Care Home: Tarrant House

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What the care home does well The registered persons provide a good quality home for the people who live there. People who use the service are positive regarding care and support received. Our Expert by Experience said if he needed to go into a residential home he would not mind moving into this one. People who use the service have a range of day opportunities available to them, and the home has a minibus. One person also has their own car. Facilities are to a high standard for example bedrooms are spacious furnished to a good standard and are individualised. Staff seem professional, organised and competent. Records, recruitment practices, and staff training are to a good standard. What has improved since the last inspection? The registered providers continue to provide a good service to people living at the home. The owners continue to maintain and upgrade decorations and furnishings as required. What the care home could do better: CARE HOME ADULTS 18-65 Tarrant House Perrancombe Perranporth Cornwall TR6 0JB Lead Inspector Ian Wright Unannounced Inspection 16 and 17 September 2008 09:15 th th Tarrant House DS0000009093.V370722.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 Tarrant House DS0000009093.V370722.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. Tarrant House DS0000009093.V370722.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Tarrant House Address Perrancombe Perranporth Cornwall TR6 0JB 01872 572214 01872 572214 tarrant@belhay.aol.com 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) Mrs Maureen Joy Tarrant Mr Steven Jon Tarrant Mrs Shirley Joy Taylor Care Home 7 Category(ies) of Learning disability (7) registration, with number of places Tarrant House DS0000009093.V370722.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15th December 2006 Brief Description of the Service: Tarrant House provides residential care for seven adults with a learning disability. Some of the people who use the service are diagnosed as autistic. Mr Steven and Mrs Maureen Tarrant are the registered persons. Mrs Shirley Taylor is the registered manager. The home is situated in Perrancombe and is approximately two miles from Perranporth. Accommodation is provided mostly on the first floor, although a few bedrooms and the office are on the ground floor. People who use the service have access to a lounge, dining area and kitchen. There is sufficient car parking to the front of the property. A copy of the inspection report is available in the office, and it is suggested a copy is requested from management or CSCI if required. Individual copies of the service user guide are also available in people’s bedrooms. The range of fees at the time of the inspection is £560-1022 per week. There are additional charges e.g. for hairdressing, chiropody, and newspapers etc. Tarrant House DS0000009093.V370722.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 the people who use this service experience good quality outcomes. This Key Inspection took place in just over ten hours over two days. All of the Key Standards were inspected. The methodology used for this inspection was: • To case track three people who use the service. This included, where possible, meeting and discussing with them their experiences, and inspecting their records. • Discussing with staff their experiences working in the home. • Discussion with other people who use the service and their representatives. • Observing care practices. • Discussing care practices with management. • Inspecting records and the care environment. An ‘Expert by Experience’ assisted the inspector with part of the inspection. This person has used learning disability services, and was able to provide us with a view of the service from the perspective of a person who may use it. Other evidence gathered since the previous inspection, such as notifications received from the home (e.g. regarding any incidents which occurred), was used to help form the judgements made in the report. What the service does well: The registered persons provide a good quality home for the people who live there. People who use the service are positive regarding care and support received. Our Expert by Experience said if he needed to go into a residential home he would not mind moving into this one. People who use the service have a range of day opportunities available to them, and the home has a minibus. One person also has their own car. Facilities are to a high standard for example bedrooms are spacious furnished to a good standard and are individualised. Staff seem professional, organised and competent. Records, recruitment practices, and staff training are to a good standard. Tarrant House DS0000009093.V370722.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: There are two statutory requirements. Action is required by law within the timescales set: • The adult safeguarding procedure needs amendment to state the Department of Adult Social Care is the co-ordinating agency regarding any safeguarding issues. This is a policy amendment, and there are no concerns regarding adult safeguarding issues. Staff must not commence employment until a satisfactory Protection of Vulnerable Adults ‘First’ check has been received. • Our Expert by Experience thought this was a good service, and enjoyed the visit. He said the use of pictures should be more encouraged as a form of communication due to people living in the home lacking literacy skills. These could be used to help people understand their daily timetable, what they would like to eat and what is on the menu for the day’s meals. Some further work may also be helpful to encourage to staff work more as enablers rather than just doing things for people. 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. Tarrant House DS0000009093.V370722.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 Tarrant House DS0000009093.V370722.