Care Home: Prosignia Ltd

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What the care home does well Good pre admission planning and processes ensure people`s needs will be understood and can be met. People can be confident their needs are understood and care will be provided in line with their individual needs, wishes and preferences. They can be confident their personal information will remain confidential. People who live in the home are encouraged to be as independent as possible. They enjoy opportunities to take part in a range of training, social and leisure activities. They can be confident their personal and healthcare needs will be met in a way that respects their individual wishes and preferences and upholds their privacy and dignity. They are protected through safe systems for handling medication. People who live in the home are listened to; staff are trained to protect people from abuse. The safe, homely, well-equipped and clean environment enhances the quality of life of people who live in the home. They benefit from the support of the committed, and competent staff team who understand their needs and actively promote their best interests. Effective quality assurance systems promote year on year improvement in the service. People`s health and safety is promoted What has improved since the last inspection? This is the first inspection of this service to be carried out since people moved into the home. What the care home could do better: Policies and procedures and record keeping needs improvement to ensure people are fully protected and compliance with regulations and standards is achieved. CARE HOME ADULTS 18-65 Prosignia Ltd 14 Church Lane Avenue Coulsdon Surrey CR5 3RT Lead Inspector Ruth Burnham Unannounced Inspection 16th April 2008 09:00 Prosignia Ltd DS0000065332.V362284.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 Prosignia Ltd DS0000065332.V362284.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. Prosignia Ltd DS0000065332.V362284.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Prosignia Ltd Address 14 Church Lane Avenue Coulsdon Surrey CR5 3RT 01737 552 391 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) info@prosigniacare.co.uk www.prosigniacare.co.uk Prosignia Ltd Mr Mohammed Nunhuck Care Home 2 Category(ies) of Learning disability (2) registration, with number of places Prosignia Ltd DS0000065332.V362284.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th April 2006 Brief Description of the Service: Church Lane Avenue is a detached bungalow situated in a residential road on the outskirts of Coulsdon Village. It is within close proximity of a public bus service and the railway station. The home is registered for two service users with a learning disability. Facilities include two en-suite bedrooms, comfortably furnished lounge, wellequipped kitchen, activities room, laundry facilities and a well-maintained back garden. There are parking facilities to the front of the property. Fees for the home are currently £2150.00 per week Prosignia Ltd DS0000065332.V362284.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Commission has since the 1st April 2006, developed the way it undertakes its inspection of care services. This inspection of the Service was an unannounced “Key Inspection”. The Inspector arrived at the Service at 09:00 and was in the Service for six hours. It was a thorough look at how well the Service is doing. It took into account detailed information provided by the Service’s owner or manager and any information that CSCI has received about the Service since the last inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. There is one Required Development at the end of this Report. There are two people living in the home, both residents were in the home for part of the visit. Residents have limited speech and require intensive staff support; it was not possible therefore to speak directly with staff or residents during the visit. Judgements were therefore made through observation during the visit, direct contact by telephone with the residents’ Local Authority Care Managers and surveys to all parties before the visit. The manager assisted with the inspection during the visit and received feedback at the end of the process. A full tour of the premises was undertaken. Both care plans and two staff files were inspected. Nine responses were received to surveys sent out to people by the Commission before the visit. The manager also completed an Annual Quality Assurance Audit (AQAA) for the Commission; this was used as part of the inspection. The inspector would like to thank the residents, the manager and staff members for their time, assistance and hospitality during the inspection. What the service does well: Good pre admission planning and processes ensure people’s needs will be understood and can be met. People can be confident their needs are understood and care will be provided in line with their individual needs, wishes and preferences. They can be confident their personal information will remain confidential. People who live in the home are encouraged to be as independent as possible. They enjoy opportunities to take part in a range of training, social and leisure activities. They can be confident their personal and healthcare needs will be met in a way that respects their individual wishes and preferences and upholds their privacy and dignity. They are protected through safe systems for Prosignia Ltd DS0000065332.V362284.R01.S.doc Version 5.2 Page 6 handling medication. People who live in the home are listened to; staff are trained to protect people from abuse. The safe, homely, well-equipped and clean environment enhances the quality of life of people who live in the home. They benefit from the support of the committed, and competent staff team who understand their needs and actively promote their best interests. Effective quality assurance systems promote year on year improvement in the service. People’s health and safety is promoted What has improved since the last inspection? 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. Prosignia Ltd DS0000065332.V362284.