Inspection on 26/06/07 for Ware Road (49)

This inspection was carried out on 26th June 2007.

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

Ware Road (49) 14/02/07

Ware Road (49) 25/08/06

Ware Road (49) 18/01/06

Ware Road (49) 20/06/05

Ware Road (49) 21/12/04

Ware Road (49) 16/06/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Ware Road (49) 49 Ware Road Hertford Hertfordshire SG13 7ED Lead Inspector Patricia Rogan Key Unannounced Inspection 26th June 2007 10:00 Ware Road (49) DS0000019608.V342543.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 Ware Road (49) DS0000019608.V342543.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. Ware Road (49) DS0000019608.V342543.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ware Road (49) Address 49 Ware Road Hertford Hertfordshire SG13 7ED 01992 501288 01992 501288 FP h3012@mencap.org.uk www.mencap.org.uk Royal Mencap Society 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) Manager post vacant Care Home 6 Category(ies) of Learning disability (6), Learning disability over registration, with number 65 years of age (6) of places Ware Road (49) DS0000019608.V342543.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14th February 2007 Brief Description of the Service: 49 Ware Road is a large Victorian house, which has been converted to provide accommodation for six people with a learning disability. The home consists of six single bedrooms, one ground floor shower room with toilet, one bathroom, one separate toilet, lounge and kitchen/diner. It has a small front garden with limited off-road parking provided. There is a large rear garden. The home is conveniently situated on the main Hertford to Ware road, which can be busy. It is close to the shopping centre of Hertford, with all its facilities and major transport links. The home was first registered 13 November 1991 under the Registered Homes Act (1984). 49 Ware Road is part of MENCAP. There is a service folder, which includes a copy of the latest Commission for Social Care Inspection Report, the home’s Complaints Procedure and other information concerning the service readily available in the home. The current fees range from £ 831to £ 895 per week according to need. Ware Road (49) DS0000019608.V342543.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. One inspector carried out this key unannounced inspection, which took place over one day when all the residents and all the staff on duty were spoken with and in depth discussions were held with the homes manager. The comments in this report reflect the findings made by the inspector during that visit and also take account of information gathered over the past months from the homes management and by way of the pre inspection questionnaires completed by residents relatives and by the homes manager. This was a positive inspection with the key standards examined with the exception of two being met. There were no outstanding requirements from the last inspection. Two requirements and two good practice recommendations are made following this inspection. Since the last inspection a new manager has commenced her duties. Her application for registration by the Commission is currently in process. All the staff commented favourably on the arrival of the new manager, one said “ the new management team is working well and now we have all got time to carry out our individual roles more adequately.” During the day of this inspection the home had a calm peaceful and homely atmosphere where residents and staff were seen to be interacting very easily together. Without exception all the residents spoke positively about the care they received; they looked happy and well cared for and were clearly comfortable making their wishes known in their own home setting. What the service does well: What has improved since the last inspection? Since the last inspection the commencement of her duties by the homes new manager along with the appointment of other new staff brings the staffing compliment of the home up to its full strength, this the first time for many months. This improvement has certainly given the home a boost and all staff that spoke with the inspector were very positive about their work. A number of Ware Road (49) DS0000019608.V342543.R01.S.doc Version 5.2 Page 6 improvements of management and care changes have already been introduced and the managers programme for this is ongoing. Since the last inspection various works of refurbishment to the environment have been completed including some redecorations, the fitting of new bathroom fixtures and retiling of these areas. Work is continuing on the establishment of a snoozelem. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Ware Road (49) DS0000019608.V342543.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Ware Road (49) DS0000019608.V342543.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 People who use this service experience good quality outcomes in this area. This judgement has been made using a range of evidence including a visit to the service. Admissions are not agreed until a full needs assessment has been carried out and the home is satisfied that it can meet these needs. Sufficient information is provided for prospective residents and their families to enable them to make an informed choice about admission. EVIDENCE: There have been no new admissions to the home since the last inspection nor indeed since the home opened when all the residents transferred from a local hospital. It was not therefore possible to examine any recent admission records. However the home has the necessary admissions policies and procedures in place and the new manager has previous experience of carrying out assessments of prospective applicants for residential homes and in arranging their admissions to the home. Ware Road (49) DS0000019608.V342543.