Care Home: Avenue Lodge

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What the care home does well People who use this service are provided with a comfortable homely environment. Individuals told us they feel safe and well supported by "good" staff. Individuals told us "I like it, it is lovely and nice here", "It is a quiet retreat" and "I love it" We found significant time and effort is spent in planning admissions to ensure that individuals are well informed and supported through the process. There is an emphasis on personal choice, independence and rights which is carried through the care planning and daily life of the service. Activities are flexible taking into account the needs and wishes of individuals. People who use the service told us they were confident staff listened to them and we observed good relationships between staff and individuals. Staff ensure that people who use the service are kept well informed on how to make a complaint and safeguarding issues.The manager provides a positive role model for staff. Staff feel well supported by the manager and their colleagues. The training provided ensures that people who use the service are supported by a well informed staff group. The manager involves people who use the service in auditing the quality of the care provided. The manager and staff continue to look for ways of improving the service they provide for individuals. What has improved since the last inspection? The extension to the building has been completed which has provided improved communal space, a larger garden and a ground floor shower and toilet. Staff continue to be provided with additional training to increase their knowledge and skills. This year mental health training has focused on rehabilitation and recovery. Staff have completed an accredited course on equalities and diversity. Staff have included more community based sports in the activities available such as swimming and badminton. CARE HOME ADULTS 18-65 Avenue Lodge 53-57 Avenue Road London SW16 4HJ Lead Inspector Liz O`Reilly Key Unannounced Inspection 22nd July 2008 10:00 Avenue Lodge DS0000027251.V368009.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 Avenue Lodge DS0000027251.V368009.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. Avenue Lodge DS0000027251.V368009.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Avenue Lodge Address 53-57 Avenue Road London SW16 4HJ 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) 0208 764 6125 Mr Nizam Hosanee Mrs Anna Maria Oozeerally Care Home 10 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (10) of places Avenue Lodge DS0000027251.V368009.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care Home Only (CRH - PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: 2. Mental Disorder, excluding learning disability or dementia - Code MD The maximum number of service users who can be accommodated is: 10 4th September 2006 Date of last inspection Brief Description of the Service: Avenue Lodge is a care home for up to six adults with mental health needs. The home is owned by Mr N. Hosanee. The property consists of two terraced properties which have been joined together and extended. The home is situated in a residential area of Mitcham, close to local shops and public transport links. Unrestricted parking is available in the street. The property is not identifiable as a care home. The aims and objectives of the home are set out in the Service Users Guide with is provided to each resident. Avenue Lodge DS0000027251.V368009.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 three stars. This means people who use this service experience excellent quality outcomes. This unannounced inspection was carried out by one regulation inspector over one day. We had the opportunity to meet with everyone who uses the service, two staff and the manager. We spoke to two people who use the service in more detail. Nine people who use the service and five staff returned completed surveys. We looked at a sample of the records kept by the service. The manager completed an Annual Quality Assurance Assessment (AQAA), which gave us information about the home and the people who live and work there. We have used information from all of the above sources along with observations made at the time of our visit to reach the judgements made in this report. What the service does well: People who use this service are provided with a comfortable homely environment. Individuals told us they feel safe and well supported by “good” staff. Individuals told us “I like it, it is lovely and nice here”, “It is a quiet retreat” and “I love it” We found significant time and effort is spent in planning admissions to ensure that individuals are well informed and supported through the process. There is an emphasis on personal choice, independence and rights which is carried through the care planning and daily life of the service. Activities are flexible taking into account the needs and wishes of individuals. People who use the service told us they were confident staff listened to them and we observed good relationships between staff and individuals. Staff ensure that people who use the service are kept well informed on how to make a complaint and safeguarding issues. Avenue Lodge DS0000027251.V368009.R01.S.doc Version 5.2 Page 6 The manager provides a positive role model for staff. Staff feel well supported by the manager and their colleagues. The training provided ensures that people who use the service are supported by a well informed staff group. The manager involves people who use the service in auditing the quality of the care provided. The manager and staff continue to look for ways of improving the service they provide for individuals. 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. Avenue Lodge DS0000027251.V368009.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 Avenue Lodge DS0000027251.V368009.