Inspection on 09/11/05 for Whitegates Care Home

This inspection was carried out on 9th November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Whitegates Care Home 25/01/07

Whitegates Care Home 22/06/05

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOME ADULTS 18-65 Whitegates Care Home Sparken Hill 5/7 Park Place Worksop Nottinghamshire S80 1AP Lead Inspector 1. Jayne Hilton Unannounced Inspection 9th November 2005 10:00 Whitegates Care Home DS0000008771.V253778.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 Whitegates Care Home DS0000008771.V253778.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. Whitegates Care Home DS0000008771.V253778.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Whitegates Care Home Address Sparken Hill 5/7 Park Place Worksop Nottinghamshire S80 1AP 01246 810101 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) NORSACA Mr Keith Lancaster Care Home 18 Category(ies) of Learning disability (18) registration, with number of places Whitegates Care Home DS0000008771.V253778.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22nd June 2005 Brief Description of the Service: Support is provided for 18 younger adults with learning disabilities and or a diagnosis of an autistic spectrum disorder. Care is undertaken by a consistent and well trained staff team. The accommodation consists of a main house set in large enclosed grounds for 12 service users, a smaller terrace style property nearby where 5 service users reside and an adjacent flat for one service user. Both properties are close to the Town Centre of Worksop. The homes are not accessible for service users with physical disabilities. Whitegates Care Home DS0000008771.V253778.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place on 9th November 2005 at 10am by Regulation Inspector Jayne Hilton. The main house where twelve service users reside was inspected on this occasion. Many of the standards had been assessed and found, to be met at the previous inspection and therefore not all were duplicated at this time. The methodology used included, a part tour of the building, sampling of three service users care files and a sample of records. Due to the complex needs of service users the inspector was not able to fully engage in communication with service users. The service users were not in the home on the day of the inspection apart from lunchtime, as they attend various activities throughout weekdays. The unit manager and two staff members contributed to the inspection. Observations were made of staff and service user interaction and the judgements of the inspector are based on the above. The focus of the inspection was on the remaining key standards not assessed over the previous twelve- month period and to assess the requirements and recommendations set at the last visit. The inspection concluded at 1pm. The inspector wishes to inform the reader of this report that the registration of this home includes both Sparken Hill and 5-7 Park place which are two separate properties. The telephone number of the Sparken Hill property is 01909478746. Amendments will be made to the inspection report template for the next inspection. What the service does well: The home provides a structured environment, which balances service users rights with risk management processes and which allows service users to integrate in the community. Service users rights and interests are safeguarded by effective policies and procedures. The health, safety and welfare of service users are overall promoted. The home has been well maintained. The home was clean, maintained and decorated to provide a homely and safe environment. The communal spaces are well equipped with TVs, music centres and computers for service users to use. Service users benefit from clarity of staff roles and responsibilities and by, an effective staff team. Service users individual and joint needs are met by appropriately trained, supported and supervised staff. Service users can be confident their views underpin all self-monitoring review and development by the home. Whitegates Care Home DS0000008771.V253778.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? What they could do better: Because of the complex needs of service users, some limitations on facilities, choice and rights are and imposed. Care must be taken to ensure that these decisions, are made by all parties involved in the service users care and that the issues are fully documented in care plans and contain signatures that the service user or their representative has agreed to it. Service users or their representatives should sign their agreement to individual and specific care plans, as there is still no evidence of this being implemented. The service users annual well person checks should be documented in the care plan. Some records, which should be available for inspection, however they were not and action is needed regarding this. Record keeping in relation to visitors and food intake by individual service users need further development. Recruitment practices were not satisfactory and an immediate requirement was set in relation to a staff member being permitted to start work without receipt of a satisfactory Protection Of Vulnerable adults register check. There was also some documentation missing from the staff personal files, which need addressing urgently. The electrical circuit safety certificate is overdue by eighteen months and must be obtained swiftly. Whitegates Care Home DS0000008771.V253778.R01.S.doc Version 5.0 Page 7 The Statement Of Purpose and Service User Guide needs to be made available in the home, as required by regulation. 