Inspection on 16/08/06 for 15 Cliffe Avenue

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

What the care home does well

The home was clean and hygienic in all areas and continues to be improved through redecoration. Every day is started with each service user choosing what they wish to do and one service user had decided to stay in the home at the time of this inspection. Another person was enjoying a `house day` during which activities such as cleaning, personal shopping and cooking or eating out are undertaken. Daily activities were clearly shown on individual daily planners and supported with symbols. The weather condition is also considered when planning daily outings and insufficient staffing levels can often mean activities have to be altered. Service users are supported to become as independent as possible and to develop daily living skills. This is encouraging and enabling service users to participate in the local community and enjoy local amenities. Two service users are working towards becoming independent and moving into supported living. This has been accomplished with previous service users and staff work to support such outcomes. One service user has had ongoing medical checks and treatment is planned. This has been fully explained to the person concerned and is clearly shown on the care plan with Widget symbols to enable a fuller understanding to be reached.

What has improved since the last inspection?

The shower room has been improved and appropriate locks are now on all bathroom and toilet areas. The redecoration and refurbishment programme continues to improve the environment in the home. Service users have helped by participating in the redecoration of their rooms and choosing what colours are used. The garden presents a comfortable area in which to spend time outside. There is new fencing, flowerbeds, a seating area and herbs are being grown in small pots. The garden is used by service users and also by those using outreach services.

What the care home could do better:

Staffing levels have continued to be erratic and staff stated they have been working hard to cover all shifts. Permanent staffing levels are required to ensure a stable and familiar environment is maintained for service users. This also ensures complete continuity of care at all times. The care plans are not reviewed on a monthly basis and record keeping is poor. Due to the absence of reviews and regular monitoring of care plans, the fact that one service user had not eaten a complete meal for some days went unnoticed. Regular gaps on the diet sheets appear to be common practice and therefore this vital sign of a problem was not picked up. Incident reports are being fully completed and some of these records were seen at this time, but these are currently not being copied to the appropriate organisations. This was discussed and information was immediately put with the incident report book to make sure this is now undertaken. Incident reports do contain full information regarding matters that occurred before any incident or accident, but current forms do not have details of how a similar incident can be avoided. There is also no indication of how or when incidents are monitored. This again does not support ongoing good practice or the safety and well being of service users. The garden shed containing a freezer and fridge that are being used by the home is currently dirty and a health and safety risk. Practices regarding the storage of the key to the medication cupboard must meet current guidelines for the safe storage of medication. The routine being undertaken at this time was not meeting these standards.The home has organisational policies and procedures in respect of abuse, whistle-blowing and complaints. However, local procedures are needed to fully support staff in their role. There is a service user complaints file in place, but the last entry was dated 2003. Complaints must be formally recorded at all times, no matter how small, to ensure the protection and well being of service users. All staff need to be aware of how to fully record complaints and this should be part of the induction process. There was no complaints book available at this time and staff were unaware of the existence of any complaints file.