Care Home: Bowley Close, 6

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What the care home does well Care planning includes people who are close to the residents and care about their welfare. Residents are supported to take part in a range of activities in the community, this includes visiting a farm, riding bikes, sailing and visiting a sensory room. The residents have all been on holiday on the last year. There is a consistent staff team working in the home. This ensures that they know the residents well and can respond to their needs appropriately. Most of the staff team have achieved the qualification NVQ 2 or above. The home looks after residents` health needs well. What has improved since the last inspection? Risk assessments and guidelines have been reviewed to ensure they are still relevant. Arrangements for the administration of medication have improved. Improvements have been made in the building, by replacing kitchen worktops, and tableware. Visits are made to the home by managers each month to make sure that the home is operating well and that residents` needs are being met. Health and safety matters are better managed, fire drills are carried out quarterly, there is a fire risk assessment and gas appliances have been assessed as safe. What the care home could do better: The way that one item of medication is given to a resident needs to be discussed with the GP to make sure that he is in agreement. Some of the files contain out of date information, this should be stored elsewhere so that current information is easily accessible. In one instance a resident had paid for some bedding, this is an item which the home must provide and pay for. A requirement is made to make sure that this does not continue. A risk assessment is needed to make sure that the use of cot sides for one of the residents is appropriate and safe. CARE HOME ADULTS 18-65 Bowley Close, 6 Farquhar Road London SE19 1SS Lead Inspector Ms Alison Pritchard Key Unannounced Inspection 18th March 2008 12:35p DS0000007065.V340773.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 DS0000007065.V340773.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. DS0000007065.V340773.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Bowley Close, 6 Address Farquhar Road London SE19 1SS Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company Name of registered manager Type of registration No. of places registered (if applicable) 0208 670 8432 0208 299 8598 www.choicesupport.org.uk Choice Support Mr George Frimpong Care Home 4 Category(ies) of Learning disability (0), Physical disability (0) registration, with number of places DS0000007065.V340773.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 4 people with learning disabilities and physical disabilities Date of last inspection 6th September 2006 Brief Description of the Service: 6 Bowley Close is a purpose built bungalow located in a quiet cul-de-sac close to the centre of Crystal Palace. There are several other care homes grouped together in the close, which opened in 1989. All are managed by a voluntary organisation, Choice Support. The home is near local facilities, including shops, cafes, pubs, a park and a sports centre. There are excellent local transport links, and the Close benefits from free on street parking for visitors. However, the area is very hilly, which can make access to Crystal Palace difficult for people with mobility problems. The home provides long-term accommodation and support for a maximum of four adults with learning and physical disabilities. The overall aim of the service is to provide care and support to enable service users to continue to make informed choices about the service that they want and their life. Each service user has their own bedroom, and shares communal facilities. At the time of this inspection, all of the residents were male. There was one vacancy at the home at the time of our visit. DS0000007065.V340773.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and carried out over a day in mid March 2008. The inspection methods included discussion with staff and the Registered Manager; observation of care practice; a tour of the building; inspection of files and a range of records and policy documents. Relatives, staff and involved professionals were sent survey forms so that they could contribute to the inspection process if they wished. We are grateful for the contributions received. The CSCI has access to information gathered through notifications from the home. A document called an ‘Annual Quality Assurance Assessment’ (AQAA) was completed by the Registered Manager of the home and returned to the inspector. It provides information from the Registered Manager about how the home is addressing the National Minimum Standards along with factual information about the operation of the home. All of this information has been taken into account in compiling this report. The Registered Manager, residents and staff facilitated the inspection visit. They were helpful and courteous throughout the process. What the service does well: What has improved since the last inspection? DS0000007065.V340773.R01.S.doc Version 5.2 Page 6 Risk assessments and guidelines have been reviewed to ensure they are still relevant. Arrangements for the administration of medication have improved. Improvements have been made in the building, by replacing kitchen worktops, and tableware. Visits are made to the home by managers each month to make sure that the home is operating well and that residents’ needs are being met. Health and safety matters are better managed, fire drills are carried out quarterly, there is a fire risk assessment and gas appliances have been assessed as safe. 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. DS0000007065.V340773.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 DS0000007065.V340773.