 15, 16 and 17. Appropriate relationships between service users and their families and friends are supported. Rights and responsibilities are recognised in the daily lives of service users. Healthy meals are presented in pleasant surroundings. EVIDENCE: The statement of purpose for the home states that visitors are encouraged and can be seen by service users privately in their rooms. The manager stated that keyworkers support service users in their relationships with their families and friends. One service user was going home to celebrate Eid the next day. Another service user was visiting with his sister and had been to stay with his mother the previous weekend. One vulnerable individual has a relationship with a friend which is potentially damaging to her. She is protected in this by the boundaries which have been imposed upon the friend by the staff at the home. The statement of purpose contains a licence agreement which includes the licencees rights and their obligations. The inspector noted that the responsibilities of service users form part of their care plans. Wakeling Court DS0000063897.V264608.R01.S.doc Version 5.0 Page 12 Service users have keys to their flats and the front and back door of the home. Their mail is taken directly to them and if keyworkers feel assistance will be needed to deal with particular items, they ask to be present when the mail is opened. The inspector ate her lunch in the dining room and observed as on previous inspections, the café style of meal presentation in the home. There are a number of tables seating four people and a hatch where service users collect their meals from the kitchen. The manager explained that menu choices are made by service users the night before for both main meals, lunch and supper. There is a rolling four week menu which is discussed at residents meetings. As noted elsewhere in this report a service user told the inspector that his choice of dishes, expressed to his keyworker had been accommodated on the menu. There is also choice of dishes on the breakfast menu. Service users in the rehabilitation accommodation the rehab house have access to cooking facilities and when the training kitchen is completed it will provide additional opportunities for cooking. The manager stated that there are some service users who do not aspire to independence in cooking, but a number do and will be supported and encouraged in this area. The dining room attached to the training kitchen will provide facilities for sampling results. Wakeling Court DS0000063897.V264608.R01.S.doc Version 5.0 Page 13 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): 19 and 21 The physical and emotional needs of service users are addressed along with their mental health needs. Ageing illness and death are respectfully handled in the home. EVIDENCE: The meeting of mental health needs is at the heart of the work undertaken at the home. Physical and emotional needs are also addressed by the care staff. The manager advised that one individual is being reassessed by the care team to ascertain whether his needs relate to aspergers syndrome/autistic spectrum disorder. She believes other service users may also be reassessed in this way. Although the service users are settled in placement the professionals working with them are keen to better understand their complex needs and the inspector felt that this demonstrates a robust approach to diagnosis. Service users are supported to attend their general practitioners (G.Ps.) but afforded privacy in consulting them, should they prefer this. G.Ps undertake medication reviews and make comments to the prescribing psychiatrist. Clinical reviews monitor psychiatric medications. Wakeling Court DS0000063897.V264608.R01.S.doc Version 5.0 Page 14 The previous inspection required the manager to ensure that afterlife arrangements assessment be offered to all service users. The inspector viewed afterlife assessments which detail service user views, on their files. Wakeling Court DS0000063897.V264608.R01.S.doc Version 5.0 Page 15 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. Service users feel their views are listened to and acted upon. They are protected from abuse, neglect and self-harm. EVIDENCE: As previously mentioned the complaints information in the service user guide needs amendment. The East Living complaints policy advises service users that they have the right to approach the CSCI direct and gives the local office address. The inspector viewed the complaints folder and noted that there is a rather low level of complaints. The last complaint received was in October 2004. There is a sheet which adequately records complaints and actions taken to resolve them. The manager advised that letters with more detailed information regarding complaints would not be kept in this folder, but filed on the service user file. The inspector viewed the adult protection policy which has been recently updated by East Living. The policy states that the procedure is subject to local multi-agency policy. The inspector discussed with the manager her understanding that all allegations of abuse must be referred to social services who will then take the lead. They will take decisions (in conjunction with the other relevant agencies) as to whether or not a strategy meeting is needed before a matter can be investigated. The strategy meeting will take decisions