Care Home: Richford Gate, 52

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What the care home does well The staff team at 52 Richford Gate provide individualised support to people with moderate learning disabilities, who have a range of needs and differing levels of independence. Service users take part in a wide range of activities, including attendance at day services, projects and adult education, as well as leisure and social activities. Service users enjoy individual annual holidays supported by staff, including trips abroad. Service users are encouraged to be involved in the running of the home, through regular house meetings, daily discussion and through the use of accessible documents. In spite of staff vacancies and acting arrangements, staff work well together to ensure a consistent service. The Acting Manager provides leadership to the staff team and has established high standards of record keeping and communication. Staff receive a thorough induction to the service. Staff have access to an established training programme, including NVQs and to regular staff meetings and supervision. What has improved since the last inspection? One new person has moved to Richford Gate since the last inspection. The project is now full. The admission process went well and the new service user seems to have settled into her new life. Staff at Richford Gate would have benefited from having fuller information about the person`s social history and Richford Gate, 52 DS0000019146.V374831.R01.S.doc Version 5.2 background to assist their work with her but this was not provided by the local authority, although requested. Monthly summaries provide a regular review of developments and progress. Risk assessments are detailed and provide new and existing staff with essential information. Staff continue to develop the use of multi media to support service users` communication. A check to control the risk of Legionella has take place. The fire detection alarm panel has been replaced. What the care home could do better: The management arrangements at the service need to be confirmed, with a permanent Manager appointed who is put forward for registration. Visits on behalf of the provider must take place as required by regulation 26, with a report made available promptly. Although some improvements to the environment have taken place with the purchase of some new furniture and equipment, no decision has been reached regarding the installation of air conditioning. Staff are concerned about keeping service users comfortable over the summer, particularly as one service user is having regular health treatment. Key inspection report CARE HOME ADULTS 18-65 Richford Gate, 52 52 Richford Gate Richford Street Hammersmith London W6 7HZ Lead Inspector Sheila Lycholit Unannounced Inspection 22nd April 2009 10:00 Richford Gate, 52 DS0000019146.V374831.R01.S.doc Version 5.2 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care home adults 18-65 can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop. The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Richford Gate, 52 DS0000019146.V374831.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Richford Gate, 52 DS0000019146.V374831.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Richford Gate, 52 Address 52 Richford Gate Richford Street Hammersmith London W6 7HZ 020 8749 0307 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@yarrowhousing.org.uk Yarrow Housing Acting Manager Leroy Muhammad Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Richford Gate, 52 DS0000019146.V374831.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 categories: 2. Learning disability - Code LD The maximum number of service users who can be accommodated is: 8 28th April 2008 Date of last inspection Brief Description of the Service: 52/53 Richford Gate is a registered care home providing support and accommodation for eight men and women with a moderate learning disability. The service is provided by Yarrow Housing, in a building owned by Kensington Housing Trust. The home, which is comprised of two separate flats, is well located, close to facilities in the local community and the shops and transport links of Shepherds Bush and Hammersmith. The building provides accommodation on two floors and is not accessible to people with mobility difficulties. Each service user has a single room. The accommodation does not have its own garden. Richford Gate, 52 DS0000019146.V374831.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means that the people who use this service experience good quality outcomes. The unannounced visit took place on Wednesday 22nd April 2009 from 10am until 3.30pm. One service user, a support worker and the domestic assistant were in the flats at the start of the visit. All of the other 7 service users were at day services or attending other activities. Two other support staff were on duty with service users in the community. Two service users returned at lunchtime and all three went to The Gate next door for the music open day. The Acting Manager, who was on a rest day, had completed an annual quality assurance assessment in detail. Discussion took place with him by telephone the following day. Support staff on duty assisted with the inspection providing access to records, information and explanation of practice. The afternoon handover was observed. What the service does well: What has improved since the last inspection? One new person has moved to Richford Gate since the last inspection. The project is now full. The admission process went well and the new service user seems to have settled into her new life. Staff at Richford Gate would have benefited from having fuller information about the person’s social history and Richford Gate, 52 DS0000019146.V374831.R01.S.doc Version 5.2 Page 6 background to assist their work with her but this was not provided by the local authority, although requested. Monthly summaries provide a regular review of developments and progress. Risk assessments are detailed and provide new and existing staff with essential information. Staff continue to develop the use of multi media to support service users’ communication. A check to control the risk of Legionella has take place. The fire detection alarm panel has been replaced. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. Richford Gate, 52 DS0000019146.V374831.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 Richford Gate, 52 DS0000019146.V374831.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 4 and 5 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Information about the service is well designed, comprehensive and regularly updated. An established admission procedure is in place, which fully involves the prospective service user. EVIDENCE: The individual files of 3 service users, including the person who moved to the house mostly recently, were looked at. The statement of purpose and service user’s guide were in an accessible format and had recently been updated. The service user’s guide includes information on how to make a complaint. Contracts and licence agreements were also available on file. A new person moved to the service in September 2008 and staff confirm that she has settle in well. Records show that staff at Richford Gate carried out an assessment, visiting her at her former placement in addition to the needs assessment provided by the Social Worker. Her transition to the service was planned over a period of time, following visits and overnight stays. Additional information would have been helpful to staff supporting her and although requested from Social Services, has not been provided. Richford Gate, 52 DS0000019146.V374831.R01.S.doc Version 5.2 Page 9 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8 and 9 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Person centred plans are being developed to a high standard, with the use of multi media to support service users’ involvement. Risk assessments are detailed and up to date and service users’ independence is supported wherever possible. EVIDENCE: Service users’ files and records show that considerable progress has been made in developing PCPs, using multi media. Review meetings and monthly summaries confirm that service users’ needs, progress and development are regularly re-assessed. Monthly summaries provide a clear record of developments during the previous 4 weeks, including contact with families, work and social activities and health care. Each of the 3 individual records looked at emphasised the independence of service users, with staff seeking ways to support people rather than curtail activities. Richford Gate, 52 DS0000019146.V374831.R01.S.doc Version 5.2 Page 10 Service users involvement in the house is supported through weekly house meetings, during which leisure activities and menus are agreed, as well as a range of other issues. Notes of the meetings are produced in an accessible format. Risk assessments are of a high standard, with detailed consideration of risks and of steps to support service users independence, while helping them to remain safe. Records show that staff are always present during family contact with one service user, although this was not clear in the risk assessment and profile. Further clarification in writing from the local authority would have been helpful to staff. Richford Gate, 52 DS0000019146.V374831.R01.S.doc Version 5.2 Page 11 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): This is what people staying in this care home experience: People using the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. 11, 12, 13, 14, 15, 16 and 17 Service users have a varied and individualised programme of work related, day centre, social and leisure activities. Good relationships with families and carers have been established and friendships are well supported. EVIDENCE: The activity programme and daily logs show that service users are supported to take part in a wide range of activities, including attendance at day services, projects and adult education colleges. Several service users have part-time work, including helping at Yarrow’s head office, for which payment is made. The advice of the multi professional learning disability team is sought where service users need psychological assessment or support. Staff reported that the behaviour of one service user, whose outbursts previously affected the life Richford Gate, 52 DS0000019146.V374831.R01.S.doc Version 5.2 Page 12 of the others in the flat, had improved with support to gain more insight and maturity. A decision not to go on holiday abroad was reversed following an improvement in behaviour. Service users independence is encouraged for example by travel training, and help with using a mobile phone and handling money. In addition to attendance at various day services, including The Gate next door, service users take part in social and leisure activities, including an annual holiday supported individually by staff. Outings and trips out are normally agreed at the weekly house meetings or may be decided individually. On the evening of the inspection visit, two people were planning to go to the cinema. Staff had printed out the local programme for them to choose which film to see. Good relationships are maintained with families and friends who regularly visit the flats. Some service users visit their families for overnight