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): 1&2 People who use this service experience excellent outcomes in these areas. This judgement has been made using available evidence including a visit to this service. Good information is available about the home and the service it provides. Assessments are carried out to make sure that the service can meet people’s needs before they move in. Care is taken to make sure that the admission process is carried out at the right pace for the individual. EVIDENCE: All of the people who use the service told us they felt they were given good information on what they could expect from the home before they moved in and that this helped them in deciding about the move. The manager informed us that people are encouraged to visit the service before they make a decision about moving in. These visits can be over one day or several days depending on the needs of the person. People who use the service confirmed this. They told us “I came to visit” “I came to see it” “yes I came to see everything, I chose my room, I spent some time here” Avenue Lodge DS0000027251.V368009.R01.S.doc Version 5.2 Page 9 We looked at a sample of two files and these showed that good individual assessments were carried out before people moving in. These assessments provided staff with information on the individual needs, preferences and wishes of each person so that an initial care plan could be set up from day one. Assessments were seen to include discussions about the service and what people’s expectations were. We found evidence, through the records and talking to people who use the service, that the admission process is well managed. Individual staff are allocated to support people and records showed time being taken to familiarise people with the service and the local community. Avenue Lodge DS0000027251.V368009.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8 & 9 People who use this service experience good outcomes in these areas. This judgement has been made using available evidence including a visit to this service. Care plans are developed to meet individual needs and wishes. A key worker system is in place which allows for good personal one to one relationships between staff and people who use the service. People who use the service are fully involved in decisions about the day to day life of the home. Care planning could be further developed with the inclusion of more short and long term goals for individuals. EVIDENCE: We found care plans cover the strengths and needs of individuals in relation to their physical, emotional, social and cultural well being. People who use the service told us they were involved in setting up their care plan. We saw that plans were signed by individuals and staff, dated and reviewed. Consideration should be given to providing more detail on how the needs of individuals will Avenue Lodge DS0000027251.V368009.R01.S.doc Version 5.2 Page 11 be supported. This could further ensure a more person centred approach is maintained. The manager informed us that they plan to work towards more rehabilitation and recovery over the next twelve months. Consideration should be given to introducing more short and long term goals for individuals to back up this work. This could assist in supporting people to achieving their own plans and dreams. If regularly reviewed this work could assist in reinforcing with people the progress they have made. Records showed that staff take time to work with people on their rights, choices, privacy and independence. Assessments and plans are set up to cover these issues and some people who use the service make their own entries in these plans. Individual risk assessments are in place and are used to support people to maintain or increase their independence. Through the care planning and assessment process staff gather significant amounts of information on the likes and dislikes of residents which assists in providing an individualised service. Staff informed us that they are kept well informed of any changes through regular discussions and that “care plans are always kept up to date”. The manager told us that over the last year people who use the service have been encouraged to be more involved in how the service is run. People who use the service told us that they worked with staff to do domestic tasks and were asked about things such as the garden, how rooms are decorated and used. We saw in the record of meetings that people who use the service are asked their opinions, offered choices and involved in quality audits of the environment. Avenue Lodge DS0000027251.V368009.R01.S.doc Version 5.2 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): 12, 13, 14, 15, 16 & 17 People who use this service experience good quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. The views of people who use the service are sought when planning the routines of daily living. Routines are flexible and people make choices in major areas of their life. The service actively supports independence and plans to extend this with more focus on education and employment over the next twelve months. EVIDENCE: Everyone who uses the service told us they make their own decisions about what they do each day. People told us, “I do loads of things here”, “ I like going to first steps trust”, “I like playing cards”, “I like buying new things for the house”, “I like going to the shops”, “I like seeing my brother and helping in the house”, “I like sitting in the garden”, “I like going to oasis” “I like going to the park and going to Mc Donald’s”. Avenue Lodge DS0000027251.V368009.R01.S.doc Version 5.2 Page 13 We observed people being asked what they would like to do throughout the day. Activities were individualised to meet these choices. We saw people reading books and newspapers, going to local shops, helping with lunch and one group of people enjoyed listening to music and dancing after lunch. One person told us that they liked the make up sessions and going out to look for new jewellery. People told us that they enjoyed going out to local markets, garden centres and art galleries. The manager informed us that since the last inspection more emphasis has been made on joining in outside sporting activities such as badminton and swimming. One person who