Care Home: Adrian Lodge

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What the care home does well The clients really appreciate the location of the Home as they find it easy to access the facilities in the town and to maintain contact with friends and relatives. Relatives speak highly of the staff team and feel that they are kept informed about relevant issues. The staff team are enthusiastic about supporting the clients and have a good understanding of their needs. Clients speak highly of the support provided by the staff. One of the clients said "the staff are easy to talk to....I love it here". The Home is well managed by a Manager who is enthusiastic and has appropriate skills and experience. Clients and staff said that the Manager is approachable and that she ensures that the Home is run in the best interests of the clients. What has improved since the last inspection? The mix of clients is slightly different than at the time of the last Inspection and so the lack of increase in staffing during the evenings has had less of an impact than it previously did. The recruitment procedures have improved and appropriate references are obtained prior to employing staff. Improvements have been made to the garden so that there is a nice seating area as well as an attractive garden. The external steps have been made safer. What the care home could do better: There has been some delays in providing training for the staff team since the new organisation took over. The Manager said that this is being addressed but a requirement has been made to ensure that staff receive appropriate training in a timely manner. Some additional records need to be kept with regard to medication and the safekeeping of clients money. CARE HOME ADULTS 18-65 Adrian Lodge 19 Gaywood Road Kings Lynn Norfolk PE30 1QT Lead Inspector Lella Hudson Unannounced Inspection 8 October 2008 10:00 th Adrian Lodge DS0000072244.V371368.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 Adrian Lodge DS0000072244.V371368.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. Adrian Lodge DS0000072244.V371368.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Adrian Lodge Address 19 Gaywood Road Kings Lynn Norfolk PE30 1QT 01553 760347 01553 760347 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) The Regard Partnership Ltd Maureen Johnston, not yet registered Care Home 12 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (12) of places Adrian Lodge DS0000072244.V371368.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following categories of service only: Care Home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Mental Disorder - Code MD The maximum number of service users who can be accommodated is 12 2. Date of last inspection 18th July 2008 Brief Description of the Service: Adrian Lodge is a ten bedded residential home, which provides care for younger adults who have mental health problems. It is owned by the Regard Partnership Ltd. The manager of the Home has recently left and the Home is now managed by Maureen Johnstone who is currently applying for registration with the Commission. The home has been converted into a residential establishment from a public house. Accommodation is provided on the ground, first and second floors. All bedrooms are single and there are communal bathrooms, dining room and lounge. There is also a bed-sit on the second floor of the Home. The Homes registration also includes the service provided to two clients who are accommodated in a separate house nearby. However, the organisation intend to apply for a variation to reduce the numbers as their domiciliary care service is now supporting these two clients. The Home is situated on a main road and is very close to the railway station, bus station and to the town centre. The Homes fees currently start at £315.00 per week with additional fees negotiated on an individual basis depending on the clients needs. Adrian Lodge DS0000072244.V371368.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is TWO STAR. This means that the people who use this service experience GOOD quality outcomes. This report contains information gathered about the Home since the last Inspection which was carried out in July 2007. It includes information contained within the Annual Quality Assurance Assessment (AQAA) which the Manager completed as well as information within surveys that were completed and returned to us. We received completed surveys from three clients, two relatives and three staff. We also carried out an unannounced visit to the Home on the 8th October 2008 between 10.45am and 4.45pm. During this visit we talked to clients, staff and relatives, looked around the accommodation and looked at a selection of records. The Home was purchased by the Regard Partnership Ltd in July 2008 and an application for registration was submitted to us for registration in May 2008. The new registration was completed in August 2008. The Manager left in August 2008 and Ms Johnstone moved from another Home within the organisation to become the Manager at this Home. She is currently applying to become the Registered Manager. What the service does well: The clients really appreciate the location of the Home as they find it easy to access the facilities in the town and to maintain contact with friends and relatives. Relatives speak highly of the staff team and feel that they are kept informed about relevant issues. The staff team are enthusiastic about supporting the clients and have a good understanding of their needs. Clients speak highly of the support provided by the staff. One of the clients said “the staff are easy to talk to….I love it here”. The Home is well managed by a Manager who is enthusiastic and has appropriate skills and experience. Clients and staff said that the Manager is approachable and that she ensures that the Home is run in the best interests of the clients. Adrian Lodge DS0000072244.V371368.