Inspection on 10/05/07 for 27 Graham Avenue

This inspection was carried out on 10th May 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 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

27 Graham Avenue 27/09/06

27 Graham Avenue 09/01/06

27 Graham Avenue 18/07/05

27 Graham Avenue 14/12/04

27 Graham Avenue 19/04/04

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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 27 Graham Avenue Brighton East Sussex BN1 8HA Lead Inspector Nigel Thompson Key Unannounced Inspection 10th May 2007 10:00 27 Graham Avenue DS0000014126.V338059.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 27 Graham Avenue DS0000014126.V338059.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. 27 Graham Avenue DS0000014126.V338059.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 27 Graham Avenue Address Brighton East Sussex BN1 8HA 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) 01273 503058 01273 552626 admin@rogate.org Hallcreed Limited Ms Kathleen Penney Care Home 4 Category(ies) of Learning disability (4) registration, with number of places 27 Graham Avenue DS0000014126.V338059.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The maximum number of service users to be accommodated is four (4). Service users must be aged between eighteen (18) and sixty-five (65) on admission. Service users with a learning disability only to be accommodated. Date of last inspection 27th September 2006 Brief Description of the Service: 27 Graham Avenue is registered to accommodate up to four people with a learning disability; it does not provide nursing care. The home is situated in a pleasant residential area of Brighton close to local shops and pubs. It is convenient for bus services into Brighton and other areas, and Preston Park train station is also nearby. The building is a three-storey semi-detached property with large rooms and has a patio area with a barbecue in the long rear garden. Residents have the use of a large lounge, a kitchen/dining room and a music room. They also have the advantage of the use of a hydrotherapy pool at one of the other properties owned by Hallcreed Ltd. There is ample free parking in the road outside the home. Information about the service, including the Statement of Purpose, Service User’s Guide and CSCI reports is made available to prospective service users or their relatives, on request, as part of the admission process. The current range of fees at 27 Graham Avenue, as of 10 May 2007, is £82.40 - £109.00 per day. 27 Graham Avenue DS0000014126.V338059.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key unannounced inspection took place over five hours in May 2007. It found that all of the key National Minimum Standards that were assessed had been met or partially met and the overall quality of care provided was good. The purpose of this inspection was to assess compliance with the requirements of the previous inspection and to generally monitor care practices at the home. On the day of the inspection there were four service users living at the home. The inspection involved a tour of the premises, observation of working practices, examination of the home’s records, contact with all four service users and discussion with two members of staff and - in the absence of the Registered Manager- the Care Service Manager (CSM). Responses from a CSCI service users’ survey, regarding their views on the home and quality of care provided, now form part of the inspection process and have also been included in this report. The focus of the inspection was on the quality of life for people who live at the home. What the service does well: The comfortable, relaxed and welcoming environment has evolved over several years and reflects the general stability and commitment within the staff team and the open and inclusive management style. Through working closely and consistently with service users, staff have developed a sound understanding of their individual care and support needs. Service users are encouraged and supported to make decisions about their lives. Where appropriate and practicable, they are involved and regularly consulted on many aspects of life in the home, including menu planning and activities. With the welcome appointment of a training officer the organisation ensures that care staff receive training appropriate for the work they perform. 27 Graham Avenue DS0000014126.V338059.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Service users individual care plans, including risk assessments, should be kept under regular review and updated to reflect changing needs and circumstances. It is important that there are sufficient qualified and competent care staff on duty at all times to meet the care and support needs of service users. Communication systems within the home, including daily progress notes and the recording of doctors’ visits, should be reviewed and improved to ensure that the emotional and health care needs of service users are met. The home’s policies and procedures should be regularly reviewed and updated and the current disorganised system of filing, including information in service users’ care plans could certainly be improved. Please contact the provider for advice of actions taken in response to this 27 Graham Avenue DS0000014126.V338059.R01.S.doc Version 5.2 Page 7 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. 27 Graham Avenue DS0000014126.V338059.R01.S.doc Version 5.2 Page 8 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 27 Graham Avenue DS0000014126.V338059.R01.S.doc Version 5.2 Page 9 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 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The thorough admission policy and procedure ensures that service users are admitted only on the basis of a full needs assessment, undertaken by people competent to do so. Prospective service users know that the home is able to meet their individual care and support needs. EVIDENCE: Information is made available to prospective and existing service users and includes the Statement of Purpose and Service User Guide. It was evident that both documents have been reviewed and updated, as required since the previous inspection, to accurately reflect the current situation at 27 Graham Avenue. It was noted that, in view of the variable and limited communication of people living in the home, the Service User Guide has been thoughtfully and imaginatively produced and information made more accessible with the use of pictures and symbols. 