Care Home: Ashley House

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What the care home does well Residents receive a caring and thoughtful service and their needs are well met at the home. Staff are trained to do the work they do and to understand the needs of the residents who have a range of different learning disabilities.Ashley HouseDS0000008081.V378289.R01.S.docVersion 5.3The home is well run and Mr Gilpin is a very ‘open’ and supportive manager, whom the residents and staff relate to very well. What has improved since the last inspection? The checks required to safeguard vulnerable adults at the home are now being done prior to new staff starting work. Regular supervision has been implemented for the staff at the home. What the care home could do better: There must be an up to date service use guide. It is a legal requirement to provide up to date information for people about the service provided in the home. Medication administration records that are handwritten need to be signed and dated by the member of staff who writes them. This is to make sure the medication details have been accurately written and residents are given the right medication. There needs to be two references obtained for new staff before they commence working at the home. This is to make sure only suitable people are employed to work in the home. Fire alarm tests need to be done on a consistently regular basis. This is to make sure that the fire alarms work in the event of a fire. Key inspection report CARE HOME ADULTS 18-65 Ashley House Ashley House 33 Sunnyside Road Clevedon North Somerset BS21 7TL Lead Inspector Melanie Edwards Key Unannounced Inspection 9th November 2009 09:30 Ashley House DS0000008081.V378289.R01.S.doc Version 5.3 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care home adults 18-65 can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop. The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Ashley House DS0000008081.V378289.R01.S.doc Version 5.3 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Ashley House DS0000008081.V378289.R01.S.doc Version 5.3 Page 3 SERVICE INFORMATION Name of service Ashley House Address Ashley House 33 Sunnyside Road Clevedon North Somerset BS21 7TL 01275 871557 01275 872528 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) Mr Trevor John Gilpin, Mrs Rachael Gilpin Mr Trevor John Gilpin Care Home 16 Category(ies) of Learning disability (16), Learning disability over registration, with number 65 years of age (16) of places Ashley House DS0000008081.V378289.R01.S.doc Version 5.3 Page 4 SERVICE INFORMATION Conditions of registration: Date of last ‘Key’ inspection. 1st November 2006 Brief Description of the Service: Ashley House is registered to accommodate up to 16 residents with learning difficulties. At the time of the inspection, there was one vacancy. The home is a Victorian property set in large attractively maintained gardens and within easy reach of shops and other local facilities. The fees for the home are negotiated on an individual basis and are dependant on the level of support needed. Ashley House DS0000008081.V378289.R01.S.doc Version 5.3 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. However based on our evidence when we did ‘random’ inspections in 2007 we think it is possible that the overall standards in the home may have dropped down between 2006 and now. Mr Gilpin and the team have managed to improve the rating back to a 2 star service. Based on our overall findings the home have worked hard to earn this rating and if this improvement continues they could improve their overall rating even further at the next inspection. We were able to meet met ten of the fourteen residents living at the home. We spoke to the registered manager and owner of the home Mr Trevor Gilpin, two care assistants and a cook about what they do to help the residents. We saw staff help residents with their needs. We saw lunch being served. We saw a selection of records relating to the running and management of the home. We saw the statement of purpose, one care plan and assessment record, five medication records, menus, information about social activities, the complaints book, the complaints procedure, the safeguarding procedure, service records for the home environment, the staff duty rota, staff training records, staff supervision information, the fire book, accident book and quality assurance information. We saw most of the environment and the only parts we did not check were a small number of bedrooms. We found the home was operating within the required conditions of registration which we impose. The conditions of registration detail the type of care and the needs of residents and the numbers of residents who may stay at the home. What the service does well: Residents receive a caring and thoughtful service and their needs are well met at the home. Staff are trained to do the work they do and to understand the needs of the residents who have a range of different learning disabilities. Ashley House DS0000008081.V378289.R01.S.doc Version 5.3 Page 6 The home is well run and Mr Gilpin is a very ‘open’ and supportive manager, whom the residents and staff relate to very well. What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. Ashley House DS0000008081.V378289.R01.S.doc Version 5.3 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 Ashley House DS0000008081.V378289.R01.S.doc Version 5.3 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. 