Care Home: Maldon Lodge

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What the care home does well The service aims to inform people considering moving into the home and to understand how they will need to be supported. The service has 50% of staff trained to NVQ level 2 standard and aims to have 85% of staff with the qualification in the next twelve months. The premises are generally clean and well maintained. They provide a comfortable environment for the people living there. People are able to personalise their rooms. The service benefits from a manager with NVQ level 4 Registered managers Award, and with whom people who live at the home and staff feel they have a good rapport. What has improved since the last inspection? The service has reviewed its safeguarding policy and this now reflects the current good practice and local agreements with Social Services Departments. This will ensure that staff understands how to report allegations of abuse appropriately. Works carried out to the premises such as handrails to garden steps have improved the risks to health and safety for people who live at the service. CARE HOME ADULTS 18-65 Maldon Lodge 123 Maldon Road Colchester Essex CO3 3AX Lead Inspector Sara Naylor-Wild Unannounced Inspection 3rd July 2008 09:30 Maldon Lodge DS0000017877.V367748.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 Maldon Lodge DS0000017877.V367748.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. Maldon Lodge DS0000017877.V367748.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Maldon Lodge Address 123 Maldon Road Colchester Essex CO3 3AX 01206 506059 01206 510916 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) Mr Kalycoomar Samboo Persad Doobay Mrs Faridabibi Doobay Mrs A Wade Care Home 7 Category(ies) of Learning disability (7), Mental disorder, registration, with number excluding learning disability or dementia (7) of places Maldon Lodge DS0000017877.V367748.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 4th July 2007 Brief Description of the Service: Maldon Lodge is a detached property situated on the outskirts of Colchester. A bus route serving surrounding areas is within walking distance from the home. The home provides seven single rooms, split between two floors. As there is no passenger lift, people on the first floor need to be able to use stairs safely. Communal areas consist of a large dining area, where in-house activities take place, a lounge to the front of the premises and a garden at the back. Part of the garden, beyond the patio, can only be accessed by a number of steps. The hard-standing area to the front of the property is used for parking. The current weekly charge for a room is between £550.00 and £650.00. Additional charges are made for chiropody, hairdressing, transport, holidays, outings and birthday parties. Maldon Lodge DS0000017877.V367748.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 star. This means the people who use this service experience good quality outcomes. This unannounced key inspection was carried out on the 3rd July 2008. As part of the inspection we checked information received by Commission for Social Care Inspection (CSCI) since the last inspection in November 2007, looking at records and documents at the care home and talking to one of the proprietors Mr Doobay, care staff and the people living at the home. In addition the Annual Quality Assurance Assessment (AQAA) completed in May 2008 was considered as part of the inspection process and a tour of the premises was completed at the visit to the care home. The service sent us their Annual Quality Assurance Assessment (AQAA) when we asked for it. This contained information about what they felt they did well. Although this information was general and did not always tell us how the service was seeking to improve the outcomes for people living at the service, beyond their present provision. The proprietor assisted the inspector at the site visit. Feedback on findings was given during the visit with the opportunity for discussion or clarification. We would like to thank the proprietor, the manager, the staff team, and people living at the service and their relatives for their help throughout the inspection process. What the service does well: What has improved since the last inspection? Maldon Lodge DS0000017877.V367748.R01.S.doc Version 5.2 Page 6 The service has reviewed its safeguarding policy and this now reflects the current good practice and local agreements with Social Services Departments. This will ensure that staff understands how to report allegations of abuse appropriately. Works carried out to the premises such as handrails to garden steps have improved the risks to health and safety for people who live at the service. 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. Maldon Lodge DS0000017877.V367748.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 Maldon Lodge DS0000017877.V367748.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): 2 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People who are considering moving into the home can be assured that their needs and aspirations will be understood by the staff prior an agreement to admit them. EVIDENCE: Two people had moved into the home since the last inspection. The documents relating to their assessments and admissions were considered during this inspection. In both cases the service had been supplied with either the Care Programme Approach (CPA) assessment completed by either the Community Mental Health Team or the Hospital Mental Health Unit’s in house assessment of the person. These gave an indication of the person’s past history and their present situation including the level of support that was being sought on their behalf. The services own assessment form contains sections to record an overview of the person’s situation and aspects of their daily living needs. The sheets have a list of questions listed beside each section that would help prompt the Maldon Lodge DS0000017877.V367748.R01.S.doc Version 5.2 Page 9 assessor when considering the person’s needs and how these would be supported by the service. In the examples seen some sections of the services assessment form had been completed with information from the CPA but the section relating to risk was not completed. This is an important element of the information the service would need to include in it’s considerations of the person’s suitability for admission to the home. The documents do not contain a conclusion in respect of the considerations of the affect of the person’s needs and behaviour on existing residents or whether the staff have the skills to meet those specific needs. This is always important in understanding how the rights of people already resident may be affected by the admission of a new person. Maldon Lodge DS0000017877.V367748.