Care Home: Wisteria Lodge

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What the care home does well The home is now full and the residents we spoke with said they were very happy living at the home and praised the staff and manager. We saw very good interaction between residents and care staff and there was a relaxed and positive atmosphere present in the home. All residents have their needs fully assessed and all staff are well trained and can meet the specialist needs of each individual in an appropriate manner. We found that residents were all supported to remain as independent as possible and were encouraged to make their own choices about how they spend their days. The home is very well decorated and furnished and provides a comfortable and homely environment for the people who live there.Wisteria LodgeDS0000071460.V376919.R01.S.docVersion 5.2 What has improved since the last inspection? Care plans have been completed for all the new residents and these are detailed and contain some thorough risk assessments to ensure the safety of the people who live in the home. Staff have received a lot of training courses and all staff have received training in diabetes care. Thorough induction training has been provided for new staff. What the care home could do better: Some more detailed risk assessments are needed for the new resident who smokes cigarettes and care planning should now be in a person centred format for all residents so that individual aims and goals can be clarified and outcomes monitored. More thorough procedures for staff recruitment must be implemented to ensure the continued safety of residents in the home. Key inspection report CARE HOME ADULTS 18-65 Wisteria Lodge 24 Brookdene Avenue Oxhey Hertfordshire WD19 4LF Lead Inspector Pat House Key Unannounced Inspection 8th July 2009 11:00 Wisteria Lodge DS0000071460.V376919.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. Wisteria Lodge DS0000071460.V376919.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 Wisteria Lodge DS0000071460.V376919.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Wisteria Lodge Address 24 Brookdene Avenue Oxhey Hertfordshire WD19 4LF 01923 350553 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) Tin Fah Chan Wan Fong Tin Fah Chan Wan Fong Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Wisteria Lodge DS0000071460.V376919.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following categories 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: Learning Disability - Code LD The maximum number of service users who can be accommodated is 4 2. Date of last inspection 7th August 2008 Brief Description of the Service: The home has four bedrooms, all for single occupancy for those with a learning disability. One bedroom is situated on the ground floor and three are on the first floor. The house has two floors but no passenger lift and so three rooms would be unsuitable for those with a physical disability. The ground floor bedroom has en-suite facilities and all the first floor rooms have wash hand basins. There are steps to the front door of the house and ramped access via the rear of the property. The home has an open plan lounge/dining room and domestic style kitchen. There is a large garden to the rear of the house. The home is an adapted and extended house, situated on a main road in Oxhey, which is a residential area of Watford. There is a small driveway outside and there is unrestricted parking available in the road. There are local shops nearby and the town of Watford, with its extensive amenities, can easily be accessed by bus. There are train stations nearby in Bushey and Watford and several motorways within a short drive. Wisteria Lodge DS0000071460.V376919.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. The information in this report is based on an unannounced inspection of the home, which took place over one day with one regulation inspector carrying out the work of the Commission. For the purposes of this report the Commission will be referred to as we. The registered manager was on duty throughout the day and we spoke with members of staff and residents. We visited all parts of the home and checked a variety of records. Before the inspection the manager had completed and returned to the Commission an annual self-assessment quality review, the Annual Quality Assurance Assessment, (the AQAA).This document included statistical information about the home and confirmation of policy reviews and equipment checks. We have also reviewed any other information we have received about this service since the last inspection. Copies of the home’s written Statement of Purpose/ Service User’s Guide, together with the home’s last inspection report, are available in the office. Fees for the home are currently £1180 per week. What the service does well: The home is now full and the residents we spoke with said they were very happy living at the home and praised the staff and manager. We saw very good interaction between residents and care staff and there was a relaxed and positive atmosphere present in the home. All residents have their needs fully assessed and all staff are well trained and can meet the specialist needs of each individual in an appropriate manner. We found that residents were all supported to remain as independent as possible and were encouraged to make their own choices about how they spend their days. The home is very well decorated and furnished and provides a comfortable and homely environment for the people who live there. Wisteria Lodge DS0000071460.V376919.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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. Wisteria Lodge DS0000071460.V376919.