1, 2.The care and support that residents’ need is properly planned and worked out when they come to the home. This means that residents will get the right care and support in the home. People do not have access to all the information they need to find out about the service provided at the home. EVIDENCE: To see what sort of information there is for people to find out about the home we looked at a copy of the statement of purpose. We asked to see a copy of the service user guide. Mr Gilpin told us since he has taken over running the home about one year ago, with time off for personal reasons he has not yet been able to fully produce an up to date and service users guide. We advised that there must be an up to date service use guide. It is a legal requirement to provide up to date information for people about the service provided in the home. Ashley House DS0000008081.V378289.R01.S.doc Version 5.3 Page 9 We saw in statement of purpose information about the service provided, the qualifications of the staff employed and the type of accommodation provided. The philosophy of the home and the way that the service aims to meet resident’s needs is also included. The complaints procedure is in each service users guide so residents know how to complain if they need to. We looked at one residents assessment record to see how well the care and support that they need is identified and planned. The information we read in the assessment record was informative and explained what the resident’s different physical, mental and social needs are. We also saw that that what to do to support the person had also been recorded clearly in the assessment records. The assessment record we saw was being regularly reviewed and updated. This is good evidence that the resident concerned can still get the right care and support that they need. We discussed with Mr Gilpin about how residents’ needs are assessed. He explained that the home has now a key worker system. He told us a member of staff would be allocated to take specific responsibility for building up a really good relationship with the resident. Ashley House DS0000008081.V378289.R01.S.doc Version 5.3 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9.People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are well supported with their individual needs and choices. EVIDENCE: The residents who we met were positive in their opinions of the staff and the care they get in the home. Examples of comments made by residents included, ‘ we are all happy here’, `this is my home’ and `they make me nice meals’. This helps demonstrate to us that residents are well supported with their individual needs and choices. We read one residents care plan so that we could find out how residents are supported and cared for and able to live a fulfilling life. We read some really useful information about the person’s range of needs and what should be done Ashley House DS0000008081.V378289.R01.S.doc Version 5.3 Page 11 to help them meet those needs. There was helpful information explaining how to help the person with their learning disability to be able to live a full and meaningful life. We saw a good level of information in the care plan about the life history of the person and what matters to them. We saw information about important family and friends and significant others in their life. We saw the care plan had been reviewed and updated regularly. This demonstrates the home make sure that it knows what residents’ needs are and can still meet them. We saw residents go out with staff for a range of social and therapeutic activities. This is good evidence of how residents are well supported to take risks in their daily lives. We discussed with the staff how they promote residents’ rights and develop their independence in their daily lives. The staff explained really well how an aim of the home is to help promote residents to live a full and meaningful life and to make choices in what they do each day. We read some helpful information about the potential risks the person may encounter and any risks from particular activities that they do in their daily life. The information we read was clear and showed us what approaches and type of responses staff should take and was helpful and informative. There are regular residents meetings held in the home. We were told that residents can discuss what they feel matters and what action they may want staff to take in relation to the day to day running of the home. We saw good evidence written on the menu records that residents are actively involved in the choice of meals served in the home. Ashley House DS0000008081.V378289.R01.S.doc Version 5.3 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. JUDGEMENT – we looked at outcomes for the following standard(s): This is what people staying in this care home experience: 12, 13,15,16,17. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are well supported to live a fulfilling life style both in and out of the home. Residents’ rights are respected in all aspects of daily living. Privacy, dignity and respect is promoted. Residents are involved in the choices of menus and a healthy diet is promoted. EVIDENCE: The residents who we met told us that they go to a number of leisure and social facilities including local community based facilities such as shops, the cinema, church and the pub. We saw good evidence that residents can pursue their own hobbies and interests while at the home. Ashley House DS0000008081.V378289.R01.S.doc Version 5.3 Page 13 We saw some really useful information written in care plans and in general care records that confirmed that residents do a range of social and therapeutic activities both in and out of the home. One resident told us they were going to college late in the week. We also saw one resident’s hand made rugs that they had made, they looked really attractive. We saw photos in the home of recent holidays and social events that residents had taken part in. We were told by staff and by residents that the home encourages contact with