Care Home: High View Residential Unit

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What the care home does well The ethos of the home is clearly aimed at working with people in a way that acknowledges and respects their rights as human beings, regardless of the complexities of each person`s care and support needs. The home benefits from having a committed staff team who are clear about the purpose and function of the service and their responsibility to maximise the life opportunities, skills and independence of the people who live here. What has improved since the last inspection? A clear procedure has been established to record complaints. Locks on bedroom are now of a type that will allow staff access in an emergency. Training has occurred for staff on the safe handling and administration of medication and have their abilities to work within the homes medication policy and procedures assessed. PRN Medication guidelines have also been developed.A system for supervising staff has been established, as too has an appraisal system, although frequency and monitoring do attract comment in this report for improvements that have still to be made. What the care home could do better: The registered person needs to ensure that proper assessments are carried out and that only people who the service can cater for are offered a placement, as well as provide proper contracts of service. Development planning is also needed as well as updates of service user progress and staff development. CARE HOME ADULTS 18-65 High View Residential Unit 84 Thurlow Park Road Dulwich London SE21 8HY Lead Inspector James Pitts Unannounced Inspection 3 November 2008 09::55a rd High View Residential Unit DS0000066673.V372048.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 High View Residential Unit DS0000066673.V372048.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. High View Residential Unit DS0000066673.V372048.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service High View Residential Unit Address 84 Thurlow Park Road Dulwich London SE21 8HY 020 8670 0168 0845 331 2725 manager@highview.com 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) High View Children`s Services Ltd Manager post vacant Care Home 7 Category(ies) of Past or present alcohol dependence (0), Past or registration, with number present drug dependence (0), Dementia (0), of places Learning disability (0) High View Residential Unit DS0000066673.V372048.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 30th January 2008 Brief Description of the Service: High View is registered to accommodate people between the ages of 18 to 65 who have been assessed as having alcohol and drug related problems, dementia resulting from alcohol and drug misuse, challenging behaviour due to substance misuse, learning disabilities or acquired brain injury. Accommodation is spread over three floors, with no lifts the home is not suitable for people who have difficulties using stairs. People living in the home benefit from large bedrooms with en suite facilities. One bedroom has a small window with only a restricted view which makes the room dark, this room may only be used for respite care and must not be used by anyone as long term accommodation. There is a well-maintained garden to the rear of the property. There is limited off-road car parking to the front of the building, however there is parking within a short walk from the home. Bus and train links are close by and the home is within walking distance of other public amenities. The cost of this service is between £1000 and £1200 per week. High View Residential Unit DS0000066673.V372048.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means people who use this service experience good quality outcomes. The charge for the service is presently £1,000 to £1300 per week dependent on degree of care and support needs. This visit took place during the daytime and there were two people at home initially with others returning home after finishing their usual daytime activities. All of the people who live at the home are able to clearly express their views and both in conversation and in questionnaires that three people sent to the Commission it is clear that there is a high degree of satisfaction with the service. Standard required records were examined which included care plans, staff recruitment and policy documentation. The Commission, as a part of this inspection, also took into consideration the annual quality assurance assessment that was completed by the home manager and other information that has been received since the previous inspection in January 2008. What the service does well: What has improved since the last inspection? A clear procedure has been established to record complaints. Locks on bedroom are now of a type that will allow staff access in an emergency. Training has occurred for staff on the safe handling and administration of medication and have their abilities to work within the homes medication policy and procedures assessed. PRN Medication guidelines have also been developed. High View Residential Unit DS0000066673.V372048.R01.S.doc Version 5.2 Page 6 A system for supervising staff has been established, as too has an appraisal system, although frequency and monitoring do attract comment in this report for improvements that have still to be made. 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. High View Residential Unit DS0000066673.V372048.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 High View Residential Unit DS0000066673.V372048.