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 Wisteria Lodge DS0000071460.V376919.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): Standards 1 and 2. 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. Written information is provided for all prospective residents and their care needs are fully assessed so that all parties can be sure the home is the right place for them. EVIDENCE: The home has a written Statement of Purpose and Service User’s Guide and these documents give detailed information about the home and are provided for all residents and prospective residents so that people can be clear about the services provided. We checked the records for the residents in the home and these contained evidence of the detailed assessments completed by senior staff at the home as well as copies of the care summaries from the referring agencies. Initial care plans had been produced from this information so that care staff could be clear about the individual’s needs and how best to meet them. Wisteria Lodge DS0000071460.V376919.R01.S.doc Version 5.2 Page 9 Wisteria Lodge DS0000071460.V376919.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6, 7 and 9. People using the service experience adequate outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Detailed care plans are completed for all people who use the service to ensure that everyone is clear about residents’ needs and preferences and clear how these needs are to be safely met. EVIDENCE: We spoke with two of the residents who were in the home during the inspection. We then tracked the care plans relating to these people. The documents contained good information about the individual needs and preferences of the residents and we saw evidence that the residents concerned had been involved in completing the plans. We saw the weekly activity planning for each person and there were some good risk assessments in place such as for the residents’ safety when they go out of the home. One resident Wisteria Lodge DS0000071460.V376919.R01.S.doc Version 5.2 Page 11 had a management plan for dealing with cigarette smoking, but a more detailed risk assessment was also needed to ensure safety in the home is maintained at all times, especially as the resident concerned looks after their own cigarettes. The care plans also need to be updated to make them person centred so that there is evidence that the aims and choices of all the residents in the home are agreed and recorded and then measured against outcomes over time. One resident we spoke with confirmed that the staff in the home encourage the residents to make their own choices about how they spend their days. We were told that the staff support those residents who need assistance to go out and support people’s wishes to try new activities. The proprietor said that currently three of the residents have external advocates who visit them to ensure that all their best interests are maintained. Wisteria Lodge DS0000071460.V376919.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): This is what people staying in this care home experience: Standards 12, 13, 15, 16 and 17. 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. People who use the service are supported to take part in the daily activities they choose and supported to remain as independent as possible. The meals provided are enjoyed by the residents and help to promote people’s good health. EVIDENCE: We spoke with one resident who said that they went out independently and visited the shops when they needed to. They showed us their bus pass which staff had supported them to obtain so that they can travel where they wish. The resident said that care staff also take people out in the home’s vehicle and that they can also come and go as they please. Wisteria Lodge DS0000071460.V376919.R01.S.doc Version 5.2 Page 13 Currently two residents attend a day centre each week but another resident said they have chosen not to go. One resident said they have “now retired”. We were told that people living in the home have recently been to the theatre and go out for meals. One resident said they enjoy helping with the gardening and go to see their relative every week. This resident also said they clean their own bedroom and that, since arriving at the home, staff have shown them how to do their own laundry so that they remain as independent as possible. The manager said that currently none of the residents wish to take part in any spiritual services but that people would be supported to take part in any chosen religion if they wanted to. We were also told that staff respected the residents’ privacy and always knocked and waited before entering their bedrooms. Care staff confirmed that it was the home’s policy to welcome the family and friends of all residents at all times. We saw examples of the four-weekly menus, which had been planned by staff with the residents’ involvement. The meals looked well balanced and two residents told us that the food was very good at the home. Records were being kept of food, fridge and freezer temperatures and the kitchen was clean and fitted with all appropriate appliances. We just reminded staff that records need to be kept to evidence the actual meals eaten by residents to comply with environmental health guidelines. Care staff said they would now keep these records for twelve months. One resident said that people in the home can use the kitchen facilities when they wanted and that food and snacks were available at all times. Staff said that some residents make their own breakfast and that all residents can make their own hot drinks. Wisteria Lodge DS0000071460.V376919.