Care Home: Mill Dale

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What the care home does well People who start using the service can be confident that their needs will be known and introductions are sensitive to the needs of individuals. Individuals are involved in decisions about their care while they are visiting Mill Dale, and play an active role in planning the care and support they receive. There is a commitment to making visits to Mill Dale a good social experience for people but further work needs to be done to better achieve this. People receive discreet personal support in a way they prefer. People are protected by the home`s policies and procedures for dealing with medicines. There are effective systems in place to safeguard the welfare of people who visit and to listen to their concerns. The home provides a warm and welcoming space, which can meet a variety of people`s needs. People using the service are supported well by a staff group that is properly recruited and skilled to meet their needs. The home is well managed in the best interests of people who use it. What has improved since the last inspection? Each person now has a care plan in place that is current and up to date. There have been improvements in involving people in developing their own care plans and in reviews. Risk assessments are now in place for each person using the service. Improvements have been made in how people using the service are listened to. Required pre-employment checks have been carried out on all staff. Management visits to the home take place every month. CARE HOME ADULTS 18-65 Mill Dale 4 Nunroyd Heckmondwike WF16 9HB Lead Inspector Cathy Howarth Key Unannounced Inspection 26th February 2008 10:15 Mill Dale DS0000067159.V360019.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 Mill Dale DS0000067159.V360019.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. Mill Dale DS0000067159.V360019.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Mill Dale Address 4 Nunroyd Heckmondwike WF16 9HB 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) 01924 325698 01924 325699 angela.teil@kirklees.gov.uk www.kirklees.gov.uk Kirklees MC vacant post Care Home 8 Category(ies) of Learning disability (8), Physical disability (8) registration, with number of places Mill Dale DS0000067159.V360019.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22nd November 2006 Brief Description of the Service: Mill Dale is owned and managed by Kirklees Metropolitan Council and provides a service to younger adults with a learning disability. The home is situated near to the town centre of Heckmondwike. The home is on a bus route for Heckmondwike, Dewsbury and Batley. The nearest train station is in Dewsbury. Mill Dale is a single storey building. There are two communal lounge areas, two dining rooms, one of which has a kitchenette. Other facilities include a large kitchen, two offices, a laundry room and a sensory room. The building is surrounded by large gardens and patio areas. Mill Dale benefits from having a hearing loop installed, to assist those people with hearing problems. Mill Dale is a no smoking house. Information provided by the home prior to the inspection indicated that the fees are £20 per night. The actual charge to individuals is means tested. People are expected to pay the cost of activities such as swimming, cinema, and meals out at the pub. The service provider ensures that information about the service is available people who wish to use it and the people currently using the service by way of the home’s Statement of Purpose, the Service User Guide and through CSCI inspection reports. Mill Dale DS0000067159.V360019.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 inspection was carried out using information provided by the service in the form of a self-assessment, responses from people using the service and their relatives and a visit by one inspector for a period of nine hours to the home. The visit included time spent observing and talking with people using the service; talking with staff and the manager; and inspection of documents relating to care and operation of the service. Overall this inspection was positive, the service has shown that improvements are being made and they are striving to make further changes to improve the outcomes for people using the service. What the service does well: What has improved since the last inspection? Mill Dale DS0000067159.V360019.R01.S.doc Version 5.2 Page 6 Each person now has a care plan in place that is current and up to date. There have been improvements in involving people in developing their own care plans and in reviews. Risk assessments are now in place for each person using the service. Improvements have been made in how people using the service are listened to. Required pre-employment checks have been carried out on all staff. Management visits to the home take place every month. 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. Mill Dale DS0000067159.V360019.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 Mill Dale DS0000067159.V360019.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 People who use the service experience excellent quality outcomes in this area. This judgement has been made using a range of available evidence including a visit to this service. People who start using the service can be confident that their needs will be known and introductions are sensitive to the needs of individuals. EVIDENCE: Mill Dale offers short stay placements to younger adults with a learning disability. Referrals come via the Community Learning Disability Teams or the transition team for young people moving from Children’s to Adult services. The file of someone who had recently started using the service was examined. It was clear from this file that detailed assessments and planning for introductions had been completed before they began to use the service. The manager also explained that they had developed further documentation to make sure any issues are picked up before someone comes to stay at Mill Dale, for example needing extra equipment or other special requirements. Now a link staff member visits the family to find out detailed requirements and develops an initial care plan and risk assessment before the person visits. This Mill Dale DS0000067159.V360019.R01.S.doc Version 5.2 Page 9 is to avoid any problems when the person does come to stay. This is good practice. On the file examined, it was clear that staff had written detailed notes about the introductory visits to note any further information or observations about the person that might need to be followed up. Mill Dale DS0000067159.V360019.