Care Home: Orchard Close (4 )

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What the care home does well People living in Orchard Close have complex needs relating to learning and physical disabilities. They also have limited communication abilities. They are supported by a committed team of staff who are knowledgeable about their needs and personal preferences. The staff are both sensitive and caring. People are treated with dignity and respect. They receive individualised care, which is specific to their physical, emotional and social needs. Staff continue to monitor the health and wellbeing of the people living in the home and work in partnership with other agencies to ensure that individual health care needs are met. People living in the home are supported to maintain positive relationships with family and friends. The premises have been refurbished and redecorated throughout. The new equipment installed successfully meets the needs of people who have additional physical disabilities. This includes ceiling hoists in each bedroom and one of the lounges.. Two adapted shower have also been installed. What has improved since the last inspection? Fire precautions within the home have been addressed. A fire risk assessment has been drawn, fire exit notices are now on display and bedrooms doors have been fitted with suitable closing devices. People living and working in the care home no longer have their safety compromised. Storage facilities have also been improved for one person, which means any equipment is out away and leaves their bedroom looking personal and homely. Improvements have been made to record keeping and people living in the home are benefiting from a more structured approach to in house activities. Rotas, staff training records, information about recruitment checks have all been improved. Staff now have access to IT systems and have found this to be of great benefit in terms of communication, personal development and training as well as supporting the people who live in the care home. Staff are able to access sites about activities or places of interest that will appeal to the people in their care. CARE HOME ADULTS 18-65 Orchard Close (4 ) 4 Orchard Close Morton Road London N1 3AS Lead Inspector Pippa Canter Unannounced Inspection 29th May 2008 11:20 Orchard Close (4 ) DS0000031851.V364736.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 Orchard Close (4 ) DS0000031851.V364736.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. Orchard Close (4 ) DS0000031851.V364736.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Orchard Close (4 ) Address 4 Orchard Close Morton Road London N1 3AS 0207 354 9436 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) maureen.power@islington.gov.uk Islington Social Services Maureen Power Care Home 7 Category(ies) of Learning disability (7) registration, with number of places Orchard Close (4 ) DS0000031851.V364736.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following category: 2. Learning disability - Code LD The maximum number of service users who can be accommodated is: 7 6th November 2007 Date of last inspection Brief Description of the Service: Orchard Close is a care home for younger adults with learning disabilities who may have complex needs such as physical disabilities and, or sensory impairment. The home provides 24-hour care and support and has its own transport. Built in 1990, the home is owned and operated by Islington Council. There is a main lobby with communal sitting rooms and dining areas. All the bedrooms are single occupancy and there is a pleasant secure garden. Located in a quiet residential cul-de-sac near Rotherfield and Morton Roads, the home is situated relatively near to community facilities such as shops, pubs and a park. Public transport is available but not necessarily accessible for people with physical disabilities. Essex Road rail station is nearby, and Highbury & Islington and Angel tube stations are within 20 minutes walking distance. There are several local bus routes and these have a limited number of wheelchair accessible buses. More detailed information about the services provided can be found in the home’s Statement of Purpose and Service User Guide - copies of these documents can be obtained directly from the home. Orchard Close (4 ) DS0000031851.V364736.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 using this service experience good quality outcomes. This unannounced key inspection took place on a weekday. The length of visit was from mid-morning to early evening, a total of seven and a half hours. The inspection focused on the key national minimum standards paying particular attention to the deficiencies recorded at the last inspection. Prior to the inspection we reviewed the information that the Commission for Social Care Inspection had about the home. This included an improvement plan and an Annual Quality Assurance Assessment. During the visit we looked around the premises paying particular attention to fire level of fire precaution sin the home and the individual bedrooms. We met people living in the home. The manager and three staff were spoken to. Staff were also indirectly observed going about interacting with residents. The inspector observed a handover. Four care plans were looked at and compared with the care being provided. There was discussion with staff and the manager about aspects of care, staffing levels, supervision, health and safety, training, complaints and adult protection. What the service does well: What has improved since the last inspection? Orchard Close (4 ) DS0000031851.V364736.R01.S.doc Version 5.2 Page 6 Fire precautions within the home have been addressed. A fire risk assessment has been drawn, fire exit notices are now on display and bedrooms doors have been fitted with suitable closing devices. People living and working in the care home no longer have their safety compromised. Storage facilities have also been improved for one person, which means any equipment is out away and leaves their bedroom looking personal and homely. Improvements have been made to record keeping and people living in the home are benefiting from a more structured approach to in house activities. Rotas, staff training records, information about recruitment checks have all been improved. Staff now have access to IT systems and have found this to be of great benefit in terms of communication, personal development and training as well as supporting the people who live in the care home. Staff are able to access sites about activities or places of interest that will appeal to the people in their care. 