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, 4, 5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The policies and procedures for admission ensure that both the home and the potential resident have enough information to decide whether it would be an appropriate place for the person to live. EVIDENCE: There have been no new admissions to the home for a long time and none are planned. Each of the current residents has an individual service user guide which describes the service they receive using plain English, pictures and symbols. The Registered Manager said that staff have gone through the guides with the residents. The admission policy of Choice Support includes provision for introductory visits to take place. The policy of the managing organisation is for social work assessments to be obtained prior to admission and for placements to be subject to a twelve week trial period. Each of the residents has a contract and this is on their file for reference. DS0000007065.V340773.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9, 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans reflect residents’ goals which are drawn up whenever possible with the involvement of relatives and advocates. EVIDENCE: The home uses a person centred model for care planning. As the residents need assistance to make decisions family members, advocates and involved professionals are included in the care planning process. Goals are identified which are reviewed regularly both at formal reviews and at key work meetings when progress towards their achievement is monitored. If the goals involve some degree of risk, then assessments are carried out so that the risk can be minimised and the resident supported in their activity. One of the files examined contained some records that were old and no longer in use, examples of these were ‘data collection sheets’ from 2005 and 2006. It would make the files clearer and allow staff easier access to current information if older documents were archived. See recommendation. The home uses a range of communication tools, for example ‘objects of reference’ are used to denote particular activities and these allow residents to DS0000007065.V340773.R01.S.doc Version 5.2 Page 10 make choices. The Registered Manager identified further use of these objects as an area to be developed by the home. The managing organisation has links with a service called ‘Customer Watch’ which is a forum through which people with learning disabilities can express their views on the services provided through Choice Support (Southwark). This ensures that the opinions of service users generally are included in the overall planning of the organisation. Choice Support has recently employed a service user involvement manager. Residents’ personal information is stored with due regard for confidentiality. Choice Support is registered under the Data Protection Act and there is a confidentiality policy to ensure that staff handle residents’ personal information with care. DS0000007065.V340773.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16, 17. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The residents benefit from opportunities to join in a range of leisure activities and lead active lives. They are assisted to be as independent as possible at meal times and account is taken of their nutritional needs and preferences. EVIDENCE: Residents are assisted to maintain and develop skills through care planning goals. Guidelines are in place to support skills teaching programmes. Staff assist residents to take part in a wide range of activities both in the community and at home. These include going to a city farm, a sensory room, swimming, and cycling using adapted bicycles. Arrangements are being made for one of the residents to go sailing. One of the residents attends a local church accompanied by staff. These activities relate to goals identified at care planning meetings demonstrating that decisions made are implemented. The location of the home, at the bottom of a steep hill, has limited the extent to which residents have been involved in the community. This is being addressed through a plan to find alternative housing for the residents. DS0000007065.V340773.R01.S.doc Version 5.2 Page 12 In the home the residents have a range of sensory materials to use, an aromatherapist visits, the residents listen to music and they take part in some household tasks. The residents have all been on holiday in the last year. On one of the files the resident’s personal history was illustrated with the use of photographs. This is a useful resource showing that the resident’s history and family background is valued. Residents are helped to keep in touch with relatives. We were told that they are informed of important matters in their relatives’ lives and invited to be part of meetings about their relatives’ care. Relatives confirmed that they find staff helpful, polite and welcoming. The routines of the home are flexible according to the residents’ needs and preferences. Staff spoke to residents respectfully and warmly. Meals are prepared by staff who plan the menu with regard to residents’ preferences, nutritional needs and culture. The menu and food stocks showed that there are fresh items available for residents. The meals are prepared in a way that takes account of the needs of those residents who find it difficult to eat independently and adapted crockery and cutlery is provided to enable them to be as independent as possible. DS0000007065.V340773.