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 and 9 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People living at the home can be confident that staff will have some understanding of their needs. However they cannot be assured that all the aspects of their daily lives have been included in a documented plan of care and monitored by staff. EVIDENCE: The care plans of four people were considered at the inspection. They varied in the amount of information they responded to from the person’s initial assessment. There were not always responses to holistic needs of the person, and in one example the social and emotional needs of the person outside of their mental health issues were not included in the plan. The plans that were present contained details that would give staff an indication of how they should support the person’s identified need. They were written in a positive way that emphasised the person’s abilities and how staff should support these. The plans were evaluated monthly by care staff. Maldon Lodge DS0000017877.V367748.R01.S.doc Version 5.2 Page 11 There were risk assessments included in the care planning documents seen, these responded to issues raised in both the person’s initial assessment and those raised subsequently. The documents set out the action under consideration, the nature of the concern and the steps taken to reduce the risk. The service also completes infringement of rights forms relating to where steps taken to reduce risk such as administering of medication. Individual’s health was monitored including issues such as weight and nutrition as well as the medical appointments that each person attended and details of their outcomes. It was not clear that the information raised in these documents was included in care plans or if how this may alter the instructions. In one example the weight record for an individual indicated that they had lost 9lb in weight in the previous 6 months. There was not any record in the rest of the persons plan in relation to this change, despite other elements of the plan indicating that the person had issues with their nutrition. Daily records were completed by staff and reflected the daily routine for each person. Comments tended to concentrate on the mood of the person with typical entries stating “appeared happy”, rather than a commentary on the effectiveness of care planning and their aims. The management of people’s monies was unchanged from previous inspection with a clear record of each person’s income and expenditure managed by the service. People spoken with during the inspection were clear about the access to their funds and they also knew restrictions detailed in care plans to individuals spending. Maldon Lodge DS0000017877.V367748.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): 12, 13, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at the service are able to take up some opportunities for activity and occupation. EVIDENCE: People spoken to during the inspection gave similar feedback to previous visits, they enjoyed colouring and spending time reading magazines and papers, one person told us about their trips into the town centre whilst others spoke of their contact with their friends and family. There were weekly activities planners posted in the home and these included Social outings, knitting, exercise, current affairs discussions, jigsaws and board games. On the day of the inspection people received visitors, did colouring, went out to the shops and socialised within the home. Maldon Lodge DS0000017877.V367748.R01.S.doc Version 5.2 Page 13 People’s care plans all contained details of how their social needs should be met. These ranged from family contacts, going out on their own or choosing not to engage at all. Some care plans referred to the organisation of community activities such as joining clubs and day centres. In one plan it stated that the aim of this element of the persons plans was to promote community links and for staff to accompany the person out on trips to the town or shops, but in another section of the plan it discusses the person going out independently. Historically the people living at the home had not wished to participate greatly in employment, development and community activities due in part to their advancing age. This had affected the development of this element of the services provision. However the assessments of people who had most recently moved to the home referred to their participation in activities outside the service as part of their goals. Overall the social and emotional elements of the care plan require further consideration and it will be particularly important that the service ensures this area of support is developed to enable people to develop and maintain links that they previously enjoyed in the community. Meals were provided against a weekly rolling menu that provided nutritional variety. People spoken with during the inspection said they liked the food, and knew they could chose from the menu. During the inspection adaptations to the menu were seen to accommodate the personal choices of people living at the home and their preferences were well known to the staff making the meal. Records of what people had eaten were maintained and supported the monitoring of peoples health and wellbeing Maldon Lodge DS0000017877.V367748.