stays. Friendships and relationships are supported, for example by service users inviting friends back for a meal. Records show that staff counsel service users regarding personal relationships and establishing boundaries that feel right for them. Menus are chosen at weekly house meetings. Staff report that while they encourage healthy eating there is some resistance from service users, for example hot dogs are supplied for breakfast in spite of the high salt content. Meals except for the Monday takeaway are cooked from fresh ingredients. A supply of fresh fruit was available and the fridges had a choice of food properly stored and labelled. Sandwich makers have been purchased for each kitchen at the request of service users. Staff need to ensure that any unusable food such as green potatoes are thrown away. Richford Gate, 52 DS0000019146.V374831.R01.S.doc Version 5.2 Page 13 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Detailed support profiles are available, indicating staff’s good understanding of how service users wish to be supported. Excellent health action plans have been compiles for each service user, in an accessible format. Steps have been taken to improve the handling of medication. EVIDENCE: Support profiles give staff clear guidance on supporting service users with personal care. Only one person needs staff assistance, while others need prompting and encouragement for example regarding mouth care or bathing. Health action plans were seen for three people. Each was completed in detail, showing the involvement of the service user. Records show that service users are supported to attend regular health care appointments. One service user’s health is of concern and staff accompany her to regular appointments and treatment. Richford Gate, 52 DS0000019146.V374831.R01.S.doc Version 5.2 Page 14 Policies and procedures for handling medication are in place. Some service users take no medication while one person has a complex regime. No service users are currently self-medicating, although several have been assisted to handle their own medication in the past. Some medication errors have been made, which were reported to CSCI and action taken. Records show that following an investigation into medication errors, two staff were written to and reminded of the importance of following agreed procedures and of communicating clearly with colleagues. Richford Gate, 52 DS0000019146.V374831.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service has a well designed complaints procedure in an accessible format. All staff, including bank staff, receive training in safeguarding adults. Risk assessments show that a high priority is given to service users’ safety, while avoiding curtailing their independence. EVIDENCE: There are no recorded complaints since the last inspection. Service users views and any concerns are regularly sought at house meetings and in key working sessions. Training records show that staff have received training in safeguarding adults and in the Mental Capacity Act. Accessible information about abuse and staying safe is available for service users. One safeguarding meeting has taken place since the last inspection. Risk assessments show that staff take steps to keep service users safe by ensuring that people who can travel independently receive travel training and can use a mobile phone. Records show that staff check by phone when any service user does not return at the expected time. CSCI has been informed of any incidents, concerns or admissions to hospital. None of the service users is able to entirely manage their own finances, though some have developed some skills in handling money. The financial records of two people were looked, which show that receipts are kept for all purchases or cash given out. Accounts are regularly reconciled and Richford Gate, 52 DS0000019146.V374831.R01.S.doc Version 5.2 Page 16 the Acting Manager confirmed that service users’ finances are audited by Yarrow’s finance staff quarterly. Richford Gate, 52 DS0000019146.V374831.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Generally staff have created a homely environment, which is kept clean and tidy. The lack of ventilation, particularly in the summer months remains unresolved, with service users and staff having to endure exceptionally uncomfortable temperatures. EVIDENCE: Some new furniture and equipment has been purchased since the last inspection, including new sofas in flat 52, new sofa covers and curtains. A good standard of cleanliness is maintained by the part-time domestic assistant who has worked at the home for many years and by other staff. Bath and shower rooms would benefit from upgrading. The main concern regarding the building is the lack of ventilation in the summer. Windows at the back of the flats overlook the tube line, which is noisy, and a workshop and have to remain closed, causing temperatures in the Richford Gate, 52 DS0000019146.V374831.R01.S.doc Version 5.2 Page 18 summer to become very hot. Among others, the bedroom of one service user who has serious health problems is affected. Estimates for installing air conditioning have been obtained but no decision reached between Yarrow Housing and Kensington Housing Trust. Richford Gate, 52 DS0000019146.V374831.