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): Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Standards1, 2, 3, 4 & 5 was assessed at this inspection. The people who use this service and others are told what the home does and how it will do it. The service does, however, need to ensure that assessments of people who are referred, even if for respite care, are focused on whether the home can meet the needs within the aims and objectives of the service. EVIDENCE: Information on its aims and objectives and the guide lists what services they offer. It is offered in a standard format. At the time of the previous inspection it was reported that one of the two files that were examined did not have a contract that was signed by the person living in the home or the manager. None of the contracts were available at this inspection and the registered provider must provide written evidence, including dates of signatures and by whom. The previous inspection noted that the files that were examined at that time contained assessments that have been carried out by the home as well as the community care assessment. Three new admissions have occurred since that time and for the two permanent admissions it was seen that the assessment of need matched the ability of the High View Residential Unit DS0000066673.V372048.R01.S.doc Version 5.2 Page 9 service to meet those needs. However, in one case it was note that a respite care client did not have needs for which the service is registered. This is another example, even if it is only a short term placement, that the service has accepted someone for admission that is not appropriate for the stated aims and objectives of the service. The Commission will now make a requirement in this report that further inappropriate admissions must not be permitted to occur. If the home is seen to fail in this area in future the Commission will consider commencement of enforcement action without further discussion. It was also previously noted that parts of the assessments that look at aspirations and needs held some information. The people that use this service often have complex needs and are not always able to express themselves freely, so they would benefit from a deeper exploration of their individual aspirations and more consideration being given to how their needs will be met. Aspirations and needs were again examined to see if the documentation on these showed improvement, which is now the case. High View Residential Unit DS0000066673.V372048.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): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Standards 6, 7, 8, 9 & 10 were assessed at this inspection. The people who use this service can feel confident that staff know what they need. They can also be assured that the staff will make sure that each person has the opportunity to maximise their opportunities to live the sort of life that they can meaningfully chose to. The team do, however, need to be clear about the expectation to update progress reports. EVIDENCE: This home provides care for people who have drug or alcohol dependence and they often have associated illnesses and disabilities so have complex needs. The care plans continue, as previously noted, to carry a lot of detail in relation to background and recent history leading to the person’s disability. The previous inspection identified that not all care plans include sufficient detail about how people wanted to receive personal care and that it would be High View Residential Unit DS0000066673.V372048.R01.S.doc Version 5.2 Page 11 beneficial to record details of how they would prefer their personal needs to be met. The care plans that were looked at during this inspection show that preferences and choices are now more in evidence and sufficient detail exists as to how these should be met. Monthly care plan review and updates are expected to be carried out by the allocated key worker. In two instances these were seen to be happening on average once per month although on occasion once every two months. In another example these were very infrequent and it was stated that the person in question does not like to be involved in keywork one to one sessions. This in itself should not prevent updating of their progress using the reporting system that is in place. Interventions designed to safeguard people living in the house are documented, and continue to be instigated only after a multidisciplinary meeting that would be attended by the person living in the home, staff and other professionals involved with their support. Files contained risk assessments that had been completed in respect of the people who live at this home. These risk assessments promote independence whilst outlining the measures that should be implemented to minimise risk and their potential harm. Although limited in some cases there is sufficient information recorded. It is again apparent, from the records and observed interaction between staff and people living in the home, that people are included in the decision making processes. Personal information is stored in the office in a locked filing cabinet and there are clear procedures in place to ensure that confidentiality and data protection protocols are observed. High View Residential Unit DS0000066673.V372048.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): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Standards 12, 13, 15, 16 & 17 were assessed at this inspection. The people who use this service can feel confident that the staff of the home will provide active support for each person to participate in the community both in terms of the activities of daily life and leisure interests. The opportunity for each to maintain personal and family relations continues to be encouraged and is actively supported by the staff team. EVIDENCE: Some of the people who live in this home have to be supported when going out, but in some cases it has been assessed as safe for particular people to people travel independently. The home had employed an activities coordinator prior to the previous inspection who had developed a schedule of activities. The activities are High View Residential Unit DS0000066673.V372048.R01.S.doc Version 5.2 Page 13 outlined week by week on a wipe board in the office and are in line with activities and interests that are identified in care plans. Records of the activities undertaken are also recorded on daily notes. Records show that, where possible, people keep in contact with family and friends and this can also mean that some might stay with their family at weekends. Where anyone may have lost contact with their family it is evident that efforts are made whenever possible to re establish these relationships. Visitors are welcome and they can be seen either in the communal areas of the house or in an individual’s own bedroom if they wish to receive a visitor in more private surroundings. The homes guide continues to clearly set out the expectation that people living in the home will participate in daily housekeeping tasks such as cooking, cleaning their own bedrooms and doing their personal laundry. Encouragement and practical assistance is provided to enable the people who use this service to re acquaint themselves, and learn, self caring skills not least with preparing meals. Considering that many of the people who use this service may have had poor unhealthy diets in the past it is seen as important that healthy and nutritious meals are prepared and provided. High View Residential Unit DS0000066673.V372048.