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, 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Assessment information obtained about people who use the service prior to admission, and information issued to people when they move in is good. This helps to ensure people’s needs are met, and suitable information is issued regarding people’s rights and responsibilities. EVIDENCE: The registered manager said people who use the service are issued with a contract of care / statement of terms of conditions of residency when they are admitted. Copies of these were inspected. Copies of pre admission assessments were also inspected and these were comprehensive. A copy of the registered persons’ assessment policy was also inspected and this is satisfactory. The assessment process includes the person visiting the home; which is very important to ensure the home is suitable for the person intending to move in. Tarrant House DS0000009093.V370722.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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who live in the home appear to have their individual needs and choices met so they should be able to live a life style according to their wishes and needs. EVIDENCE: Each person has a care plan, and there is evidence these are reviewed appropriately. People who use the service appear to be encouraged to make decisions regarding their lives where possible. Suitable risk assessments are in place to assess any risks or actions to promote independence. The registered persons look after some people’s monies, for which suitable records are maintained. The registered person’s act as an agent for financial benefits / saving accounts for some people’s monies for which suitable records are kept. People who use the service told the Expert by Experience that they can go out shopping for personal items and can have their own money when they need it. Our Expert by Experience said staff should make sure people using the service have access to advocacy services if they need these. Tarrant House DS0000009093.V370722.R01.S.doc Version 5.2 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Suitable opportunities for activities, educational opportunities and contact with the wider community are provided so people have the opportunity to live a varied lifestyle. Food provided appears to be to a good standard. EVIDENCE: People who use the service said they have a range of activities. Care plans and daily records illustrate people have a variety of opportunities available to them on a regular basis. The registered persons have a minibus to help people to move around the community and to go out on social trips. Our Expert by Experience said there should be more pictures of people’s daily activities to help people to understand what their daily timetable is. People who live in the home are also due to go on holiday shortly. People have the choice to go, some have chosen to stay at home and this has been respected. Tarrant House DS0000009093.V370722.R01.S.doc Version 5.2 Page 11 People who use the service said they visit friends and relatives regularly, and they are encouraged to maintain contact via the telephone or post. Visiting arrangements are flexible, and there is suitable space for people to receive visitors privately. Our Expert by Experience was told all the people using the service have family contact. Some people go to stay with relatives or go just to visit them for the day. People using the service said they could have their friends to visit but tend not to do this. People using the service can use the home’s phone, this can be taken to their bedrooms to ensure privacy and no charge is made for calls. People who use the service said they could get up and go to bed when they wish. However staff finish their duty at ten o’clock each evening so people may need to go to their bedrooms at this time- to watch TV etc. even if they do not wish to go to sleep. The manager said people tended not to want to stay up late anyway. Some people who use the service may also need reminding to get up on the days e.g. when they attend the day centre. People who use the service said staff worked with them in a way, which respected their privacy and dignity. People who use the service have some involvement in household tasks for example doing laundry, some cleaning tasks etc. Food provided appears to be to a good standard. People who the inspector spoke to said food is to a good standard. Suitable records are maintained regarding food provided. Our Expert by Experience was told that people living in the home can help in the kitchen, but currently no one is allowed in the kitchen on their own. The kitchen is usually locked for health and safety reasons when not in use. People using the service should be encouraged to use the kitchen on their own if it is safe for them individually to do so. However, it is understood that many people living in the home may need further help to develop their skills before they can do this. Our Expert by Experience was told that there are daily menus which the staff help the people using the service to choose what they would like. The use of pictures should be encouraged to help people choose what they want to eat, and also to help people living in the home know what meals will be available that day /week. There are suitable laundry facilities. Laundry tends to be done by staff. Again people using the service should be encouraged to use these facilities if it is possible for them to do so. Tarrant House DS0000009093.V370722.R01.S.doc Version 5.2 Page 12 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Personal and health care support is delivered to a good standard, and there are suitable links with medical professionals. The management of medication is to a good standard. People who use the service, and their representatives therefore should be able to be assured personal and health care needs are suitably met. EVIDENCE: People who use the service said they receive suitable care and support from staff. Any personal care needs are clearly documented