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Inspection on 15/12/08 for 11 Kenton Road

Also see our care home review for 11 Kenton Road for more information

This is the latest available inspection report for this service, carried out on 15th December 2008.

CSCI found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 11 Kenton Road 11 Kenton Road Harrow Middlesex HA1 2BW     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Sheila Lycholit     Date: 1 5 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 32 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 32 Information about the care home Name of care home: Address: 11 Kenton Road 11 Kenton Road Harrow Middlesex HA1 2BW 02084238090 02089330307 nigel.brookarsh@ntlworld.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Residential Care Providers Ltd Name of registered manager (if applicable) Rajnikant Vinodrai Joshi Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 6 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: Learning disability - Code LD Date of last inspection Brief description of the care home 11 Kenton Road is a registered care home providing personal care and accommodation for 6 adults aged between 18 and 65 who have learning disabilities. The registered provider is Residential Care Providers Ltd., a small, local care organisation. The home is a three-storey house situated on a busy main road in Harrow. It is close to all community facilities and amenities. Community transport is accessible but the home also has its own car. Initial registration was in 2000. All the bedrooms are single with no en-suite. There is a rear garden with seating which is accessible through the kitchen or the dining room. At the time of the unannounced inspection, the home had full Care Homes for Adults (18-65 years) Page 4 of 32 care home 6 Over 65 0 6 Brief description of the care home occupancy. Information about fees, and the Service User Guide, are available on request from the provider organization. Care Homes for Adults (18-65 years) Page 5 of 32 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The unannounced inspection took place on Monday 15th December 2008 from 11.40am until 6pm. The Manager, who was on duty with three support staff made herself available throughout the visit. The Registered Person, who also operates another home nearby, visited the home for the weekly seniors meeting. He had completed an annual quality assurance assessment and discussed in more detail some of the information provided. At the start of the inspection 2 residents were at home, 3 were attending day services and 1 was at college. All returned later in the day. A tour of the building took place, which included residents, and handover and other practice was observed. Care Homes for Adults (18-65 years) Page 6 of 32 Care Homes for Adults (18-65 years) Page 7 of 32 What the care home does well: 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 set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 32 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 32 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Up to date information about the service is available but would be improved by being produced in an accessible format. Established assessment procedures are in place, though no new residents have been admitted since the last inspection. Evidence: Copies of the service users guide and complaints procedure were seen in some of the residents room. The guide is clearly written but needs to be in an accessible format and to cover all the areas in standard 1.2. All places at 11 Kenton Road are occupied and no new residents have been admitted since the last inspection. One resident returned to the home in November following a long period in hospital. The individual files of three residents were looked at. All contained assessment information. Records show that staff refer residents for regular assessments, though the Registered Provider commented on the difficulty in obtaining assistance at times from the multi-professional team for example regarding supporting residents communication. Care Homes for Adults (18-65 years) Page 10 of 32 Care Homes for Adults (18-65 years) Page 11 of 32 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans show that staff have considerable knowledge and understanding of residents needs. Care planning would be further improved by the use of photos, pictures and symbols to make plans more accessible. Evidence: Three residents files were looked at, together with daily notes and other records. Each file contained a comprehensive care plan, covering all aspects of the residents care and support. Care planning would be further improved by the use of photos, pictures and symbols, to support residents in contributing to their plans. The Manager confirmed that the home has recently acquired a camera and software to produce more accessible plans. Key workers produce a monthly summary noting significant developments, as well as contact with families and social events and activities. Key workers sign to confirm that they have reviewed each area of the residents care plan monthly. As the majority of residents communicate non-verbally, it is recommended that Care Homes for Adults (18-65 years) Page 12 of 32 Evidence: communication plans are developed, detailing how residents communication is to be supported, for example by the use of photos, objects of reference, signs and gestures. The assistance of the local Speech and Language Therapy team would be beneficial. The file of a resident who had returned to the project in early November following a long period in hospital was seen. Much of the information on her care plan was out of date, as her condition had changed considerably. Risk assessments were also out of date and needed to be rewritten. Some hand written notes were available in the office but had not been developed into a care plan. Staff must ensure that care plans and risk assessments reflect a residents current needs and are up dated promptly following any prolonged absence from the service. Some restrictions are placed on residents in line with their risk assessments, for example the front door is kept locked and is alarmed, as residents would be in danger from the busy road outside. Care Homes for Adults (18-65 years) Page 13 of 32 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are supported to take part in a range of activities, both in the house and in the community. Contact with families is well supported. Residents religious and cultural needs are recognised and valued. Healthy