uses the service told us that they particularly liked these activities. Staff told us “ we spend time with each service user chatting, taking them out and finding out things they like and enjoy” and this was reflected in the care planning we looked at. The pre admission assessments include a section on ‘What is Important to Me’. This assists staff in making arrangements to meet the social and cultural needs of individuals. Assessments and plans are also in place on choices, independence and rights. Records show that staff take time to discuss these issues and explain to people their rights. Staff told us that people are supported to attend religious centres of their choice. Individuals are consulted on their particular dietary needs and wishes and these are catered for. Visitors are welcome at any time. One person told us their relative “loves coming here for tea”. Everyone who uses the service told us they enjoyed the food. At the time of this visit lunch was served in the garden and was seen to be a social event. Lunch was taken at a leisurely pace and people had time to chat amongst themselves and with staff. Avenue Lodge DS0000027251.V368009.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 & 20 People who use this service experience good quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. The care planning system and emphasis on choice ensures that people who use the service receive personal support in the way they prefer. The physical and emotional health care needs of individuals are met. Medication is well managed. EVIDENCE: Staff told us they were “always” provided with good, up to date information on the needs of the individuals they support. People who use the service told us they felt they were feeling better since they moved into the home. One person told us “I am getting well here”, another person said “I like it because the staff get me to do things and I am staying well”. Everyone is registered with a local GP practice and the service has good relationships with local community mental health teams. We found on file evidence of regular visits from these teams along with reviews. Avenue Lodge DS0000027251.V368009.R01.S.doc Version 5.2 Page 15 Complimentary letters were on file from the teams, which were sought for the in house quality monitoring. People who use the service are encouraged to take up regular dental and optical checks. Medication is well managed with good records kept. Staff are aware of and respect the rights of people in the area of medication and health care. They recognise and work with the decisions made by individuals about how their health care is managed. Since the last inspection staff have introduced Yoga and relaxation sessions within the service. The manager informed us that these were mostly focusing on deep breathing and basic exercises. People who use the service told us they enjoyed these sessions. A nutrition plan and assessment is carried out with includes information on personal preferences and needs. Staff keep a record of the weight of individuals and will offer advice on diet and healthy eating. Avenue Lodge DS0000027251.V368009.R01.S.doc Version 5.2 Page 16 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 People who use this service experience excellent quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. People who use the service feel safe and well supported. Individuals have a clear understanding of how to make a complaint. Systems are in place for all complaints to be recorded. All staff are trained in safeguarding people and people who use the service are kept well informed of their rights. EVIDENCE: Everyone who uses the service told us that they knew who to speak to if they have a complaint. Most people told us they would go to the manager and one person said they would talk to their keyworker. People told us they felt confident that any concern they had would be taken seriously and acted upon. Staff know what to do if there is a complaint. One member of staff provided us with very good information on what they would do should they receive a complaint. People who use the service will be supported to access advocacy services if needed. The last meeting for people who use the service included a discussion on the right to make a complaint and how to do this. What is abuse and what to do about it was also discussed. This assists in making sure that people who use Avenue Lodge DS0000027251.V368009.R01.S.doc Version 5.2 Page 17 the service are aware of their right to make complaints and to live free from abuse. The minutes of the last staff meeting showed discussions on safeguarding people and Whistleblowing. All staff have completed training on safeguarding people. The manager has completed the Train the Trainer course on this issue. People who use the service are encouraged to manage their own finances. Arrangements are made for people to have their own post office account where any income is sent directly. Staff provide support for those people who have difficulty in budgeting. Agreements are reached with individuals about a daily living allowance and this is supplied from their money held in the service. Records of money held were found to be well maintained, up to date and accurate. Avenue Lodge DS0000027251.V368009.