Care Home: 2 Thornhill Close

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What the care home does well On the day of the inspection, the inspector arrived when one person was getting ready to go out with their family for a Christmas meal. The person was clearly excited to be going out with their family. The staff rota had been arranged to ensure one member of staff was available to accompany the resident on this outing. The service provides a homely atmosphere to the people who live there and each resident`s bedroom is decorated to reflect their interests and personality. Service plans are very detailed and provide comprehensive and person centred information about how the person likes to be cared for. As the residents are unable to express themselves verbally the care plan is based on residents` reactions and through a process of elimination. Each resident has a key worker who is responsible, with the manager for ensuring that every aspect of the care plan is implemented. All three residents have lived at the home for several years and some staff have known the residents throughout this period of time and have developed good relationships and empathy with this small group of very dependent people. Staff work hard to ensure all the residents living at the home the opportunity to participate in the local community. The staff team receive regular training, both mandatory and specific to the needs and abilities of the residents living in the home. The service has thorough recruitment procedures, which are fully implemented. What has improved since the last inspection? The majority of previous requirements have been met and it was evident that the staff are committed in further developing the quality of care and services that were offered. Since the last inspection a manager has successfully been appointed and registered with the Commission for Social Care Inspection. The manager is experienced and has within the last year successfully completed the Registered Managers Award in Care. The manager has worked for Leonard Cheshire Disability for several years and has a good understanding of the principles and ethos of the organisation. Since the last inspection the manager has introduced some new ideas and practices into the home for example the newly developed service plans, which now comprehensively reflect the wishes and needs of the people living at Thornhill. The new format is easy to use and the information very accessible for staff reference. Good use of photographs and symbols has been included.All the records checked throughout the inspection process were up to date and had been signed by staff and were being safely stored in the home. The manager has a clear understanding of the key principles and focus of the service based on person centred planning and values and with the staff team aim to continually improve the home and services. What the care home could do better: No major issues were identified during this inspection. A recommendation has been made for the service to seek support from independent advocacy services, as residents are unable to express their views independently and some do not have regular input from family or other representatives. There was significant evidence that the support workers are working hard to continue to improve, and develop the service. However, the organisation needs to make every effort to enable residents and or their representatives and staff to express their views formally through the quality assurance procedures concerning both the current services and the future plans for the development of the service and facilities at Thornhill. It is important each service in the network of Cheshire homes has its own identity and is personalised to the specific services and facilities according to the group of residents living in each home. CARE HOME ADULTS 18-65 Thornhill Close (2) Dorchester Dorset DT1 2RE Lead Inspector Marion Hurley Key Unannounced Inspection 14th December 2007 11:00 Thornhill Close (2) DS0000026745.V356178.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 Thornhill Close (2) DS0000026745.V356178.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. Thornhill Close (2) DS0000026745.V356178.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Thornhill Close (2) Address Dorchester Dorset DT1 2RE 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) 01305 266589 NO FAX www.leonard-cheshire.org.uk Leonard Cheshire Disablility Jane Ann Street Care Home 3 Category(ies) of Learning disability (3), Physical disability (3) registration, with number of places Thornhill Close (2) DS0000026745.V356178.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28th July 2006 Brief Description of the Service: 2 Thornhill Close is a care home providing personal care and accommodation to three adults who have a learning disability. The home is one of seven similar services in Dorchester that are owned and operated by Leonard Cheshire Disability, a not for profit organisation providing services to people with disabilities. The home is located in a popular residential area of Dorchester, within walking distance of the town centre. Dorchester has a wide range of shops, banks, GP surgeries and other amenities, which are used by service users on a daily basis. All residents have single bedrooms and share the communal lounge, separate dining room, small kitchen and separate utility room, bathroom and WC. The home is staffed 24 hours a day. Leonard Cheshire Disability arranges activities during the day for the residents at an extra cost to the residential fees. Fees are individually negotiated according to the residents needs. Copies of inspection reports are available upon request from the Leonard Cheshire Home administration Office in Dorchester. Thornhill Close (2) DS0000026745.V356178.