Care Home: Becklow Road

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What the care home does well 161 Becklow Road provides a person centred service to 6 people with a learning disability. Good community presence is ensured by supporting people to take part in a range of activities, including using local leisure and adult education services. Staff know the residents well, including their likes and dislikes. Residents’ cultural and religious needs are identified and supported. Relationships with families and friends are good, with regular contact in person or by telephone. Residents’ health care needs are given a high priority. Staff have good access to training including NVQs. People live in a pleasant modern building, which is kept clean and tidy and in good repair. Record keeping is of a high standard. What has improved since the last inspection? All but one of the residents has gone on an individual holiday in the UK with staff. Staff have attended a range of training, particularly in the last 6 months, including training in the safe use of restraint (SKIP), safeguarding adults and fire safety. Copies of the local safeguarding procedures are available in the office.Becklow RoadDS0000019147.V378556.R01.S.docVersion 5.3Following a fire risk assessment in 2008 a number of improvements have been implemented. Personal emergency evacuation plans have been drawn for each person and testing of the alarm is taking place regularly. The building has been redecorated and new furniture purchased. What the care home could do better: While progress has been made in developing person centred plans (PCPs), ways of monitoring action agreed at reviews and in relation to PCPs need to be established, for example by the use of monthly summaries. Up to date communication plans should be available for each resident who communicates non–verbally. The bath/shower rooms would benefit from updating. Key inspection report CARE HOME ADULTS 18-65 Becklow Road Becklow Road 161-163 Becklow Road Shepherds Bush London W12 9HH Lead Inspector Sheila Lycholit Key Unannounced Inspection 14th December 2009 10:15 Becklow Road DS0000019147.V378556.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. Becklow Road DS0000019147.V378556.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 Becklow Road DS0000019147.V378556.R01.S.doc Version 5.3 Page 3 SERVICE INFORMATION Name of service Becklow Road Address Becklow Road 161-163 Becklow Road Shepherds Bush London W12 9HH 020 8932 3916 020 8743 2333 info@yarrowhousing.org.uk 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) Yarrow Housing Georgina Morgan Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Becklow Road DS0000019147.V378556.R01.S.doc Version 5.3 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category 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: 2. Learning disability - Code LD The maximum number of service users who can be accommodated is: 6 8th February 2008 Date of last inspection Brief Description of the Service: 161/163 Becklow Road is a home for 6 people with a learning disability aged 18 - 65. There are 6 people living at Becklow Rd at present, four men and two women. The home is operated by Yarrow Housing Limited, and is located in the Shepherds Bush area of London, close to local shops and a bus route. The house is a detached, three storey modern building. The top floor provides an office, shower, toilet and sleep-in facilities for staff. The 1st floor has three bedrooms, sitting room, kitchen and bathroom and lavatory. The ground floor has three bedrooms, kitchen, sitting room and two accessible bath/shower rooms. The house has a large private garden. Becklow Road DS0000019147.V378556.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 that the people who use this service experience good quality outcomes. The unannounced visit took place on Monday 14th December 2009 from 10.15am until 3.15pm. At the start of the visit there were 5 residents at home with 5 staff. One resident had spent the weekend with his family and returned later. The Manager was attending training at Yarrow Housing’s head office nearby and returned to assist with the inspection. The 5 residents left later in the morning with staff to go shopping at Lakeside. The inspection included a tour of the building, examination of records and documents, discussion with staff and observation. Information received during the past 12 months, including the provider’s annual quality assurance assessment, were also considered. What the service does well: What has improved since the last inspection? All but one of the residents has gone on an individual holiday in the UK with staff. Staff have attended a range of training, particularly in the last 6 months, including training in the safe use of restraint (SKIP), safeguarding adults and fire safety. Copies of the local safeguarding procedures are available in the office. Becklow Road DS0000019147.V378556.R01.S.doc Version 5.3 Page 6 Following a fire risk assessment in 2008 a number of improvements have been implemented. Personal emergency evacuation plans have been drawn for each person and testing of the alarm is taking place regularly. The building has been redecorated and new furniture purchased. 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. Becklow Road DS0000019147.V378556.