Inspection on 12/01/08 for Real Life Options 2-4 Bethecar Road

This is the latest available inspection report for this service, carried out on 12th January 2008.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Real Life Options 2-4 Bethecar... 13/02/07

Real Life Options 2-4 Bethecar... 08/12/05

Real Life Options 2-4 Bethecar... 22/02/05

Real Life Options 2-4 Bethecar... 06/07/04

Similar services:

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Edenvale

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Chatsworth Care - Dawson House

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Chatsworth Care - Tudor Lodge

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Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Real Life Options 2-4 Bethecar Road 2-4 Bethecar Road Harrow Middlesex HA1 1SF Lead Inspector Tony Lawrence Key Unannounced Inspection 12th January 2008 10:15 Real Life Options 2-4 Bethecar Road DS0000017518.V355864.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 Real Life Options 2-4 Bethecar Road DS0000017518.V355864.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. Real Life Options 2-4 Bethecar Road DS0000017518.V355864.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Real Life Options 2-4 Bethecar Road Address 2-4 Bethecar Road Harrow Middlesex HA1 1SF 020 8248 5867 F/P 020 8248 5867 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) www.reallifeoptions.org Real Life Options Mr Michael Piekarczyk Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Real Life Options 2-4 Bethecar Road DS0000017518.V355864.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Some of whom also have a physical handicap. Date of last inspection 4th September 2007 Brief Description of the Service: 2-4 Bethecar Road is a registered care home providing care and accommodation for up to six people who have a learning disability. The home currently has two vacancies. The registered provider is Real Life Options. The home is located in a residential area close to central Harrow and Harrow and Wealdstone. The home consists of two semi-detached houses that have been converted into one house. There is parking for up to three cars at the front of the property. The home is close to a variety of amenities that include shops, a library, a cinema, banks, a post office and restaurants. Public transport facilities, including buses and trains, are within a few minutes walk of the home. People living in the home also have their own car. The home has six single bedrooms, shared communal areas and a large, well-maintained enclosed garden. The manager confirmed that the weekly fee for the home is £1,678. Real Life Options 2-4 Bethecar Road DS0000017518.V355864.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection took place on Saturday 12th January 2008 from 10:15 – 14:15. Tony Lawrence, Regulation Inspector, carried out the inspection. He spent time talking with three people living in the home and staff on duty and checked care records kept in the home. The weekly fee for the home is £1,678. The Inspector would like to thank all residents and staff for their help with this inspection. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Real Life Options 2-4 Bethecar Road DS0000017518.V355864.R01.S.doc Version 5.2 Page 6 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 Real Life Options 2-4 Bethecar Road DS0000017518.V355864.R01.S.doc Version 5.2 Page 7 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3 and 5. People living in the home experience Good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. There is a statement of purpose that is specific to the home. It clearly sets out the objectives and philosophy of the service. New residents are provided with an Individual Service Agreement that sets out in detail the services provided, the role and responsibility of the provider, and the rights and obligations of the individual. EVIDENCE: The Deputy Manager confirmed that there are currently four people living in the home and two vacancies. No prospective new residents are currently being assessed to live in the home. Real Life Options and the Commission have agreed a temporary reduction in staffing levels until the vacancies are filled. The effect of this reduction in the support provided must be reviewed to make sure that residents are not adversely affected (see Standard 33). The home provides a Statement of Purpose that was reviewed by the Manager in 2007. The Statement provides most of the information needed to meet these Standards and refers to the Commission. During this visit the Inspector checked one person’s care plan file. The file included an excellent Individual Service Agreement (ISA) that detailed the facilities and services provided in the home, staffing arrangements and the home’s complaints procedure. The ISA is well produced, using pictures and photographs to make the information more accessible to residents who have communication difficulties. The file also included a licence agreement between the home and the individual resident that detailed the main terms and conditions of residence. Real Life Options 2-4 Bethecar Road DS0000017518.V355864.R01.S.doc Version 5.2 Page 8 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 and 9. People living in the home experience Adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Each resident has a care plan, but the practice of involving residents in the development and review of the plan is variable. The plan includes basic information necessary to deliver the person’s care, but is not detailed or person centred. The care plan is not used as a working document and does not consistently reflect the care being delivered. EVIDENCE: During this visit the Inspector checked the care plan file for one person living in the home. The Inspector felt that Real Life Options had excellent care planning systems that should make sure that each resident had an individual plan that is person centred, but these systems were not used well by managers and staff in the