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. Orchard Close (4 ) DS0000031851.V364736.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 Orchard Close (4 ) DS0000031851.V364736.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 moving into the care home and their relatives can be assured that they care needs and aspirations will be met. EVIDENCE: The previous inspection report recorded the quality of this outcome area as adequate. The service had breached their conditions of registration by admitting a seventh person when the home was registered to accommodate six people. An application to increase the number of beds was submitted and approved. As from 22nd November 2007, the care home is registered to accept seven people. A certificate of registration is on display in the office. At the time of the inspection there were six people being accommodated with one vacancy. For this inspection, we looked at and tracked the care of two people living in the care home both of whom were the most recent admissions. The AQAA records that staff learn and reflect on practice to ensure that transfers to the service can always be improved and supportive. This inspection has identified that the service has an admission procedure that is designed to support both the potential service user and their relatives. People being referred to the Orchard Close (4 ) DS0000031851.V364736.R01.S.doc Version 5.2 Page 9 service are given clear information and introductory visits to enable them and their families to make an informed choice about whether to move into the home. Admissions are not made to the care home until a full needs assessment has been undertaken. The assessment is designed to identify the levels of support required, specialist equipment that may be needed and to give staff a clear idea of how to offer person centred care. The assessment takes account of social as well as cultural needs, dietary preferences, hobbies and interests, personal care and medical background. A copy of the local authority needs assessment also feeds into the process. Risk assessments are also available. These are well informed and encourage as much independence and autonomy as can be achieved. Orchard Close (4 ) DS0000031851.V364736.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. People living the care home are supported to take as much control over their lives as possible through the development of person centred plans. A comprehensive risk management strategy supports people to maximise independence and choice. EVIDENCE: Four care plans were looked at altogether but two were looked at in more detail. Staff understand the importance of putting people at the centre of their care so that are able to have control as much as possible through their person centred plan (PCP). The care plans are in a meaningful format including pictures and photographs. They are written in plain language, are easy to follow and look at all aspects of the person’s life focusing on individual likes and dislikes and strengths and aspirations. They include references equality and diversity. Discussions with the staff showed that they have the skills and ability to support the person using the service to have positive outcomes. Orchard Close (4 ) DS0000031851.V364736.R01.S.doc Version 5.2 Page 11 Each person using the service has a key worker and this enables staff to work on a one-to-one basis and contribute to the care to make it individual. The care plans are reviewed monthly and summary reports are available which evaluate whether goals and objectives have been met. Risk assessments are drawn based on a sound risk management strategy. They are reviewed and working practices revised in line in order to keep people using the service safe from harm but encourage autonomy. All records will be retained the regulatory amount of time which is three years from the date of the last entry. Orchard Close (4 ) DS0000031851.V364736.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, 14, 15, 16 & 17 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in Orchard Close can enjoy activities in the home as well as the wider community, which provides more interest and stimulation. Staff understand and fully support important links with family and friends. Meals continue to be nutritiously balanced and offer a healthy and varied diet reflecting personal choice as well as dietary and cultural needs. EVIDENCE: The people living in the care home have a range of needs including high dependency physical disabilities and have limited verbal communication. The staff know and have recorded the preferred communication style of the individual so that choices can be made as far as possible. Since the last inspection the manager and staff team have been addressing the level and variety of activities available in the home especially as two residents do not enjoy going out. In line with an action plan, the shift plan format has been Orchard Close (4 ) DS0000031851.V364736.R01.S.doc Version 5.2 Page 13 revised to show hourly timetable. Records show that each individual has an activity plan and this can be programmed into the shift plan. Residents are being encouraged to be involved in meaningful activities both in the care home and in the wider community. The service recognises the importance of maintaining family relationships. Staff are supportive and take account of concerns and anxieties of parents. Two of the residents require artificial feeding. The remaining four residents have a diet that is varied and nutritious but also takes account of their dietary and cultural needs. Orchard Close (4 ) DS0000031851.V364736.