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 People who use the service experience good quality outcomes in this area. This judgement has been made using a range of available evidence including a visit to this service. Individuals are involved in decisions about their care while they are visiting Mill Dale, and play an active role in planning the care and support they receive. EVIDENCE: The files of two people using the service were examined and the inspector spoke with and observed individuals in the home. Each person had a care plan and risk assessment, which outlined the main areas where they might need support and where they might be at risk. The care plan also addresses areas such religious and cultural needs and communication. In addition, when each person is visiting, there was a summary of the main needs in an ‘active file’ which was used by staff on duty as a quick reference Mill Dale DS0000067159.V360019.R01.S.doc Version 5.2 Page 11 guide and where staff record daily notes. This is a good idea to make the information more easily accessible on a day to day basis as offering respite care means that often the individuals may not be as familiar to staff who may not have seen individuals for some time. It is therefore essential that staff have access to the information about people’s needs in order to keep them safe and offer a quality service. The inclusion of a copy of the full care plan within the active file would also be recommended so that staff can also access this more easily. Also it was noted that information about people’s dietary needs and preferences was not available within the kitchen. When one new user indicated that he wanted a drink, staff had to go to the office first to check his diet sheet before being able to offer a drink. There was evidence of regular reviews of care plans. People who responded to the surveys sent out were generally very positive about how individual needs are met. In response to the question what does the service do well one relative responded: “The care home are very good…they try their best to help with the things we have asked them to do.” Another said: “The care home meets all of X’s needs. He looks forward to visiting Mill Dale. People who are able to manage this are given a key to their rooms during their stay so that they can have privacy. Staff have a master key to get into rooms in the event of an emergency. One positive development is involving people in expressing their own needs and preferences. Staff and people using the service have attended a workshop on using posters with pictures to express their needs. Some people have already started doing this and staff aid they felt this was a positive development. Mill Dale DS0000067159.V360019.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 & 17 People who use the service experience adequate quality outcomes in this area. This judgement has been made using a range of available evidence including a visit to this service. There is a commitment to making visits to Mill Dale a good social experience for people but further work needs to be done to better achieve this. EVIDENCE: People who visit Mill Dale come for a variety of reasons - to expand their social opportunities, meet up with friends or to give carers a break. People who responded to the surveys indicated that they enjoy the opportunities and activities on offer in the home. There have been two meetings with people using the service and their carers since October 2007. People using the service made several requests for Mill Dale DS0000067159.V360019.R01.S.doc Version 5.2 Page 13 improvements to activities such as having a pool competition, to have a large screen TV and a karaoke machine. Many of the requests have been addressed and have added to people’s enjoyment. Some people said that they would prefer to go out more. One relative answered in response to question how the home could improve “more staff and taking the people out more often.” However these surveys were returned some time ago, in November 2007. On the day of this visit, the inspector saw that the staff have made efforts to improve the activities on offer and staff have taken their minibus tests in order to be able to take people out in a minibus which they have access to sometimes in holidays and at weekends. People who use wheelchairs are still having limited opportunities to go out, as staff are still awaiting training in clamping wheelchairs safely in the transport. One person who uses a wheelchair indicated a certain amount of frustration about not being able to go out much when they stay. The staff rota has activity sessions allocated to allow staff the opportunity to plan ahead for activities. During this visit it was seen that these only occur on weekdays rather than weekends when the home is most likely to be full, and also lately these have been cancelled due to needing staff cover. Mill Dale DS0000067159.V360019.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 People who use the service experience good quality outcomes in this area. This judgement has been made using a range of available evidence including a visit to this service. People receive discreet personal support in a way they prefer. People are protected by the home’s policies and procedures for dealing with medicines. EVIDENCE: People using Mill Dale have the opportunity to express their personal care needs within their care plan so that this is done according to their needs and preferences. One person’s plan showed a detailed plan for how they prefer to shower. Another outlined particular terms used by the individual for personal care task so that discretion was maintained. Staff were observed offering personal care in a discreet manner. As people only visit Mill Dale for respite care, the home does not have responsibility for people’s health care as this remains with the individuals and their carers. Any health