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was undertaken as part of the statutory inspection process in accordance with the Care Standards Act, 2000. All key standards were assessed according to the Care Home for Adults (18-65) National Minimum Standards. The time spent on the inspection process totalled ten hours, three of which were spent at the home. The purpose of the inspection was to make sure the home was being run for the benefit of the people who live there and in accordance with statutory requirements and regulations. The residents have varied communication needs, some of whom have verbal needs and communicate through sounds, gestures and actions and it was not possible to formally speak to the residents at the home however particular time was spent observing the care provided and interactions between residents, and the support workers. Documentation examined included the resident’s care/service plans, staff rota and medication records and all records pertaining to health and safety. Additional information received by the inspector prior to the inspection was also taken into account. This included the Annual Quality Assurance Assessment (AQAA) completed by the staff, and other information such as Regulation 37 notifications of significant events and Regulation 26 visits in the home. The registered manager was not present during this unannounced inspection, however the inspector met with the manager on December 24th in the regional offices of the provider, Leonard Cheshire Disability. Staff recruitment, training and overall management of the home were discussed and appropriate documentation checked. Two members of staff were on duty during the inspection and were available to assist the inspector with the required information. The inspector wishes to thank the residents and the staff on duty for their help and support in the process of this inspection Thornhill Close (2) DS0000026745.V356178.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? The majority of previous requirements have been met and it was evident that the staff are committed in further developing the quality of care and services that were offered. Since the last inspection a manager has successfully been appointed and registered with the Commission for Social Care Inspection. The manager is experienced and has within the last year successfully completed the Registered Managers Award in Care. The manager has worked for Leonard Cheshire Disability for several years and has a good understanding of the principles and ethos of the organisation. Since the last inspection the manager has introduced some new ideas and practices into the home for example the newly developed service plans, which now comprehensively reflect the wishes and needs of the people living at Thornhill. The new format is easy to use and the information very accessible for staff reference. Good use of photographs and symbols has been included. Thornhill Close (2) DS0000026745.V356178.R01.S.doc Version 5.2 Page 7 All the records checked throughout the inspection process were up to date and had been signed by staff and were being safely stored in the home. The manager has a clear understanding of the key principles and focus of the service based on person centred planning and values and with the staff team aim to continually improve the home and services. 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. Thornhill Close (2) DS0000026745.V356178.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Thornhill Close (2) DS0000026745.V356178.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Policies and procedures are in place to ensure a service user and their representative would be involved in any prospective move and full assessment undertaken to ensure needs could be met. The home needs to develop a Statement of Purpose, and Service User Guide, which is specific to Thornhill to ensure prospective residents, and their representatives have relevant written information to make an informed choice. EVIDENCE: Cheshire Homes reviewed and issued a generic Statement of Purpose in May 2007 and this now needs to be adapted to each individual service /home. The documents should identify the specific services and facilities available in each home for the service users and their representatives. A service user guide has recently been produced and this again needs to be personalised to each home. The staff confirmed that the home has not admitted anyone for several years but described the principles and procedures for a positive admission. Thornhill Close (2) DS0000026745.V356178.R01.S.doc Version 5.2 Page 10 The support workers confirmed that people offered a place at the home would be supported throughout the admission process and care taken to make sure they settled into their new environment. The provider Leonard Cheshire Disability has policies and procedures in place to appropriately deal with any prospective admissions. Thornhill Close (2) DS0000026745.V356178.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Detailed care plans are available to ensure staff are aware of how residents should be supported. Staff ensure that the people who live at the home get the opportunity to explore new experiences and they closely monitor their reaction ensuring they feel comfortable and happy. EVIDENCE: Discussion with staff demonstrated their in-depth knowledge of the needs of the people who live at the home and examination of the care plans provided written evidence of this detailed information. Each aspect of the persons’ care is written into the plan and details about how they prefer to be cared for are included. Thornhill Close (2) DS0000026745.V356178.R01.S.doc Version 5.2 Page 12 The service /care plans were comprehensive and incorporated relevant personal details, likes an dislikes, health care needs, social and recreational preferences and personal achievements. The plans determine how residents’ needs are met. They were well written and with sufficient details to ensure all staff have the information they need