Care Home: Crompton Drive (1)

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Crompton Drive (1) 1 Crompton Drive Croxteth Park Liverpool Merseyside L12 0JX Two star good service The quality rating for this care home is: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Paul Kenyon Date: 1 6 0 3 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (20092008) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Information about the care home Name of care home: Address: Crompton Drive (1) 1 Crompton Drive Croxteth Park Liverpool Merseyside L12 0JX 01515466093 01515466093 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies): Community Integrated Care Care home 3 Number of places (if applicable): Under 65 Over 65 3 0 Learning disability Additional conditions: Date of last inspection 0 6 0 2 2 0 0 7 A bit about the care home 1 Crompton Drive is a small care home. It provides accommodation for three service users who have a learning disability. It is part of the Community Integrated Care organisation, which specialises in homes for people with learning disabilities and the elderly. The home is a three bed roomed bungalow situated in a residential area of Croxteth Park and has been registered since 1999. It is a modern bungalow that provides single accommodation, a lounge/dining area and a private rear garden. Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: Two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home How we did our inspection: This is what the inspector did when they were at the care home This was a key inspection visit to Crompton Drive. We did not let the service know we were visiting beforehand. The visit took place in the morning and extended into the afternoon. We spoke with the staff and the manager and observed the way in which the people who live there are supported. For this inspection we were accompanied by an Expert by experience. This is a person who is able to look at the quality of life for individuals. For this visit the expert looked at The way in which people can make decisions about their lives Their view on how they are supported by staff How they are asked about the quality of support provided Interaction with the staff team How their rights are upheld by the service The findings of the expert are included in this report. We examined records relating to the support provided to individuals and toured the premises. We also looked at the information that the service had provided to us before the visit. This is known as an annual quality assurance assessment (AQAA). What the care home does well The service is very good at providing individual support and identifying the needs of individuals. It provides this support keeping the risks faced by people in mind. The service is good at supporting people to access the community and makes sure that people can maintain contact with their family and friends. The rights of people are respected and they have their nutritional needs met. The people who use the service are supported in line with their needs and have their health needs met. The safe management of medication promotes their health and safety. The people who use the service and their families are able to influence the running of the service through the availability of the services complaints procedure and they are protected from abuse. The people who use the service live in a comfortable, well-maintained and hygienic environment. They are protected by the recruitment procedure and are supported by staff trained to meet their needs. People benefit from receiving support from a well-managed service and have their views and those of their families taken into account. Their health and safety is promoted. What has got better from the last inspection What the care home could do better If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Paul Kenyon Unit 1 3rd Floor Tustin Court Port Way Preston PR2 2YQ 01772 730 100 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 set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line - 0870 240 7535 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who use the service have lived there for some time so this standard is not applicable to them. Evidence: There are three individuals who live at Crompton Drive. Records and a discussion with the Manager noted that all three have lived there for some time and that there has been no new people admitted for some time. As a result this standard is not applicable to Crompton Drive at present. Care plans were viewed. These provided evidence that the needs of individuals are subject to an ongoing review. Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who use the service have their needs identified in care plans in a very individual manner and as a result have all aspects of their needs met. They are encouraged to make decisions about their lives reflecting their communication abilities. Their health and safety is promoted through the risk assessments devised by the staff team and the frequency they are reviewed. Evidence: Two care plans were viewed. Care plans are known as essential lifestyle plans and are presented in a manner which is centred on the personal preferences of each person. Details of care plans include what is important to the person. In addition to this, there is information from staff in respect of what support would mean that the person had had a good day and what staff actions would mean that the persons needs had not been met which would resulting a bad day for that person. The training needs of staff are included within each care plan and this is linked to the needs of the person. Information is in place outlining what needs to be done to keep people healthy and safe. Details are in place of the individuals routines during key times of the day. One care plan included photographs of family and friends given that this person reacts positively to pictures of familiar people. Another care plan has been presented in a file, which is decorated with items, which reflect the persons interests. Both care plans viewed had been reviewed within the past six months. Care plans include reference to the communication skills of individuals and what certain non-verbal communication displayed by individuals may mean. Staff members who have supported individuals for a number of years have compiled this. Care plans include reference to accessing the local community, family relationships, mobility and the day-to-day physical support required by each person. Evidence: The disability of the individuals living at