Care Home: Claxton House

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What the care home does well What has improved since the last inspection? The correct book is now used for recording the administration and storage of controlled drugs. Claxton House now has a very good complaints procedure and evidence was noted, which showed how the proprietors regularly invite feedback from service users, relatives/friends and external services by way of questionnaires and discussions. Service users` money was seen to be stored safely and all recordings and receipts are in place. Following correspondence between Social Services and the Commission, the previous requirement relating to service users` bank accounts is deemed met. Staff have been trained and hold food hygiene certificates. Additional improvements since the last inspection are mainly to the premises and include: Heating system repaired, additional radiators (including covers) and a new hot water system to improve service users` bathing and showering facilities. Also, refurbishment of the shower room, four bedrooms, main lounge, corridors, kitchen, office, staff room and utility room. A new conservatory has been erected adjoining the dining room, which has increased the dining space and further improved communal areas. The gardens have been tidied and landscaped. What the care home could do better: All risk assessments need to show implementation dates and/or evidence of when they have been reviewed. CARE HOME ADULTS 18-65 Claxton House Church Lane Claxton Norwich Norfolk NR14 7HY Lead Inspector Debra Allen Unannounced Inspection 16th January 2008 10:20 Claxton House DS0000067451.V359074.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 Claxton House DS0000067451.V359074.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. Claxton House DS0000067451.V359074.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Claxton House Address Church Lane Claxton Norwich Norfolk NR14 7HY 01508 480312 F/P 01508 480312 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) Atlanta Healthcare Ltd Mrs Robina Clarke Care Home 15 Category(ies) of Learning disability (9), Learning disability over registration, with number 65 years of age (6) of places Claxton House DS0000067451.V359074.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15th February 2007 Brief Description of the Service: Claxton House is a three storey Victorian house that has been modernised, but still retains many of its original features. There is currently no assisted passage to any of the floors, although plans are in place for a lift to be installed. The home provides accommodation and care for up to fifteen people with a learning disability and the accommodation is provided over the three floors in the form of one shared bedroom with washbasin and thirteen single bedrooms, eleven of which contain a washbasin and two have access to their own bathroom. Service users currently have communal use of five toilets, four bathrooms and three shower facilities, two lounges, (one on the first floor and one on the ground floor), a conservatory and a dining room. Two of the single bedrooms are contained in a flat located on the third floor and are designed to enable two people to live a more independent life style. The house stands in extensive grounds and has a static mobile classroom to the rear of the property that is used for day care and activities for those living at the home. The grounds provide ample space for residents to walk in and there is a patio area with seating, tables, chairs and recreational equipment to the rear of the home. There is parking space available to the front and side of the main building. The home is located in the small village of Claxton, which is approximately six miles east of Norwich in a rural setting. The fees for living at the home currently range from £396 - £716 per week. Claxton House DS0000067451.V359074.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Care Services are judged against outcome groups, which assess how well a provider delivers outcomes for people using the service. The key inspection of this service has been carried out, by using information from previous inspections, information from the providers, the residents and their relatives, as well as others who work in or visit the home. This has included a recent unannounced visit to the home. This report gives a brief overview of the service and the current judgements for each outcome group. This inspection was carried out over a period of five hours, during which time discussions were held with the manager, deputy, staff and service users. A guided tour of the premises was also carried out, together with a service user and member of staff. Care plans, staff files, health and safety information and other records required for regulation were also examined as part of the inspection process. Completed surveys were returned prior to the inspection by twelve service users, nine staff and four relatives/friends, all of which contained very positive comments. One recommendation has been made as a result of this inspection. What the service does well: Claxton House has a very good pre-admission process and comprehensive needs assessments are carried out. Care plans and risk assessments are very clear and have a very positive and enabling approach – i.e. how people can do things rather than why they can’t. Service users are able to assist with various daily household tasks and, on the day of inspection, one person was observed assisting in the kitchen and making drinks, while another person did the shredding for the office. Some service users attend work placements or training centres during the week, but there are also opportunities for day care activities at home such as art, craft, gardening, cooking or going for walks. On days off or evenings, service users have a variety of choices in order to relax such as reading, sewing, knitting, watching television/DVDs or listening to music. The