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 and 36 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Although the staff team has a number of vacant posts, staff work together to ensure a consistent approach to supporting service users. New staff receive a thorough induction to the service and have good access to training and supervision. EVIDENCE: Two new staff have started work at Richford Gate since the last inspection. Vacancies remain and are covered by bank staff, some of whom have worked at the service for a number of years and agency staff. In spite of vacancies and acting arrangements a cohesive staff team has developed. The afternoon handover was observed to which staff contributed. In discussion staff seemed motivated to provide consistent support to service users. Relationships between staff and service users observed during the inspection were warm and positive. New staff receive a structured induction to the service, including training held at Yarrow’s head office. One member of staff who had completed his induction and was waiting for his LDQ portfolio to be signed off, described his introduction to work at Richford Gate as ‘excellent’. Richford Gate, 52 DS0000019146.V374831.R01.S.doc Version 5.2 Page 20 Staff are recruited by Yarrow’s HR Team and Managers of Yarrow’s services. The HR Team carry out all recruitment and appointment checks including CRB checks, which are confirmed to the Manager. However the Manager does not receive confirmation, in spite of requesting it, of agency CRB checks. Staff have access to an established training programme. Training records show that mandatory training, including refresher training has taken place or is booked. The Manager estimates the current percentage of staff with NVQ2 or above to be 75 . This includes regular bank staff. Staff receive good support from the Acting Manager through Team Meetings and supervision. One regular bank staff confirmed that she also receives supervision. Detailed notes of Team Meetings are available, which provide a clear record of discussion for any staff unable to attend. Communication systems including handovers and logs are well recorded. Richford Gate, 52 DS0000019146.V374831.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 42 and 43 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Although the service is currently well managed, a permanent Registered Manager should be appointed. A quality assurance system that takes into account the views of service users and other stakeholders is in place. Health and safety is given a high priority. Visits on behalf of the provider are not taking place as frequently as required. EVIDENCE: The Deputy Manager, has been acting Manager since August last year, while the Registered Manager works at another service. The Acting Manager has achieved the Registered Managers Award and is experienced in working with people with a learning disability. Staff spoke highly of the support and Richford Gate, 52 DS0000019146.V374831.R01.S.doc Version 5.2 Page 22 guidance they receive from him. Because of the acting arrangements, the service is operating with only two senior staff instead of three. Management arrangements at the service must be resolved, with a permanent Manager appointed who is put forward for registration. A quality assurance system which seeks the views of service users and their families is in use and informs Yarrow Housing’s overall development plan, as well as the running of Richford Gate. Health and safety records are generally well kept. All staff attend training in health and safety during their induction period. A new fire detection system panel has been installed since the last inspection. Records show that the fire detection system is serviced 4 times a year. The alarm is tested weekly and fire drills take place 4 times a year. Some checks were not recorded in the log but were noted on the monitoring sheets. Hot water temperatures and fridge and freezer temperatures are checked regularly. A check for precautions against the risk of Legionella has taken place since the last inspection. The Manager confirms that staff were informed that risks were low as there is no stored hot water at the flats. Instructions on ensuring that shower heads are checked were given to staff. Records of visits on behalf of the provider indicate that visits take place less frequently than monthly and that reports are not always made available following a visit. Richford Gate, 52 DS0000019146.V374831.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 4 2 3 3 X 4 3 5 3 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 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 2 35 3 36 4 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 2 X LIFESTYLES Standard No Score 11 3 12 4 13 3 14 4 15 4 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 4 3 X 2 3 3 X X 3 2 Version 5.2 Page 24 Richford Gate, 52 DS0000019146.V374831.R01.S.doc 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 YA9 Regulation 13 Requirement Risk assessments and support profiles should give clear guidance to staff regarding supervised visits for one service user. Steps must be taken to ensure that service users live in a comfortable temperature, for example by the installation of air conditioning or improved ventilation. Yarrow Housing should provide the Manager with confirmation of CRB checks for all staff including agency staff. A permanent Manager should be appointed who is put forward for registration. Visits on behalf of the provider must take place at least monthly, with a report made available promptly. Timescale for action 31/05/09 2 YA24 23 31/05/09 3 YA34 19 31/05/09 4 5 YA37 YA43 8 26 30/06/09 31/05/09 Richford Gate, 52 DS0000019146.V374831.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. Refer to Standard Good Practice Recommendations Richford Gate, 52 DS0000019146.V374831.R01.S.doc Version 5.2 Page 26 Care Quality Commission London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG National Enquiry Line: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). 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