in care plans, and staff seem clear regarding what assistance people require. Care plans document appropriate links with GP’s, dentists, chiropodists and other professionals. People who use the service said they regularly saw medical professionals when required. Our Expert by Experience was told all people using the service could see a doctor when they need one. The Expert was told some women who use the service may not tolerate some health checks e.g. smear tests, so they currently may not have them. The manager of Tarrant House DS0000009093.V370722.R01.S.doc Version 5.2 Page 13 the home said she is working with NHS professionals to assist people using the service to make a more informed choice in this area. The Expert by Experience was told people using the service could have a massage from a masseur if they wish, and a chiropodist regularly visits. Medication is stored securely, and dispensed via a ‘monitored dosage system’. Medication records kept are appropriate. There is a suitable medication returns system. Staff have received suitable training regarding the handling of medication. Tarrant House DS0000009093.V370722.R01.S.doc Version 5.2 Page 14 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 generally good. This judgement has been made using available evidence including a visit to this service. There is a suitable complaints procedure but some amendment is required to the adult safeguarding procedure. Practice regarding dealing with complaints and adult safeguarding issues however appears appropriate. Subsequently people who use the service, and their representatives can be assured there are appropriate procedures to deal with any concerns or bad practice. EVIDENCE: The registered persons have a satisfactory procedure regarding dealing with complaints. Information regarding the complaints procedure is included in the home’s service user guide. A copy of this document is in each person’s bedroom. The registered persons have an adult safeguarding procedure. This requires some amendment so it is in line with safeguarding procedures in Cornwall. For example allegations must be reported to Cornwall County Council’s Department of Adult Social Care who will act as the co-ordinating authority for the investigation of any allegations. The registered persons should not investigate any allegations, beyond basic information gathering, unless delegated by social services to do so. The majority of staff have also attended training regarding the prevention of abuse. Staff and people who use the service all said they had not witnessed any bad or abusive practices. All staff have Criminal Record Bureau check, and a Protection of Vulnerable Adults check (where applicable). Staff however should not commence employment until a POVA First check is obtained. Tarrant House DS0000009093.V370722.R01.S.doc Version 5.2 Page 15 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Tarrant House provides a pleasant, homely, clean and well-maintained environment for people who use the service. EVIDENCE: The building was inspected. The building appears to be well maintained, clean, pleasantly decorated and homely. There is a pleasant garden, which people living at the home can use. Our Expert by Experience said ‘the home is very nice, it does not feel like a residential home. The home is clean and tidy and does not have any bad smells’. All communal rooms are homely and comfortable. There is a lounge, and a dining room. The lounge is well carpeted, the furniture is clean and tidy, and there is a fish tank and a parrot in a cage. There is a personal computer which people using the service can use. There is also cable TV, a DVD and a video. There is also a conservatory which is also used for recreational activities e.g. board games/ arts and crafts. Tarrant House DS0000009093.V370722.R01.S.doc Version 5.2 Page 16 Our Expert by Experience would recommend that there are more pictures of people around the home showing the different activities they do. He felt that though people’s bedrooms are very personal, the rest of the home could be developed to reflect the people who live there. People living in the home were keen to show the Expert by Experience their belongings. Subsequently having photo’s in communal areas would be good to personalise the home more. Bedrooms are to a good standard. They are spacious, individualised and comfortable. People told our Expert by Experience that they can chose how their bedrooms are decorated, and can have personal things in their bedrooms which they like. For example one person likes butterflies and another likes Labrador dogs, so they have lots of things according to these interests. There are sensory lights in some bedrooms to help people to relax. All people have TV’s in their bedrooms. One person has a TV, freeview box and DVD. Decorations throughout the home are to a good standard. There are suitable toilet facilities for communal use, and these are situated near to people’s bedrooms. Two people also have their own bathrooms in their bedrooms. Suitable kitchen and laundry facilities are provided. The home was clean and hygienic at the time of inspection. Tarrant House DS0000009093.V370722.R01.S.doc Version 5.2 Page 17 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 Quality in this outcome area is generally good. This judgement has been made using available evidence including a visit to this service. Staffing levels, recruitment checks and staff training appear to be to a suitable standard. However improvement is required to ensure staff do not commence employment until they receive a Protection of Vulnerable Adults check (POVA First). Generally, however, people who use the service receive appropriate staff support from suitably recruited and trained staff. EVIDENCE: The Expert by Experience said he felt staff were friendly and talk nicely to the people living in the home. Rotas show at least three members of staff are on duty from 08:00 to 22:00. Two staff sleep in between 2200 and 0800. A cleaner is also