Inspection on 10/01/06 for 147 Cheriton Road

This inspection was carried out on 10th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

147 Cheriton Road 16/01/07

147 Cheriton Road 06/07/05

147 Cheriton Road 02/02/05

147 Cheriton Road 02/08/04

147 Cheriton Road 05/01/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 147 Cheriton Road Folkestone Kent CT19 5HE Lead Inspector Michele Etherton Announced Inspection 10th January 2006 9:40 DS0000023286.V265580.R01.S.doc Version 5.0 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 DS0000023286.V265580.R01.S.doc Version 5.0 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. DS0000023286.V265580.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service 147 Cheriton Road Address Folkestone Kent CT19 5HE 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) 01303 850475 Nicola.masters@hft.org.uk Home Farm Trust Mrs Nicola Anne Masters Care Home 8 Category(ies) of Learning disability (8) registration, with number of places DS0000023286.V265580.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 6th July 2005 Brief Description of the Service: 147 Cheriton Road, is located on a busy main road running through a pleasant residential area of Folkestone. The Home is close to a mainline rail station and is on a public bus route, it is close to a range of leisure and educational facilities and is within walking distance of the main town shopping area. The Home is Registered for 8 adults with learning disabilities and offers a spacious and comfortable environment to those who wish to develop their daily living and independence skills, the ethos of the Home encourages empowerment of Service Users, assertiveness and maximisation of potential with a view to moving on to a shared flat etc with minimal staff support at a later stage. Current Service Users prefer to be referred to as `Tenants. The premises consist of a large semi detached period property still retaining some original features. The accommodation ranges over four floors with a basement providing space for a laundry facility and additional storage. The kitchen, dining room, and tenants lounge in addition to the staff office/sleep in room and wash facilities are located on the ground floor, with access to the rear garden via the dining area. Tenant bedrooms are located on the first and second floors, and are all single occupancy. Access to these floors is by stairs only, the Home is therefore, unsuitable for anyone with a mobility problem. The Home has been open for approximately 12 years. Tenants are supported by a manager and seven care staff, a sleep in staff member is also provided at all times. Outreach is provided by the home to former tenants. DS0000023286.V265580.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection and took place between 9.40 am and 4.45 pm. The purpose of the inspection was to check progress made by the home on addressing an outstanding requirement and implementing good practice recommendations identified at the previous inspection. A number of key inspection standards were also still to be assessed for this inspection year. During this visit a tour of the premises was undertaken when all communal areas were viewed including three tenant bedrooms (viewed with their permission). The Inspector met and spoke with 4 staff including the manager. Throughout the course of inspection the inspector met and spoke with six service users (some in more depth than others) who were coming and going from the home. A reduced range of documentation was also assessed. Feedback from were received from relatives, tenants and health and social care professionals and their views have been taken account of in undertaking the inspection and have contributed to the compiling of this report. What the service does well: What has improved since the last inspection? The home has reviewed the content of person centred plans, and added additional information, some previous recommendations for improved practice have been fully addressed and others have been partially addressed. Improvements have been made to the environment with all bathrooms redecorated, the dining room floor covering replaced, and several outstanding risk assessments addressed. DS0000023286.V265580.R01.S.doc Version 5.0 Page 6 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. DS0000023286.V265580.R01.S.doc Version 5.0 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 DS0000023286.V265580.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,5 Prospective tenants are provided with information about the service they are considering, however, their decisions would be better informed by the inclusion of existing tenants views into user guide information. The assessment process for new tenants could be improved upon by more clearly evidencing how the views and concerns of staff and other tenants have been taken account of, in influencing the decision to admit or not. Amendments to the tenants terms and conditions document are still needed to ensure compliance with the standard. EVIDENCE: The home has developed a report of feedback obtained from existing tenants that reflects their personal comments and views regarding the service, this needs to be anonomised and incorporated into the current user guide, to aid and inform the decision making of prospective tenants. Although partially addressed this remains an outstanding recommendation. The inspector was satisfied from viewing assessment record information and speaking with staff, that the facility exists for staff to be involved in the assessment process at local level through observation, monitoring incidents, etc and giving feedback. There was, however, insufficient evidence to demonstrate where placement decisions are taken, that consideration is given to user and staff feedback, or that it is influential in this process. As a DS0000023286.V265580.R01.S.doc Version 5.0 Page 9 consequence this outstanding recommendation has only been partially addressed at this time The home is still to address an outstanding recommendation to amend tenant contracts in compliance with standard 5.2, this has been delayed owing to some planned moves amongst the current tenants, and other moves less certain. In view of the continued delay the Home manager has agreed to approach the current Housing association to review the current tenant terms and conditions for 147 Cheriton Road, until addressed this remains an outstanding recommendation. DS0000023286.V265580.