27 Graham Avenue DS0000014126.V338059.R01.S.doc Version 5.2 Page 10 The CSM confirmed that there have been no admissions to 27 Graham Avenue since 1993. Also, with no proposed changes, there is very little likelihood of anyone moving into the home in the foreseeable future. In line with the organisation’s current admission policy, following a referral to the home, the Director and/or the CSM would carry out a full pre-admission assessment of the prospective service user, to identify the individual’s care and support needs and establish whether such needs could be met. 27 Graham Avenue DS0000014126.V338059.R01.S.doc Version 5.2 Page 11 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 & 9 Quality in this outcome area is adequate. This judgement has been made using available evidence, including a visit to this service. Comprehensive, if somewhat disorganised care plans enable staff to meet the assessed support needs of service users in a structured and consistent manner, however they do not always reflect changing needs. Service users are treated with respect and encouraged and enabled to make decisions about their day-to-day living. EVIDENCE: Staff spoken to during the inspection confirmed that, despite the variable and limited verbal communication of some service users, effective and regular interaction and consultation takes place constantly throughout the home. This was evident from direct observation of staff supporting service users in a professional, sensitive and respectful manner. 27 Graham Avenue DS0000014126.V338059.R01.S.doc Version 5.2 Page 12 Despite a previous requirement, it was evident from service users individual care plans that were examined that plans, including risk assessments, are clearly not being kept under regular review and updated to reflect changing needs and circumstances. Two out of the three plans that were inspected had evidently not been reviewed for more than a year. The CSM confirmed that annual reviews are carried out, however she was unaware of whether interim reviews were held and there was no documentary evidence of such reviews taking place or of information in care plans being routinely updated. Following discussion with the CSM, it is recommended that service users’ care plans be more organised and structured, making information more readily accessible. It is also recommended, to ensure consistency and continuity, that service users’ daily progress notes be recorded in individual files 27 Graham Avenue DS0000014126.V338059.R01.S.doc Version 5.2 Page 13 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 & 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 enabled and supported to maintain contact with family and friends as they wish and effective links with the community enrich their social and educational opportunities. Service users benefit from appropriate recreational and leisure activities and menus that are balanced and nutritious, reflecting their individual likes and preferences. EVIDENCE: The CSM confirmed that, where appropriate, service users’ family links continue to be encouraged and supported, however not all service users have regular family contact. Visiting to the home is largely unrestricted and relatives and friends are made welcome at any reasonable time. 27 Graham Avenue DS0000014126.V338059.R01.S.doc Version 5.2 Page 14 As previously documented, despite the limited and variable communication skills of service users, staff have evidently worked closely and sensitively with individuals to develop effective levels of interaction. The recreational and leisure interests of service users are identified and recorded in their individual care plan and they continue to be supported to access activities and facilities, reflecting their individual needs, preferences and abilities. Activities and facilities regularly accessed by service users include attending a local day centre, various trips out, swing ball, swimming and a variety of other leisure activities. Although service users continue to be supported to access such activities and facilities, the current minimal staffing levels inevitably impact on the social opportunities available for individuals. This was confirmed by staff, spoken with during the inspection and evident from examination of the staff duty rota that indicated on occasions, including weekends, only one member of staff was on shift. The CSM and staff working in the home confirmed that menus are varied and balanced and are based on service users’ identified likes and preferences. An alternative to the main meal is always available and a copy of the menu is generally displayed in the kitchen – however this was not made available on the day of the inspection. A member of staff confirmed that service users are not generally involved in meal preparation. 