Crompton Drive is such that it is not possible for them to verbally express their wishes, however, care plans include communication details where the non verbal communication and some limited verbal communication displayed by individuals has been interpreted as meaning specific things of consent or disapproval. Care practice was observed and it was noted that staff interact with individuals on a significant basis and explain the actions they are about to undertake to the person. One person responded positively to the way in which staff spoke to them. Using the communication skills of individuals, staff were able to interpret these as basic decisions individuals were making. One person is able to mobilise using a walking aid. This person was noted on some occasions during the visit to move independently through the building when he wanted to. The person was able to make basic decisions and staff enabled them to do this. The expert by experience observed that staff were very experienced in understanding the moods gestures looks and ways of understanding what each individual needed. One of the staff members was very helpful and I liked how she spoke to the resident asking him if he would like a drink and explaining how she knew what he wanted. She told me he loved going out but if he was cold he would sit on his hands to let them know when he was hungry he would sit at the dining table or go into the kitchen. When he wanted another he made them aware by moving his cup to edge of the table in a certain way. Although he could not speak to me I felt that he was communicating through staff who knew him so well They tried to maintain his independence as much a possible by encouraging him to walk with his frame and giving him a special spoon so he was able to feed himself Information was available to suggest that the organisation who operates the service seeks to ensure that they are as independent from the financial management of individuals as possible. This is achieved with the management of accounts, which are not necessarily in the direct control of the organisation. Information was available in the building about local advocacy services. One person receives the involvement of advocacy services. The advocate visited the person on the day of the visit. This person does not have any family involvement and therefore an advocate has been brought introduced. Two other individuals have strong family links and it is considered that they act as their advocates at present. Two risk assessments were examined. These cover issues such as the use of bed rails, risks in the environment, activities, feeding, bathing, accessing the wider community, injury to self and others, manual handling and use of vehicle. Risk assessments had been reviewed between June 2008 and February 2009. In the case of one person, a management plan had been devised in respect of behaviours that could put others at risk of injury. The management plan has been devised with other professionals involved. The same person had a risk assessment to reflect the fact that they were able to mobilise throughout the building with the use of a walking aid. Evidence: Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this 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 people who use the service are able to use local facilities with staff support and are able to maintain contact with their family and friends. Individuals are treated with respected by the staff team and have their nutritional needs met. Evidence: No individuals pursue any education or occupation but tend to spend time pursuing activities, which involve access into the wider community. The service has a minibus yet there have not been many drivers available of late. The Manager hoped that new staff would be able to become drivers and therefore widen opportunities for individuals to use this. The transport has been adapted to enable access for those who use wheelchairs. There was evidence that individuals do use local public transport and this was evidenced by information that was available in individual files. The Manager stated that for trips to use local facilities, the people who use the service tend to go on a one to one basis with staff support rather than as a group. This was evidenced during the visit. Detail on care plans noted that each person has been brought up as a member of a Christian faith. While individuals do not practice these faiths by attending church, it was stated by the Manager that customs and beliefs are respected within the home on certain feast days. Information suggested that two individuals have strong family links. One person had photographs of their family included in their care plan as well as photographs of their Evidence: family in their bedroom. There were cards and letters from family members outlining their satisfaction with the service and they passed on their personal thanks to the staff team. The other person. The expert by experience observed Throughout most of my visit one of the residents had visitors. In relation to the rights of individuals, the expert by experience noted On arrival, I met the Inspector Paul Kenyon and was introduced to the manager of Crompton Drive, Anna. She did not immediately invite me in but went and spoke to one of the residents and asked if it was alright if I came in to see them, I thought this was nice and immediately showed the respect given to the residents. Again each resident was asked if they would be willing to talk to me The staff were attentive and polite and treated him with respect all the time They did not answer questions about him until they spoke to him first I thought they showed a lot of respect for the residents and their welfare was more important the Inspection I like how the staff respects the individual residents Our experience was the same. On arrival the Inspector was only invited in once the Manager had consulted with all people who live there. This was repeated for other visitors. Individuals were also consulted when we wished to tour the building and enter into peoples bedrooms. Two individuals are artificially fed. Staff interviews confirmed that they had received training in this and this was confirmed through staff training records. On the day of the visit, one person had a problem with their feeding tube. The staff team were able to contact health care professionals who are specialists in this and the situation was resolved. Evidence was available that this support was available to the staff at all times. The other person is