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): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Standards 18, 19, 20 & 21 were assessed at this inspection. The people who use this service can feel confident that they will get the right support to take care of their personal and healthcare needs. Anyone who needs to take medicine regularly to help them stay well will get the proper support from staff to make sure that this happens. EVIDENCE: It is apparent from discussions and interactions observed that staff understand the concepts of using a person centred approach when working with the people living in the home. Improvement has also been made in highlighting how this support will be provided with details written more clearly in care plans. All of the people living in this home are registered with the local GP and there was evidence on record that they are assisted to seek medical attention when needed. The files also contained psychiatric, psychologist and other assessments as required. High View Residential Unit DS0000066673.V372048.R01.S.doc Version 5.2 Page 15 The fees include the costs of a weekly meeting with the homes own psychologist; the meetings are managed in a flexible and responsive way at the home. Notes are kept of the meetings, and samples of these were seen. People who do not want to participate can opt out but do not receive a reduction of fees. One person is supported to manage their own medication and staff check regularly to see that this medication is being taken. The Medication, its storage and records were examined during this visit. The home has the medication dispensed into blister packs by the chemist who also produces record sheets referred to as MAR sheets. The previous inspection identified that there were some gaps in the MAR sheets where staff had not signed to indicate that the medication had been given. No gaps were identified during this inspection and the blister packs were properly being kept. Guidelines for medication that is not taken regularly but only occasionally when needed (PRN medication) have been introduced and give more detail of the areas that need to be considered as was previously recommended. How the home would support people as they become older and face death is more fully addressed and evidence of discussion and expressed wishes is recorded where people have decided to wish to engage in this discussion. High View Residential Unit DS0000066673.V372048.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): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Standards 22 & 23 were assessed at this inspection. The people who use this service can feel increasingly confident that the staff team at the home know what to do if there are complaints or concerns about abuse. The home has improved and clear guidance for staff about the procedures to be followed in either of these circumstances and complaints recording has achieved the necessary improvement. EVIDENCE: It was identified at the previous inspection that the way that the home records complaints does not allow the complaint to be followed from start to finish. A hard covered notebook was used, with only the date and the detail of the complaint recorded. At this inspection it was seen that a folder with a separate detail of each complaint is now used. This assists the home to track the progress of complaints from start to finish and is a much clearer and easily audited system. People who use this service have made two complaints since the previous inspection. Each was recorded and a reply letter was sent to explain how the complaint (s) were investigated and the outcome. Each of the complaints that had been made was minor in nature and each was satisfactorily resolved. There is clear written guidance and information for staff about what to do if they think that anyone who lives here is being hurt or abused by another High View Residential Unit DS0000066673.V372048.R01.S.doc Version 5.2 Page 17 person, or if an allegation is made by a third party. One concern was reported in the last year and the necessary authorities were informed. This matter was investigated under statutory safeguarding procedures and it was concluded that no actual harm had been caused to anyone who uses this service. Training is provided to staff about safeguarding and this type of training is now a standard aspect of the induction process for new employees. High View Residential Unit DS0000066673.V372048.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Standards 24 & 30 were assessed at this inspection. The people who use this service can feel confident that they are living in a well maintained, clean, comfortable and pleasant home. EVIDENCE: The building is an attractive town house, well decorated in a contemporary style and is comfortably furnished, is clean and well maintained. A tour of the home showed that the bedrooms are spacious, appropriately decorated, furnished and reflect the preferences of the individual using each room. All of the bedrooms have locks and people living in the home are encouraged to lock their rooms when they leave the building. The locks that have been fitted are basic Yale locks and the occupant and these have been adjusted so High View Residential Unit DS0000066673.V372048.R01.S.doc Version 5.2 Page 19 that they cannot disable the ability to open the door from the outside using a key in emergencies. As well as a separate dinning room and comfortable lounge there is a room that has a snooker table that people can use freely. The kitchen is quite big and there is an area where people can sit while food is being prepared so that everyone can feel involved in the process. When people are assessed as needing specialist equipment the home will make arrangements for it to be supplied. Grab rails are fitted to the corridor and stairs on the lower floor to assist someone who has difficulties walking and using stairs. High View Residential Unit DS0000066673.V372048.