home. The last inspection report included a requirement that care plans and risk assessments were reviewed regularly. The Person Centred Plan the Inspector saw made excellent use of pictured and photographs to make information easier to understand. The resident’s likes and dislikes were well recorded and the section on communication was very well completed, with good guidance for staff. However, the plan included no agreed goals or action plan and was last reviewed in November 2005. Real Life Options 2-4 Bethecar Road DS0000017518.V355864.R01.S.doc Version 5.2 Page 9 The Deputy Manager explained that a number of planned reviews had been cancelled in the past 12 months, as the local Learning Disability Team was unable to send a representative. Review dates had been agreed for the three other people living in the home for the week after this inspection, but not for the person whose care was checked by the Inspector. The Deputy Manager explained that the Learning Disability Team had again cancelled the planned reviews, but the home’s Manager had arranged for the reviews to go ahead without the learning disability team. The Manager must make sure that regular reviews of residents’ care plans take place and this must also happen for the person whose care was reviewed by the Inspector during this visit. Managers and staff must also make sure that Person Centred Plans include clear, meaningful goals and an action plan to show how residents will be supported to meet these. During this visit the Inspector saw staff working well together to support the three residents who were at home. All three people were offered choices and supported to take part in activities, independently and with support from staff. The last inspection report in September 2007 included a requirement that risk assessments were dated and regularly reviewed. During this visit, the Inspector saw one risk assessment that was well-completed and included good guidance for staff. However, the assessment was dated June 2004 and the Deputy Manager was unable to show the Inspector evidence that the assessment had been reviewed since then. This requirement is also repeated. Real Life Options 2-4 Bethecar Road DS0000017518.V355864.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 and 17. People living in the home experience Good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The service has a commitment to enabling residents to develop or maintain their skills, including social, emotional, communication, and independent living skills. The staff promote individual rights and choice, but also consider the protection of individuals in supporting them to make informed choices. EVIDENCE: When the Inspector arrived for this visit, three of the four residents were at home. One person had gone to spend the weekend with relatives and was expected to return later in the day. During the day, one person went out on his own for a walk to local shops. Although staff said this person often goes out independently, the Deputy Manager made sure that a member of staff went with him on this occasion because of health issues. The care plan checked by the Inspector included some very good guidance for staff on the person’s morning, evening and weekend routines. This guidance emphasised what the person could do for themselves and areas where support was needed from staff. The care plan file also included a weekly programme of Real Life Options 2-4 Bethecar Road DS0000017518.V355864.R01.S.doc Version 5.2 Page 11 activities and the daily diary showed that the person was supported to take part in a range of activities in the home and the local community. Staff in the home have also developed picture boards for each resident, using photographs to illustrate each person’s daily activities. This is another example of the excellent use of photographs in the home to make information easier for residents to understand. Details of the resident’s relatives, friends and other significant people were included in their Person Centred Plan and there was evidence that relatives had been involved in the last review of the plan. Staff on duty during this visit were aware of other residents’ relatives and friends and arrangements for contacting these people. The home has an attractive dining room that looks out into the garden. There is a large notice board where staff use photos to illustrate each day’s meals. This was up to date and showed the meals that would be provided on the day of this visit. Real Life Options 2-4 Bethecar Road DS0000017518.V355864.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 and 21. People living in the home experience Good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home has an efficient medication policy supported by procedures and practice guidance, which staff understand and follow. There is a need to make sure that residents have access to specialist healthcare services when these are needed. EVIDENCE: The residents’ care plan the Inspector saw during this visit included some good information about the individual’s personal care needs, although there was no evidence that this had been reviewed or updated for more than two years. The guidance for staff included in the care plan was good, with an emphasis on what the person could do for himself. The care plan file reviewed by the Inspector included good evidence of joint work with health care professionals, including the person’s GP, psychiatric services, dentist and optician. The file included reports from the person’s psychiatrist dated October 2007 and January 2008. The requirement made at the last inspection to record the opening dates of medicinal creams used in the home had not been met and is repeated in this report. During this visit the Inspector checked the management of residents’ prescribed medication. The home has secure storage for all medication and Real Life Options 2-4 Bethecar Road DS0000017518.V355864.R01.S.doc Version 5.2 Page 13 the administration records were well completed for all four people living in the home. There is a need to make sure that residents are referred for chiropody treatment when this is needed. The Inspector saw one person who needed treatment from the chiropodist, but there was no evidence that this had been recognised by staff and an appointment made. Staff should also work with residents and their relatives / representatives to record information about each person’s wishes with regard to illness, ageing and death. The Inspector felt that the organisation had good systems for recording this sensitive information, but staff in the home working with the person whose needs were reviewed during this visit did not use these. Real Life Options 2-4 Bethecar Road DS0000017518.V355864.