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 Becklow Road DS0000019147.V378556.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): 1, 2 and 5 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. Clearly produced information about the service is available in an accessible format. There is a sound assessment and admission procedure. EVIDENCE: A copy of the statement of purpose and service user’s guide was seen on each of the 3 residents’ files looked at. These are clearly written with up to date written information supplemented by photos and symbols. An up to date contract for each person was on file, which had been signed by them and the Manager. No new residents have been admitted since the last inspection. The home has an established admission procedure, which fully involves the prospective resident. Residents’ needs are regularly reassessed with the involvement of the local Learning Disability Team. Becklow Road DS0000019147.V378556.R01.S.doc Version 5.3 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8 and 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. Person centred planning is well developed, including the use of multi media. EVIDENCE: An up to date PCP was seen on each of the 3 individual files looked at. PCPs are compiled in an accessible format and are presented at reviews using multi media to allow residents to be fully involved. Records show that reviews take place at least annually and that residents and their families are fully involved in the preparation for the meeting. Staff had arranged a review for one person in the absence of the relevant local authority because delays in arranging a meeting were resulting in his placement review becoming overdue. Minutes of staff meetings show that residents’ progress and development is discussed but not necessarily in relation to their PCP or action agreed at reviews. Progress in relation to action agreed at reviews or in other meetings Becklow Road DS0000019147.V378556.R01.S.doc Version 5.3 Page 10 needs to be monitored to ensure that work with residents remains focussed and that action agreed is implemented and goals achieved. The completion of monthly summaries, which are used elsewhere at Yarrow Housing services, would allow senior staff to monitor that agreed action is being implemented. Communication plans were seen for 2 people who communicate non verbally but these were compiled in 2005 and had not been up dated. All residents who use non verbal communication should have an up to date communication plan. Risk assessments are regularly reviewed and show staff’s understanding and knowledge of the person. House meetings take place weekly, with notes available, which are usually in an accessible format. Records show that where residents are reluctant to attend a meeting, staff consult with each person individually. Becklow Road DS0000019147.V378556.R01.S.doc Version 5.3 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): This is what people staying in this care home experience: 12, 13, 15, 16 and 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 supported to take part in a range of activities, including participation in local community services. Good relationships have been established with families who play an active part in residents’ lives. Healthy eating is promoted. EVIDENCE: A weekly activity plan is displayed showing each person’s programme for the week and the staff who will be supporting them. On the day of the inspection alternative arrangements were being made as the adult education classes shown on the plan were closed for the Christmas holiday. Residents attend some sessions at Hammersmith and Fulham day services and at The Gate, Yarrow’s own day service. Two residents have their own cars and the home has the use of a minibus on Wednesdays for outings. Becklow Road DS0000019147.V378556.R01.S.doc Version 5.3 Page 12 Discussion with the Manager and records show that good relationships are maintained with families. Two people go to stay with their families at weekends. Contact with families who live further away is maintained by phone calls as well as visits. Positive feedback from families was seen on residents’ files. In 2009 five of the six residents went on individual holidays in the UK supported by staff, which the Manager states were very successful. One resident went on holiday with his family but it has been agreed that a holiday supported by staff will be arranged for him in 2010. Residents on the ground and first floor eat separately, with menus, in a pictorial format, displayed on the notice boards. The Manager said that staff try to encourage healthy eating and fridges contained fresh vegetables and a bowl of fruit was seen in one of the kitchen. Kitchens are normally kept locked when no staff are present because of the tendency of some residents to seriously overeat. Residents are encouraged to take part in preparing meals and there are cooking sessions scheduled each week on the activity plan. Records show that one resident regularly shops with staff at the local market and is supported to prepare Caribbean food. Records show that residents’ weight is monitored. Becklow Road DS0000019147.V378556.R01.S.doc Version 5.3 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 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. Support plans give clear guidance to staff about how residents wish to be supported. Staff ensure