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. Whitegates Care Home DS0000008771.V253778.R01.S.doc Version 5.0 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Whitegates Care Home DS0000008771.V253778.R01.S.doc Version 5.0 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,5 A Statement Of Purpose has been produced for the home but prospective service users do not appear to have the information they need as there was no Statement of Purpose or Service User Guide available in the home, however service users do have an individual contract with the home. EVIDENCE: A statement of purpose was not available for inspection and the inspector requested that this be sent to CSCI, once located, so it could be fully assessed. There was also no evidence that a service user guide was available for service users and both must be available as required by regulations 4 and 5. The Statement of Purpose was sent to the inspector prior to completion of this report and in the main meets the standard. It is recommended that the actual room sizes be added as extra sheets that can be easily changed as necessary without the whole document needing to be rewritten. The actual registration category as stated on the certificate should be included. The terms and conditions/contract between the home and service user were available for inspection, and a copy kept with the individual service users file. Whitegates Care Home DS0000008771.V253778.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): 7 Service users make decisions about their lives, with assistance as needed. EVIDENCE: At the previous inspection some limitations /restrictions that had been implemented were documented in the care plans and justified to be in the persons best interests, however there was a door alarm on one service users room which although appeared justified, had not been fully documented in the individual care plan. The service user had moved from the home since the previous inspection, however the service user using the room and his relatives had agreed to keep the door alarm in place, as the service users needs were similar. The manager was advised that all limitations on facilities, choices or human rights to prevent self harm or self neglect or abuse or harm to others should be fully documented in the individuals care plan and agreed by the relevant representative and professionals involved in the service users care. This was clearly now in place, however there was, no actual signatures for the agreement and this is strongly recommended. Not all service users are able to make safe and informed decisions and choices all the time due to the complex nature of their needs. Staff, do try to ensure Whitegates Care Home DS0000008771.V253778.R01.S.doc Version 5.0 Page 11 service users are involved or informed in respect of all decisions made on their behalf. Service users preferred term of address is documented in the care plan. Communication systems are in place for those service users who cannot verbally communicate. A staff member informed the inspector that service users point to the symbols to inform staff they require a drink for example and symbols are in place for blackcurrant juice, tea, coffee etc. Choices are offered for meal options and despite service users complex communication needs, it was reported that, likes and dislikes are well communicated by the service users. Service users or their representatives should sign their agreement to the care plan, as there is still no evidence of this being implemented. Whitegates Care Home DS0000008771.V253778.R01.S.doc Version 5.0 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 17, Service users enjoy a healthy diet. EVIDENCE: A mealtime was observed and staff was noted to be assisting service users with eating in a calm and discreet manner. Staff, sit and eat with service users and encourage a homely atmosphere. There is a balanced menu offering a range of nutritious meals and a range of choices. Some meal choices are recorded on a daily basis, but the inspector advised that this needed further development, to ensure records were kept, which meet regulation. Regulation 17 [Schedule 4] requires that food provided for service users is recorded in sufficient detail to enable any person inspecting the record to determine whether the diet is satisfactory, in relation to nutrition and otherwise, and of any special diets prepared for individual service users. It is therefore recommended, that all food intake of service users be documented. Whitegates Care Home DS0000008771.V253778.R01.S.doc Version 5.0 Page 13 A practical method of this was suggested by the inspector, of using a page a day diary to document all service users dietary intake, for that day and which can easily be monitored by staff. The diary could also be utilised for food probing records and fridge and freezer temperatures. There was also a record sheet used for newly admitted service users, which would be ideal for daily reporting on each individual service users daily lifestyle and events. Service users were seen eating different choices of meals. Special dietary needs can be met. A regular check is made of peoples weight and a record is kept of this. Dining arrangements are flexible in order to meet individuals presenting needs. A good supply of food items, including fresh fruit and vegetables were seen in the fridge and store cupboards. The kitchen is designed to allow service users to be involved in snack making and accessing drinks with supervision. Drinks are provided at intervals between meals and when service users require. Two staff are employed as breakfast assistants to support staff and service users with the morning routines. Whitegates Care Home DS0000008771.V253778.R01.S.doc Version 5.0 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, Service users personal and healthcare needs are met, however improved documentation could further improve this. EVIDENCE: The previous inspection assessed that the healthcare needs of service users are well monitored and documentation is kept of routine chiropody dental and ophthalmic checks. There was however no record of annual healthcare checks, smear tests etc. It was recommended that these be implemented and where not possible to undertake, a statement of the effect should be made in the care plan and the reason why. This inspection identified that although there was evidence of attendance for hospital appointments and routine, chiropody etc, no documentary evidence was provided for annual health checks/well person checks, despite the manager and staff member confirming these had been arranged for service users since the previous inspection. Whitegates Care Home DS0000008771.V253778.