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Standards 32, 34, 35 & 36 were assessed at this inspection. The people who use this service can feel confident that there is a committed staff team to meet their needs and that these staff are safe people to support them. EVIDENCE: Three staff files were examined and these show that the home continues to have a proper and diligently applied recruitment policy. Background checks that include criminal records bureau checks are undertaken and two references are obtained. A copy of photographic identification and the recruit’s application, a health declaration and other documents are in place as required in Schedule 2. The majority of staff hold an NVQ qualification in care. The home benefits from having a suitably equipped and furnished room for training. Records show that training undertaken continues to include adult protection, first aid, care planning and health and safety. The staff continue to demonstrate a commitment to providing a caring and supportive environment for the people High View Residential Unit DS0000066673.V372048.R01.S.doc Version 5.2 Page 21 living in the home. Staff were observed working and talking with the people living in the home in an open, respectful and friendly way. There were a variety of supervision notes on staff files, some being far more regular than others. The registered provider, who is now also the manager of the home, has introduced a monthly supervision schedule to address the need to ensure that this happens at least six times per year. This will be checked again at the next inspection of the service to determine if it has succeeded in meeting this standard for staff support. A recommendation was made at the previous inspection that the manager should establish arrangements to carry out annual appraisals. The appraisals were most recently completed in late 2007 but update on development and training plan progress has not occurred, as it should do. High View Residential Unit DS0000066673.V372048.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Standards 37, 39 & 42 were assessed at this inspection. The people who use this service can feel confident that they are living in a home that has more effective management oversight. EVIDENCE: The former manager, who was registered last year, left the home a few weeks ago. The registered provider has applied to the Commission to be the registered manager (she did hold that position previously) and is completing the process with the Commission at the present time. High View Residential Unit DS0000066673.V372048.R01.S.doc Version 5.2 Page 23 It was noted at the previous inspection that not all staff feel that the lines of accountability are clear and said that the manager’s instructions have been countermanded on occasion by the owner and that has lead to people being unsure of whose lead to follow and unease in relationships. As the registered provider is now directly in charge of the home these lines of accountability are clear for staff at the present time. Concern was again raised about an inappropriate admission to the home, albeit as a respite care client. This has been referred to in the first section of this report and a statutory requirement will be made in this report. People’s rights and best interests are protected by the homes policies and procedures and information given in the Annual Quality Assurance Assessment indicated that they are reviewed and updated at regular intervals. The owner of the home is also now the registered manager. It was noted at the previous inspection that Regulation 26 visits were not being recorded properly in sufficient detail and did not respect the confidentiality of those using this service or working at the home. Although the registered provider is now also the registered manager these visits are not presently required she must remain mindful to adopt the correct procedures should a separately registered manager be appointed in the future. She also said that there might be a separate person tasked to carry out these visits in any case to further assess the quality of the service in any case, which would be recognised as good practise should this be implemented. An annual development plan has not been compiled which must occur. The standard health and safety checks and certification documents were also examined and it was seen that these show that due regard is given to keeping everyone safe from unnecessary hazards. High View Residential Unit DS0000066673.V372048.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 1 3 3 4 3 5 1 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 3 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 3 X 2 X X 2 x High View Residential Unit DS0000066673.V372048.R01.S.doc Version 5.2 Page 25 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA2 Regulation 14 (1) (d) Requirement The Registered Person must ensure that no further inappropriate admissions occur to the home. None of the contracts were available at this inspection and the registered person must provide written evidence, including dates of signatures and by whom. The registered person must compile an annual development plan. Timescale for action 08/12/08 2. YA5 5 (1) ( c ) 08/01/09 3. YA39 24 (1) & (2) 08/01/09 High View Residential Unit DS0000066673.V372048.R01.S.doc Version 5.2 Page 26 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 progress reports for the people who use the service should be consistently updated at monthly intervals as the policy of the home requires. The appraisals that were most recently completed in late 2007 should have the progress on development and training plans updated for individual staff. 2. YA36 High View Residential Unit DS0000066673.V372048.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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