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents benefit from the staff team’s understanding of their communication methods and this enables them to provide sensitive care which take account of their needs. Overall medication is managed well although clarification with the GP about one practice is required. EVIDENCE: Observation of care practice showed that generally care is given with respect and understanding of the residents’ needs. In one instance a member of staff was seen to assist a resident with moving while wearing latex gloves. The Registered Manager agreed that this is unnecessary and inappropriate and stated his intention to raise the issue. The residents have health action plans which have been drawn up with the local GP practice. The plans include information about the residents’ identified health care needs and take account of preventative health issues. The home has good relationships with the practice and with a multi-disciplinary team which specialises in the care of people with learning disabilities. As the residents are unable to communicate their feelings verbally the staff must be attuned to their communication patterns and other signs. A health care professional who responded to our request to complete a survey DS0000007065.V340773.R01.S.doc Version 5.2 Page 14 acknowledged that this is difficult and said of the home ‘I think they do a good job.’ This was demonstrated during the inspection, when staff and the Registered Manager, became aware that the behaviour of one of the residents might have indicated that he was unwell. The GP was called and he confirmed that they had taken appropriate action. The awareness and familiarity of the home with the residents is an important element in ensuring that their needs are met. There was information that showed that specialists’ advice has been sought and implemented in order to reach the best outcomes for the residents. The people with whom the home has contact include speech and language therapists, podiatrists, audiologists, dentists, and opticians. Medication stocks and administration records were checked along with the storage facilities. None of the residents is able to look after their own medication. The storage is safe, secure and suitable for the purpose. All of the residents have had their medication reviewed recently. There is an effective system for checking the medication when it arrives from the pharmacist. The system had detected an error and action had been taken to ensure it was corrected. The records of medication returned to the pharmacist were also in good order. All of the staff have been trained in the administration of medication and the Registered Manager has assessed their competency for the task. There were no unexplained gaps on the medication administration record. One item of medication, given on an ‘as needed’ basis was being given in a drink to a resident. This is called ‘covert’ administration and is not permitted. The exception to this is when a medical practitioner states that the person lacks ‘capacity to consent to treatment’ and the medicine is essential to their health and well being. Advice has been forwarded to the Registered Manager about this issue and it is required that the matter is discussed with the GP. See requirement 1. DS0000007065.V340773.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Complaints and safeguarding policies and procedures contribute to the protection of residents. EVIDENCE: The complaints procedure of Choice Support meets the required standards and includes details of the timescales within which issues will be investigated. No complaints were received during the last year. We were told by one person who had used the complaints procedure in the past that they were satisfied with the action taken in response, and they felt encouraged that the complaint had led to improvements in the service. The Annual Report issued by Choice Support includes information that the organisation has conducted a thorough review of their policies, procedures and training to ensure that they are aimed at the protection of people who use their range of services. Choice Support introduced a new ‘safeguarding adults policy and procedure’ in March 2007. The judgement of the CSCI is that this is a thorough document, which is clearly written, and links all the aspects of safeguarding. The policy also introduces a new initiative of an internal protection committee. It is judged that this demonstrates that Choice Support is actively working to improve processes and practice. Staff receive annual training on the operation of the safeguarding adults policy. New staff receive training in the issue as part of their induction. The issue is also discussed at team meetings. There are safe arrangements for the management of residents’ money with balances being checked at each handover meeting and periodic additional DS0000007065.V340773.R01.S.doc Version 5.2 Page 16 checks by the Registered Manager and the Service Manager. One resident had purchased some bedding from his personal finances although these are items which should be provided by the home. See requirement 2. DS0000007065.V340773.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 27, 28, 29, 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents benefit from a homely and comfortable environment which suits their needs. EVIDENCE: The home is located in a purpose built bungalow which is accessible to all of the residents. The communal space consists of a living room / dining room which is adequate in size for the numbers and needs of residents. The room is furnished and decorated well in a homely manner with photographs, plants and pictures. Improvements have been made to the building through replacement of the kitchen worktops, new carpet and new furniture in the living room. Residents each have their own bedroom which is personalised with photographs and items of interest to the residents. For instance one of the residents has a fish tank in his room. There is a bathroom and a shower room each of which has a WC, and a separate WC. There are a range of aids and adaptations in the home, DS0000007065.V340773.R01.S.doc Version 5.2 Page 18 including hand rails, a shower chair, a bath aid and grab rails in the WCs. One of the residents has rails on the side of his bed. A risk assessment had not been carried out to ensure that these are safe. Advice has been provided for the Registered Manager to make an assessment, which should be available for inspection. The building was cleaned to a good standard. The laundry facilities are suitable for the needs of the home and located in a room separate from the food preparation areas. There is a small garden to the rear of the home. The manager said that it is his intention to improve the area by providing new seating and to develop the garden further to make better use of the space. DS0000007065.V340773.