family and friends. Some residents see important people in their lives on a very regular basis. We observed staff were respectful and polite. We saw staff knock on resident’s bedroom doors before being invited in to rooms. Some residents can have their own key to their bedroom if they want to, to give them more privacy. We saw residents walking around the home and they were talking with the staff. We noticed that people looked really relaxed and settled in their surroundings. We also saw that residents got up at different times during the morning. This tells us residents can make choices in their daily lives. The residents we met told us the food in the home is good. The cook told us residents are fully involved in the choices of the menus. The daily menu is written on a notice board to assist residents to know what meals are on offer that day. The cook and the staff ask the residents what meal choices they would like each week or so. The residents menu choices looked well balanced, and traditional. Residents can make a choice of what meal they would like to have. The residents who we met spoke positively about the quality of the meals that are provided. Ashley House DS0000008081.V378289.R01.S.doc Version 5.3 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are well supported with their health needs and their personal care. EVIDENCE: We saw information written in residents care records about the preferred dayto-day routine of people and their particular likes and dislikes in their daily routine. This helps ensure residents’ needs are met in the way that is they like We saw information in the daily records that showed us that staff monitor and observe the health of residents. We saw good evidence of how staff call the doctor, if they are concerned about the person. Mr Gilpin told us residents go to two local doctors surgeries with the support of staff. Ashley House DS0000008081.V378289.R01.S.doc Version 5.3 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23.People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Complaints are dealt with properly. There are effective ways to protect residents from abuse. EVIDENCE: We looked at the complaints records to see how complaints are dealt with by the home. There had been a number of complaints made since before the last inspection. We could see that Mr Gilpin and the staff actively encourage and support residents to make their concerns known. We saw good evidence that complaints are taken really seriously and properly addressed by Mr Gilpin. When we talked to staff and Mr Gilpin they demonstrated an understanding of the importance of supporting residents to make their views known if they are unhappy about any aspect of life in the home. We saw residents who were talking to the staff and looking really relaxed to approach them. We saw a copy of the homes complaints procedure. We saw that this has our contact information as well if people need to get in touch with us. Ashley House DS0000008081.V378289.R01.S.doc Version 5.3 Page 16 Mr Gilpin told us there are regular residents meetings. This is a way residents take control in their lives and can make complaints if they need to. We saw a copy of the homes policy relating to the issue of protection of vulnerable adults from abuse. The policy is to help to guide staff to take the correct course of action if they ever have to respond to an allegation of abuse. We saw evidence in the staff training records that staff do a good level of training in understanding the principle of keeping people the protection of vulnerable adults from abuse. The staff we met told us they had done recent training on the subject of abuse and how they protect residents in the home. Ashley House DS0000008081.V378289.R01.S.doc Version 5.3 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,28,30.People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a home that is clean, safe and satisfactorily maintained. The environment is homely and is a relaxing place to live. EVIDENCE: Ashley House is in a residential area of the town of Clevedon. The home is a short distance from the main shopping area of the town. The home is near to bus stops, a train station, shops, coffee shops, pubs, and a church. This means residents can be part of the community if they so wish. The home is a three-storey building. Residents use all parts of the building although the office is located in the basement. There is a stair lift to help to help people with reduced mobility. Ashley House DS0000008081.V378289.R01.S.doc Version 5.3 Page 18 We found the home looked clean in all areas that we saw. We saw domestic staff working really hard cleaning the home. The environment looked to be satisfactorily maintained. Mr Gilpin told us there are two maintenance staff who help in the up keep of the home. He said he has a contract with an external maintenance company for any bigger repairs. One resident kindly showed us their bedroom. The bedrooms looked clean and satisfactorily maintained. All bedrooms are for single use. We saw that rooms had been decorated in different colours and we were told residents had chosen their own colours for their rooms. Residents had their personal possessions in their rooms. We saw residents sitting at the dinning room and in the lounge talking together. We noticed that residents looked really relaxed in their surroundings. We saw bathrooms near to the lounges and bedrooms. We saw that the bathrooms and toilets were clean and had towels and soap to help reduce risks from cross infection between people in the home. Ashley House DS0000008081.V378289.R01.S.doc Version 5.3 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34,35.People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are cared for by enough