Inspection on 01/10/07 for 151 Tunbury Avenue

This inspection was carried out on 1st October 2007.

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 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

151 Tunbury Avenue 20/01/10

151 Tunbury Avenue 11/07/06

151 Tunbury Avenue 15/12/05

151 Tunbury Avenue 28/06/05

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Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

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

CARE HOME ADULTS 18-65 151 Tunbury Avenue 151 Tunbury Avenue Chatham Kent ME5 9HY Lead Inspector Debbie Sullivan Key Unannounced Inspection 1st October 2007 09:05 151 Tunbury Avenue DS0000064404.V348831.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 151 Tunbury Avenue DS0000064404.V348831.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. 151 Tunbury Avenue DS0000064404.V348831.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 151 Tunbury Avenue Address 151 Tunbury Avenue Chatham Kent ME5 9HY 01622 769100 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) MCCH Society Ltd Care Home 3 Category(ies) of Learning disability (2), Learning disability over registration, with number 65 years of age (1) of places 151 Tunbury Avenue DS0000064404.V348831.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 23rd November 2006 Brief Description of the Service: 151 Tunbury Avenue is one of a number of homes managed by MCCH Society Ltd. The home offers 24-hour care for service users with a learning disability and can accommodate people with a physical disability. It is a large detached bungalow located within a pleasant residential area. The home has access to transport that is shared between several homes from that group. Service users have opportunities to access a range of activities at home and in the community. The team of support staff receive training provided by the organisation and either have an NVQ 2 or 3 in care or are working towards gaining one. The fees charged for this service start at £1,287 per week and are based on an assessment of individual need. 151 Tunbury Avenue DS0000064404.V348831.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced key inspection of 151 Tunbury Avenue took place over six and a half hours in the company of the manager, support staff, and service users. The property was toured, a range of records and other documentation were read and time was spent speaking individually with service users and staff. Due to the nature of the service some judgements have mainly been based on information in documentation and from observation, and discussion with the manager. The Annual Quality Assurance Assessment document completed by the manager provided additional information. Services are required to complete an AQAA annually. A random inspection took place on 23rd November 2006 to follow up progress on the requirements made at the key inspection of 11th July 2006. The majority of requirements had been met and no new requirements were made at the random inspection. The overall finding was that good progress had been made. What the service does well: What has improved since the last inspection? Each service user has been provided with a contract with the home. There is more use of person centred planning and care plans have been revised to give more information on the service users individual aspirations, needs and preferences. Service users are more involved in their care planning. 151 Tunbury Avenue DS0000064404.V348831.R01.S.doc Version 5.2 Page 6 Nutritional needs have been assessed and are regularly reviewed by a dietician and staff have been provided with more information on healthy eating. Medication procedures have improved with better information on medications overall and clearer PRN guidelines being made available to staff. An occupational therapy assessment of toileting and bathroom facilities has taken place. Service users all have a copy of the complaints procedure, it is displayed in the home and they are provided with a quality assurance survey six monthly. 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. 151 Tunbury Avenue DS0000064404.V348831.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection 151 Tunbury Avenue DS0000064404.V348831.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3 and 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users and their representatives have access to information about the home. Needs are assessed prior to admission and contracts are now in place. EVIDENCE: The home has a statement of purpose and service user’s guide, both offer up to date information and are in written and pictorial formats. A service user had been involved in preparing new information on policies for the service users guide, such as the smoking and pets policy. There have been no new admissions for some time and there were no plans for any change to the service user group. The needs of service users had been assessed before they moved in and are regularly reviewed within the person centred care process. The manager gave examples of where needs had changed and the service had adapted to meet them. 151 Tunbury Avenue DS0000064404.V348831.R01.S.doc Version 5.2 Page 9 Contracts were not in place at the last key inspection but had been provided when the random inspection took place, the contracts outline the terms and conditions of care to be provided. 151 Tunbury Avenue DS0000064404.V348831.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans reflect the individual needs, preferences and goals of service users and are person centred. Service users are supported to make decisions about their lives and to be involved in the daily running of the home. EVIDENCE: The care plan format has been revised since the last key inspection and the home is using more person centred planning. Each service user has a care and health care plan; both contain thorough information. As far as possible service users are encouraged to be involved in developing their care plans and one service user had signed some of the content including their gender preference for personal care support. Needs, preferences and goals are well recorded and reviews take place. 