on a daily basis. The plans have been written with the involvement of residents as far as possible. Each resident has their own keyworker who has specific responsibility with the manager in ensuring the records and reviews are kept up to date and accurately reflect the residents’ wishes and needs. Risk assessments are in place and form part of the individual service plan and are used to ensure the safety of the resident whilst at the same time enabling them to take part in every day activities. Additional risk assessments linked to individual activities, tasks or behaviour management are in a separate section in the file. Residents are offered choice throughout their daily routines and individual plans reflect these preferences. None of the residents are able to make informed decisions and it is recommended that the home obtain the support from independent advocacy services to at least attend the resident’s annual review. Thornhill Close (2) DS0000026745.V356178.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are able to participate in a variety of appropriate activities, and staff make sure people are involved in the local community. Residents are supported to maintain personal and family relationships and their rights are respected. Residents enjoy a healthy diet and their needs and wishes are respected in this regard. EVIDENCE: As part of the individual plans, residents personal development needs are taken into account and each of the three people living in the home have a different programme of activities, which are kept under review for example, Thornhill Close (2) DS0000026745.V356178.R01.S.doc Version 5.2 Page 14 some are home based, another include a mixture of structured and ad hoc activities. Other activities and events are arranged in the local area, and these include meals out, shopping trips, walks and other activities depending on the residents’ choice. The manager explained that each resident is allocated up to £120 per month by the placing authority and this money is intended to support the resident to access meaningful activities. The manager discussed the home’s hope to access the resident’s money, which could be used to create more one to one time for the residents and to access more community based facilities though some activities will not automatically involve spending much of the allowance. Key workers should be encouraged to be responsible for each person’s “day service funds “ and think positively how to use the money to ensure maximum benefit for the individual resident. The home has strong links with families of residents living in the home and supports the residents in maintaining regular contact wherever possible both through visits to the home and the relatives home. On the day of the visit one resident was going out for lunch with family members with the support of a member of staff. Residents are encouraged to take part in everyday domestic activities as far as they are able and help in choosing colours for the home, and in meal planning and guidance, where necessary is sought from local professionals to ensure a balanced and nutritious diet is provided. Staff are aware of individual preferences and encourage residents to choose their food by showing them packages and photographs of meals. Thornhill Close (2) DS0000026745.V356178.R01.S.doc Version 5.2 Page 15 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 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ health needs are identified and arrangements in place to meet these needs. Input from specialist services such as doctor, dentist, dieticians and psychologists and other services ensure that resident’s complex needs are maintained. EVIDENCE: It was clear from the detailed individual plans and in discussion with staff that residents’ views are taken into account and that personal support is suited to their individual preferences. Residents’ health care needs are clearly set out in the service/care plans with very detailed instructions, which include preferences, and safe ways of providing personal care also being incorporated. The home has good links with the local medical services and support from health and social care professionals and this multi-agency approach ensures that all physical and emotional health needs of each resident are met. Thornhill Close (2) DS0000026745.V356178.R01.S.doc Version 5.2 Page 16 None of the residents in the home are able to administer their own medication but policies and procedures are in place to ensure that staff dealing with medication are competent and all necessary training is provided. An inspection of the homes’ medication storage and administration systems showed that medication was being stored, administered and recorded appropriately. Thornhill Close (2) DS0000026745.V356178.R01.S.doc Version 5.2 Page 17 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 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. All complaints are appropriately dealt with and residents and their representatives know that their concerns will be listened to and acted upon. Staff have a good working knowledge of the procedures regarding safeguarding adults and this ensures residents are protected from abuse, neglect and self-harm. EVIDENCE: The provider Leonard Cheshire Disability has corporate policies and procedures for dealing with complaints. A summary of the procedures are included in the Statement of Purpose and the information includes how to contact the local Health and Social Care Agencies and the CSCI. No complaints have been received since the last inspection. The provider Leonard Cheshire Disability has appropriate adult protection procedures and policies. Staff spoken with provided clear information and illustrated their understanding of Adult Protection issues and how the home would relate to local authority protocols Staff spoken with confirmed that they were aware of the whistle blowing procedure and that they