that health care needs are identified and monitored. The handling of medication is sound. EVIDENCE: Support plans were seen on each of the 3 individual files looked at. These give detailed guidance to staff on how a resident likes to be supported with personal care. The Manager stated that same gender care is always provided to protect residents’ dignity. Health action plans and records of health care appointments show that staff work with health care colleagues to identify health care needs and ensure that action is taken. Action agreed in health care plans, for example the need for Optician visits and dental checkups, is normally checked at reviews. Information about specific conditions affecting residents, such as epilepsy and diabetes, is available for staff in the office. Becklow Road DS0000019147.V378556.R01.S.doc Version 5.3 Page 14 Medication was seen to be safely stored in wall mounted metal cabinets in the kitchens. The Boots monitored dosage system is used. The last report of a visit by the Boots Pharmacist was seen, which showed that she found the handling of medicines to be satisfactory and made no recommendations. Recent MAR sheets were looked at, which with one exception were fully completed. The Manager was able to confirm that the gaps from the previous shift, when she had been on duty, were an oversight and that the person had received their medication. Staff record the reason for administering any PRN medication on the reverse of the MAR sheet. It is recommended that the procedure for ‘leave’ medication seen on file be expanded to reflect current practice in the home. The list of signatures of the staff giving medication should be updated. Becklow Road DS0000019147.V378556.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 and 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. A clear complaints procedure is available in an accessible format. Policies, procedures and staff training in safeguarding ensure that staff understand the vulnerability of residents and are aware of what action to take if they have any concerns. EVIDENCE: The complaints procedure, which is in pictorial format as well as text, is displayed in the home and is included in the service user’s guide. Residents’ views about the service are sought at house meetings and through annual questionnaires. The complaints record shows that no complaints have been received in the past 12 months. Consideration should be given to recording ‘informal’ complaints and concerns to contribute to quality monitoring and the development of the service. Training records show that all staff have received training in safeguarding adults, including refresher training. Copies of the local safeguarding policy and procedures are available in the office, as recommended at the previous inspection. All staff have attended recent training in the safe use of restraint (SKIP) and most have attended training in the Mental Capacity Act. There have been no safeguarding referrals in the past 12 months. Records show that where there have been concerns about residents’ behaviour that challenges, advice from the Learning Disability Team has been sought. Becklow Road DS0000019147.V378556.R01.S.doc Version 5.3 Page 16 Staff record any bruising or marks and seek an explanation of how they occurred. It is recommended that staff use body charts to record the site of any bruises or other marks more accurately. Residents’ finances are regularly checked by Yarrow Housing’s finance staff, as well as by staff at the house. An audit had recently taken place of all residents’ finances. The Manager was awaiting a report but stated that as far as she was aware the audit was satisfactory. Becklow Road DS0000019147.V378556.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, 27 and 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. People live in an attractive modern building close to shops and services. The house is kept clean, tidy and in a good state of decoration. EVIDENCE: 161-163 Becklow Road is a purpose accommodation in a residential area in Shepherds Bush, close to local shops and on a bus route. Residents live in 2 separate flats on the ground and first floor, which each has 3 single bedrooms, a sitting room and kitchen/dining room. There is also a laundry room and accessible bathrooms. The building has been redecorated since the last inspection and new furniture and equipment purchased. The ground floor sitting room leads out to a pleasant, well kept garden, which contains an outside eating area. Three residents’ rooms were looked at, which were furnished to meet people’s needs and contained a range of their possessions, reflecting individual Becklow Road DS0000019147.V378556.R01.S.doc Version 5.3 Page 18 interests. A new lower double bed had recently been purchased for one person who has seizures to reduce the risk of injury. The Manager said that she was considering ordering a ‘crash’ mattress for use at nights to further improve his safety. The office/sleep-in room on the top floor has a shower and WC and is kept in good order. In contrast to the rest of the building, the bath and shower rooms are in need of redecoration and repair. Flooring is stained, tiles missing and the rooms are generally unwelcoming. The building is kept very clean and tidy by the support workers, who clean the house in the absence of a domestic assistant. The Manager stated that the domestic assistant’s post has been frozen temporarily. Becklow Road DS0000019147.V378556.