27 Graham Avenue DS0000014126.V338059.R01.S.doc Version 5.2 Page 15 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 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Staff have developed close and positive relationships with service users and demonstrate an awareness and sound understanding of their individual care and support needs. Service users are protected by clear and comprehensive policies and procedures in place for the control and safe administration of medication. EVIDENCE: The CSM emphasised the importance of staff developing close working relationships with individual service users and being aware of changes in mood or behaviour. She also confirmed that the key worker system is being developed and is soon to be implemented within the home. Documentary evidence was in place to demonstrate that the health and emotional care needs are continuing to be met within the home. 27 Graham Avenue DS0000014126.V338059.R01.S.doc Version 5.2 Page 16 All service users are registered with local GPs and have access to other health care professionals, including district nurses, physiotherapists and dentists, as required. However it was noted, in care plans that were examined, that not all appointments with, or visits by, health care professionals are recorded. Up to date, detailed policies and procedures relating to the control, storage, administration and recording of medication are in place. Medicines are stored and recorded appropriately. All staff responsible for administering medication have received training and are individually assessed and authorised to do so. The CSM confirmed that, following risk assessments, no service user currently self-administers their own medication. 27 Graham Avenue DS0000014126.V338059.R01.S.doc Version 5.2 Page 17 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 & 23 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The home’s complaints procedure ensures that service users, staff and visitors feel able to express any concerns, confident that they will be listened to and acted upon. Service users are protected, through policies and procedures relating to abuse and adult protection. EVIDENCE: Since the previous inspection, as required, a copy of the home’s complaints procedure is now in place in the entrance hall, for the benefit of service users’ relatives and other visitors to the home and includes updated contact details for the CSCI. Members of staff, spoken with during the inspection, confirmed that they would have no hesitation in speaking to the manager or making a complaint if necessary and each person was confident that they would be listened to. For the benefit of service users living in the home, a simple illustrated complaints procedure has been developed, with the use of symbols. 27 Graham Avenue DS0000014126.V338059.R01.S.doc Version 5.2 Page 18 However due to their variable levels of mental capacity, the CSM added that it is unclear as to individual service users’ awareness or understanding of the process It was noted that there have been no concerns or complaints recorded by the home since the last inspection. The organisation has produced detailed policies and procedures relating to adult protection and abuse, including a whistle blowing policy. However, as previously documented, it is understood that these documents are currently being reviewed and updated by the CSM, as part of a ‘general overhaul’ of policies and procedures within the home. Staff are evidently made aware of relevant policies and procedures relating to abuse and adult protection through their induction training. The CSM confirmed that since the last inspection staff have undertaken specific adult protection training, in accordance with the multi agency guidelines for the protection of vulnerable adults. This was supported through discussions with members of staff during the inspection and evidenced through individual training records. . 27 Graham Avenue DS0000014126.V338059.R01.S.doc Version 5.2 Page 19 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, 28, 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The service is accessible, safe and clean and remains clearly suitable for it’s stated purpose. Service users benefit from all necessary specialist equipment and pleasant accommodation that is comfortable, well maintained and decorated to a satisfactory standard. EVIDENCE: It is evident that there has been little change in the physical environment of the home since the previous inspection and standards remain satisfactory throughout. During my ‘guided tour’ of the premises it was evident that the generally well maintained décor and adequate furniture and furnishings continue to provide a comfortable, pleasant and homely environment for service users. 27 Graham Avenue DS0000014126.V338059.R01.S.doc Version 5.2 Page 20 The home also provides service users with adequate and accessible communal areas including a spacious lounge, a good-sized kitchen diner and a ‘music’ room. At the rear of the property is a patio area with a long well maintained garden. The home continues to meet the requirements of the fire service and the environmental health department. The home has sufficient bathrooms/WC facilities for service users. One bedroom has an en-suite bathroom. The CSM confirmed that independence and individuality continue to be promoted within the home and this is evident from the personalising of service users’ individual rooms, reflecting individual preference and interests. It was noted that infection control policies and procedures are in place and clearly adhered to. On the day of the inspection, levels of cleanliness and hygiene throughout the home were found to be satisfactory 27 Graham Avenue DS0000014126.V338059.R01.S.doc Version 5.2 Page 21 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, 35 & 36 Quality in this outcome area is adequate. This judgement has been made using available evidence, including a visit to this service. There is not always sufficient trained and competent staff on duty to meet the assessed needs of the service users. Service users are protected by satisfactory staff recruitment policies, procedures and documentation. EVIDENCE: In addition to the comprehensive induction programme undertaken by all newly appointed staff, the CSM confirmed that appropriate core skills training is provided, including first aid, moving and handling, food hygiene and fire safety. This was confirmed through discussions with staff and supported by training records examined: ‘Since I’ve been here there has been plenty of training and now with the training officer there is even more opportunity.’ 