eating is encouraged, with a range of freshly cooked meals that reflect the cultural background of residents. Evidence: On the day of the inspection three residents were attending a day centre and one was at Harrow College. Activity plans show that residents are supported to take part in a range of activities including attendance at day services, adult education classes and social clubs. Residents are supported individually by staff to take part in leisure activities such as swimming, as well as going out for coffee and lunch. Photos displayed in the home show residents and staff on holiday, at parties and events and Care Homes for Adults (18-65 years) Page 14 of 32 Evidence: with families and friends. Daily notes record that residents attend places of worship, including the local Temple and Synagogue. Residents religious and cultural needs are also recognised in the menus and food provided in the home. Contact sheets show that good contact is maintained with families and friends, with some residents regularly going home or being visited at 11 Kenton Road. One relative was visiting at the time of the inspection. Healthy eating is given a high priority, with meals cooked largely from fresh ingredients. Staff and residents were eating a freshly cooked evening meal together on the day of the inspection. Menus are varied, reflecting the likes and dislikes of residents, as well as their cultural backgrounds. Residents weight is recorded monthly. Staff have supported one resident who is underweight to increase her food intake and she has put on some weight. Staff were seen to regularly prompt her to eat and drink. The kitchen was clean and tidy, with well stocked cupboards, although staff said that they had been planning to shop that day. Residents are encouraged to help with preparing food and with shopping. Care Homes for Adults (18-65 years) Page 15 of 32 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Support guidelines show that staff are knowledgeable about how residents wish to be supported with personal care. A priority is given to ensuring that residents health care needs are met. Steps are taken to ensure that medication is handled safely, although the medication procedure needs updating. Evidence: Guidelines on supporting residents with their personal care were seen on each of the three residents files looked at. The information was detailed, written from the residents perspective and showed that staff have a thorough understanding of residents personal care needs. Well completed annual health check forms were seen and the separate record of health care appointments shows that any health concerns are followed up. Oral health care records are detailed and records of dental treatment show that residents are supported to look after their teeth and to receive regular check ups and treatment. Staff commented on the good support they had received from the Mental Health Team regarding a residents care and treatment. Care Homes for Adults (18-65 years) Page 16 of 32 Evidence: The home uses a measured dosage system supplied by a local Pharmacy. Medication is stored in a secure cupboard. MAR sheets seen were fully completed with no gaps. The opening dates of liquid medication and creams and lotions was noted on the labels. The Pharmacist makes regular visits to the home. The last 2 reports were seen which were satisfactory with no recommendations. The homes medication policy needs to be updated to ensure that it reflects current guidance on covert medication, handling controlled drugs and leave medication. Although no controlled drugs are currently handled, consideration should be given to providing a CD cupboard that meets current standards. Records show that staff give medication to one resident by crushing tablets and disguising them in tea or fruit juice because she refuses to take it if presented in tablet form. Written permission from the GP is on file. The medication is essential to the residents health and well being. The Manager must ensure that disguised or covert medication is only given following the agreement of the multi-disciplinary team, including the Pharmacist and after discussion with the family or advocate. Care Homes for Adults (18-65 years) Page 17 of 32 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A complaints policy and procedure has been developed which is in an accessible format. Systems are in place to protect residents from abuse and recording of incidents is good. Steps should be taken to develop closer contact with the local Safeguarding Team and relevant incidents should be referred promptly for advice and guidance. Evidence: The Manager confirmed that no complaints and no safeguarding referrals had been made in the past 12 months. Since the last inspection the complaints policy has been produced in an accessible format. Copies were seen in the rooms of two of the residents. It is recommended that staff consider ways of recording lower level complaints and concerns to ensure that issues are noted, action taken and as a means of improving the service. For example during the inspection one resident pointed out a stain on the inside of a fitted cupboard in his room where the air conditioner had apparently leaked. Similarly a relative mentioned that the bedrooms were very cold. Residents records show that staff have taken steps to try to obtain advocacy services for residents, though in some sponsoring authorities, this service has been discontinued. The Manager confirmed that all staff receive training in safeguarding vulnerable adults. The training is provided in-house using a training package. The Manager was not aware of any training offered by the local Safeguarding Team but undertook to contact Care Homes for Adults (18-65 years) Page 18 of 32 Evidence: them. It is recommended that the Safeguarding Team is asked to look at the homes training materials to confirm that the content is in line with local multi-agency policies and procedures. An up to date copy of the local policy and procedures must be available in the home. Incident reports are recorded in detail, though a recent incident where one resident bit another should have been reported to the Safeguarding Officer and a decision made about whether to call a strategy meeting. Financial records for two residents were looked. These were in good order, with receipts obtained for purchases and a running total kept. It is recommended that the Manager and or Registered Provider reconcile the accounts more regularly. Care Homes for Adults (18-65 years) Page 19 of 32 