menus are varied, wholesome and nutritious and service users are able and encouraged to be involved in meal preparations. Claxton House DS0000067451.V359074.R01.S.doc Version 5.2 Page 6 There is a very good complaints procedure and effective quality assurance process and the manager regularly invites feedback from service users, relatives and external services by way of questionnaires. Service users are able to access and have regular involvement with many healthcare professionals such as doctor, community nurse, psychiatrist, chiropodist, dentist, audiologist, optician, continence nurse, occupational therapist, physiotherapist and the diabetic clinic. Staff at Claxton House give service users comprehensive explanations in ways they can understand with regard to medical conditions to assist individuals to make informed choices in respect of their treatment. Staff are well trained and receive regular supervision. The manager and deputy are very positive and supportive of the staff and service users and have a genuine empowering and enabling approach with everyone. What has improved since the last inspection? The correct book is now used for recording the administration and storage of controlled drugs. Claxton House now has a very good complaints procedure and evidence was noted, which showed how the proprietors regularly invite feedback from service users, relatives/friends and external services by way of questionnaires and discussions. Service users’ money was seen to be stored safely and all recordings and receipts are in place. Following correspondence between Social Services and the Commission, the previous requirement relating to service users’ bank accounts is deemed met. Staff have been trained and hold food hygiene certificates. Additional improvements since the last inspection are mainly to the premises and include: Heating system repaired, additional radiators (including covers) and a new hot water system to improve service users’ bathing and showering facilities. Also, refurbishment of the shower room, four bedrooms, main lounge, corridors, kitchen, office, staff room and utility room. A new conservatory has been erected adjoining the dining room, which has increased the dining space and further improved communal areas. The gardens have been tidied and landscaped. Claxton House DS0000067451.V359074.R01.S.doc Version 5.2 Page 7 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. Claxton House DS0000067451.V359074.R01.S.doc Version 5.2 Page 8 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 Claxton House DS0000067451.V359074.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 & 5 - Quality in this outcome area is good. Full needs assessments are carried out before people move in, so they can be assured that the service will meet these needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Although all the current service users have lived at Claxton House for a number of years, discussions with the manager and deputy manager, documentation seen on the day of inspection and information contained within the AQAA (Annual Quality Assurance Assessment), provided good evidence to confirm that detailed care needs assessments are completed prior to service users moving in. These assessments were noted to contain information regarding people’s needs and wants, such as likes, dislikes, hobbies, goals, personal history, mobility and personal care requirements. It was noted that all service users have a copy of the Service User’s Guide and a written contract. Claxton House DS0000067451.V359074.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 & 10 Quality in this outcome area is good. Care plans contain assessments of needs, wants and choices and are regularly reviewed and updated as necessary. Service users are actively involved in all aspects of life in the home, their views are taken into consideration and they are supported to make decisions and take risks. Service users’ information is secure and confidentiality is maintained. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Six care plans were looked at on the day of inspection and each was found to contain very clear and detailed information relating to how each person needed and wanted to be supported. It was also evident that enablement and dignity was very strongly promoted. Claxton House DS0000067451.V359074.R01.S.doc Version 5.2 Page 11 The contents of the care plans were seen to include a photograph, personal details, profile, actual care plan, policy in event of death, reviews, daytime activities, records of achievement, medical information, incident forms, risk assessments, inventory, correspondence, complaints procedure and service user’s evaluation of the home and care received. The risk assessments that were looked at were also clear and detailed and written in a very positive and ‘enabling’ manner. However, it was noted that a number of these assessments showed no implementation date or evidence of when they had been reviewed. A recommendation has therefore been made to this effect. Observations, discussions and records looked at confirmed that service users actively participate in daily life in and around the home and they are supported to make choices and decisions about their own lives. It was also noted that service users regularly choose to assist with various daily household tasks and, on the day of inspection, one person was observed assisting in the kitchen and making drinks, while another person did the shredding for the office. All the service users’ records and personal information was seen to be stored securely, thereby helping to ensure confidentiality is maintained. Claxton House DS0000067451.V359074.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): 11, 12, 13, 14, 15, 16 & 17 Quality in this outcome area is good. Service users have opportunities for personal development, are part of the local community and engage in appropriate leisure activities. Service users are supported to have appropriate personal relationships. Service users are offered a healthy diet and enjoy their meals and mealtimes. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Discussions with service users and evidence noted in care plans confirmed that a number of service users attend work placements or training centres during the week, but there are also opportunities for day care activities at home such as art, craft, gardening, cooking or going for walks. On days off or evenings, service users have a variety of choices in order to relax such as reading, sewing, knitting, watching television/DVDs or listening to music. Claxton House DS0000067451.V359074.R01.S.doc Version 5.2 Page 13 It was evident that the people living at Claxton House are supported in respect of maintaining contact and relationships with friends and family and the comment cards that were returned also confirmed this fact. Information provided in the AQAA confirmed that, wherever possible, service users’ wishes are paramount with regard to what they want to do, where they go and who they go with. Lunchtime, for the people at home at the time of inspection, was observed as being a very informal and relaxed occasion with service users being actively involved in the preparation and selection of their meal and some choosing to assist with clearing up afterwards. Menus for the main meals were seen to have been compiled over a four-week period and the options were noted to be wholesome and nutritious with alternatives available if required. Comments and feedback confirmed that the service users enjoy their meals. Claxton House DS0000067451.V359074.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 & 21 Quality in this outcome area is good. Service users receive personal support in the way they prefer and their physical and emotional healthcare needs are met. Service users are protected by the home’s policies and procedures for dealing with medication helping to ensure their well-being and safety. Service users are treated with dignity and respect with regard to ageing, illness and death. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The care plans looked at gave clear explanations with regard to how people wanted and needed to be supported with their personal care and there was evidence of an enabling approach, rather than ‘doing-things-for people’. Evidence was also seen, in the care plans, of involvement and support from external professionals such as GP, community nurse, psychiatrist, chiropodist, Claxton House DS0000067451.V359074.R01.S.doc Version 5.2 Page 15 dentist, audiologist, optician, continence nurse, occupational therapist, physiotherapist and the diabetic clinic. Information provided in the Home’s AQAA, (Annual Quality Assurance Assessment), confirmed that staff at Claxton House give service users a comprehensive explanation, in a manner they can understand, with regard to any medical condition, in order to assist them to make informed choices in respect of their treatment. With regard to medication, service users are protected by the home’s policies and procedures and staff are trained appropriately in this area. In compliance with a previous requirement, the correct book is now used for recording the administration and storage of controlled drugs and this was seen to have been completed appropriately with no errors or omissions noted. Observations and discussions confirmed that service users are treated with dignity and respect with regard to ageing, illness and death. Records, notes and feedback showed how the manager and deputy supported colleagues, service users and friends, following the sudden death of a service user last year. As there was no registered next of kin, the manager and deputy took responsibility for the funeral arrangements and ensured that staff, service users and friends were kept informed and involved in the arrangements as much as they wanted to be. Claxton House DS0000067451.V359074.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 Quality in this outcome area is good. Service users feel their views are listened to and acted on and they are protected from abuse, neglect and self-harm as far as is possible. This judgement has been made using available evidence including a visit to this service. EVIDENCE: In compliance with a previous requirement, Claxton House now has a very good complaints procedure and evidence was noted which showed how the proprietors regularly invite feedback from service users, relatives/friends and external services by way of questionnaires and discussions. One concern has been raised since the last inspection, but this is noted to have been satisfactorily resolved very quickly. Staff and service user meetings, which were noted to be held on a regular basis, also give all the service users the opportunity to have their say and raise concerns or discuss issues in a group setting. ‘Resident Representative’ group meetings have also recently been introduced in the home. Evidence of staff training in adult protection and whistle-blowing was also noted, which helps to ensure that service users are protected from abuse, neglect and self-harm. Service users’ money was seen to be stored safely and all recordings and receipts are in place. Following correspondence between Social Services and The Commission, the previous requirement relating to service users’ bank accounts is deemed met. Claxton House DS0000067451.V359074.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, 26, 27, 28, 29 & 30 Quality in this outcome area is good. Service users live in homely, comfortable and safe environment, which is clean and hygienic. Service users bedrooms, toilets and bathrooms are individual and private and shared spaces complement their individual rooms. Specialist equipment is available and provided, if required, to maximise independence. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A tour of the premises, guided by a service user and staff member, showed Claxton House to be clean, hygienic and very pleasantly decorated throughout most areas, with numerous improvements noted. It also had a very comfortable and homely atmosphere. Claxton House DS0000067451.V359074.R01.S.doc Version 5.2 Page 18 The guiding service user was happy to show me their room, which they said they were very happy with, although they also said they were looking forward to the pending improvements, which would result in them having their own ensuite shower. Other bedrooms seen, also looked very comfortable and personal. A number of service users were seen using the various communal areas and everyone appeared very relaxed and content. Some specialist equipment was noted during the tour and it was evident that any requirements in this area would be met. Meanwhile, some of the main improvements since the last inspection include: heating system repaired, additional radiators (including covers) and a new hot water system to improve service users’ bathing and showering facilities. Also, refurbishment of the shower room, four bedrooms, main lounge, corridors, kitchen, office, staff room and utility room. A new conservatory has been erected adjoining the dining room, which has increased the dining space and further improved communal areas. The gardens have been landscaped and service users spoken to said they enjoyed spending time outside, especially having picnics and barbecues. Further plans for improvements during the next twelve months were confirmed as having a lift installed and further bedrooms to have en-suite facilities. Claxton House DS0000067451.V359074.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): 31, 32, 33, 34, 35 & 36 Quality in this outcome area is good. Staff have clear roles and responsibilities, are well trained, competent and appropriately qualified. The home has robust recruitment policies and procedures and staff are well supported and supervised which helps protect service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Discussions were held with the deputy manager and another staff member and both said they felt the team worked extremely well together. They were also very complimentary with regard to the support and training received from the manager. It was acknowledged that the changes, since the new manager/owners took over Claxton House have been quite daunting and challenging at times, but it was also commented that everyone has been well supported and there has been a marked reduction in the staff turnover during the past year. Claxton House DS0000067451.V359074.R01.S.doc Version 5.2 Page 20 Training records were looked at and evidence was seen of courses attended such as first aid, fire safety, health & safety, food hygiene, adult protection, medication and the mental capacity act. The deputy manager is currently undertaking the NVQ4 Registered Manager’s Award, a senior staff member is completing a CQSW at Norwich City College and the majority of support workers have either completed or are undertaking their NVQ2 or NVQ3. The personnel files that were looked at contained all the relevant records such as application form, contract, confirmation of identification and clear, enhanced Criminal Records Bureau (CRB) disclosures, therefore confirming that the home/organisation has robust recruitment procedures. Evidence was also seen to show that staff received one-to-one support and supervision on a regular basis. Staff spoken to also confirmed this fact. Claxton House DS0000067451.V359074.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, 40, 41, 42 & 43 Quality in this outcome area is good. Claxton House is a well run home and the service users benefit from the ethos, leadership and management approach. Service users’ views underpin the self-monitoring, review and development of the home. Service users’ rights and best interests are safeguarded by the home’s policies, procedures and record keeping. The health, safety and welfare of service users are promoted and protected. This judgement has been made using available evidence including a visit to this service. Claxton House DS0000067451.V359074.R01.S.doc Version 5.2 Page 22 EVIDENCE: The manager and deputy are both very positive and supportive of all the staff and service users and it was evident through observations and discussions that they have a genuine empowering and enabling approach with everyone. Claxton House has an effective quality assurance process, evidence of which was noted in the AQAA and the fact that feedback from service users, relatives and external services is regularly invited, by way of questionnaires. The policies and procedures were looked at and found to be comprehensive and generally in good order. Full reviews are currently underway and ongoing. The atmosphere observed during the inspection was cheerful and relaxed and observations confirmed that the service users were genuinely in their own homes with their best interests, health and happiness being absolute priority. Claxton House DS0000067451.V359074.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 x 2 3 3 x 4 x 5 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 4 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 4 4 2 3 LIFESTYLES Standard No Score 11 4 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 4 3 3 3 3 3 3 3 Claxton House DS0000067451.V359074.R01.S.doc Version 5.2 Page 24 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. Standard Regulation Requirement Timescale for action 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 YA9 Good Practice Recommendations It is recommended that all risk assessments show implementation dates and/or evidence of when they have been reviewed. Claxton House DS0000067451.V359074.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF 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 Claxton House DS0000067451.V359074.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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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