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 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who live at the home can be confident that they will be supported in a manner that respects their rights to dignity. EVIDENCE: Care plans seen during the inspection, contained reference to how people’s personal care should be supported. From observation and discussion with people who lived at the home it was apparent that the arrangements for supporting peoples personal hygiene was organised to protect their dignity. Medication management had been considered at this visit and the records and practice of staff in recording and dispensing medications met with the expectations of good practice. Records of individuals prescribed medication matched the monitored dosage storage containers fore each person, and these were appropriately stored in lockable facilities. There were not any prescribed controlled drugs in use in the home at the time of the inspection. Maldon Lodge DS0000017877.V367748.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at the home can be assured that the staff understands how to protect them. They can be confident that they will be listened to and their views acted upon EVIDENCE: The service had conducted a quality assurance audit using the requirements made at the previous inspection and the response from surveys distributed to people who live at the home and their supporters. The survey responses were mainly positive and the audit reflects this. It also stated that all the outstanding requirements from the last CSCI inspection report had been addressed. Discussions with a director of the company during the site visit to the home indicated that other issues are also dealt with immediately, with a range of ways in which people living at the home can raise issues including a monthly ‘resident’ Meeting. The services complaints policy was in place and apart from minor alterations required to the Commissions contact address, reflected the requirements of the Care Homes Regulations 2001. The service had not received any complaints since the last inspection and the Commission had not been informed of any concerns. People living at the home said they felt confident in Maldon Lodge DS0000017877.V367748.R01.S.doc Version 5.2 Page 16 speaking to either the manager or the company directors about any issues they had. They said they were frequently available and were easy to approach. The service’s Safeguarding policy had been reviewed since the last inspection. The document sets out the forms of abuse that staff must be aware of and gives staff step-by-step instructions to follow in the event of witnessing or reporting suspected abuse. This includes contacting the directors of the company, and reporting the matter to social service and the police with accompanying relevant telephone numbers. This document would be a practical support to staff when dealing with a report of abuse. The document also has a copy of the Essex Safeguarding alert form, although the proprietor was advised this had been updated and reissued. Maldon Lodge DS0000017877.V367748.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 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at the home can expect to enjoy a homely environment that provides for their needs. EVIDENCE: The premises of Maldon Lodge are very domestic in nature. People living at the home were encouraged to personalise their bedrooms and to make use of the communal space inside and outside the home. Repairs and alterations to the home had been carried out since the last inspection. This included a new kitchen and fitting of rails to one side of the garden steps as recommended by the services health and safety inspection. There was also an ongoing annual redecoration plan for the home. Maldon Lodge DS0000017877.V367748.R01.S.doc Version 5.2 Page 18 The provision of low surface temperature radiators was not discussed at this inspection, although the requirement to ensure that people are protected from scalds and burns continues to be made of the providers. The provision of equipment for the management of infection controls was in place. The services policy gives clear guidance on the steps staff should take to maintain the cleanliness standards of the home, and staff are provided with protective clothing. Annual training includes health and safety topics such as infection control and food hygiene training as required. All bathrooms and toilets had hand-washing facilities with appropriate means of washing and drying. Maldon Lodge DS0000017877.V367748.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 and 36 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People living at the home can be assured that staff are trained, but cannot be assured that their skills are sufficient to meet people’s assessed needs. EVIDENCE: The staff rota for the weeks prior to and following the inspection indicated that here was two staff on duty in the waking day of 07:00 and 22:00. There was also one person on sleep in duty at night. There was not an indication of how the service had reviewed this provision when considering the assessed needs of people newly admitted to the service. The care plan of three people indicated that there was an aim for them to participate in communal activities, and that this would require staff to support them in this activity. Although this had not occurred at the point of the inspection it was unclear how the existing arrangements would support this, and those of the other people remaining at the home. The proprietor stated that he or staff from the companies other establishment could be accessed for these purposes. Maldon Lodge DS0000017877.V367748.R01.S.doc Version 5.2 Page 20 Three staff files were considered at the inspection visit. They demonstrated that the services recruitment practice was robust and supported them in protecting the people living at the home from abuse. The documents gathered for the appointment of staff included a completed application form, two references, proof of identity and checks against the Criminal Records Bureau (CRB) and Department of Health’s Protection of Vulnerable adults (POVA) lists. The staff training records for staff indicated a range of subjects that supported their understanding of health and safety such as food hygiene, infection control, basic life support, safer moving and handling, COSHH and