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 Tenants benefit from clearly defined goals, and improved detail in respect of needs and routines ensures appropriate care support is provided to achieve goals. Tenants are supported and enabled to make decisions about their lives. EVIDENCE: Two, person centred plans were viewed at inspection. The home have improved the content and detail of information provided within person centred plans, that informs and enables new and existing staff to better understand and support the needs of tenants effectively, and help them with working towards achieving goals. It was agreed with the manager that the addition of information specific to individual tenants currently held within the knowledge base of the existing staff members, should be written down to further enhance all staff’ ability to meet their needs.. Although person centred plans are developed with the tenants, the home still needs to offer them the facility to sign their agreement to the plan. Risk assessments were also viewed these are drawn up from direct consultation with tenants, and usually forwarded to care managers for approval, the home manager has agreed to ensure that tenants are also involved in signing agreement to their risk assessments. The inspector considers these outstanding recommendations to have been only partially addressed until user consents have been implemented. DS0000023286.V265580.R01.S.doc Version 5.0 Page 11 The inspector viewed three Tenant bedrooms with permission, all tenants are offered their own room key and some were observed during inspection locking and unlocking their own bedroom doors. One service user spoke of changes to their bedroom that they had been influential in, and in one instance further planned changes. All of the tenants enjoy an active lifestyle with a number involved in voluntary work placements, and two in paid work placements. Tenants decide whether to increase or decrease their activities and have been actively involved recently in identifying alternative activities that they would wish to pursue, owing to changes to adult education arrangements.. DS0000023286.V265580.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 15,16,17 Tenants are supported and facilitated to maintain contact with families and friends. Tenants enjoy an active, fulfilling daily lifestyle that respects their rights. Tenants actively participate in the development of menus and the preparation and cooking of meals, recording of tenants food intake could however, be improved upon to ensure variety and nutritional value is being appropriately maintained. EVIDENCE: Feedback from relatives and tenants indicate that regular contacts are maintained. Tenants confirmed visits home for Christmas, family holidays and special occasions, staff support and facilitate contacts by helping with letter writing and in some instances transportation to ensure contacts are maintained. Visiting arrangements to the house are flexible. Discussion with staff and tenants confirmed tenants responsibility for their own personal effects and have lockable facilities in their rooms to which they have keys. They also have their own room keys and are responsible for locking their bedrooms. Staff were observed throughout the inspection interacting with tenants and participating in supervised activities in house, e.g. supporting letter writing activities, cooking. Other tenants were observed occupying their own time with drawing etc. The inspector observed tenants leaving and DS0000023286.V265580.R01.S.doc Version 5.0 Page 13 entering the house, to attend or return from activities, sometimes with staff supervision. All tenants have housekeeping responsibilities. DS0000023286.V265580.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,20 Staff support tenants according to need and preferences, where preferences have not been expressed, staff should work to best practice to ensure tenants rights are not compromised. Service users benefit from improvements to medication arrangements implemented since the last inspection. EVIDENCE: Generally, personal support is offered to tenants in accordance with their needs and expressed preferences, discussion with staff highlighted good insight into the need to maintain the dignity and privacy of tenants, whilst continuing to provide discreet support. It would appear that male staff are still routinely offering female tenants personal care support at times other than emergencies. Whilst respecting tenants rights to maintain personal care routines, where no expressed preference has been made or recorded in regard to who provides that support, it is an expectation that the female tenants will be offered support from a staff member of the same gender as best practice clearly there will always be a need for male staff to be able to offer personal care support in an emergency, but this should be viewed as the exception rather than the rule. It is recommended that the Home manager review shift patterns to ensure that gender appropriate staffing is available at those times when female tenants require personal care support. The medication standard was assessed at the last inspection and highlighted the need for the home to develop a risk assessment for one user who self DS0000023286.V265580.R01.S.doc Version 5.0 Page 15 administers a topical medication. Improvements also needed to be made to the quality of sample staff signatures used for medication administration. The inspector was satisfied from documentation viewed at inspection that these shortfalls have now been addressed. The inspector discussed with the manager the need to ensure that details of tenants medical treatment programmes etc, where staff have a direct responsibility for making appointments, monitoring etc are clearly recorded in tenant files, and not knowledge retained by only a few longer term staff. The manager understood the implications of this information not being readily available to all staff and has agreed to review person centred plans and supporting information to ensure this is incorporated. DS0000023286.V265580.