27 Graham Avenue DS0000014126.V338059.R01.S.doc Version 5.2 Page 22 Despite a previous requirement, concerns remain regarding the minimal staffing levels operated within the home and the potential impact this has on the care and support of service users, as well as the inevitable affect on their social and recreational opportunities. This was confirmed by a member of staff, spoken with during the inspection: ‘If you are on shift on your own of course people can’t go out individually, so they do miss out sometimes’. A current duty rota was made available for inspection, which indicated that occasionally there is still only one member of staff on duty, both mornings and evenings, particularly at weekends. As discussed with the CSM, this situation is unsatisfactory and clearly does not always ensure that the assessed needs of service users are being met, or that their best interests being served. She was able to confirm that this was a temporary situation and that the matter is being addressed. Additional staff are currently being recruited, through the organisation’s head office. In accordance with company policy, the CSM confirmed that formal supervision is now provided for all care staff on a regular basis. Although individual supervision records were not made available for examination, staff spoken with during the inspection acknowledged the benefits of effective supervision and confirmed feeling valued and supported by the manager: ‘It’s such a small place, we talk all the time and she (the manager) is always very supportive’. The organisation is clearly aware of the need for thorough and robust recruitment procedures, to ensure the protection of service users. Individual files that were examined at the head office, relating to recently appointed members of staff, were found to be well maintained, containing all relevant and necessary information, including two satisfactory references, proof of identity and satisfactory Criminal Record Bureau (CRB) and Protection of Vulnerable Adults (POVA) disclosures. 27 Graham Avenue DS0000014126.V338059.R01.S.doc Version 5.2 Page 23 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 & 42 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Service users benefit from a competent and experienced manager and are protected by satisfactory health and safety procedures. Their best interests are safeguarded by adequate and effective quality monitoring systems. EVIDENCE: The home’s registered manager has worked for the organisation for fourteen years and has been in her current position for the past eight years. She has considerable relevant experience and continues to undertake appropriate training to update her knowledge and skills. 27 Graham Avenue DS0000014126.V338059.R01.S.doc Version 5.2 Page 24 The organisation’s training officer was able to confirm that the manager has recently completed the NVQ level 4 in Management and Care. As part of the quality assurance system, the home continues to use a pictorial satisfaction feedback chart for service users to demonstrate how they are feeling about the service they receive. However, despite a previous requirement, there is still no evidence of feedback from service users’ relatives and stakeholders in the community being sought or formally obtained. The CSM confirmed that improved quality assurance systems are being developed but have yet to be implemented. The health, safety and welfare of service users and staff evidently remains of paramount importance within the home. The CSM and a member of staff working in the home confirmed that training is provided in many aspects of safe working practices, including moving and handling; food hygiene; fire safety and first aid. This was also evidenced by staff training records. that were examined All portable electrical appliances are now regularly tested and risk assessments are carried out for all hazardous substances used in the home. COSHH assessments and guidelines are in place. Regular fire drills are undertaken and recorded. Temperature regulators are fitted to all hot water outlets, accessible to service users. All accidents, incidents and injuries are recorded and reported, as required. 27 Graham Avenue DS0000014126.V338059.R01.S.doc Version 5.2 Page 25 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 X 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 3 26 X 27 X 28 3 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 2 34 X 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 2 X 3 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 3 3 X 3 X 2 X X 3 X 27 Graham Avenue DS0000014126.V338059.R01.S.doc Version 5.2 Page 26 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 YA6 Regulation 15 (2) (b) Requirement It is required that service users care plans, including risk assessments, be kept under regular review and updated to reflect changing needs and circumstances. (Previous timescale of 31/12/06 not met). It is required that sufficient qualified and competent care staff are on duty at all times to meet the assessed needs of service users. (Previous timescale of 30/11/06 not met). It is required that quality monitoring systems be improved by seeking the views of service users’ relatives and other stakeholders.(Previous timescale of 31/12/06 not met). Timescale for action 31/07/07 2. YA33 18 (1) (a) 30/06/07 3. YA39 24 (1) (3) 31/07/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations 27 Graham Avenue DS0000014126.V338059.R01.S.doc Version 5.2 Page 27 1. YA19 2. YA41 It is recommended that communication systems, including daily progress notes and doctors’ visits, be reviewed and improved to ensure that the emotional and health care needs of service users are met. It is recommended that all policies and procedures be regularly reviewed and updated and that the current disorganised system of filing, including information in care plans, be improved. 27 Graham Avenue DS0000014126.V338059.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. Extracts may not be used or reproduced without the express permission of CSCI 27 Graham Avenue DS0000014126.V338059.R01.S.doc Version 5.2 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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