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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. Adrian Lodge DS0000072244.V371368.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 Adrian Lodge DS0000072244.V371368.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 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Effective assessments are carried out for clients prior to them moving into the Home. EVIDENCE: Discussions with the Manager and a look at the records relating to the admission of clients show that appropriate procedures have been followed. The pre admission assessments include information gathered from the client, their relatives and any health and social care professionals involved in their care. Adrian Lodge DS0000072244.V371368.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, 8 & 9 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The clients are supported to take risks as part of an independent lifestyle. The information within the care plans and risk assessments provides guidance to staff about how to support clients with this. The clients are consulted on and participate in the day to day running of the Home. EVIDENCE: We looked at two of the care plans and risk assessments. These documents contain detailed guidance to staff about how to meet the needs of the clients. They also contain evidence that individual risks are identified and that plans are in place with regard to managing these risks effectively without placing unnecessary restrictions on the clients. Any restrictions that are in place are discussed with the clients and are also decided upon after discussion with health professionals who are involved in the clients care. We discussed the care provided with one of the clients and he was fully aware of the content of his care plan and of the reasons for any restrictions that are Adrian Lodge DS0000072244.V371368.R01.S.doc Version 5.2 Page 10 in place. The responses within the staff surveys with regard to whether they receive up to date information about the clients needs varied between “yes” and “usually”. In addition to the main care plan and risk assessment file there is also a shorter version available as a quick reference guide to the staff. This is kept in the same folder as the daily notes which staff record in at the end of each shift. This provides information which is more easily accessible to staff as currently the format of the larger files is confused and repetitive. The Manager said that the new organisation is providing new formats for the care plans and that the information will be transferred onto these within the next few months. Clients told us that they take part in regular ‘house meetings’ and that the staff listen to their views. Minutes are kept of these meetings. Clients also told us that they are encouraged to take part in household tasks within the communal areas and to keep their own rooms clean. The clients surveys that we received are mixed in the response to whether they are encouraged to make their own decisions with one stating “usually” and two stating “yes”. We looked at the system in place for looking after the clients money. The Manager is currently only looking after money for one client although the Manager is sent money from the organisations head office which is to be given to two of the clients. There are no written details about the arrangements in place for looking after the clients money and the Manager is not provided with copies of bank statements relating to the clients money. Receipts and records are kept for expenditure made on behalf of clients. Adrian Lodge DS0000072244.V371368.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, 14, 15, 16 & 17 Quality in this outcome area is Excellent This judgement has been made using available evidence including a visit to this service. Clients are supported to take part in meaningful activities and to pursue their individual interests. Communication with relatives is good. EVIDENCE: The Home is situated close to the main town of Kings Lynn and also close to the bus and train station. The clients who spoke to us all said that they really appreciate the location of the Home. Two of the clients have moved to this Home from another Home owned by the same organisation because they wanted to be closer to the amenities within the town. Some clients said that it is easier to maintain contact with friends and family due to the location of the Home. The clients are encouraged to maintain and develop their own interests and hobbies. Some of the clients are able to go out to pursue activities independently and some need additional staff support to do so. Clients told us Adrian Lodge DS0000072244.V371368.R01.S.doc Version 5.2 Page 12 that they receive the support that they need to do this. The clients told us about a range of activities that they are involved in. These include leisure, sport, educational and social activities. One of the clients has been supported by the Homes social fund to purchase a bike which enables him to maintain his independence. All three of the clients surveys state that they are able to do what they want to do. The relatives surveys all state that they are kept up to date with information relating to their client. We spoke to one of the relatives and they spoke very highly of the support provided to their relative and to themselves. They said that the staff are always friendly and sensitive to their anxieties. The clients are encouraged to do their own cooking at least twice per week but this is flexible depending on the clients needs and choice in this matter. The kitchen is mainly kept unlocked but recently the main fridge has had to be locked following a risk assessment of