fire protection. In addition staff had undertaken subjects commiserate with their roles such as Safeguarding Adults and a medication management course. There was not evidence of staff having taken part in training that related specifically to the needs of people living at the service. Specifically their understanding of the varied diagnosis relating to learning disabilities and mental health, strategies for management of challenging behaviours, risk management and the Mental Capacity Act 2005. The service has three of the 7 existing staff who held their National Vocational Qualification (NVQ) level 2 and the service’s AQAA stated that a further three staff were working towards attaining the qualification this year. The quality of induction records varied in their details and completion. The file of one person who had been working at the home for some months contained a blank competency based Skills for Care Common Induction Standards workbook, and a check list of induction subjects relating to the elements such as understanding of people living at the home, tour of premises and a fire drill. This was despite their application indicating they had never previously worked in a care setting with vulnerable adults. Notes in the person’s supervision record did include records of discussions about the service’s policy and procedure, the key worker system, food precautions, fire precautions and English language difficulties Supervision records were also varied in the application of their consistency across the staff team. In one case the person had received supervision in January 2008 but none since, and another person had received two supervisions in the last 6 months, and two in the previous 12 months. Staffs spoken with felt that they had access to the manager at any time and did not feel they were not supported by the lack of formal supervision. However supervision is an important element of how the service supports staff development and delivers the quality of care according to its statement of purpose. The service’s AQAA states, “Our staff team are well trained to give support and understand the service users needs regarding of their disabilities, culture and communication problems. The staff has got the qualities, qualification, training Maldon Lodge DS0000017877.V367748.R01.S.doc Version 5.2 Page 21 and support required to meet the statement of purpose and the assessed needs of the service users…All care staff has received a structured induction training base on foundation training to sector skills council specification including training on the principals of care, safe working practices, the experiences and particular needs of the service user group…” Maldon Lodge DS0000017877.V367748.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): 37, 39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at the home can expect to be supported by leadership who have demonstrated their suitability for the role. EVIDENCE: The manager has completed her NVQ level 4 Registered Manager’ Award, and has continued to develop her role in the service. People who live at the home spoke highly of the manager and demonstrated a good relationship with her. Staff spoken with were confident in her management and felt she was supportive of them as a team. Maldon Lodge DS0000017877.V367748.R01.S.doc Version 5.2 Page 23 The manager had completed and submitted the Annual Quality Assurance Assessment (AQAA) to the Commission. The document was fully completed and demonstrated an understanding of the overall expectations of the service. However the details of how the service achieves its goals and the review of the requirements from the last inspection were not clear in the document. There were systems in place to gain the views of people living in the home including monthly residents meetings, open door policies and feedback from relatives, professionals and visitors. Records relating to the management and monitoring of health and safety issues within the service were considered at the visit. These included certificates relating to gas and electrical safety tests, maintenance of fire safety equipment and moving and handling equipment. These were all in order. Maldon Lodge DS0000017877.V367748.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 X 2 3 3 X 4 X 5 X 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 2 33 X 34 2 35 3 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 2 X 2 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 X 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 2 X X 3 X Maldon Lodge DS0000017877.V367748.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? Yes 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 YA36 Regulation 18 Requirement Staff must have the supervision they need to carry out their jobs effectively. This requirement has not met the agreed timescale of 30/09/06. 2. YA35 18 Staff must have the training they 31/12/08 need to promote good practice. Specifically the training programme must include subjects relating to the assessed needs of people living their and provide staff with sufficient skills to meet these. Timescale for action 31/12/08 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 YA23 Good Practice Recommendations Care plans should give staff clear guidelines for meeting individual needs to ensure consistent good practice and DS0000017877.V367748.R01.S.doc Version 5.2 Page 26 Maldon Lodge the best possible outcomes for the person they are supporting. 2. YA33 The number of staff on duty should be sufficient to support the assessed needs of people living at the home. Specifically this relates to the support required in accessing community based activities. The service should ensure that their Annual Quality Assurance Assessment reflects the views of people using the service and responds to the requirements of the Commissions inspection report. 3. YA39 Maldon Lodge DS0000017877.V367748.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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 Maldon Lodge DS0000017877.V367748.R01.S.doc Version 5.2 Page 28 - 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. 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