able to eat independently and was observed being provided with specialist cutlery in order to achieve this. A dining table is available for this person to have their meals and this person was provided with hot drinks throughout the visit. No menu is used for this person and they are provided with the meals that they prefer. During the visit, efforts were made by staff to visit the shop to ensure that preferred foodstuffs were available for this person so that they could have their dinner. The kitchen is domestic in scale and food stocks were adequate. The food preferences of this person were available in care plans. The expert by experience observed I liked how she spoke to the resident, asking him if he would like a drink and explaining how she knew what he wanted Staff explained when he was hungry he would sit at the dining table or go into the kitchen When he wanted another he made them aware by moving his cup to edge of the table in a certain way They tried to maintain his independence as much a possible by giving him a special spoon so he was able to feed himself Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this 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 people who use the service are supported in a manner, which reflects their needs and respected their rights as individuals. Their health is promoted by the practices of the service and their health and safety is promoted through the safe management of medication. Evidence: We looked at care plans during the visit. These suggested that all three individuals require a lot of support in relation to their care. This is presented in care plans in a very detailed manner and includes details on how individuals should be transferred. This level of support is reinforced by details included in daily routines as well as by manual handling assessments. Aids and adaptations are available for individuals in assisting them to be transferred. For another individuals, his mobility is assisted by the provision of a walking aid which he used throughout the visit. During the visit, we were informed that one person was receiving personal care in private and this was verified by the bedroom door being closed. Daily routines are recorded for all people in detail and confirm their preferences for getting up, having meals and going to bed. Individuals have their gender recognised by the clothes they wear. Additional support is provided for individuals through the assistance with other health professionals such as speech therapists and agencies providing support in specialised feeding. Records were examined relating to the health of individuals. All individuals are fully reliant on the staff team to monitor their health and arrange appointments as necessary. During the visit, one individual had an issue relating to their nutrition. Steps were taken by the staff team for the person to attend a hospital so that the issue could be resolved. Records were available suggesting that all individuals are registered with a Doctor and have access to specialists in artificial feeding, speech therapists, dieticians, opticians and doctors. All appointments are recorded with any Evidence: issues recorded as well as the action required to maintain the health of each person. Interviews were held with members of staff. They confirmed that they had received training in medication. Medication records confirmed that when medication is received, all details are recorded to confirm receipt and that a disposal record is also maintained. The nature of the disability of individuals is such that they are reliant on staff to administer medication. Records confirmed that all medication is administered appropriately. Medication is securely stored in lockable facilities. Two people have their medication administered in the same manner as they are fed through tubes. Procedures are in place for this for staff to refer to. Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this 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 people who use the service and their families are able to influence the running of the service by the way in which they receive information about how their concerns will be dealt with. Individuals are protected from abuse. Evidence: We have not received any complaints about the service since the last visit. The service has also not received any complaints as confirmed through its complaint records and the annual quality assurance assessment it provided to us before the visit. A complaints procedure is available for families and others. This is on display and includes reference to the time in which complaints will be investigated. In addition to this, a complaints procedure had been produced for those who use the service. Symbols had been included within this. Consideration is made in care plans about the effects on individuals if their needs were not met and how this would mean that this would be a bad day for them. The emphasis for staff in care plans is to recognise when support is not being provided, as it should and how this can be avoided. This recognises that the communication skills of individuals are limited and they cannot always express specific dissatisfaction with the service. We have not received any information since the last visit to suggest that there have been any allegations of abuse. Staff interviews noted that they were aware of the whistle blowing procedure and understood the principles behind this. They also confirmed that they had received training in the protection of vulnerable adults and were aware of what to do if any allegations were made. In addition to this, a staff handbook is issued to all staff outlining principles of whistle blowing and protecting individuals. Staff are also issues with a code of conduct from the General Social Care Council and this again outlines the responsibilities to protect individuals. The Manager has access to the Local Authority safeguarding procedure. Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this 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 people who use the service live in a well decorate, home like and hygienic environment Evidence: The expert by experience made the following observations: My support worker and I were welcomed into a large, comfortable living space that was warm, bright and clean. The lounge had large a comfortable settee, chairs and a television The dining room opened out onto the back garden Again this room was bright and friendly with personal photos on the walls and a TV and radio. I did think his room was small We confirmed these observations. Crompton Drive is a bungalow, which is in keeping with the building in the local vicinity. It is indistinguishable as a registered care home. The building is all on one level, which enables the people who use the service to access all areas of the building and external areas. All areas were noted to be well-decorated and home like in appearance. All furniture and fittings are of a good standard. A system is in place for the reporting of repairs and all reported repairs are recorded. Bedrooms were noted to include items, which reflected the gender of each person, as well as personal items. There were no offensive odours noted in the building during the visit. Protective personal equipment such as aprons and gloves are available when needed. A laundry is available which is separate from food preparation areas. This contains industrial style appliances and is clean and organised. The building was clean and tidy throughout the visit. Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. An effective staff team who understand and do what is expected of them supports people. This is what people staying in this care home experience: Judgement: People using this 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 people who use the service are protected by the recruitment process and are included within it. They are supported by staff who are trained to meet their needs. Evidence: Three personnel files were viewed. Two files relating to staff who had only just come to work at Crompton and another related to a person who was coming to work there in the next two weeks following this visit. In all cases, files included information, which suggested that the people who use the service had been protected by the way in which police checks and references had been obtained. There was also information about the experience that individuals had had as well as the personal qualities needed to support people successfully. One individual sits in on interview panels and uses her non verbal communication during this time. This was confirmed by the expert by experience Because of this she sat in on interviews for new staff and was able to make her feelings known to them .The individuals name is included in interview notes. Staff were interviewed about the training they received. In all cases, staff confirmed that they had received training in health and safety topics such as first aid, food hygiene and manual handling. In addition to this training had been provided in artificial feeding, medication, epilepsy and the administration of specialist medication. Training records confirmed these. Two files were examined relating to staff who had only just come to work at Crompton Drive. Staff had received an induction in relation to the home but had also been enrolled on an induction programme, which relates to the values they needed to successfully support the individuals living in the service. Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Those people who use the service receive support from a well-managed staff team. The people who use the service and their families are able to influence the way in which the service is run through the way the service examines its own practice. The health and safety of the people who use the service is promoted. Evidence: The manager has been working at Crompton Drive for a number of years and has the experience to do the job. She has almost completed qualifications, which will reinforce her position as Manager. Throughout the visit, the Manager demonstrated her knowledge of all the individuals living at Crompton especially their day-to-day needs and their abilities to communicate. Staff were asked about their views about the Manager. They considered her to be firm but fair, they felt respected by her, is dedicated, professional and works beyond the call of duty. The staff team co-operated with us when we visited and enabled us to talk to people in private and to observe care practices. No requirements were raised at the last inspection and no requirements are raised as a result of this visit. There was evidence that visits by representatives of the organisation visited on a monthly basis in order to make an assessment on the support provided by the service. Reports on these visits are made available to the Manager. The home has been recognised as having reached an exceptional level of achievement by the organisation. A certificate on display in the building evidenced this. The Manager stated that questionnaires are sent to families on an annual basis to gain their experiences of the support provided to their relations. Evidence: A number of records were viewed relating to the way in which the health and safety of individuals is protected. Fire detection equipment is tested on a regular basis and staff are provided with the opportunity to follow fire evacuation and receive training. Interviews with staff confirmed that they receive training in health and safety issues. Electrical and gas systems in the building are tested regularly and equipment used by individuals such as portable lifting hoists are serviced every six months. Portable electrical appliances are tested annually. Records available in the building evidenced this. Health and safety checks in the building take place every week, monthly and six monthly. These checks cover water temperatures on a weekly basis, fire systems on a monthly basis and any other issues on a six monthly basis. There was evidence through records that were there are health and safety issues, these are reported and addressed. Are there any outstanding requirements from the last inspection? Yes  No  Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No Standard Regulation Requirement Timescale for action Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No Standard Regulation Description Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set No Standard Regulation Description Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 13 The service should ensure that more staff are able to drive the services minibus so that the people who use the service are able to benefit from spontaneous trips into the wider community Those people who use the service should be enabled to experience attendance at church services to determine their preferences and to meet their religious needs 2 13 Helpline: 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 We want people to be able to access this information. 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