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 and 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. The service has sufficient trained staff to meet residents’ needs, including opportunities for one to one support. Staff have access to a comprehensive training programme based on the needs of the service. EVIDENCE: Staffing levels reflect the needs of residents, who need one to one support at periods during the day. Night cover is provided by staff sleeping-in and one waking night support worker. There are currently 4 vacant posts which have been advertised. The Manager said that interviews would be taking place in January. In the meantime the posts are covered by staff from Yarrow’s bank who know the residents well. Yarrow Housing has a sound recruitment procedure and staff files from a number of projects were found to be in good order, with all recruitment checks completed, when seen at Yarrow’s head office earlier in the month. Becklow Road DS0000019147.V378556.R01.S.doc Version 5.3 Page 20 Records show that staff are provided with a structured induction and complete a probationary period. The majority of staff have completed or are enrolled on NVQ2 or 3. Training records are well kept and show that staff have attended a range of workshops in addition to mandatory training. Good communication within the team is encouraged through regular staff meetings, which are recorded in detail. Hand-over sheets cover all essential information for the incoming staff. The Manager stated that supervision for staff takes place regularly. Becklow Road DS0000019147.V378556.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, 41, 42 and 43 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 Manager is knowledgeable about residential care and is responsive to the needs of residents. The health and safety of residents and of staff is given a high priority. EVIDENCE: The Manager, who has worked for Yarrow Housing for a number of years, including as Manager of another home, was recently registered with the Commission. She is experienced in working with people with a learning disability and knows the residents’ needs well. The Manager confirmed that she is enrolled on the Leadership and Management award. She is a NVQ Assessor. Becklow Road DS0000019147.V378556.R01.S.doc Version 5.3 Page 22 The senior staff team consists of the Manager and 2 Deputy Managers. Both posts are filled, although one person is temporarily covering a post at another home. Yarrow Housing has well established systems to promote user involvement, including regular tenant forums, membership of the Board and annual satisfaction questionnaires. Record keeping at the home is generally of a high standard, with systems in place to ensure good communication between staff. Some records would benefit from the inclusion of the date for example service user guides and support plans. Records show that all staff receive training in health and safety including refresher training. Health and safety records seen, including fire safety records were up to date. A fire risk assessment undertaken in September 2008 identified a number of areas for improvement. The Manager stated that all work has been completed, although she not yet received a copy of the new fire risk assessment report. Personal emergency evacuation plans (PEEPS) were seen on file for each person. The home received a 4 star rating from the local Food Safety team following an inspection in July 2008. Reports show that monthly visits on behalf of the provider (regulation 26) have been taking place regularly since July 2009. Becklow Road DS0000019147.V378556.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 3 2 3 3 X 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 2 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X 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 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 3 3 3 Version 5.3 Page 24 Becklow Road DS0000019147.V378556.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 YA6 Regulation 15 Requirement Steps must be taken to ensure that the implementation of action agreed at reviews and in PCPs is monitored, for example through the use of monthly summary reports. Up to date communication plans should be available for each person who communicates nonverbally. Bath and shower rooms are in need of refurbishment. Timescale for action 31/01/10 2. YA6 15 28/02/10 3. YA27 23 31/03/10 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 YA20 Good Practice Recommendations The medication policy and procedure regarding ‘leave’ medication should be updated to reflect current practice in the home. An up to date list of signatures of staff giving medication should be on file. It is recommended that ways of capturing all concerns and complaints, in addition to formal complaints, are established to contribute to the development of the DS0000019147.V378556.R01.S.doc Version 5.3 Page 25 2. YA22 Becklow Road 3 YA23 service. The use of body charts for recording bruises and other marks should be considered. Becklow Road DS0000019147.V378556.R01.S.doc Version 5.3 Page 26 Care Quality Commission London Region 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. 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