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): Standards 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. People who use the service have their health needs met in the way they prefer by staff in the home and procedures followed for administering medication are generally thorough and help to protect residents from the risk of harm. EVIDENCE: During the inspection we checked the care plans of the residents living in the home and saw details recorded of the visits made to and from Health professionals. Appropriate referrals had been made to Health agencies and we saw evidence that everyone’s health needs were reviewed and monitored on a regular basis. One resident said that staff support them to manage their own personal care and that help was always provided in a way they preferred. Currently all the residents in the home are male and there are staff of both genders on duty in the home so that residents can make choices about who assists them with their care. The staff said that the practice nurse from the Wisteria Lodge DS0000071460.V376919.R01.S.doc Version 5.2 Page 15 local doctors’ surgery comes to the home to weigh the residents monthly and to advise on any dietary issues. We checked the system for administering medication in the home. The home has a dedicated fridge for storing medication which needs to be kept at a low temperature and there is a record book available for recording any controlled drug administration. Staff told us that they have received training in diabetes care since the last inspection but we did recommend that more written instructions are provided for care staff to ensure that they are clear about what is considered a safe range when checking glucose levels. The system for administering medication was thorough but care staff in the home have been dispensing a resident’s medication into a separate container for them to take to a day centre. This secondary dispensing should not take place as medication must be administered from the original containers to protect people from the risk of harm. Care staff also must not sign residents’ records that medication was administered at the day centre as only the staff at the day centre can verify that this took place. The manager confirmed that alternative arrangements would be made for residents to receive their medication when they are out of the home. The home also holds a medication contingency pack for the benefit of the residents but more detailed records should be kept for this to ensure accurate audits can take place. The manager said this would now be done. Wisteria Lodge DS0000071460.V376919.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): Standards 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. People who use the service can be confident their concerns will be listened to and that procedures followed in the home will protect them from abuse. EVIDENCE: The home has written policies covering Complaints, Whistle Blowing and Adult Safeguarding. The staff we spoke with were clear about these policies and their implications. We spoke with one resident who confirmed that care staff had “gone through” the procedures for making a complaint and said that they would not hesitate to tell a member of staff if they had any concerns. The manager said that the complaints policy would be produced in an easy read format and would be shared with all residents. Wisteria Lodge DS0000071460.V376919.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): Standards 24 and 30. 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. People who use the service live in a home which is well maintained and benefit from living in comfortable and hygienic surroundings. EVIDENCE: We visited all parts of the home and observed the garden during the visit and all rooms were clean and well furnished and decorated to a high standard. The garden is accessible and tidy and is being planted gradually and is appropriate for the use of residents. There is a covered smoking area to the side of the house for the use of residents and staff. One resident told us they had been provided with a door key, but had lost this. They said they are able to lock their bedroom if they wish and staff confirmed that bedroom door locks can be opened from the outside to ensure residents’ safety in an emergency. Wisteria Lodge DS0000071460.V376919.R01.S.doc Version 5.2 Page 18 The resident we spoke with said that all areas of the home were cleaned daily and that there was always a good supply of hot water for their use. The bathrooms and toilets are fitted with soft paper towels and liquid soap as recommended in guidelines for good infection control. Wisteria Lodge DS0000071460.V376919.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): Standards 32, 34 and 35. 