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Tenants are confident about using the complaints procedure and are encouraged to do so by staff. Details recorded of investigation could be improved upon to ensure this process has been thorough. Robust procedures protect tenants within the home from abuse, neglect and self –harm, consideration should be given as to whether improvements could be made to the risk assessment of external situations to minimise risks further. EVIDENCE: The home has responded to a previous recommendation to ensure all complaints are recorded in a central record. The complaints record viewed at inspection indicated complaints from individuals and groups of service users, however, the detail recorded of the investigations undertaken and their outcomes was insufficient to make a judgement that this had been undertaken thoroughly and to the satisfaction of the complainants. Improvements to recording were discussed with the manager at inspection and the inspector was satisfied that these would be implemented. The manager and staff have actively sought the provision of agreed behaviour guidelines to work more effectively with one tenant, and these are to be reviewed shortly. The home operates a good system for the management of Tenants monies. All tenants have their own savings book, and are in receipt of DLA mobility monies. Personal allowance monies for three tenants held by the home on their behalf were checked at inspection with cash amounts accurately balancing with financial records maintained by the home. Tenants have lockable facilities in their rooms and are responsible for their own personal effects. DS0000023286.V265580.R01.S.doc Version 5.0 Page 17 The home has actively responded to a report of bullying from a tenant at their place of work. An adult protection referral has also been made as a result of an incident that occurred externally to the home, the investigation has taken place, and the referral is now awaiting closure. The inspector has discussed the incident with the home manager and has recommended that the home review or implement risk assessments of activities that involve external friends of tenants. DS0000023286.V265580.R01.S.doc Version 5.0 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, Tenants benefit from improvements and upgrading to the environment EVIDENCE: The inspector made a tour of the premises, viewing all communal areas and three tenant bedrooms with their agreement. The previous inspection highlighted that the carpet in the dining room was worn and posed a potential risk to tenants, this has now been replaced with a wooden laminate flooring. Tenant bathrooms throughout the property have been redecorated and present a cleaner, and more pleasant environment, a first floor bathroom although repainted is still to be upgraded, with pipework covered and broken tiling replaced. A risk assessment for flooring in a tenant bedroom has been completed. A review of staff smoking arrangements has been undertaken in response to the disposal of cigarette noted at the last inspection, new protocols have been established for staff to follow. From discussion with the manager the inspector was satisfied that ongoing upgrade works are planned, including the installation of a porch, pigeon guards, the upgrading of the main hallway. Cracks in plaster work above the stairs on the ground floor, have also been reported and are awaiting investigation, none of these improvements feature in a service development plan (see standard 39) DS0000023286.V265580.R01.S.doc Version 5.0 Page 19 DS0000023286.V265580.R01.S.doc Version 5.0 Page 20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33, 34, 35, Staffing levels are less that that recommended through the residential care staffing tool and need reviewing to ensure they are adequate. Feedback from the manager and staff indicate a robust recruitment is in place however, this could not be supported from documentation available in the home. Tenants are supported by staff who receive appropriate and regular training EVIDENCE: Discussion with the manager and staff indicated that tenant dependency levels have been assessed as 1 high, 3 medium, 4 low. A calculation of recommended staffing hours using the residential forum staffing tool indicates that despite additional staffing provided to support the newest and most highly dependent tenant, and taking account of time spent out of the home on activities by tenants that a shortfall of approximately 20 hours exists. Feedback from staff, users and relatives does not indicate that any of these groups have concerns about staffing levels at this time, however, it is recommended that the home completes the staffing tool itself and reviews staffing levels accordingly. In discussion with new staff and with the manager it would appear that the Home and HFT ensure that a robust recruitment is undertaken of new staff, however, this could not be evidenced from personnel files held at the home, as several were without relevant documentation required under schedule 2 of the Care Homes Regulations. This recommendation has been ongoing for some time with the home experiencing difficulties in obtaining copies of DS0000023286.V265580.R01.S.doc Version 5.0 Page 21 documentation to incorporate in home files. It is a requirement that the home can evidence through documentation within the home that a robust recruitment procedure