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this 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 house is well located, close to shops, services and public transport and provides comfortable accommodation for residents. High standards of cleanliness and hygiene are maintained. Evidence: 11 Kenton Road is a 3-storey house on a busy road, close to the shops, services and public transport of Harrow. The house has a pleasant rear garden, with garden furniture. Parking is available at the front of the house, which is where the homes own vehicle is kept. There is a large, comfortable sitting room and adjacent dining room, with sufficient space for all residents and staff to sit together for a meal. A sensory room on the ground floor has soft seating and a variety of tactile equipment. Three bedrooms were seen with the permission of the residents. Each is of a good size, with sufficient storage. Bedrooms seen had been personalised with a range of possessions, reflecting residents interests. One resident has a computer, which he said he would like connected up to the internet. The Manager explained that she was aware of his request, which would be met now that the home was on-line. While the rest of the house was warm, residents bedrooms were cold, as the radiators were not working. This was also commented on by a relative who was visiting. The Manager confirmed that she had reported the problem to the Registered Person who was Care Homes for Adults (18-65 years) Page 20 of 32 Evidence: arranging for a heating engineer to call. Staff should consider whether the use of labels on residents cupboards and drawers is necessary, as it detracts from the attractive appearance of the rooms. The 2 bathrooms, one of which has a walk-in shower were warm and clean. The hot water temperature in the ground floor bathroom seemed to be running at quite a high temperature, although daily checks indicated that the hot water was always at a safe temperature. The Manager undertook to ask staff to re-check the temperatures. A high standard of cleanliness is maintained and staff were seen to mop up spills and accidents straightaway, using protective clothing. A laundry with 2 washing machines and 2 driers is located on the top floor. Staff were reporting problems with the driers, though during the tour of the building the driers were seen to be venting into the laundry because of a loose connection. The Manager said that she would ask a member of staff who does minor repairs to reconnect the venting system when he came on duty that evening. Care Homes for Adults (18-65 years) Page 21 of 32 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a capable staff team, with low levels of staff turnover. Sufficient staff are on duty to meet the needs of residents, including individual activities. Staff are provided with relevant training and opportunities to acquire accredited qualifications, though training and recruitment records need to be improved. Evidence: Rotas show that 4 staff are normally on duty on each early shift and 3 on each late shift. The Manager is on the rota and works weekends and does sleep-ins. Night cover is provided by one member of staff sleeping-in. A bed is available in the office. The Manager explained that at least one female member of staff is always on duty to provide personal care to the two female residents. Some staff also work at the Registered Providers other service for people with a learning disability, although rotas indicate that continuity of staffing at 11 Kenton Road is maintained. Hand overs take place each day and are recorded, using a pro-forma. There is also a communication book, which staff are expected to read when they come on shift. Staff have the opportunity to study for NVQ level 2 and 3. Of the 11 support staff, 3 have completed NVQ3 and 1 is enrolled on the course. Three staff have completed NVQ2 and 2 are waiting for confirmation that they have achieved the award. Staff recruitment and training records are kept loosely in individual filing slings, Care Homes for Adults (18-65 years) Page 22 of 32 Evidence: making it difficult to check that all documents are available. Staff files must be reordered to and checked to ensure that copies of recruitment checks, interview notes, probationary records and other documents are available. A checklist would be of benefit at the front of the file, noting dates information sent for and received. Two of the 3 staff files seen contained evidence of a satisfactory criminal record check, identity check and references. No interview notes were available. One file of a recently appointed member of staff contained little information. The Manager explained that the staff member had initially been recruited to the other service and the relevant documents were still held there. One reference was in the form of a general reference headed to whom it may concern. It is recommended that a pro-forma is used to request references, covering all relevant areas of performance. Discussion with the Manager and certificates of training show that staff receive relevant in-house training, though no training programme or plan is available. It was difficult to see from staff files whether core training, including refresher training is up to date. In discussion a member of staff confirmed that she had attended refresher training this year to update all areas of essential training. Notes of staff meetings show that meetings take place regularly, with a range of issues discussed. Two staff, including the Manager, have received training in staff supervision, although records indicate that supervision has not been taking place regularly. An appraisal and performance development system is in place but it is unclear from records how issues identified at appraisal are followed up. In discussion an experienced member of staff said that she felt well supported by senior staff and enjoyed working at the service. Care Homes for Adults (18-65 years) Page 23 of 32 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this 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 home is operated by an experienced provider and a Manager who knows the residents very well. Steps have been taken to introduce an annual quality assurance review and the provider has achieved external accreditation through achieving the Investors in People award. Sound health and safety systems are in place. Evidence: The Manager has worked at the home for 5 years, initially as a support worker and later Deputy Manager and was appointed to the Managers post in September this year. The Manager confirmed that she