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 Prosignia Ltd DS0000065332.V362284.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): 1&3 People who use the service experience adequate outcomes in this area. The manager is currently reviewing written information about the home to ensure people who may consider moving into the home in the future and their representatives can understand what the home is like to help them decide if the home will be suitable for them. Good pre admission planning and processes ensure people’s needs will be understood and can be met although records have not been retained in line with regulations. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There are 2 people living in the home who have been admitted since the home opened in 2006. The manager is currently updating information about what life is like in the home to include photographs and make it more accessible for the people who currently live in the home and anyone who may consider moving to the home in the future. Information is contained in the statement of purpose and service user guide, which are currently under review, the manager agreed to send copies to the Commission once completed. Although there are no written assessment procedures and no record of the admission process it was clear that both the people who live in the home had been admitted following an individualised programme of familiarisation and assessment. Both Care Managers from the local authority responsible for Prosignia Ltd DS0000065332.V362284.R01.S.doc Version 5.2 Page 9 placement and funding were contacted as part of the inspection. They were full of praise for the service and very satisfied with the success of the admissions process for each of their clients. The manager described how he and other staff members had visited each person before they moved in. Each person had staff support from their previous placements when they first moved into the home, the level and duration of this support was tailored to individual need. Unfortunately documentation from this time has not been retained by the home and the manager was advised that all records must be retained in line with the Care Homes Regulations. Prosignia Ltd DS0000065332.V362284.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): 6,7,9 & 10 People who use the service experience good outcomes in this area. People can be confident their needs are understood and care will be provided in line with their individual needs, wishes and preferences. People can be confident their personal information will remain confidential. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Each person who lives in the home has an individual plan of care. Care plans are developed with the involvement of residents, care managers and relevant healthcare professionals. Care plans are detailed and take account of individual needs, abilities and choices, they provide clear guidance to staff on how to provide care. They are reviewed regularly and updated to reflect changing needs. Formal reviews are carried out with the person’s care manager each year. People can be confident their needs will continue to be met. Local Authority Care managers who were spoken to were very happy with the care provided and commented on the improvement they have seen in their Prosignia Ltd DS0000065332.V362284.R01.S.doc Version 5.2 Page 11 clients since admission to the home. They also commented on the respect health care services have for the manager’s knowledge and understanding of how to manage peoples’ specific conditions such as autism. People’s needs are complex, varied and can be challenging. They have limited verbal communication skills; however staff seen on the day of the inspection clearly know the residents very well and understand how each person prefers to communicate. Each person was engaged in some activity during the visit including going out for lunch. Support is offered and provided discreetly in a way that promotes privacy and dignity. All interaction observed was respectful, good humoured and kind. People’s right to make decisions about how they wish to live their lives are respected. People are supported to make decisions in a number of ways. Each resident has one to one, and sometimes two to one support. Staff know the resident well and understand their needs. Photographs and pictures are used to help people make choices; photographs are used to help people choose meals. Life skills are being developed through involvement in household chores. Both residents are supported to maintain contact with relatives who are able to visit the home and spend time with them. One person is supported to keep in touch with people where he lived before moving to this home. The home facilitates visits and encourages staff from the previous residence to maintain contact. People are protected from harm through good risk management processes for all activities. The manager is developing risk assessments further to include all aspects of daily life. People can be confident their personal information remains confidential. Personal information is stored securely and is available solely to authorised and appropriate people. Prosignia Ltd DS0000065332.V362284.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): 11 – 17 People who use the service experience good outcomes in this area. People who live in the home are encouraged to be as independent as possible. They enjoy opportunities to take part in a range of training, social and leisure activities. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People are supported to be as independent as possible. They are actively encouraged to make their own choices and to live their lives as they wish, so far as they are able. Records seen indicate that religious and cultural needs are known and respected. Regular trips are also organised to places of interest to residents. Each person has their own activity plan detailing activities they enjoy. Staff support people to use local services such as hairdressers, pubs, leisure centres and local restaurants. Prosignia Ltd DS0000065332.V362284.R01.S.doc Version 5.2 Page 13 People are supported to maintain contact with family and friends; visitors are welcome in the home at all reasonable times. Peoples’ privacy is respected. Observation of staff during the visit shows they are committed to promoting the interests of people who live in the home. Interaction observed during the visit was warm, supportive and respectful. Staff know the residents well and understand their needs. People who live in the home are involved in choosing meals through the use of a pictorial menu. People have their nutritional needs assessed and menus are planned in consultation with them. A record of food provided has not so far been maintained in line with regulations however the manager agreed to implement this immediately. Prosignia Ltd DS0000065332.V362284.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 – 20 People who use the service experience good outcomes in this area. People who live in the home can be confident their personal and healthcare needs will be met in a way that respects their individual wishes and preferences and upholds their privacy and dignity. They are protected through safe systems for handling medication. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People who live in the home are provided with care in a way that respects their individual wishes and preferences and upholds their privacy and dignity. Routines are flexible and relevant within the context of peoples’ individual needs and abilities. People are able to choose when to go to bed and when to get up and are supported to choose their own clothes, hairstyles and other aspects of personal grooming. People are supported with their healthcare needs. The manager is developing an individual health action plan for each person; currently health is monitored through daily records. Visits are arranged to the local G.P and people have regular health checks. The manager said short-term care plans are developed Prosignia Ltd DS0000065332.V362284.R01.S.doc Version 5.2 Page 15 prior to appointments to prepare people and ensure the success of these visits. People are supported in the same way to access other healthcare professionals where necessary, including dentists and opticians. Where people have specialist healthcare needs, the home liaises with specialist healthcare professionals to ensure they receive the best possible care. People are protected from harm through the safe handling of medication. Medication is managed through a monitored dosage system. Where medication is only used periodically as required there are clear administration procedures in place. Medicines are stored securely and records seen were well maintained and up to date. Prosignia Ltd DS0000065332.V362284.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 outcomes in this area. People who live in the home are listened to, staff are trained to protect people from abuse. Where the home carries out financial transactions on behalf of residents adequate records have not been maintained for their protection. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staff know and understand how people communicate and recognise when they are unhappy. People are listened to and action is taken to ensure any unhappiness is addressed. This is evidenced by the improvement in residents’ wellbeing and the decrease in incidents of challenging behaviours since they have moved into the home. There has been one complaint from a neighbour, this was resolved satisfactorily and the Commission was kept informed throughout the process. People who were contacted as part of the inspection said they had no complaints but would know who to talk to if they were concerned about anything. There is a clear complaints procedure. People who live in the home can be confident they are protected from abuse. All staff have completed training in safeguarding vulnerable adults. All staff are checked through the Criminal Records Bureau before appointment. It was not possible to inspect financial records where the home acts on behalf of residents at this visit as these were not available. Prosignia Ltd DS0000065332.V362284.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 – 30 People who use the service experience good outcomes in this area. The safe, homely, well-equipped and clean environment enhances the quality of life of people who live in the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People who live in the home benefit from the homely environment and family atmosphere. The home is well furnished and each resident has their own room. All accommodation is on the ground floor; communal areas of the home include a lounge and an activities/music room. There is a small office. There is a small dining table in the kitchen where residents eat. People benefit from access to the garden, there are plans to further improve this area this year to make it more user friendly for the people who live in the home. The home was warm and clean throughout. People are encouraged to personalise their bedrooms, these have been furnished and equipped to meet Prosignia Ltd DS0000065332.V362284.R01.S.doc Version 5.2 Page 18 individual needs. Each person has their own en-suite bathroom and toilet facilities. There is a small, suitably equipped laundry area. Prosignia Ltd DS0000065332.V362284.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 – 36 People who use the service experience good outcomes in this area. People who live in the home benefit from the support of the committed, and competent staff team who understand their needs and actively promote their best interests. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People who live in the home benefit from the support of the well trained staff team. Staff clearly have a good understanding of peoples’ needs. All interaction throughout the inspection was warm and respectful. There is a high level of commitment to promoting the best interests of people who live in the home. There are enough staff available to meet peoples’ needs. On the day of the site visit there was one to one staff support for each resident, this is the minimum staffing level provided, for specific activities two to one staff support is provided. People who live in the home are protected through robust procedures, which include checks through the Criminal Records Bureau and taking up 2 written Prosignia Ltd DS0000065332.V362284.R01.S.doc Version 5.2 Page 20 references prior to appointment. Two staff files were examined. These were up to date and well maintained. People who live in the home can be confident staff are well-supervised and competent to carry out their duties. The majority of staff have NVQ qualifications at Level 2, 3 or 4. All staff undertake additional training relevant to understanding the specific needs of the people they care for. Refresher training is arranged regularly for all mandatory training. All staff have regular formal supervision sessions and all new staff complete a formal induction programme. Prosignia Ltd DS0000065332.V362284.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 People who use the service experience good outcomes in this area. Effective quality assurance systems promote year on year improvement in the service. People’s health and safety is promoted. Policies and procedures and record keeping needs improvement to ensure people are fully protected and compliance with regulations is achieved. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager is highly qualified to postgraduate level in management and learning disability. This is the first inspection of the home since residents were admitted. Social care professionals with responsibility for current residents were full of praise for the service and spoke of significant improvement in their clients’ quality of life since they moved into the home. Prosignia Ltd DS0000065332.V362284.R01.S.doc Version 5.2 Page 22 They also spoke of the high regard health care professionals have for the management of the service. People are benefiting from the ongoing programme of improvements where the service is being adapted to meet the individual and changing needs of the residents. People are involved as far as possible in decisions about how the home is managed. The assistant manager completed the Annual Quality Assurance Audit for the Commission as part of the inspection. This shows improvements that have already been made and further improvements, which are planned, in the coming year. It also shows that people are protected and their health and safety is promoted through good fire safety systems and regular safety checks. There was some concern that portable appliance testing had not yet been carried out however the manager is arranging this in the next week. Records seen during the visit were sparse. It is unfortunate that the manager has not retained a number of records such as admission documentation, records of meals and records of financial transactions carried out on behalf of residents. Where records such as care plans have been changed and updated, previous records have not been retained leaving no audit trail. The majority of records examined had not been dated. It was of particular concern that there were no records where the home acts on behalf of residents in relation to their finances. The manager explained that relatives transfer monies into residents’ accounts for the home to administer. All records of transactions along with receipts are sent to the relatives and copies have not been retained in the home. The manager agreed to address all these issues and ensure relevant records are kept in the home in future in line with the Care Home’s Regulations. However we are confident the current situation in relation to record keeping is not having a negative impact on outcomes for residents Staff have access to a full range of policies and procedures however these are generic having been purchased as a package. Specific policies and procedures asked for during the inspection could not be located within this very large lever arch folder. The manager agreed to revise relevant policies and procedures to make them specific to the service and more easily accessible to staff. People are protected from harm through safe working practices. all staff receive training in basic food hygiene, first aid, moving and handling, health and safety, fire safety and infection control. Prosignia Ltd DS0000065332.V362284.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 3 2 x 3 2 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 3 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 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 3 3 x LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 3 x 3 2 2 3 x Prosignia Ltd DS0000065332.V362284.R01.S.doc Version 5.2 Page 24 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 YA3 YA23 YA41 Regulation 17 Requirement (1) The registered person shall (a) maintain in respect of each service user a record which includes the information, documents and other records specified in Schedule 3 relating to the service user; (2) The registered person shall maintain in the care home the records specified in Schedule 4. (3) The registered person shall ensure that the records referred to in paragraphs (1) and (2) (a) are kept up to date; and (b) are at all times available for inspection in the care home by any person authorised by the Commission to enter and inspect the care home. (4) The records referred to in paragraphs (1) and (2) shall be retained for not less than three years from the date of the last entry. Timescale for action 30/06/08 Prosignia Ltd DS0000065332.V362284.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 Refer to Standard YA40 Good Practice Recommendations Policies and procedures should be revised to be specific to the service and include all policies listed in appendix D of the standards. They should be easily accessible to staff. Prosignia Ltd DS0000065332.V362284.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Prosignia Ltd DS0000065332.V362284.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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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