the needs of one of the clients. The staff have provided a smaller fridge which contains milk to enable clients to still be able to make their own drinks. The clients told us that they are aware of the reasons for this restriction but that they are not all happy about this. The Manager explained the process that has been followed prior to the decision to lock the fridge. She is well aware of the difficulties of meeting the needs of all of the clients when sometimes these conflict. The assistant manager is discussing healthy eating with the clients and is proposing to provide menus which should encourage clients to eat more healthily. One of the members of staff who used to work at the Home is providing cooking sessions on a weekly basis and clients told us that they really enjoy this. One of the clients has a bed-sit which has a small kitchen area. This enables the client to prepare her own meals and hot drinks within her own accommodation. Adrian Lodge DS0000072244.V371368.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 & 20 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The personal and healthcare needs of the clients are met. Medication is managed safely. EVIDENCE: The care plans contain detailed information about the physical and mental health needs of the clients. There is evidence that mental health professionals are involved in the care of the clients and that advice given by them is incorporated within the care plans. Staff who spoke to us were aware of the information within the care plans and gave consistent answers when asked about the care provided to clients. Clients told us that they feel that their needs are met at the Home. The relatives surveys returned to us all were mixed in their response to whether the clients needs are met with one stating “always” and two stating “usually”. Additional comments were made such as: ‘the staff give….good encouragement to do things’ ‘the staff treat….with respect and explain things well’ and ‘they make….feel safe’. Adrian Lodge DS0000072244.V371368.R01.S.doc Version 5.2 Page 14 The relative who spoke to us said that they are really pleased with the support and care that their relative is receiving. Discussions with staff, the Manager and one of the clients gave good examples of how staff recognised the initial signs of ill health for one of the clients and of the action taken to ensure that the client received the most appropriate help. This was followed by support to enable the client to return home as soon as was possible. The medication system was seen. Clients are encouraged to look after their own medication if they are able to do so safely. Medication is stored securely and records are kept of the receipt and administration of medication. The Manager said that there is currently no detailed written guidance about the use of individual PRN (as required) medications. Adrian Lodge DS0000072244.V371368.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 & 23 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Complaints are taken seriously and responded to appropriately. The clients are protected by the Homes procedures and staff training about Safeguarding issues. EVIDENCE: All three of the clients surveys state that they know who to speak to if they are unhappy about something. The responses were mixed with one stating “usually” and the other two stating “always” when asked whether staff treat clients well and whether they listen and act on what clients say. Clients told us during our visit that the staff do listen and that any concerns or complaints are responded to appropriately. The relatives surveys all state that they know how to make a complaint. One relative said that the staff ‘make….feel safe’. One of the relatives told us that the Manager always deals with issues that they may raise with her. We looked at the record of complaints and this contains formal responses to issues raised by clients. Even seemingly minor concerns have been treated as a formal complaint and responded to appropriately. The training matrix provided by the Manager does not include details about Safeguarding training. However, discussions with staff provided evidence that they had received training and were aware of the correct procedure to follow in the event of a concern about a safeguarding issue. The Manager is also aware Adrian Lodge DS0000072244.V371368.R01.S.doc Version 5.2 Page 16 of the procedure to follow to make a Safeguarding Alert. The Manager did say that the refresher training has not taken place but that there are plans to address this situation to ensure that all staff have received updated Safeguarding training. Adrian Lodge DS0000072244.V371368.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. The Home provides adequate accommodation for the clients but would benefit from redecoration. EVIDENCE: We were shown around the communal areas of the Home. One of the clients also showed us their bedroom. Clients are encouraged to personalise their own rooms and to keep them clean. All of the clients have their own room and one client has a bed sit which is situated on the second floor of the house. There are communal bathrooms, toilets, a large dining room, kitchen and large lounge. The lounge has been redecorated and is attractive, homely and comfortable. However, the rest of the Home is in need of redecoration and looks shabby in places. Adrian Lodge DS0000072244.V371368.R01.S.doc Version 5.2 Page 18 The clients are encouraged to share the cleaning of the communal areas and staff provide support with this when needed. The majority of the Home was clean although the toilets were in need of cleaning. A lot of work has been carried out to improve the garden area. This is now an attractive area with nice seating and areas for clients to do some gardening. The external steps have been mended so that they are now safe to use. Adrian Lodge DS0000072244.V371368.