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. People who use the service can be assured they will be supported by well trained staff but procedures for recruiting staff must be more thorough to ensure residents are protected from the risk of harm. EVIDENCE: The residents we spoke with said that there were always enough staff on duty in the home to meet their needs. Currently some staff work at both this home and a nearby sister home according to the numbers of residents at home at any time. We checked the recruitment and training files of some staff members. A wide range of staff training courses have taken place since the last inspection. All the training considered basic to ensure a competent staff group has taken place and additional courses have been provided in appropriate specialist areas such as Diabetes Care and Supporting People in Crisis. We saw evidence of the Wisteria Lodge DS0000071460.V376919.R01.S.doc Version 5.2 Page 20 induction training provided for all new staff and saw the questionaires new staff complete to ensure they have understood the training. The manager confirmed that ongoing training would be taking place which covers dementia care and the Mental Capacity Act. There are currently four qualified nurses employed at the home and another member of staff is completing NVQ 3 training. In the AQAA the manager has confirmed that 6 members of staff are currently trained to NVQ level 2 or above. We checked the recruitment records for some members of staff. The application forms we saw completed were not adequate as there was little room for full work histories which are needed to ensure the staff recruited are appropriate to work with vulnerable people. The manager said that an updated form would be used for all new people recruited and has been used in the sister home. However we found some additional shortfalls in some recruitment records including one member of staff who did not have a reference from a current employer and one where no current address had been provided. References must also be verified to ensure they are bona fide and should not be addressed “to whom it may concern”. Staff files should also contain signed copies of individual terms and conditions so that it can be certain that all parties are clear about their roles and responsibilities. Wisteria Lodge DS0000071460.V376919.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): Standards 37, 39 and 42. 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. People who use the service can be sure the home is well run and has procedures in place to ensure their safety and to ensure their views are included in the running of the home. EVIDENCE: The home’s manager is a registered Learning Disability nurse with extensive experience in this field as well as appropriate management experience. The manager has achieved the NVQ level 4, Registered Manager’s Award and has been registered with the Commission. Both the staff members and the Wisteria Lodge DS0000071460.V376919.R01.S.doc Version 5.2 Page 22 residents we spoke with praised the manager and said that he was always approachable and included their views in all day to day planning. The home has certificates which evidence compliance with fire safety and these were seen at the previous visit. The home has a fire alarm system which, to ensure the safety of residents and staff, includes emergency lighting and automatic door closures which are activated if the fire alarm sounds. The home has not fitted window restrictors in bedrooms and the manager said that this was on the advice of the fire safety officer. We saw one bedroom window which could provide a hazard for some vulnerable people and the manager said that individual risk assessments would be completed for any resident using this room. Care staff confirmed that fire drills take place in the home and the manager said that the names of those taking part and the outcomes of the drills will now be recorded. The manager has stated that all rooms have thermostatically controlled radiators and that individual risk assessments would determine if these needed to be covered or not. The manager said a risk assessment to confirm the first aid needs of staff would also be completed. We saw the home’s accident recording book, which is compliant with data protection requirements. The home has a written policy on Quality Assurance but not all the procedures listed have been put into operation yet. Some of the current residents have been admitted to the home during the year and the manager said that quality procedures will be started now the home is full. These procedures will evidence that care standards are maintained and that people using the service have their views reflected in the running of the home. However the staff we spoke with said that regular meetings do take place where staff and residents can voice their views. Wisteria Lodge DS0000071460.V376919.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 3 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 x 34 2 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 3 x x 3 x Version 5.2 Page 24 Wisteria Lodge DS0000071460.V376919.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 YA6 Timescale for action 15(1)&12(1)(a) The risk assessment covering 01/10/09 a resident smoking in the home must be more detailed and must clarify the details of where and by whom the cigarettes and matches are to be held and must assess any possible associated risk to the individual and to the other people resident or working in the home. 15(1)&(2) Person centred care plans must be completed for all residents which detail their agreed goals and which monitor how these goals are achieved and reviewed. Thorough recruitment procedures must be implemented in the home and full employment histories and two appropriate verified references must be obtained before anyone commences work at the home. 01/12/09 Regulation Requirement 2. YA6 3. YA34 19 & Schedule 2 01/10/09 Wisteria Lodge DS0000071460.V376919.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 Wisteria Lodge DS0000071460.V376919.R01.S.doc Version 5.2 Page 26 Care Quality Commission Care Quality Commission Eastern Region Citygate Gallowgate Newcastle Upon Tyne NE1 4PA 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). 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. Wisteria Lodge DS0000071460.V376919.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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