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 and 9. People who use this service experience good quality outcomes in this area. This judgement has been made using a range of evidence including a visit to the service. Good care plans are maintained for each resident so that staff are clear what needs to be undertaken to meet peoples assessed needs and goals. Appropriate procedures are in place to ensure the safety of the people using this service both inside and outside of the home. The residents are given every encouragement to make as many decisions about their own lives as it is safely possible for them to do. EVIDENCE: The care plans examined were found to be well maintained with recent reviews further evidencing that person centred planning (PCP) is fully functioning in this home, that the residents are actively involved with all aspects of their daily lives and that good consideration is given to meeting their varied verbal communication abilities. Staff remain enthusiastic about the PCP approach and Ware Road (49) DS0000019608.V342543.R01.S.doc Version 5.2 Page 10 examples such as the PCP activities board in several bedrooms evidencing the further development of this format with its aim to provide more interesting choices for the residents. Risk assessments for activities both external and internal to the home were regularly updated. The focus of these assessments was to ensure safety whilst still enabling residents to take reasonable risks as they seek to maintain and develop independent life styles. The individual needs of one resident who may be developing dementia were seen to be kept under regular review with staff and the resident is being supported by the community nursing service in aspects of their care. During this inspection the inspector witnessed many examples of residents making their own choices known to the staff and of these being listened to and acted upon. These ranged from a resident choosing what to have and where they were going to have a tea time snack; another on returning from their day centre activities requesting to go immediately to the garden to use the swing to a third asking for an early shower. The staff had good understanding of the residents various ways of communication and a clear knowledge of their preferred patterns of behaviour assisting those who liked to be part of a group but also accommodating others who preferred to spend time alone in their rooms. Ware Road (49) DS0000019608.V342543.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 and 17. People who use this service experience good quality outcomes for this area. This judgement has been made using a range of evidence including a visit to the service. The diverse social and activity needs of the residents are well supported. Staff assist the residents to use local community facilities. A varied and healthy diet of freshly prepared good quality food is provided. EVIDENCE: All the residents have individually planned social and activity plans, which were well recorded as part of their new person centred care, plans. It was noted that these plans are also regularly reviewed to take account of any changing needs or wishes. Each residents plan encompasses four or five days attendance at either a local day centre or college classes as well as some regular evening and weekend activities involving sport or community events. One resident, to meet their particular needs, has a one to one programme, which operates more from the home base. The home arranges a number of Ware Road (49) DS0000019608.V342543.R01.S.doc Version 5.2 Page 12 outings particularly in the summer months - these may be for a number of residents or for individuals. One resident who was ‘at home’ on the day of this inspection enjoyed an outing for a pub lunch with staff members. Staff commented that now the home is fully staff the residents’ can be assisted to go out much more often. Regular BBQs are held to which friends and relatives are invited and the manger commented that this was enabling her to get to know the residents relatives in an informal and relaxed setting. All the residents have some family, friends or significant others, with whom they maintain contact, and several are able to have regular staying visits with them while others are assisted by the staff to maintain letter or telephone contact. It was recognised that e-mail contact can also now be considered for some and is especially appropriate where great distances are involved. The inspector was shown a number of photographic records of the resident’s activities and recent holidays. All the residents have at least one staying away holiday each year at a destination and for a duration, which meets their preferences and needs. One resident explained plans for a July holiday in Hastings to the Inspector. A nutritious and varied diet is available to the residents. The fridge evidenced that a healthy eating plan is followed with low fat items, yogurts and bowls of fresh fruit being seen to be freely available. The weights of the residents are regular recorded and any assistance required with this is now given via the community nursing service following the demise of the County dietician service last year. Residents told the inspector that they liked their food and had plenty of it, one adding that they also liked to go out to eat or to have a take a away. Ware Road (49) DS0000019608.V342543.