151 Tunbury Avenue DS0000064404.V348831.R01.S.doc Version 5.2 Page 11 Changes in needs are well recorded. The person centred planning process is still fairly new within the home and the manager intends to expand its use more. Staff are provided with relevant training. Service users are encouraged to make decisions on a daily basis and to express their views at regular meetings with their key workers. Staff have been exploring ways to introduce activities and inclusion for a service user who has no verbal communication and observation. During the inspection they showed that they are aware of the service users’ mood and provide support accordingly. One service user likes to be involved in doing their own laundry and had made decisions about meals they wanted provided. A small folder that condenses the information on care plans called “my folder” has been introduced to make information easy for service users to access whilst they can always see their main care plan. Service users are supported in making decisions about choice of meals, activities, holidays and how to spend their time at home. The manager said that one service user had had an advocate for a while and this could be reintroduced if necessary. Risk assessments are undertaken for activities at home and in the community, where a new activity takes place, such as a holiday an assessment is made. Information on service users is stored confidentially and staff respected personal information when discussing service users’ needs with each other. 151 Tunbury Avenue DS0000064404.V348831.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,14,15,16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are supported to participate in activities at home and in the community and contact with friends and family is promoted. Improvement needs to take place regarding the rights of all service users to have free access to the garden, whilst rights in other areas of daily living are respected. EVIDENCE: Each service user has a personal weekly activities timetable, these include at home and community activities. During the inspection one service user went out to a music group that helps to develop motor skills, and received an invitation to the birthday party of a friend who lives in another MCCH house. The organiser of the music group also visits the house to provide sessions. 151 Tunbury Avenue DS0000064404.V348831.R01.S.doc Version 5.2 Page 13 Community activities include, shopping, attending church, going out for lunch, going to a nightclub, and visiting friends. One service user is not overly keen on going out but has an interest in dogs, so is supported in going to local puppy and dog training session regularly. Another service user who likes music had recently been to see the “Lion King” and whilst in London saw someone singing opera. The manager said that the service user non-verbally communicated that they enjoyed this so this interest is being promoted. At home service users can watch TV, listen to music, chat with staff and are supported with finances. Financial recording is robust and records checked were accurate. One service user was off on holiday during the inspection, they were going to Witshire with two permanent staff members for five days; a lot of preparation had gone into arranging the holiday. The house has space for visitors to see service users privately away from their bedrooms, visits are welcomed and the manager keeps in touch with a service user’s family over progress. Staff respect the rights of service users and this had improved regarding the use of one service user’s bedroom to access the garden, this no longer takes place and the service user confirmed it had stopped, although the other service users are unable to access the garden at all now. This is not so much a problem in colder months and the manager was able to provide written evidence that the organisation has now agreed to put decking round one side of the house to allow wheelchair access to the garden. There is a menu and the manager said that it is flexible with changes being made if service users choose. One service user sometimes chooses to eat a low fat option and is able to prepare their own meals and drinks. Nutritional needs are now more closely monitored and a dietician who visits quarterly has assessed each service user. One service user has osteoporosis and is provided with high calcium snacks to boost their diet, another has blended and thickened meals. Information on healthy eating and nutritional needs is available for staff to follow. The manager said that there are plans to provide a more accessible work surface for service users along with other alterations to the kitchen, but there is no date yet for work to start. 151 Tunbury Avenue DS0000064404.V348831.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 and 21 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The personal and healthcare needs of service users are well met and recorded. The home has good relationships with health professionals. Medication procedures have improved. EVIDENCE: Personal care support preferences are recorded on care plans; one service user had signed their form. Staff observed to respected preferences and provided personal care discreetly. Service users have a wide range of health needs and these are well documented and any concerns referred on swiftly. The manager said that there were good links with health professionals; these include, the dietician, speech and language therapist, district nurse, physiotherapist, occupational therapist and GP. Some health needs are connected with ageing and staff have become 151 Tunbury Avenue DS0000064404.V348831.R01.S.doc Version 5.2 Page 15 more aware ageing issues. One service user’s medication had been completely reviewed three months ago by a neurologist with the result that they had become more alert and involved and were able to communicate a little verbally. Two service users have cataracts and the manager said that it was planned that a new television be provided in the lounge with a bigger screen. One service user was being encouraged to practice walking with their Zimmer and was keen to tell the manager how far they had walked. Awareness of health needs is being promoted with health professionals being invited to team meetings. Medication procedures are improved with clearer guidelines in place for some PRN medication, the manager had been dissatisfied with communication from a GP over medication changes, so service users have changed GP and the communication is better. The pharmacy used had been contacted in writing over anomalies in some medication information and all records have now been checked and corrected. Medication is stored safely and two staff administer. If service users choose wishes in the event of death these are recorded on the care plan. 151 Tunbury Avenue DS0000064404.V348831.