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 and 23. People living in the home experience Good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The complaints procedure is supplied to everyone living at the home. The policies and procedures for safeguarding adults are available and give clear specific guidance to those using them. Staff working at the service know when incidents need external input and who to refer the incident to. EVIDENCE: Following a requirement made at the last key inspection of the home in September 2007, the Deputy Manager confirmed that all staff had been reminded of the local safeguarding adults procedures in team meetings and individual supervision. All staff had completed their Learning Disability Award Framework induction and foundation training and this included an introduction to safeguarding adults issues. The Manager had also provided flow charts that guided staff through the local reporting procedures. Staff on duty during this visit were able to tell the Inspector about the guidance and local reporting procedures. The home had also obtained a copy of the local authority’s safeguarding policy and procedures and this was kept in the office for staff reference. During this visit the Inspector checked the finance records for all four people living in the home. The records were well maintained and there was evidence that money had been repaid to residents following a requirement made at the last inspection. There remains a need for managers in the home to self-audit the use of residents’ personal monies. For example, one record showed that a resident had spent money on lunch for himself and a member of staff. Although the money had been refunded, the person’s diary showed that he had been at home all day when the money was spent. Staff must make sure that the support they give residents is accurately recorded. Managers must check the use of residents’ money to make sure that accurate records are kept and money is spent appropriately. Real Life Options 2-4 Bethecar Road DS0000017518.V355864.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): 24, 27, 28 and 30. People living in the home experience Good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home provides a physical environment that is appropriate to the specific needs of the people who live there. The home is a very pleasant, safe place to live the bedrooms and communal rooms meet the NMS or are larger. EVIDENCE: The home is located in a residential area close to central Harrow and Harrow and Wealdstone. The home consists of two semi-detached houses that have been converted into one house. There is parking for up to three cars at the front of the property. The home is close to a variety of amenities that include shops, a library, a cinema, banks, a post office and restaurants. Public transport facilities, including buses and trains, are within a few minutes walk of the home. The home has six single bedrooms, shared communal areas and a large, well-maintained enclosed garden. During this visit the Inspector saw all communal parts of the home. All areas were well decorated and comfortably furnished. Care staff are responsible for cleaning and all parts of the home were clean and hygienic. Real Life Options 2-4 Bethecar Road DS0000017518.V355864.R01.S.doc Version 5.2 Page 16 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 and 35. People living in the home experience Good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Staff knew the care needs of residents and worked well together to meet these. The effects of recent staffing reductions need to be reviewed to make sure residents are not adversely affected. EVIDENCE: When the Inspector arrived for this visit, the home’s Deputy Manager was on duty with 2 support workers. All three staff had started work at 07:00. Two more staff were on duty from 14:00. Throughout the day, the Inspector saw that staff worked well together to support residents, as well as carrying out cleaning and cooking tasks. Three residents were at home and the fourth person was spending the weekend with relatives. The home currently has two vacancies and Real Life Options have agreed a reduction in the number of staff on duty during the day. During this visit, the Inspector felt that there was some evidence that staff were finding it hard to maintain residents’ access to activities in the home and the local community. The rota showed that, at times, there are only two staff on duty and this makes it difficult to provide residents with individual support. Real Life Options must review the effect of the recent staff reduction in staffing levels and tell the Commission the outcome of this review. Real Life Options 2-4 Bethecar Road DS0000017518.V355864.R01.S.doc Version 5.2 Page 17 The Inspector checked the staff files for two people working in the home. The files were well organised and included evidence that employment references had been provided and both staff had obtained an Enhanced Disclosure from the Criminal Records Bureau, showing that they are suitable to work with vulnerable adults. During this visit the Inspector checked the training records for some staff working in the home. The Deputy Manager told the Inspector that Real Life Options have recently concentrated on making sure that staff complete the Learning