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 Service users are protected by relevant policies procedures and practices for dealing with complaints and abuse awareness. EVIDENCE: The complaints procedure is being developed to include versions that service users may find more accessible. The home has a contractual arrangement with an external advocacy service should this type of support be needed with making a complaint. The complaints procedure has appropriate time scales for response and action. The home has no recorded complaints being made through the homes complaints procedure since the last inspection, however there had been a complaint made via CSCI, which was assessed by social services under the adult protection procedures, and which it was agreed to be investigated by the provider and found to be not upheld. The unit manager reported that despite the complaint not being upheld a number of action points have been agreed and implemented for the future. Whitegates Care Home C53 C03 S8771 Whitegates V234327 220605 Stage 0.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 30 Service users live in a homely, comfortable, clean and safe environment. EVIDENCE: The home has been well maintained and does not look out of place in the community in which it is placed. The home is maintained and decorated to provide a homely and safe environment. The window frames on the front elevation of the main house have been repaired and painted. The home was clean and well maintained. Whitegates Care Home C53 C03 S8771 Whitegates V234327 220605 Stage 0.doc Version 1.30 Page 17 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): 32,33 34, 35,36 Service users benefit from clarity of staff roles and responsibilities and by, an effective staff team. The recruitment practices were found not to be robust and an immediate requirement set in relation to this. Service users individual and joint needs are met by appropriately trained, supported and supervised staff. EVIDENCE: The staffing rota was examined. The unit manager reported that three service users are on one to one contracts. For the twelve service users based in the main house 4 staff and 2 breakfast assistants are provided. Seven staff are provided for evenings and 5-7 at weekends, depending how many service users are residing or away staying with relatives. 1 staff sleeps in and 1 remains on waking duty for night cover and another staff member is on call. Separate staff, are provided for day care and activities and maintenance support is provided by two full time and two part time handy persons. Domestic and catering hours are assessed as sufficient. A staff member reported that he felt supported and that the staff team were supportive of each other when sickness meant staff rotas would be affected. He also reported that he had never felt vulnerable due to the staffing levels provided. Evidence was provided that new staff undertake a supervised induction period, which meets skills for work standards. LDAF [Care work with people with learning disabilities] Whitegates Care Home C53 C03 S8771 Whitegates V234327 220605 Stage 0.doc Version 1.30 Page 18 National Vocational Qualification training is ongoing and a large proportion of staff are undertaking or have achieved NVQ 2 or 3. Staff confirmed they had training in first aid, food hygiene, manual handling, BILD and fire safety training. Training programmes were evident for the current year and following twelve months, which includes adult protection, autism awareness, infection control, equality and diversity, health eating, safe handling of medicines, effective personal development, supervisory management as well as the mandatory subjects. NORSACA has its own recruitment policy and procedures. NORSACA are currently looking at ways that service users can meaningfully be involved in the recruitment of new staff. Staffing and personnel issues are dealt with centrally and subsequently staff files have been held at a central office. [The Head of Services Mr Keith Lancaster had explained to the inspector previously, how this arrangement is currently being reviewed as Care Home Regulations state that relevant staff files should be kept on site and has been highlighted in recent NORSACA homes inspections.] On commencement of the inspection the acting manager contacted the appropriate person to arrange for staff files to be brought over to Whitegates Care Home, for inspection. Eight files were examined, although there was evidence in seven of these, that Criminal Records Disclosures had been returned, there was no evidence of POVA [Protection Of Vulnerable Adults Register checks] The disclosure document was not evident itself. The Regulations require that CRB’s, be kept for inspection. Not all of the files had the other required documentation, required by regulation as listed in schedule 2, for example, some did not have copies of birth certificates, driving licence/passport or proof of address. One file was missing a CRB and POVA check, despite the staff member being permitted to start work under supervision. The current regulations are that staff must not commence duties without the receipt of satisfactory CRB, POVA register checks and two satisfactory references. In the circumstances that staff, are