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, 25 & 30 People who use this service experience good quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. People who use this service are provided with a comfortable, homely environment. The building is well maintained, clean and fresh. EVIDENCE: All areas of the service we saw were well maintained and furnished to a good standard. Since the last inspection of the service an extension has been completed and changes have been made to the lay out of communal areas. A new ground floor shower and toilet is available and more en suite shower rooms with toilets have been created. A number of people who use the service said that they liked their own room. One person told us they liked going out to buy ornaments and said they “love the colour of the walls and carpet”. Staff support individuals to make the room more personalised. Avenue Lodge DS0000027251.V368009.R01.S.doc Version 5.2 Page 19 People who use the service have been consulted on the arrangement and use of the various communal areas of the home. Individuals help out in the garden with weeding, planning and watering. All of the people who use the service told us that it is “always” clean and fresh. Comments received included “it is nice, fresh and clean”, “the home is lovely, sometimes I do the polishing”. One person when asked if it was always clean told us “of course it is”. Avenue Lodge DS0000027251.V368009.R01.S.doc Version 5.2 Page 20 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 People who use this service experience good quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. The staffing levels are sufficient for meeting the needs of people living there. There are good recruitment procedures in place that help to protect individuals. Good opportunities for training ensure that people who use the service are supported by a well informed staff group. EVIDENCE: People who use the service have confidence in the staff group and know them well. Everyone who uses the service told us that staff “always” treated them well and all said that staff listened to them and acted on what they said. One person said, “they are lovely they treat me very well”, another person said “I love my keyworker, they are helping me get well”. Staff told us they felt there were enough staff on duty at any one time to meet the needs of individuals. Staff felt they worked well as a team, were kept well informed and were well supported by the manager. Avenue Lodge DS0000027251.V368009.R01.S.doc Version 5.2 Page 21 Staff also felt they had good opportunities for training. The training supplied over the last twelve months included, equalities and diversity, medication, recovery and rehabilitation in mental health, death and dying, infection control, food hygiene and safeguarding people. 90 of the staff group are working towards NVQ level 2 or above. This training ensures that people who use the service are supported by a well informed staff group. We looked at a sample of staff files. These were well maintained and showed evidence of appropriate checks being carried out on staff before they start work. This assists in safeguarding people who use the service. Since the last inspection of the service amendments have been made to the regulations on the recruitment of staff. From now on a full employment history must be sought at application. Any gaps in employment must be explained and recorded on file. Consideration could be given to providing training and support to people who use the service so that they could be involved in the recruitment of staff. Avenue Lodge DS0000027251.V368009.R01.S.doc Version 5.2 Page 22 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 People who use this service experience excellent quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. The manager has the skills, knowledge and experience to run the service. People who use the service are consulted, listened to and fully involved in the day to day running of and planning for the service. The health and welfare of people who use the service is promoted and protected. EVIDENCE: People who use the service made very positive comments about the manager. People expressed confidence in the manager to deal with any problems they may be having. They felt that she listened to them and provided good advice. Avenue Lodge DS0000027251.V368009.R01.S.doc Version 5.2 Page 23 Staff told us the manager met with them on a regular basis to offer support and discuss the way they were working. One member of staff said “I feel the manager supports us in everything we do”. Staff told us that “all information is communicated straight away” and that the manager was “always here to provide good care for staff and residents”. Staff described the manager as a “very good person” who had “really assisted me to gain knowledge and skills”. An annual review of the care provided is carried out by the service. Questionnaires are provided for people who use the service, staff and other people involved in the home. The results of these surveys are used to look at ways of developing the service. People who use the service are involved in auditing the service and policies and procedures. Staff carry out regular checks to ensure the health and safety of everyone who uses or visits the service. We looked at a sample of these records which were found to be up to date. Avenue Lodge DS0000027251.V368009.R01.S.doc Version 5.2 Page 24 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 3 2 4 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 4 23 4 ENVIRONMENT Standard No Score 24 3 25 3 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 4 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 4 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 4 X 4 X X 3 X Avenue Lodge DS0000027251.V368009.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA34 Regulation 19 Schedule 2 (6) Requirement To assist in safeguarding people who use the service a full employment history must be obtained from staff as part of the recruitment process. Any gaps in employment must be explained and recorded on file. Timescale for action 01/10/08 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 To assist in supporting people to gain more independence and a sense of achievement consideration should be given to setting more specific short and long term goals within care planning. Consideration should be given to providing more detail on how individual needs are going to be supported. Consideration should be given to providing support and training for people who use the service to be more involved in the staff recruitment process. 2. 3. YA6 YA34 Avenue Lodge DS0000027251.V368009.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG 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 Avenue Lodge DS0000027251.V368009.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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