is applying for registration. The Manager has achieved NVQ3 and is planning to start NVQ4 at the earliest opportunity. An annual quality assurance review has been introduced, undertaken for last year by an independent agency. The summary report for 2007 was seen and indicated considerable satisfaction with the service from stakeholders. The report for 2008 is not yet available. The provider company, Residential Care Providers, achieved the Investors in People Care Homes for Adults (18-65 years) Page 24 of 32 Evidence: award in May this year. The certificate is displayed in the home. A health and safety policy is available and staff receive training in health and safety including moving and handling, food handling, First Aid and fire safety. However the absence of up to date training records, discussed under standard 35, make it difficult to confirm when staff have completed health and safety training, including refresher training. The fire risk assessment was revised in October this year. Fire safety records show that the fire alarm system is tested weekly at different points and the fire detection system and fire fighting equipment is regularly serviced and maintained. Records show that two fire drills took place this year. The frequency of fire drills needs to be increased to four a year. General risks assessments are up to date. Staff undertake a number of regular checks, which are recorded. The Registered Person visits the home at least weekly, when he attends the seniors meeting and came on a routine visit on the day of the inspection. A pro-forma is available for monthly visits under Regulation 26 but some reports for this year were not on file. A business plan for the service is available and is displayed in the office. Care Homes for Adults (18-65 years) Page 25 of 32 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 26 of 32 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 1 5 The service users guide should be available in an accessible format and cover all of the areas noted in standard 1.2. To ensure service users and their representatives have sufficient information about the service. 28/02/2009 2 6 5 Care plans and risk assessments must be updated promptly following any return to the service after a prolonged absence. To ensure the residents current needs are identified. 31/01/2009 3 6 15 Care plans should be developed further to include accessible formats. Staff should ensure that when reviewing plans all recent information is taken into account. 31/01/2009 Care Homes for Adults (18-65 years) Page 27 of 32 To promote residents involvement in their care plans and to ensure plans are up to date. 4 9 13 Risk assessments must be regularly updated to reflect any changes in behaviour or condition and to take into account recent incidents. To promote the safety of residents and staff. 5 20 13 The homes medication 28/02/2009 policy and procedure needs to be updated to cover refusal of medication and giving medication covertly. The policy should also include medication while residents are away from the home, for example staying with families, on holiday or at day services. The policy on covert medication must include reference to the Mental Capacity Act and consultation with the multiprofessional team and family or advocate. To ensure that residents receive medication as prescribed. 6 23 13 Any incident involving one resident assaulting another must be reported to the local Safeguarding Officer and Care Managers, as well as to CSCI. An up to date copy of the local multiagency safeguarding policy 31/01/2009 31/01/2009 Care Homes for Adults (18-65 years) Page 28 of 32 and procedures must be available in the home. To ensure that steps are taken to try to prevent further incidents and to protect residents. 7 24 23 Steps must be taken to ensure that residents bedrooms are kept at a comfortable temperature and that problems with the central heating are resolved promptly. So that all parts of the building can be kept at a warm temperature in cold weather. 8 34 18 Staff files must be kept in good order and contain all recruitment documents, including interview notes and at least two references. To ensure all checks are carried out and residents are kept safe. 9 35 19 Records must be kept of staff training, in addition to copies of certificates. A training programme and training and development plan should be available based on the needs of the service. To ensure that staff are properly trained. 10 36 18 Staff must be provided with supervision at least 6 times a year. 31/01/2009 31/01/2009 31/01/2009 31/01/2009 Care Homes for Adults (18-65 years) Page 29 of 32 To ensure support for staff and to identify training needs and any issues regarding performance. 11 42 13 Fire drills must take place at 31/01/2009 least 4 times a year at different times of the day. To ensure all staff are familiar with the homes fire safety procedures. 12 43 26 Although the Registered Person visits the service frequently, reports of his visits in line with Regulation 26 were not available for each month. To confirm that the Registered Person is monitoring the running of the home and the welfare of residents. 31/01/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 2 3 4 5 6 6 20 22 23 When staff review care plans, they should ensure that plans reflect new developments and changes. A communication plan should be developed for each of the residents who communicates non verbally. The installation of a controlled drugs cupboard that meets current standards should be considered. Ways of recording concerns and minor complaints should be considered. Consideration should be given to checking residents money more frequently and ensuring that the accounts are reconciled. Care Homes for Adults (18-65 years) Page 30 of 32 6 23 The Manager should contact the local safeguarding team to check whether the team will make training available to staff at the home. The content of the current training package used for staff should be discussed with the Safeguarding Officer to ensure that it is up to date and in line with local procedures. Consideration should be given to using a pro-forma for reference requests, asking for all relevant information, including dates of starting and leaving employment. 7 34 Care Homes for Adults (18-65 years) Page 31 of 32 Helpline: 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 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) Commission for Social Care Inspection (CSCI). 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. 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