about actions necessary. Wakeling Court DS0000063897.V264608.R01.S.doc Version 5.0 Page 16 The inspector was satisfied that the manager has a proper grasp of adult protection procedure and is supported by the organisational policy. The manager advised that no form of physical restraint is used at the home. Wakeling Court DS0000063897.V264608.R01.S.doc Version 5.0 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, 28 and 30 The home provides a safe and clean environment. The shared spaces are not currently cosy or comfortable. EVIDENCE: The previous inspection required the installation of an alarm call system. The has been installed, although the work was not fully completed at the time of the inspection. Service users considered to be at risk will have wristbands and there were pull cords in evidence. There is currently one handset for staff and there will be another to allow for one to be on charge at all times. The previous inspection required that the garden pond be repaired and refilled. The pond has been cleaned out covered over on a temporary basis. The manager stated that pebbles have been delivered and the plan is for the pond to be filled with these and a water feature added later on. The manager advised that the garden is being tended by contractors every two months. Wakeling Court DS0000063897.V264608.R01.S.doc Version 5.0 Page 18 The previous inspection required all opened food containers stored in the refrigerator to have opened on dates. The inspector inspected the main refrigerator in the kitchen and was satisfied that this practice is followed. The refurbishment of the property is currently underway and there is a great deal of disruption with teams of men at work. External doors are being left open and some communal areas of the home were cold on the day of the inspection. The carpets and curtains are looking very tired and in need of replacement. The manager advised that new furniture, curtains and flooring will be provided. She advised that all the bathrooms are to be refurbished. The smoking room has been taken out of commission and is going to be fitted out as a dining room to complement the training kitchen next door. Workmen were in the process of dismantling the existing kitchen units on the day of the inspection. Service users are currently allowed to smoke in their flats and outside of the building. Another smoking area in the form of a conservatory adjoining the lounge, is under consideration. The inspector suggests that should the manager develop a supplement to the service user guide, which relates specifically to Wakeling Court, she could include a section on where smoking is allowed. The inspector is satisfied that service users are still warm and comfortable in their flats, but she hopes to see the shared areas looking much smarter and more comfortable at the next inspection. Wakeling Court DS0000063897.V264608.R01.S.doc Version 5.0 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, 35 and 36. The staff are generally well qualified and experienced and support service users competently. Recruitment policy and practice supports service users. Training levels are good but there are particular exceptions in the staff group. Levels of supervision are not adequate. EVIDENCE: There is a good level of qualification and experience among the staff group. Their work is well planned and managed and this was evidenced by the care plans, the daily schedule of activities and the recordings on daily sheets. The manager has a good grasp of the training levels of the staff and where there are shortcomings which need to be addressed. The inspector viewed three staff files. The previous inspection required that the files be divided tidily into categories, and this has been done. The inspector viewed the training folder, recently compiled by the manager. Staff have individual profiles and it is clear exactly what training each member has done. The inspector noted that two individuals had had no training in 2005. The manager advised that there are certain individual who because of their shift patterns find it difficult to access training. Wakeling Court DS0000063897.V264608.R01.S.doc Version 5.0 Page 20 The manager advised that she would expect all workers to renew each year their training on:Health and Safety Moving and Handling Fire Training The inspector also viewed the East Living corporate training calendar where some training courses are marked as mandatory for all workers. The manager must ensure that all workers are enabled, whatever their shift pattern to access adequate training. Unless there are exceptional circumstances, disciplinary action must be taken against workers who fail to attend mandatory training. This is a requirement. The manager advised that she is undertaking a ten week course from the Tavistock Centre, which will deal with psychoanalytical concepts. The inspector studied the records of supervision for three staff and had concerns about the supervision records of two. The manager felt that staff sickness could have delayed the delivery of supervision. The first worker had been supervised in September and October but not since. This worker had had five days sick leave in December. The second worker had been supervised in September and October and not since. She had had no sick leave. The inspector understands that the policy of East Living is to supervise staff every month. The regulations require that staff have regular recorded supervision meetings at least six times a year. This was a requirement of the previous inspection. The inspector felt that the requirement has not been met and is therefore restated. 