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 & 21 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in the care home have their health care needs met by a competent and caring work force. Medication practices are safe but need to meet with the organisation’s own internal policy. People’ wishes concerning ageing, illness and death are being addressed. EVIDENCE: People living in the care home have a range of complex health needs. These are addressed through individual health action plans. These show that residents have access to health and remedial services. Working practices are detailed and take account of individuals’ personal and healthcare support routines including artificial feeding for one resident. There is an anomaly in that the Community Nursing Service remains responsible for the associated care for a PEG feeding for the resident and the support staff assume responsibility for the resident who requires a gastronomy. Training for this was given. It is envisaged that staff in the home will take over responsibility for both types of feeding but before the District Nurses can delegate responsibility, staff will need training and an assessment of competence. Orchard Close (4 ) DS0000031851.V364736.R01.S.doc Version 5.2 Page 15 Care plans contained clear information on how to support people and meet their personal care needs. Detailed working practices are again available taking account of safety, privacy, dignity and personal preferences. Observation showed that staff work to the person centred plan and were competent carrying out tasks. Residents have aids and equipment they need and records show that these are well maintained and staff are familiar with their use. The medication administration records were audited as a requirement had been set at the last inspection. There were no gaps in recording however on 12 occasions there had only been one set of initials to record that medication has been administered. The policy is for two sets of initials. This was referred to the manager. Discussions with staff confirmed that they have received training in administering rectal diazepam and this is recorded on training records. A requirement had been set at the last inspection because the end of life wishes had not been recorded in respect of ageing, illness and death. The manager has recorded peoples’ wishes in conjunction with parents. However such a record needs to include people’s view on CPR, which needs to be signed off by a GP. The staff team have experienced illness and death and showed a sensitive and compassionate approach. Orchard Close (4 ) DS0000031851.V364736.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in the care home can be assured that their concerns will be listened to and addressed. They are safe from harm and protected by welltrained staff that are supported by robust policies and procedures. EVIDENCE: The Annual Quality Assurance Assessment submitted by the manager showed that the home had received one expression of concern. Records show that this had been looked into and practices changed. This supports the service’s reputation of taking complaints seriously and taking action to improve practice. The service has robust policies and procedures for the protection of vulnerable adults. They clear specific guidance to those using them. Discussions with staff highlighted that they have a good understanding of what constitutes abuse and when incidents need to be reported externally. Training records confirm that staff have attended training in safeguarding. This will be cascaded to other staff in the team. Other training around managing challenging behaviour is also made available to staff as needed. Equipment that may be used to restrain individuals such as bed rails and/or wheelchair belts are used as the result of comprehensive risk assessments. Orchard Close (4 ) DS0000031851.V364736.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, 26, 27, 29 & 30 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in the care home have a safe clean and pleasant environment that meets their needs. EVIDENCE: The home provides a physical environment that is appropriate to the specific needs of the people who live there. It is a well-maintained environment providing specialist aids and equipment to meet. The home offers a pleasant, well-equipped and clean environment for residents. The vacant room is still being used for storage but the remainder of the occupied rooms are personalised to reflect the occupants’ personality, likes and interests. Lack of storage had been commented on at the last inspection and this has been rectified with the introduction of bedroom lockers. There was no trailing leads or trip hazards. There are good hygiene practices that prevent cross Orchard Close (4 ) DS0000031851.V364736.R01.S.doc Version 5.2 Page 18 infection. Protective clothing is available and the arrangements for the safe disposal of clinical waste is satisfactory. A Fire Officer from the local fire brigade (LFEPA) has inspected the care home and advised on fire exit signs and door closures. The report is that fire precautions in the home are satisfactory. Orchard Close (4 ) DS0000031851.V364736.