received training on Safe Guarding adults Thornhill Close (2) DS0000026745.V356178.R01.S.doc Version 5.2 Page 18 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 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The living environment is appropriate for the lifestyle and needs of the residents and is homely, comfortable, clean and safe. Improvements have been made to the general decoration of the home and individual rooms. EVIDENCE: The living environment provides a pleasant home for the residents living there and is domestic in nature. A variety of pictures and photographs around the home add to this domestic feel. It is well furnished and mostly decorated to a good standard On the day of the inspection the home was clean and tidy and there were no unpleasant odours. Staff were aware and could describe how to follow infection control procedures. Thornhill Close (2) DS0000026745.V356178.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34 & 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Rotas show well thought out ways of making sure the home is staffed efficiently, with particular attention given to busy times of the day and the changing needs of the people who live at the home. EVIDENCE: The home has sufficient staff available to support the needs, and chosen activities of the people who live at the home in an individualised and person centred way. The provider, Leonard Cheshire Disability has recruitment procedures that clearly define the process to be followed. The service recognises the importance of effective recruitment procedures in the delivery of good quality services and for the protection of individuals. Three staff files were examined and contained all the required information by regulation. Job descriptions and contracts of employment were seen on the Thornhill Close (2) DS0000026745.V356178.R01.S.doc Version 5.2 Page 20 staff records and all statutory checks and references and identification were in evidence. The provider offers a good programme of training for staff and records of both mandatory and specific training were examined, which clearly demonstrated that the staff are given all the appropriate training. Thornhill Close (2) DS0000026745.V356178.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is managed effectively for the benefit of the residents and detailed health and safety policies ensure the safety of residents and staff. The manager has a clear understanding of the key principles and focus of the service based on organisational values and priorities and works hard to continually improve the home and services. Thornhill Close (2) DS0000026745.V356178.R01.S.doc Version 5.2 Page 22 EVIDENCE: The service manager responsible for the Cheshire Home services in the Dorchester locality stated that at this stage the services and individual homes do not have a current quality assurance system. Such a system is needed to ensure that all stakeholders are consulted about the overall quality of care the homes provide, and for written evidence of a year on year development /service plan. It is very important that residents and or their representatives are involved in the self-monitoring and quality assurance procedures. Please note work is in progress to achieve this. A senior member of staff now undertakes a monthly audit of a specific area of practice, for example the procedures for managing and handling resident’s laundry, safe handling and administration of medication and these are practical ways to ensure quality is monitored and maintained From discussions with the manager and staff, it is clear that the home is well run and that the residents’ views are taken into account in all aspects of the running of the home. Policies and procedures are in place to ensure that the health and safety of residents and staff are maintained and frequent training is provided to staff. Cleaning materials were being securely stored in a locked cupboard Information taken from the AQAA (Annual Quality Assurance-self assessment) and records seen on the day showed that on the whole facilities and equipment within the home were being serviced and inspected appropriately. Fire alarm tests were carried out weekly and fire-training records were up to date with all staff attending as required. No specific health and safety hazards were found at this inspection. The manager has a clear understanding of the key principles and focus of the service based on person centred planning and values and with the staff team aim to continually improve the home and services. Thornhill Close (2) DS0000026745.V356178.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 3 32 X 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 x x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 X 2 X X 3 x Thornhill Close (2) DS0000026745.V356178.R01.S.doc Version 5.2 Page 24 NO 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(1)(2) Requirement Timescale for action 31/03/08 2. YA39 The service must develop a Statement of Purpose & Service User Guide, which clearly sets out the role and responsibilities of the provider and details the services and facilities available specific to the home. Please note this is work in progress. 24(1)(2)(3) The home must establish and maintain a system for reviewing and monitoring the quality of care provided by the home and where possible involve residents or their representatives. A new timescale has been agreed. 31/03/08 Thornhill Close (2) DS0000026745.V356178.R01.S.doc Version 5.2 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 Refer to Standard YA7 Good Practice Recommendations It is recommended that independent advocacy services be involved with residents to assist then to make decisions about their lives. Thornhill Close (2) DS0000026745.V356178.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF 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. 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