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20. People who use this service experience good quality outcomes in this area. This judgement has been made using a range of evidence including a visit to the service. Personal Care and Health Care offered to the residents continues to be of a high standard and is appropriate to meet their needs. A robust medication storage and administration system is in place to safeguards the people who use the service. EVIDENCE: Personal care was seen during this inspection to be being delivered to the residents in a kind and understanding manner by staff who clearly had a through understanding of their care needs both physical and emotional. A good and easy rapport was seen to exist between them. One staff member was seen to reassuringly intervene when a resident became anxious and agitated, whilst another was gently directed to expend an excess of excited energy by taking a swing in the garden - an activity which they clearly enjoyed and was calmed by. Ware Road (49) DS0000019608.V342543.R01.S.doc Version 5.2 Page 14 There was good evidence of the residents’ involvement with a number of health professionals; residents are assisted by staff to visit their GPs at their surgeries when needed and a specialist Consultant to monitor the progress of recent behavioural changes is following one resident. The care plans evidenced that regular contact is maintained with chiropody, hearing and optical services. Medication records were spot checked and found to be satisfactory. All staff who administer medication have been trained to do so. The manager confirmed that residents would be encouraged and enabled to self medicate where this was appropriate and could be done so safely but that at present none of the residents were in this position. The home continues to use the MDS, monitored dosage system supplied by Boots and the manager confirmed that the service was prompt and that they were well supported by their suppliers. There are secure and adequately sized medication storage facilities but there is not a Controlled Drugs (CD) cupboard. The manager must ensure that if (or when) a Controlled Medication is prescribed, and this would most likely be without prior notice, that the legally required safe storage arrangements could immediately be in place to ensure the homes compliance with the law. There is a Homely Remedies policy and procedures but it could not be evidenced that a doctor had approved this. There was not a policy and procedures for when residents’ stay away from the home and medication is administered by their relatives. Ware Road (49) DS0000019608.V342543.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. People who use this service experience good quality outcomes in this area. This judgement has been made using a range of evidence including a visit to the service. A complaints policy and procedures is in place, which is in an appropriate format for its service users and is known to them. Policies and procedures concerning Adult Protection and Whistle Blowing, which follow the format given in Hertfordshire Safeguarding Adults Joint Agency guidelines, are in place for the protection of the people who use the service and staff. Residents’ views are regularly asked for listened to and whenever possible acted upon. EVIDENCE: There have been no complaints since the last inspection. An incident of unexplained bruising found on the morning of this inspection was being dealt with properly following the homes procedures. The records evidenced that staff receive training concerning adult protection and whistle blowing. Staff who spoke with the inspector were able to evidence their familiarity and understanding of these procedures and several mentioned the particular need for vigilance with the residents who have no speech. Ware Road (49) DS0000019608.V342543.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 People who use this service experience adequate quality outcomes in this area. This judgement has been made using a range of evidence including a visit to the service. The physical design and layout of the home enables the residents to live in a generally well-maintained comfortable and homely environment, which encourages their independence. However, the maintenance of consistent safe temperatures from the hot water outlets must be assured for the safety of the people who use the service. EVIDENCE: At the time of this unannounced inspection a tour of the building found it to be very clean and tidy and to have good order. Evidence could be seen of wellknown and understood running patterns throughout, these to ensure the smooth functioning of the home. All areas were well decorated with bright fresh colours chosen by the residents; furniture in the communal areas was functional, appropriate and maintained in good order. The individual resident’s Ware Road (49) DS0000019608.V342543.R01.S.doc Version 5.2 Page 17 bedrooms seen were all found to be homely and arranged and appointed in a style that reflected their individual tastes and needs. Several had PCP activity boards giving a vital guide to the resident’s day-by-day activities. The safe and attractive garden was well appointed with a large patio area and good BBQ facilities. A mixture of flowers and herb garden borders were found to be well tended and a large swing area along with appropriate safety flooring was seen to be well used by one resident when they returned from their day centre activities. To one side of the garden a new chalet is being fitted out as a snoozelem and residents discussed with the inspector how they were contributing to this work. The manager agreed to check the fire safety precautions for this facility. There are adequate numbers of bath and toilet facilities for the number of residents - these all being of a domestic design. However, there are no assisted bathing facilities and the manager must consider when these may be needed to appropriately meet the changing needs of the residents as they age. Risk assessments for the building were completed and reviewed. Generally the building is well maintained and safety aspects given due attention. However the records evidenced that the regular checks of the hot water temperatures in outlets in resident’s bedrooms fluctuated above the acceptable safe temperatures. Whilst a comment concerning these high temperatures had been noted in the past, no action that may have been taken could be evidenced. Ware Road (49) DS0000019608.V342543.