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, 33, 34, 35 & 36 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in the home are supported and kept safe by a well-trained staff team. EVIDENCE: Rotas show that there are sufficient staff on each shift to meet the needs of the people living in the home. The home has responded to comments made in the last report and rotas are not in ink and record the full names of staff. There are still vacant posts and therefore a reliance on agency staff to fill shifts. The same agency staff are supplied on a consistent basis. London Borough of Islington has a contract with an agency to supply agency workers and this stipulates that recruitment and selection must be robust. However the registered manager was advised that as she is accountable to ensure that staff are competent and “fit for purpose”. Therefore she must request evidence that CRB & POVA checks have been done and training records from the agency. The manager confirms that vacant posts will be advertised. There is a good recruitment procedure and the home is supported by a Human Resources Department to ensure that the process is followed. Staff personnel Orchard Close (4 ) DS0000031851.V364736.R01.S.doc Version 5.2 Page 20 records are held centrally and in response to the last inspection report, the manager has recorded pertinent information regarding enhanced CRB checks, references and qualifications on staff training an development files. The Commission will make arrangements to inspect a sample of recruitment and selection records held by the Borough. Training records have been updated and show that staff have attended training that is relevant to their role and responsibilities, keeps them updated and enables them to meet the needs of the people living in the care home. There is evidence recorded that supervision and appraisals are taking place. Staff confirm that they are supported by the manager and colleagues. Orchard Close (4 ) DS0000031851.V364736.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 41, 42 & 43 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in the care home benefit from a service that is managed to meet their needs and safety. EVIDENCE: The manager has the required qualifications and experience and is competent to manage the home. Staff confirmed that she is approachable and supportive. She returned the Annual Quality Assurance Assessment within the required time scale. It contained clear and relevant information and showed that she had a clear idea of the strengths of the service and where improvements need to be made. The manager promoted equal opportunities, is described as having good communication skills and understand the importance of person centred care. Orchard Close (4 ) DS0000031851.V364736.R01.S.doc Version 5.2 Page 22 A range of quality assurance systems are used to measure the success of how the home is achieving its aims and serve the best interests of the people who live there. Examples include regular care plan reviews, meetings and an annual quality action plan. Recording keeping has improved as evidenced in previous outcome areas. There is now clarity on the length of time that records have to be retained along with the timescale for sending in notifications to the Commission. The previous inspection report recorded that staff should have access to the monthly reports on the conduct of the home compiled by the registered provider. This is now the case. However the monthly visits have been interrupted as the person responsible has been off sick. The provider needs to address this situation and have a contingency plan in place if the situation arises again. It has been established that the service must send copies of the monthly reports if the Commission requests them. A sample of health and safety records was audited. These were found to be up-to-date and accurate. However the fire bell test had not been conducted on a weekly basis. This is the delegated responsibility of a staff member but when the person is away there is a tendency for other staff to forget. It is recommended that fire alarm test is the responsibility of the team or shift leader on that day. Training records in respect of health and safety are now up-to-date. Following the inspection by the Fire Officer and his advice, fire safety notices are now on display throughout the home and all bedrooms doors have recognised and safe door closures. Staff now have access to IT systems. Staff commented that this had brought benefits in respect of staff development, communication and planning on behalf of residents in the home. Orchard Close (4 ) DS0000031851.V364736.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 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 3 27 3 28 X 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X 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 3 X 3 3 3 Orchard Close (4 ) DS0000031851.V364736.R01.S.doc Version 5.2 Page 24 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 YA20 Regulation 13(2) Requirement Timescale for action 25/07/08 2. YA34 17(2)19(4 b) 3. YA39 26(5a & b) 4. YA42 13(4)(c). When medication is administered, it must be in accordance with the internal guidance i.e. there must be two sets of initials. This will enhance accuracy and maximise safe practice. The registered persons must 30/08/08 ensure that agency staff supplied to the home have had a thorough and robust recruitment process. Evidence needs to be recorded similar to that for permanent staff. The registered provider must 30/08/08 have contingency plans in place to ensure visits are carried out monthly when the delegated person is not available. There must have in place a food 30/08/08 safety risk assessment. This should include where food is purchased, transported, stored and cooked. This is to promote and make proper provision for the health and welfare of the service users. Orchard Close (4 ) DS0000031851.V364736.R01.S.doc Version 5.2 Page 25 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. Refer to Standard YA6 YA35 Good Practice Recommendations Each service user should have a copy of their person centred plan in their bedrooms so that staff have on hand information about their support needs. Training records for agency staff should be kept in the home to show that they have the knowledge and skills to meet the service users needs. Agency staff should also sign in acknowledgment once their induction is complete. Orchard Close (4 ) DS0000031851.V364736.R01.S.doc Version 5.2 Page 26 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. Extracts may not be used or reproduced without the express permission of CSCI Orchard Close (4 ) DS0000031851.V364736.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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