needs are recorded on the care plans and any ongoing requirements regarding health are met within the home, for example if someone needs help with physiotherapy or special diets because of their Mill Dale DS0000067159.V360019.R01.S.doc Version 5.2 Page 15 health. One person became ill during the visit and staff responded promptly to contact the carer and to get a GP emergency appointment. The home operates a safe and effective medication system. The care coordinators and night staff are responsible for administering medication. Staff who do so have been trained. When people come to stay they bring their medication with them and this has to be properly labeled from the pharmacist so that staff are sure that they are giving out medication as prescribed. Medication supplies examined on this visit were correct. The medication policy is kept in the medical file along with a list of staff who are authorised to administer medication. There were some problems in late 2007 with staff making mistakes with medicines. However this appears to have improved and no mistakes have been made more recently following this being addressed in team meetings and supervision. The storage facilities are good. Medication is kept in a separate room and there is a cupboard and a small fridge, for medication that needs to be stored at a cool temperature. Mill Dale DS0000067159.V360019.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 People who use the service experience good quality outcomes in this area. This judgement has been made using a range of available evidence including a visit to this service. There are effective systems in place to safeguard the welfare of people who visit and to listen to their concerns. EVIDENCE: The home operates within the Kirklees Council’s complaints procedure. The procedure is clear and easy to understand. The procedure is also available in CD format as well as other languages, upon request. The procedure is displayed in the front entrance of the home. People are also informed of the procedure within the home’s statement of purpose and service user guide. Both informal and formal complaints are recorded and looked into. People who responded to the surveys said they were aware of how to raise concerns and make complaints. There have been a small number of complaints (8) since the last inspection and these have been resolved satisfactorily. There was evidence of learning from complaints, for example in improving transition information from children’s services. There have been two referrals under safeguarding procedures (adult protection) since the last inspection. There had been some concern in 2007 about the understanding of staff about making referrals. However staff have received training in this area and discussions in team meetings and supervision Mill Dale DS0000067159.V360019.R01.S.doc Version 5.2 Page 17 appear to have helped raise awareness levels. Appropriate information and referrals appear to have been made more recently. Staff training records showed that not all staff were up to date with training in managing aggression and violence. There have been some incidents over the last year where staff have had to intervene to protect people using the service and some people have one to one support either to be protected or to ensure that individuals do not pose a threat to others. Staff training is critical in supporting the safety of people using the service. Mill Dale DS0000067159.V360019.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): 24 & 30 People who use the service experience good quality outcomes in this area. This judgement has been made using a range of available evidence including a visit to this service. The home provides a warm and welcoming space which can meet a variety of people’s needs. EVIDENCE: Mill Dale is a new building and the décor of the home is of a very high standard. The fixtures and fittings are of a high quality creating a homely and comfortable environment for people who visit. The building has plenty of communal space which people can use in different ways to meet different needs and interests. For example there is a sensory room, a games room and a breakfast kitchen, where people can make snacks, in addition to the main lounge and dining room. This means that staff can support people with different interests without people impinging on each other. On the day of this inspection, two people were decorating Easter eggs while others were watching TV and another was spending time in their room. Mill Dale DS0000067159.V360019.R01.S.doc Version 5.2 Page 19 The acting manager explained that they had recently taken steps to brighten up the environment, so staff had put in bright shower curtains and ornaments in the Jacuzzi room. A mannequin has also been placed in the entrance hall, which is dressed up, and props placed to reflect up coming events. At the time of this visit it was due to be Mother’s day and so the mannequin reflected this. Staff explained that this helps people to have an awareness of the time of year and important events in the calendar. Another new innovation has been the introduction of picture boards. These have a collage of pictures chosen by people visiting Mill Dale on a theme. One of these showed pop stars on this visit. Again this is to reflect what people are interested in and so that people can feel that their interests are reflected in the environment. The plan is to change these on a regular basis. People have free access to the kitchen and staff support people to bake and to get drinks as they wish. Snacks are also readily available in the breakfast kitchen when it may not be safe for people to be entering the kitchen. People’s bedrooms were seen to be relatively bland but this is inevitable to some extent given that people do not live at Mill Dale. Recently the rooms have been equipped with small drinks fridges following a request for a vending machine, which turned out to be too expensive. Rooms were spacious and all have a lockable cabinet. One area to be addressed is that there is no way for individuals to control the temperature in the rooms. One ensuite bathroom was very warm and the building was generally very warm. The manager said that the temperature is controlled remotely from a central control and could not be altered. This should be looked into further as it restricts the options for people to have a comfortable environment that suits their particular needs or preferences. Mill Dale DS0000067159.V360019.