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users have access to the complaints procedure and support can be provided to enable them to raise concerns. The policies and procedures in place serve to protect service users and awareness of adult protection is improved. EVIDENCE: Each service user has a copy of the pictorial complaints procedure in their room and the procedure is displayed near the front door. A service user spoken with knew how to complain, others would need support to make their views known and one service user can access an advocate if needed. One complaint had been received since the last key inspection and there is an open adult protection alert that was raised over a year ago that does not relate to any staff currently employed. The views of service users are also obtained in six monthly quality assurance surveys. Staff are receiving POVA training and updates scheduled. There is an MCCH adult protection policy; the AQAA states that this was reviewed in March 2007. Procedures are in place to protect the safety of a service user who can sometimes display challenging behaviour. . 151 Tunbury Avenue DS0000064404.V348831.R01.S.doc Version 5.2 Page 17 151 Tunbury Avenue DS0000064404.V348831.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26,27,28,29 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users live in a clean and comfortable home. Improvements are needed to the bathroom and to kitchen and garden access so that assessed needs are fully met and service users can have opportunities for more choice and independence. Access to the laundry must be relocated to improve the standard of hygiene. EVIDENCE: The home is comfortable and clean and service users’ bedrooms are personalised. One service user spoken with said that they liked their room. One bedroom contains some sensory equipment and another service user has their own large fish tank in their room, only one bedroom is en-suite. 151 Tunbury Avenue DS0000064404.V348831.R01.S.doc Version 5.2 Page 19 Communal space comprises of the lounge, dining room and kitchen. The house generally is in need of refurbishment and the lounge especially is looking “tired”, the carpet is very stained in places. The kitchen is fairly spacious and the manager provided a copy of the plan to provide access to the laundry so that dirty washing does not need to be taken through the kitchen and to provide a low level work top, there is no date set yet for this work to commence and it must be seen as a priority. As a precaution all washing is put into bags before it goes through the kitchen, but as there is frequently soiled laundry the use of this route must stop as soon as possible. The bathroom/toilet is used by all the service users and again is in need of refurbishment. The last two inspections identified that there were plans to renovate it and add a walk in shower but again there is still no date for work to be done. An occupational therapy assessment has now taken place of the bathroom and toilet facilities, bath equipment has been provided that is acceptable but a new bath would alleviate the need for this and further reduce any risk to service users or staff. The occupational therapist provided a toilet seat so that the use of a makeshift handling belt to prevent two of the service users falling off the toilet was no longer necessary, but when tried out the seat was found to be unsuitable. The OT is looking for a source of more suitable equipment and the manager was going to chase this up. The occupational therapist and physiotherapist have enabled access to other specialist equipment including a reclining chair for one service user and new wheelchair for another. The garden is well maintained and attractive with a patio area, it is accessible from the patio via a ramp with handrails but the only access to the patio for wheelchair users is through a bedroom. The practice of using this access has ceased but as a result two service users are restricted. The organisation has now agreed that decking around one side of the building and leading to the access to the garden will be fitted, this work must start to ensure that service users can get into the garden especially when weather improves again in the Spring. 151 Tunbury Avenue DS0000064404.V348831.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35 and 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A staff team who are knowledgeable about their needs and relates well to them supports service users. Staff receive relevant training and regular supervision. The provision of a full staff team following recruitment will benefit service users. EVIDENCE: The home is staffed by the manager and a team of support staff, there is one senior. Since the last key inspection the team had changed and staff are settling into their roles. There had been some use of agency staff in recent weeks due to staff holidays and sickness. The manager expected this to improve as two staff off sick were due to return and recruitment for a vacant post was receiving good initial response. It is planned that a service user will be on the interview panel. Permanent staff sometimes cover gaps in the rota to provide consistency of care and the manager monitors their hours so that they stay within the limit. The provision of MCCH bank staff is less available as bank arrangements are under review. Night time cover had been reviewed, there is 151 Tunbury Avenue DS0000064404.V348831.R01.S.doc Version 5.2 Page 21 one sleep in night staff with the option to change to waking or two staff if a service user is unwell or needs change. A service user spoken with said they did not like having agency staff but liked “my own staff”. One member of staff had gained NVQ levels 2 and 3 in care and all the others were working towards an NVQ in care. MCCH provides a good range of training and the training matrix tracked the need for mandatory training or updates, service specific courses are also available such as person centred planning and epilepsy. It is recommended that training on sensory impairment and communication be provided. Staff observed during the visit were respectful at all times to service users, genuinely interested in providing a good service, knowledgeable about their needs and service users relate well to them. A staff member said that “staff work well together”. The CSCI Provider Relationship Manager inspects staff recruitment records centrally at least once a year, the latest inspection found no major shortfalls in processes. Some staff training and supervision records were seen on the visit supervisions are held approximately six weekly and are recorded and team meetings take place. The manager receives supervision from the senior service manager. Health professionals are being invited to staff meetings to help increase awareness of needs. 