needed urgently to maintain staffing levels then they can be permitted to start work once a satisfactory POVA register check and two references are received, but they must work under supervision until the CRB is returned. An immediate requirement is therefore set that staff must not be permitted to commence duties without the receipt of a satisfactory POVA register check. The staff member must therefore refrain from working in the care environment until this is obtained. Annual appraisal and supervision and records of these were evidenced. Whitegates Care Home C53 C03 S8771 Whitegates V234327 220605 Stage 0.doc Version 1.30 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,41,42 Service users can be confident their views underpin all self-monitoring review and development by the home. The health, safety and welfare of service users are generally promoted, however prompt attention is needed regarding the electrical safety certificate. Not all of the records required by regulation were available for inspection. The management arrangements for the home are currently under discussion and it is recommended that this is resolved promptly. EVIDENCE: The registered manager has been promoted to Head of Services and the management arrangements for the home is still being decided. It is recommended that an application for the unit manager to become registered should be submitted promptly. NORSACA has its own quality monitoring systems in place. The Quality Network Review Process involves supporters and service users from one home, assessing another. Outcome reports are produced. Regulation 26 visit reports were evident. Whitegates Care Home C53 C03 S8771 Whitegates V234327 220605 Stage 0.doc Version 1.30 Page 20 It was established that there is no record of visitors to the home as required by regulation. A visitor’s board is sited at the front door and used to indicate, who is in and out of the building, however Schedule 4 of the regulations states that a record of all visitors to the care home, including the names of visitors must be kept. At the previous visit it was identified that, not all records were available for inspection, including health and safety checks, servicing of equipment etc. A requirement was made that all records must be available for inspection and the manager should make appropriate arrangements for this to happen for future inspections. There was some available at this inspection but not all had been facilitated, such as the gas safety certificate, the Environmental Health Officers last visit report and evidence that systems are in place to prevent legionella. Therefore this requirement is outstanding and must be complied with by the new target date to avoid enforcement action. The identified records have now been sent to the Commission and found to be satisfactory. Water outlet temperature tests were seen and satisfactory. The electrical circuit test certificate was seen and was out of date by eighteen months. This must be rectified urgently. The fridges were checked and food was appropriately stored and date labelled after opening. Whitegates Care Home C53 C03 S8771 Whitegates V234327 220605 Stage 0.doc Version 1.30 Page 21 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 X X 3 Standard No 22 23 Score 3 X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X 3 X X X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X X X X 3 LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X 3 3 1 3 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Whitegates Care Home Score X 3 X X Standard No 37 38 39 40 41 42 43 Score 1 X 3 X 2 2 X C53 C03 S8771 Whitegates V234327 220605 Stage 0.doc Version 1.30 Page 22 Yes YA17 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 YA1 Regulation 4, 5 Requirement Timescale for action 09/12/05 2 YA34 7.9,19 Ensure that The Statement of Purpose and Service User Guide are made available as required by regulation 1, a] Staff must not be permitted 09/11/05 to undertake duties with Vulnerable Adults without the return of a satisfactory POVA check. Immediate 1pm, 9/11/05. 1, b] the named staff member must refrain from duties, which effect direct contact with service users until a satisfactory POVA has been obtained. Immediate effect from 1pm 9/11/05 Ensure all staff files contain the required documentation as specified in Schedule 2 of the regulations. Ensure all records required by regulation are available for inspection. Outstanding requirement not met. Ensure records are kept of all visitors to the home. Ensure the electrical circuit safety check is carried out by 9/12/05 3 YA34 7,9,19 09/12/05 4 YA41 17 09/01/05 5 6 YA41 YA42 17 16, 23 09/12/05 09/12/05 Whitegates Care Home C53 C03 S8771 Whitegates V234327 220605 Stage 0.doc Version 1.30 Page 23 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 YA1 Good Practice Recommendations It is recommended that the actual room sizes be added to the Statement of Purpose, as extra sheets that can be easily changed as necessary without the whole document needing to be rewritten and the actual registration category as stated on the certificate should be included also. Service users or their representatives should sign their agreement to the care plan and any agreement to limitations or restrictions imposed. Improve the record keeping in relation to service users meal intake and options. Ensure all service users access an annual well person check and that this is documented in the care plan. 2 3 4 YA7 YA17 YA19 Whitegates Care Home C53 C03 S8771 Whitegates V234327 220605 Stage 0.doc Version 1.30 Page 24 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT 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 Whitegates Care Home C53 C03 S8771 Whitegates V234327 220605 Stage 0.doc Version 1.30 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. 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