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): 32, 34, 35 and 36 People who use the service experience good quality outcomes in this area. This judgement has been made using a range of available evidence including a visit to this service. People using the service are supported well by a staff group that is properly recruited and skilled to meet their needs. Staff receive good support and leadership. EVIDENCE: There is a fairly small but stable staff team at the home. There is the manger and four care co-ordinators who lead the team. Because the manager role is split between two homes it is the Care Coordinators who lead the team operationally day to day. The council is currently investing in training for this level of workers to ensure they have the skills for the role. Staff have just begun this training. Other staff complete induction training and the council’s basic level courses, including such things as adult protection, fire safety, moving and handling. Staff are also encouraged to complete NVQ training. Some progress has been Mill Dale DS0000067159.V360019.R01.S.doc Version 5.2 Page 21 made on this and some staff are now on a ‘fast track’ programme. The home does already exceed the target of 50 staff qualified. It should be noted that staff mainly do NVQ Level 3 rather than 2, which is above the National Minimum Standard for the sector, which asks for Level 2. In addition to NVQ staff receive training in specific areas that are relevant for this group of people who use the service. These include Adult Protection. Moving and Handling, Mental Capacity Act 2005, basic Food Hygiene and Infection control. Most of these were up to date and most staff had completed basic training. Areas to address are that a significant number of staff were not up to date with infection control training or managing aggression and violence. Staff rotas were seen but we were told that these are changing from a rolling rota to better meet the needs of the service. As mentioned previously the rotas had activity shifts on but these were having to be cancelled to provide ordinary cover. Some people who visit the home have needs, which mean they need to have more intensive support on a 1:1 basis. One area identified for improvement is in providing catering cover. As Mill Dale is next door to Crescent Dale, which provides care for people on a more long-term basis, the acting manager has developed a plan to share the catering so that staff will not have to be drawn away from direct support for people in order to provide meals. This plan is to be implemented in the near future following leave. This is a positive step and should help enable staff to be free to support individuals better. Staff records were seen as part of this inspection. Records relating to recruitment showed that overall the recruitment of staff is robust. Staff supervision and support systems were seen to be good. Staff receive regular supervision that exceeds the National Minimum Standard level of three monthly. Day staff meetings are held monthly and night staff meetings are held approximately three monthly. Feedback from relatives indicated a high level of confidence in the staff team. One person said: “The staff are warm and welcoming.” Mill Dale DS0000067159.V360019.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 People who use the service experience good quality outcomes in this area. This judgement has been made using a range of available evidence including a visit to this service. The home is well managed in the best interests of people who use it. EVIDENCE: Mill Dale has had a period of instability due to a number of management changes in the short time it has been open. There has been no registered manager for some considerable time. However a new manager has now been appointed and was due to start work on 4th March 2008. This manager must be registered without further delay. The acting manager was present on the day of inspection. She has been running the home since October 2007. Since that time it was clear that Mill Dale DS0000067159.V360019.R01.S.doc Version 5.2 Page 23 considerable efforts have been made to address some issues about quality within the home, such as feedback from carers/relatives about changeover times, addressing consultation with people using the service and refining admission processes. Monthly visits by senior managers, as required by regulation, have been carried out. Also the acting manager indicated that she felt she has received good support from the Group Manager. Health and Safety systems were seen to be working well within the home. Fire safety tests and drills were found to be up to date. There were no obvious hazards noted in any areas of the building. Mill Dale DS0000067159.V360019.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 4 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 2 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 2 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 2 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Mill Dale DS0000067159.V360019.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 2 3 4 Refer to Standard YA6 YA13 YA23 YA24 YA35 Good Practice Recommendations The care plans for individuals should be more easily accessible to staff and the cook so that individual needs can be easily met. Further efforts need to be made to ensure that people who use wheelchairs are supported to be able to go out and participate in leisure and community activities. All staff should have training to ensure they can respond appropriately when people may be at risk of violence or aggression. The issue of individual controls for temperature in bedrooms should be addressed to allow people to vary the temperature if they wish. All staff should have up to date training in infection control procedures. Mill Dale DS0000067159.V360019.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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 Mill Dale DS0000067159.V360019.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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