151 Tunbury Avenue DS0000064404.V348831.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37,38,39,40,41,42 and 43 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed and service users benefit from improvements that have been made in the past year. Service users have opportunities to give their views on the home. Improvements to the property will further protect the health and safety of service users and staff. EVIDENCE: The manager is in the process of applying for registration and is working towards the NVQ 4 in care, it is hoped this will shortly be completed. The management of the home has presented challenges over the past year with the introduction of a new staff team and changes in the needs of service 151 Tunbury Avenue DS0000064404.V348831.R01.S.doc Version 5.2 Page 23 users; these have been effectively managed. Positive work had taken place by the time of the random inspection to meet the majority of requirements made at the key inspection in July 2006, those still outstanding all relate to the need to improve the environment and safety, and the organisation must address them. The home is well run and service users are given opportunities to air their views via quality assurance surveys and meetings with staff. A range of organisational policies and procedures are in place and those specific to the home are developed, such as the smoking policy that involved a service user. Records are kept securely and are well maintained, records are respectfully and appropriately completed by staff. The AQAA was returned to CSCI within the given timescale. Health and safety checks take place and equipment is serviced, fridge and freezer temperatures are taken twice daily, fire equipment is regularly checked and the last full fire practice in June 2007 was well documented. Health and safety measures will improve with new access to the laundry. A designated manager from another MCCH service undertakes regulation 26visits and the senior service manager is in regular contact. 151 Tunbury Avenue DS0000064404.V348831.R01.S.doc Version 5.2 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 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 2 25 3 26 3 27 2 28 2 29 2 30 1 STAFFING Standard No Score 31 3 32 2 33 2 34 X 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 DS0000064404.V348831.R01.S.doc 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 2 17 3 Score PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 151 Tunbury Avenue Score 3 3 3 3 2 3 3 3 3 2 3 Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? YES 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 YA16 Regulation 12(4a) Timescale for action The registered person shall make 01/12/07 suitable arrangements to ensure that the care home is conducted in a manner that respects the privacy and dignity of service users. In that, service users must be able to access the garden without going through another service users bedroom. This requirement is repeated from the last key inspection and is partially met in that access via the bedroom has ceased and the organisation has given agreement to alternative access being provided. Work on the decking to provide access must take place and evidence of a start date be provided to CSCI by the date given. Prior to the date given for timescale for action the manager advised that the work on fitting decking had commenced. 151 Tunbury Avenue DS0000064404.V348831.R01.S.doc Version 5.2 Page 26 Requirement 2. YA27 23(2)(n) The registered person shall ensure that suitable adaptations are made and such support equipment and facilities as may be required are provided, for service users who are old infirm or physically disabled. In that the bathroom must be refurbished and fitted with a more suitable bath and shower facilities. Evidence that work is scheduled must be provided by the date given. 31/12/07 3. YA30 13(3) The registered person shall make 31/12/07 suitable arrangements to prevent infection, toxic conditions and the spread of infection at the care home. In that work to relocate access to the laundry must be put into place so that access is not via the kitchen. 4. YA42 13(7) The registered person shall ensure that no service user is subject to physical restraint unless restraint of the kind employed is the only practicable means of securing the welfare of that or any other service user and there are exceptional circumstances. In that, the use of the makeshift restraint on the toilet must be assessed by an appropriately qualified person to ensure that the correct equipment is being used. All safety restraints must be fitted according to manufacturers instructions. 01/12/07 151 Tunbury Avenue DS0000064404.V348831.R01.S.doc Version 5.2 Page 27 This requirement has been partially met in that an OT assessment has taken place but equipment they provided was unsuitable. The manager must liaise with the OT to prevent further undue delay in meeting this requirement. 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. Refer to Standard YA33 Good Practice Recommendations It is strongly recommended that the organisation put into place the proposed reviewed bank staff arrangements so that when there are gaps in the rota bank staff who may know the home can be used rather than agency carers. It is recommended that staff be provided with training on sensory impairment and communication needs. It is recommended that the Manager complete the NVQ4 in management and in care. 2. 3. YA35 YA37 151 Tunbury Avenue DS0000064404.V348831.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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. 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