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34 and 35. People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to the service. There is a stable staff group who are trained and skilled and are employed in sufficient numbers to support the people who use the service and to ensure the smooth running of the home. The recruitment practices are robust thereby offering protection to the service users. EVIDENCE: The home is fortunate in being able to retain its core group of quality staff who are well trained and experienced and many have worked with these residents for many years. Since the last inspection two long standing staff vacancies have been filled and the new manager has commenced her duties, these additions bringing the staffing establishment up to its planned level. During this inspection good staff team working was observed and all staff spoken with were very positive about their work and spoke appreciatively of the training opportunities, supervision and management support that they Ware Road (49) DS0000019608.V342543.R01.S.doc Version 5.2 Page 19 receive. Five of the care staff currently hold NVQ at level 2 and four other staff are nearing completion of NVQ levels 2 and 3 courses. The manager is studying for NVQ the Registered Managers Award and the deputy manager holds NVQ at level 4. The records evidenced that a rolling programme of staff training is planned following training needs identified during individual staff supervision meetings. Courses recently attended included First Aid, Moving and Handling, Food Hygiene, Risk Assessment and Dementia Awareness. One staff member is participating in Mencap’s Career Progression programme. The new manager confirmed that her judgement was that the present staff establishment numbers are sufficient to meet the current needs of the residents and that staff have adequate time to carry out their care duties without these being compromised by other roles. Despite a number of interruptions and unexpected occurrences during the time of this inspection it was seen that staff were in sufficient numbers and had sufficient experience to ensure the smooth running of the home. All the required documentation concerning recent staff recruitment was available for inspection and the necessary checks and documentation had been received before the staff commenced their duties. An adequate induction programme had been put in place and staff confirmed that this was being followed and that they felt well supported in their new jobs. Ware Road (49) DS0000019608.V342543.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 and 42. People who use this service experience good quality outcomes in this area. This judgement has been made using a range of evidence including a visit to the service. People using this service are safe guarded by a sound management approach led by an experienced and trained manager whose open approach encourages resident’s independence and choices. A quality assurance system in place, which seeks the views of the people who use the service. Ware Road (49) DS0000019608.V342543.R01.S.doc Version 5.2 Page 21 EVIDENCE: Although only commencing duties in this home in April 2007 the new manager has had several years’ previous experience as the Registered Manager in a similar home also run by Mencap. She has applied to the Commission for registration for this home; she is part way through her studies for the Registered Managers Award qualification. All the staff who spoke with the inspector said that the new management team had quickly established itself in the home, and that they felt consulted and included in plans for the running of the home and were positive about some of the planned improvement changes that were being considered as one said “ these should improve our service to the residents”. On the day of this unannounced inspection the operational procedures of the home were found to be working smoothly with good consideration being given to the residents needs and to their choices. Comments received from relatives prior to this inspection confirmed the homes sound management and good communication between them. The policies and procedures were found to be well known and owned by the staff and to promote the health safety and welfare of the residents. Spot checks made on the homes regular health and safety audits found these to be well maintained and regularly carried out. The items raised during the last Environmental Health Inspection had been attended to. The manager was able to show the inspector the results of Mencaps last quality audit of the home when the comments of resident’s relatives and stakeholders in the home were obtained. There appeared to be a good understanding of equality and diversity issues and a grasp of the complexity and varying strands of these issues. Ware Road (49) DS0000019608.V342543.R01.S.doc Version 5.2 Page 22 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 x 3 3 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 2 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 x 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x 3 x 3 x x 3 x Ware Road (49) DS0000019608.V342543.R01.S.doc Version 5.2 Page 23 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 YA24 Regulation 13(4)(a) Requirement Timescale for action 31/07/07 2 YA20 13(2) The temperature of all hot water outlets must be maintained at safe levels this to ensure the residents safety at all times A policy and procedures for when 31/08/07 residents medication is administered by relatives away from the home must be in place to ensure the safety of the residents. 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 YA20 YA24 Good Practice Recommendations The manager must assure herself that a safe and secure storage arrangements for Controlled Medication could be promptly available in the home. The manager must ensure that the homes bathing facilities fully meets the needs of all its residents. Ware Road (49) DS0000019608.V342543.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Hertfordshire Area Team CPC1 Capital Park Fulbourn Cambridge CB21 5XE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Ware Road (49) DS0000019608.V342543.R01.S.doc Version 5.2 Page 25 - 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!