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, 33, 34, 35 & 36 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Clients are supported by an effective staff team. Staff are clear about their roles and receive support to carry these out. Effective recruitment procedures are followed. EVIDENCE: All of the staff surveys returned to us state that recruitment checks were carried out prior to their employment, that they receive relevant training and that they receive regular supervision. The responses were mixed with regard to whether there is enough staff and whether communication amongst the team works well. Clients told us that the staff are very supportive and caring and that they take a lot of time to explain things to them. The clients also said that the staff are easy to talk to. We observed staff supporting clients in a respectful and relaxed manner. There was positive communication between staff and clients. We looked at a selection of staff files and saw that appropriate recruitment procedures were followed prior to offering someone a job. The Manager is Adrian Lodge DS0000072244.V371368.R01.S.doc Version 5.2 Page 20 carrying out regular formal supervision and staff said that they feel that they can always speak to the Manager if they need to. There has been some shortfalls in the provision of training since the new organisation took over as they implement their own arrangements for providing training. The Manager said that there are now new plans in place for the provision of mandatory and additional training about issues specific to the clients needs. The majority of the clients currently living at the Home are independent with regard to going out of the Home. The usual staffing levels are for there to be two staff on duty during the day in addition to the Manager. There is usually then only one member of staff on duty from about 4pm until the next morning. Staff provide a sleep in at night. Discussions with staff and clients show that this level of staffing during the evenings meets clients basic needs but does mean that clients who need support to go out are not able to do so. The Manager said that the new organisation has recently decided to employ a member of staff to carry out waking nights. Discussions with staff and clients indicate that they do not understand why this decision has been made and would prefer additional staff to be available during the evenings. The Manager is discussing this with the organisation. Adrian Lodge DS0000072244.V371368.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, 38, 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 well managed with the views of the clients regularly sought. The health and safety needs of the clients and staff are protected. EVIDENCE: The Manager moved to this Home from another Home within the organisation. She has appropriate skills and experience to manage the Home and has applied to the Commission to become the Registered Manager. The Manager has completed the Registered Managers Award and NVQ Level 4. The clients and staff spoke highly of the new Manager. They said that she is enthusiastic, knowledgeable and that she is approachable and easy to talk to. Discussions with the Manager show that she is aware of the strengths of the Adrian Lodge DS0000072244.V371368.R01.S.doc Version 5.2 Page 22 Home but is also aware of areas in need of improvement. She has already taken action in some areas and has plans to make further improvements. She said that she receives good support from her new line Manager. The Manager has received responses from the questionnaires that she gave to clients with regard to their views about the quality of the service provided. She has not yet audited the responses from these but said that they are mainly positive. She intends to send questionnaires to relatives soon. There are several ways in which the quality of the service is measured and these all need to be brought together into an annual review of the service. The Manager said that the hot water is not currently regulated but that the organisation are arranging for this to be done as they recognise it as a possible risk to the clients. We looked at a range of health and safety records which show that regular monitoring is carried out of health and safety issues as well as regular maintenance and servicing of equipment. Adrian Lodge DS0000072244.V371368.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 X 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 2 25 X 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 3 X LIFESTYLES Standard No Score 11 X 12 4 13 4 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 3 2 X X 2 X Adrian Lodge DS0000072244.V371368.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 YA7 Regulation 13 (6) Timescale for action It is required that a financial care 31/12/08 plan is kept for all clients when the organisation looks after the clients money. A copy of all records relating to their money must be available to the clients It is required that written 30/11/08 guidance is available for the use of PRN medication It is required that staff receive 31/12/08 appropriate training and that this is kept updated Requirement 2 3 YA20 YA35 13 (2) 18 (1) 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 YA6 Good Practice Recommendations It is recommended that the format of the care plans is reorganised so that it is easier to find information and so that there is less repetition Adrian Lodge DS0000072244.V371368.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact 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 Adrian Lodge DS0000072244.V371368.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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