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 restated requirement. The manager advised that her line manager is offering her excellent support and supervision. Wakeling Court DS0000063897.V264608.R01.S.doc Version 5.0 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 and 42 The home is well run for the benefit of service users. Their health, safety and welfare is promoted and protected. EVIDENCE: The view of the inspector based on the inspections she has carried out at the home, is that it is generally well run. There is an effective management structure and systems are in place to ensure safety, security and the proper delivery of care suited to the needs of service users. The inspector viewed the fire safety procedure and the records for fire safety. The alarms and emergency lighting are tested by a contractor and there was evidence of both of these being done in September, 2005. The manager stated that the contractor calls every three months and she knows they came in December. Unfortunately it was not possible to locate the documentary evidence. There was evidence of a number of recent call out visits and there was evidence of in house weekly testing of 10 fire alarm points. Wakeling Court DS0000063897.V264608.R01.S.doc Version 5.0 Page 22 Fire drills are carried out and a false alarm when the alarm is set off inadvertantly is counted as a fire drill. There was a record of a false alarm on 12th October 2005 The manager stated that a fire drill was planned for the day after the inspection and fire training is planned for later in the week The manager stated that the majority of the staff have had first aid training and refresher courses. The staff training records supported this. The inspector viewed the record of water temperature checks on hot water taps in the home. The record was satisfactorily kept and the water temperatures throughout the home were acceptable apart from in the kitchen. A kitchen tap had much hotter water recorded at almost 70o celcius (C). The inspector and manager tested one of the taps in the kitchen and found this to be the case. There are signs behind the kitchen taps warning of risk from very hot water. The manager must ensure that there is a risk assessment in place with regard to service users, who are allowed to enter the kitchen, being protected from scalding from water in kitchen taps. This is a requirement. The inspector viewed the accident and incident book. The records before December 2005 have been archived. Since December there has been one incident regarding a staff member and three involving service users. The manager stated that this was unusually high. The reports were properly completed and signed off by the manager. The incidents and accidents appeared to have been appropriately dealt with. Wakeling Court DS0000063897.V264608.R01.S.doc Version 5.0 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 x 3 x x Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 x x x x Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x 3 x 3 LIFESTYLES Standard No Score 11 x 12 x 13 x 14 x 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score x 3 x 3 2 2 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Wakeling Court Score x 3 x 3 Standard No 37 38 39 40 41 42 43 Score 3 x x x x 2 x DS0000063897.V264608.R01.S.doc Version 5.0 Page 24 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 1 Regulation YA5 Requirement Timescale for action 01/03/06 2. 35 YA18 3 36 YA18 The manager must ensure that the service user guide fully meets the specifications of the regulations (previous timescale July 2005 and 01/11/05 not met). The manager must ensure that 01/03/06 all workers are enabled, whatever their shift pattern to access adequate training. Unless there are exceptional circumstances, disciplinary action must be taken against workers who fail to attend mandatory training. The manager must ensure that 01/03/06 supervision of staff is undertaken not less than six times per year, including staff who are supervised by senior staff (previous timescale 01/09/05 not met). The manager must ensure that there is a risk assessment in place with regard to service users, who are allowed to enter the kitchen, being protected from scalding from water in kitchen taps. DS0000063897.V264608.R01.S.doc 4. 42 YA23 01/03/06 Wakeling Court Version 5.0 Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard YA1 YA6 Good Practice Recommendations The inspector recommends that the statement of purpose would be improved by an index. The inspector noted that daily information sheets had not been filed up to date in the service user files and recommends that this is routinely done. Wakeling Court DS0000063897.V264608.R01.S.doc Version 5.0 Page 26 Commission for Social Care Inspection East London Area Office Gredley House 1-11 Broadway Stratford 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. Extracts may not be used or reproduced without the express permission of CSCI Wakeling Court DS0000063897.V264608.R01.S.doc Version 5.0 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. 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