employed. The registered manager also works in the home. Mr Tarrant visits the home on a regular basis. Our Expert by Experience thought staff seemed very caring. He thought staff could possibly be encouraged to do more things with people (i.e. as supporters and enablers) rather than just for people. Tarrant House DS0000009093.V370722.R01.S.doc Version 5.2 Page 18 The registered persons have a suitable approach to providing National Vocational Qualifications (NVQ) or the Learning Disabilities Qualification (LDQ) for care staff. Recruitment records were inspected. These were generally to a good standard. Records obtained include an application form, two references, a record of staff induction, a protection of Vulnerable Adults ‘First’ check (POVA First) and a Criminal Records Bureau check (CRB). However, it is essential staff do not commence employment until a POVA First check has been completed. It is illegal to recruit someone who is on the Protection of Vulnerable Adults list (A list of people deemed unsuitable to work with vulnerable adults) and this must be checked. From the records inspected some staff commenced employment before the results of this check was returned. The registered persons said they would ensure this check was completed appropriately in future. The registered manager said where staff are awaiting their subsequent full CRB check, they are supervised, and do not participate in any personal care duties. Suitable induction records were available for all staff. We spoke to one member of staff who said their induction included shadowing more experienced staff; formal instruction from management and viewing videos/ DVD’s regarding various issues. Staff training required by regulation is to a good standard. Staff appear to have received most training required by regulation (i.e. first aid certificate (at appointed persons level), training in manual handling, fire training, infection control training and food handling). If this training has not been received there is a suitable plan in place so staff will receive this training shortly. Staff also receive training regarding epilepsy and autism. Tarrant House DS0000009093.V370722.R01.S.doc Version 5.2 Page 19 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, 42 Quality in this outcome area is good. Management appears to be professional, well organised and supportive. This will help to ensure people who use the service receive a good quality service that meets their needs. EVIDENCE: The registered persons appear caring, approachable and competent. Staff and people who use the service were positive about their approach. There is a suitable approach to quality assurance. Surveys to ascertain the views of stakeholders involved in the service were completed in 2007. A survey will be completed again shortly. Letters of appreciation e.g. from relatives are maintained on file. There are also regular meetings with people who live in the home, and also staff meetings. There is a good system of regular audit of issues such as training, health and safety, complaints etc. The registered persons ensure all aspects of the service are maintained to a good standard, for example as evidenced in this report. Before the inspection, the registered provider supplied the commission with a copy of the company business plan, which outlines plans for the service’s development over the next year. Tarrant House DS0000009093.V370722.R01.S.doc Version 5.2 Page 20 The registered persons have a suitable health and safety policy. Regular health and safety checks are completed. Other records kept of checks required by regulation are satisfactory. For example there are suitable records of the testing of fire equipment, gas appliances, portable electrical appliances and the electrical hardwire circuit. Accident records are suitably maintained. Health and safety risk assessments are satisfactory including a suitable system regarding the prevention of Legionella. However, some risk assessments may need reviewing as they have not been reviewed in the last year. Suitable insurance cover was available for inspection. Tarrant House DS0000009093.V370722.R01.S.doc Version 5.2 Page 21 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 3 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 4 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Tarrant House DS0000009093.V370722.R01.S.doc Version 5.2 Page 22 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 YA23 Regulation 10, 12, 13, 19 Requirement The registered provider must update its adult safeguarding policy to state Cornwall County Council’s Department of Adult Social Care is the coordinating agency regarding any investigations of suspected abuse. This will help provide more assurance that agreed multi agency procedures will be followed when necessary. New staff must not commence employment until a Protection of Vulnerable Adults POVA ‘First’ check has been completed. This will ensure the person is not on the POVA list; which means they are forbidden with working with vulnerable adults. Timescale for action 01/11/08 2 YA23 YA34 7, 17, 18,19 01/11/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Good Practice Recommendations DS0000009093.V370722.R01.S.doc Version 5.2 Page 23 Tarrant House 1. Standard YA18 YA8 Encourage the use of pictorial communication methods more e.g. with menu planning, activity plans etc. to help people living in the home understand more about what they will eat, what they will do etc. during the day. Encourage the use of advocacy services where appropriate. Look at developing further ways the staff team can do tasks with people (as supporters and enablers) rather than only for people. 2. 3. YA8 YA11 YA31 Tarrant House DS0000009093.V370722.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA 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 Tarrant House DS0000009093.V370722.R01.S.doc Version 5.2 Page 25 - 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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