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35, 36Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from staff team which is familiar with their needs and well trained and supported. EVIDENCE: There is a low rate of staff turnover and this assists in providing consistent care for the residents. As noted above the familiarity of the staff team with the residents and their communication methods ensures that they are able to understand their needs. The staff team consists of, in addition to the Registered Manager, an Acting Assistant Team Manager and seven support workers, one of whom works part time, and two work only at night time. Recruitment to the vacant posts in underway and efforts are being made to increase the number of drivers on the staff team as this will assist residents to go out more frequently. On the day of the inspection visit there were three care staff working in the morning and two in the evening. These are the usual staffing levels and allow individual care to be provided for each of the residents in the morning. The Registered Manager was working between 8am and 4pm. Overnight there is one member of staff awake in the home. Outside of office hours additional management assistance is available through the Choice on-call system. DS0000007065.V340773.R01.S.doc Version 5.2 Page 20 Six of the care staff team have achieved NVQ level 2 or above. Training and development needs are identified for staff in supervision with the manager. The supervision sessions are held at approximately six weekly intervals. Additional support is available in between these sessions and staff meeting provide an additional forum for discussion and support. Confirmation was given that the recruitment procedure includes appropriate references and checks including enhanced CRB checks. Staff confirmed that these checks were conducted prior to them beginning work at the home. Records were not inspected on this occasion but arrangements are being made to do so. DS0000007065.V340773.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed. Residents’ views are included in the organisation’s quality assurance systems. Attention to health and safety in the home ensure that residents and staff are safe. EVIDENCE: The Manager of this service has been registered under the Care Standards Act since March 2006. he is appropriately qualified and experienced for the role. Feedback was received about the manager’s commitment to his work, saying ‘I would recommend the manager anywhere, …you couldn’t get anyone better.’ Observation and feedback was that there is open communication amongst the staff team and this ensures that they work towards shared goals. Managers from other Choice Support service make visits to the home and complete reports of the visits. They include input from staff, observations of residents experience of life in the home and suggestions for improvement. DS0000007065.V340773.R01.S.doc Version 5.2 Page 22 The Directors, Managers and Trustees of Choice Support meet regularly with representatives of service users who sit on a ‘service user forum’. They are involved with reviews of policies and procedures and two people with learning disabilities are part of the organisation’s Quality Assurance sub-committee. Values Into Action (VIA) have conducted a survey on behalf of Choice Support to assess the quality of their services. Quarterly reports are made to the local authority which funds the residents’ placements and these are another tool to monitor the quality of the service they receive. Health and safety matters are managed well. Chemical cleaning products are stored securely. The Registered Manager undertakes weekly checks to ensure the premises are safe and that alarms are working properly. Fire drills are carried out quarterly and a fire risk assessment is in place. Improvements required at the last inspection have been implemented. DS0000007065.V340773.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 X 4 3 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 3 26 X 27 3 28 3 29 2 30 3 STAFFING Standard No Score 31 X 32 3 33 4 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 4 14 4 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 4 2 X 3 4 3 X X 3 X DS0000007065.V340773.R01.S.doc Version 5.2 Page 24 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 YA20 Regulation 13(2) Timescale for action The Registered Person must 16/05/08 discuss the administration methods of one item of medication with the GP. This will make sure that the GP is in agreement with the practice of giving a medicine in a drink. This will make sure that in circumstances in which a resident cannot give consent staff act in the resident’s best interests. The Registered Person must make 16/05/08 sure that residents do not pay for items, which must be provided by the home. This will make sure that residents are not paying for items for which they are not liable. The Registered Person must make 16/05/08 sure that a risk assessment is made for the use of cot sides for one resident. This will make sure that they are safe for the resident to use. Requirement 2. YA23 16(2)(c) 3. YA29 13(4)(a) DS0000007065.V340773.R01.S.doc Version 5.2 Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA6 Good Practice Recommendations The Registered Person should consider archiving older documents in care planning files to ensure that current guidelines and goals are easily identifiable. DS0000007065.V340773.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection SE London Area Office River House 1 Maidstone Road Sidcup Kent DA14 5RH 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 DS0000007065.V340773.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. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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