is undertaken for all new staff. From discussion with individual staff, the manager and a review of training matrix and individual staff training information, the inspector was satisfied that new staff are receiving an in depth induction that incorporates LDAF training, the inspector recommended that the manager ensure that the current induction package has been developed in keeping with the recent changes to induction for care staff implemented by the sector skills council. DS0000023286.V265580.R01.S.doc Version 5.0 Page 22 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39, The home is well managed by a competent and qualified manager. Limited progress has been made in the development of quality assurance, or the homes ability to evidence how tenants views influence service development. EVIDENCE: The home is well managed, the current manager is experienced, competent and qualified, she can also demonstrate an ongoing personal commitment to training and development. The inspector has commented on the inadequacy of the detail provided within the regulation 26 provider visit reports received by the commission, these are not routinely submitted to the commission and are lacking in the required detail needed to ensure that visits are being undertaken sufficiently robustly, it is essential that providers can demonstrate that they have met and spoken with named tenants and staff on each visit, feedback at inspection from staff and users indicated mixed views as to whether this is done regularly or in sufficient detail to enable the provider representative to make a valid judgement about the service, as a result it is a requirement that these shortfalls within regulation 26 reports are addressed. DS0000023286.V265580.R01.S.doc Version 5.0 Page 23 The home has introduced a system for seeking tenants views at least three times per year, and has compiled a report of these views. This needs to be extended to analyse feedback and incorporate in development plans for the service, which have to date not be developed or made available for inspection. Whilst the home adopts a number of quality checks of various parts of its service these are stand alone and do not form any part of a quality assurance system or self monitoring procedure; it is a requirement that the home develops a quality assurance and quality monitoring system, extends feedback to other stakeholders, develops a service development plan, and can evidence how the views of tenants and other stakeholder influences this. Having viewed staff training information the inspector was satisfied that all members of the staff team have received infection control training and fire safety and that a previous recommendation in respect of this has been achieved. Two new staff appointed since the last inspection are still to complete some core skills training, and HFT must ensure that provision of this training does not slip beyond six months from employment for all core skills. DS0000023286.V265580.R01.S.doc Version 5.0 Page 24 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 x x 2 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 3 x x x Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x x LIFESTYLES Standard No Score 11 x 12 x 13 x 14 x 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score x x 3 2 3 x CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 x 3 x Standard No 37 38 39 40 41 42 43 Score 3 x 2 x x 3 x DS0000023286.V265580.R01.S.doc Version 5.0 Page 25 Are there any outstanding requirements from the last inspection? Yes(partially completed) 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 Requirement Timescale for action 30/03/06 2 YA34 19 (sch 2) 3 YA39 24 &26 tenants or their representatives where necessary to sign their agreement to the PCP/care plan (previous requirement partially addressed within timescale). Home to provide documentary 10/02/06 evidence within the home that a robust recruitment procedure is in place Regulation 26 provider visit 10/02/06 reports to contain detail of service users, staff spoken with. The home to develop a quality assurance and quality monitoring system, extends feedback to other stakeholders, develops a service development plan, and can evidence how the views of tenants and other stakeholder influences this. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. DS0000023286.V265580.R01.S.doc Version 5.0 Page 26 No. 1. 2. 3. 4. 5. 6. 7. 8 9 Refer to Standard YA1 YA2 YA5 YA6 YA17 YA18 YA22 YA23 YA35 Good Practice Recommendations Tenants views recorded by the home are to be incorporated into the user guide and routinely updated (Partially addressed from previous inspection) HFT to more clearly evidence how feedback from staff and tenants influences placement decisions.(Partially addressed from previous inspection) That 5.2iii & 5.2vii of the standard are incorporated in with the licence agreement for all tenants at Cheriton road Tenants agreements to Care plan/PCP and risk assessments to be recorded in care plan information.(partially addressed from previous inspection) Improvements to be made to the recording of tenant food intake Home to review staff work patterns to ensure gender appropriate staff are available to those tenants who require personal care support routinely. More detail of investigation and outcomes to be incorporated into complaints recording Risk assessments to be put in place for all external activities including visits to friends. Manager to ensure that staff induction programme takes account of changes to care staff induction implemented by sector skills council DS0000023286.V265580.R01.S.doc Version 5.0 Page 27 Commission for Social Care Inspection Kent and Medway Area Office 11th Floor International House Dover Place Ashford Kent TN23 1HU National Enquiry Line: 0845 015 0120 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 DS0000023286.V265580.R01.S.doc Version 5.0 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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