staff to support and care for them and to meet their range of different needs. Residents are not fully protected by the home recruitment procedures. EVIDENCE: We checked the number of staff on duty for the last four weeks to see if there are enough staff on duty to support the residents effectively. Ashley House DS0000008081.V378289.R01.S.doc Version 5.3 Page 20 We saw on the duty rota that there are a minimum of two to three support staff on duty for a day shift. There are two staff on duty in the afternoon. Three are two staff who do a ‘sleeping in shift’ at night and are available for support if needed. There is also a full time cook employed, domestic staff and a part time activities coordinator. Mr Gilpin works additional to the two staff on duty each day and he does full time hours running and managing the home. He is also available on call outside of these times for support and advice if needed. Based on what we found when we did the inspection the number of staff on duty are meeting residents needs. We checked staff employment files of three care staff. We saw written professional references taken up for staff prior to offering work at the home. However two staff only had one written reference obtained about them before they had stared working at the home. Residents are better protected if there are two references for new staff as this helps to demonstrate that only suitable people have been employed to work at the home. All staff must do a criminal records bureau check before starting employment. These checks aim to make sure the home employees only suitable people to work with residents. Ashley House DS0000008081.V378289.R01.S.doc Version 5.3 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42.People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well run. The quality of the care in the home is being effectively monitored. The health and safety of residents’ staff and visitors to the home is mostly protected. However fire alarms are not being consistently checked often enough. This could put people at risk. EVIDENCE: Mr Trevor Gilpin has been the manager and owner of the home for over a year, before he purchased the home he was the manager of the home under different owners. He has many years of experience caring for people with a Ashley House DS0000008081.V378289.R01.S.doc Version 5.3 Page 22 range of needs and leaning disabilities. He has been registered with us as the manager of the home and has been in charge since 2004. This demonstrates he is fit and competent to be the manager. The staff told us that Mr Gilpin is approachable and they could go to him with any concerns at anytime. As already mentioned residents there are residents house meetings and residents can discuss what matters to them with Mr Giplin and other staff Mr Gilpin has put in place a really good system for monitoring the quality of the care and the service that residents receive. We saw the information that had been obtained from a recent exercise involving residents, relatives and significant others. We saw that residents are well consulted about a varied range of matters to do with the service. We found that the environment looked safe and satisfactorily maintained in the areas we saw. The staff do regular training in a range of health and safety subjects including food safety. This is a really good way for staff to help residents to prepare and cook food in a safe way. The staff have also done training in health and safety matters including first aid, infection control and fire safety. This should help keep residents safe if staff are knowledgeable and well trained in health and safety subjects. We checked the fire logbook record and this showed the required weekly and monthly tests of the fire alarms and the fire fighting equipment were being carried out. However we saw that the fire alarms had not been recorded as having been checked for four weeks. We advised Mr Gilpin that the fire alarms should be checked every week to make sure they work in the event of a fire. We saw records that showed staff check the temperatures of all high-risk cooked food before it is served to people to make sure it is hot enough and safe to eat. Ashley House DS0000008081.V378289.R01.S.doc Version 5.3 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 X 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 3 26 X 27 X 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 2 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 2 X Version 5.3 Page 24 Ashley House DS0000008081.V378289.R01.S.doc 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 5 Requirement There must be an up to date service use guide. It is a legal requirement to provide up to date information for people about the service provided in the home. Medication administration records that are handwritten need to be signed and dated by the member of staff who writes them. This is to make sure the medication details have been accurately written and residents are given the right medication. Timescale for action 09/01/10 2. YA20 13 09/11/09 3. YA34 Schedule2 4. YA42 23 There must be two references for 09/12/09 new staff recruited to work at the home. This is to help to demonstrate that only suitable people have been employed to work at the home. Fire alarms must be checked on 09/11/09 a consistently regular basis. This is to make sure they work in the event of a fire. Ashley House DS0000008081.V378289.R01.S.doc Version 5.3 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. Refer to Standard Good Practice Recommendations Ashley House DS0000008081.V378289.R01.S.doc Version 5.3 Page 26 Care Quality Commission Care Quality Commission Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). 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