Disability Award Framework (LDAF) Induction and Foundation training. All staff working in the home, with the exception of one weekend night staff, have now completed this training. Real Life Options 2-4 Bethecar Road DS0000017518.V355864.R01.S.doc Version 5.2 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 41, 42 and 43. People living in the home experience Good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home has an experienced and qualified Manager who is registered with the Commission. Standards of record keeping in the home are generally good. EVIDENCE: The home’s Manager has worked in the home for a number of years and has a professional qualification in nursing people with a learning disability. The Manager should tell the Commission when he completes his National Vocational Qualification Level 4 training. During this visit the Inspector saw that Real Life Options had good systems for reporting the results of quality assurance outcomes in the home. These include the views of residents, their relatives / representatives, agencies funding the service and other significant people. The report also includes the home’s performance against a number of quality indicators. To evidence that residents are receiving good standards of care and support, there is a need to Real Life Options 2-4 Bethecar Road DS0000017518.V355864.R01.S.doc Version 5.2 Page 19 make sure that the Quality Assurance Report is completed annually and a copy sent to the Commission. During this visit the Inspector checked a selection of records kept in the home, including residents’ care plans, risk assessments, finance and medication records. While standards of record keeping are generally satisfactory, there remains a need to make sure that important records, especially care plans and risk assessments, are reviewed and updated regularly. There are no health and safety issues following this visit. The last inspection report included a requirement that representatives from Real Life Options must make sure that monthly monitoring visits are carried out and reports sent to the home and the Commission following each visit. The manager must make sure that staff are aware of the monthly monitoring reports and that they are used to develop practice in the home. During this visit, the Deputy Manager showed the Inspector copies of reports completed following visits made in August, September and October 2007. Although the Deputy Manager was aware that a visit had taken place in November or December, the report was not available and the requirement is repeated in this report. Real Life Options 2-4 Bethecar Road DS0000017518.V355864.R01.S.doc Version 5.2 Page 20 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 3 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 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 2 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 2 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 2 2 2 3 X 2 X 3 3 2 Real Life Options 2-4 Bethecar Road DS0000017518.V355864.R01.S.doc Version 5.2 Page 21 Yes 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 Regulation 15 (1) Requirement Managers and staff must make sure that Person Centred Plans are regularly reviewed and include clear, meaningful goals and an action plan to show how residents will be supported to meet these. To make sure that people’s care is provided appropriately, the Manager must make sure that important reports and assessments, including risk assessments, are dated and regularly reviewed. This requirement is repeated. The original timescale of 31/10/07 was not met. To make sure that residents’ physical care needs are met, staff must make sure that residents are referred for chiropody treatment when this is needed. To make sure that people’s healthcare needs are met safely, staff must record the opening date on medicinal creams used in the home to make sure that use by dates are met correctly. This requirement is repeated. DS0000017518.V355864.R01.S.doc Timescale for action 31/03/08 2. YA9 15 (2) 31/03/08 3. YA19 13 (1) b 31/03/08 4. YA20 13 (2) 31/03/08 Real Life Options 2-4 Bethecar Road Version 5.2 Page 22 5. YA23 17 (2) 6. YA33 18 (1) a 7. YA39 24 8. YA43 26 The original timescale of 31/10/07 was not met. To make sure that residents are protected, managers must check the use of residents’ money to make sure that accurate records are kept and money is spent appropriately. Real Life Options must review the effect of the recent staff reduction in staffing levels on residents’ access to activities and tell the Commission the outcome of this review. The Manager must make sure that the Quality Assurance Report is completed annually and a copy is sent to the Commission. The provider must make sure that monthly monitoring visits are carried out and reports are sent to the home and the Commission. The manager must make sure that staff are aware of the monthly monitoring reports and that they are used to develop practice in the home. This requirement is repeated. The original timescale of 31/10/07 was not met. 31/03/08 31/03/08 31/03/08 31/03/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard YA21 YA23 YA37 Good Practice Recommendations Staff should work with residents and their relatives / representatives to record information about each person’s wishes with regard to illness, ageing and death. Staff must make sure that the support they give residents is recorded accurately. The Manager should tell the Commission when he DS0000017518.V355864.R01.S.doc Version 5.2 Page 23 Real Life Options 2-4 Bethecar Road completes his National Vocational Qualification Level 4 training. Real Life Options 2-4 Bethecar Road DS0000017518.V355864.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Harrow Area office Fourth Floor Aspect Gate 166 College Road Harrow HA1 1BH 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 Real Life Options 2-4 Bethecar Road DS0000017518.V355864.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. 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