Inspection on 07/11/08 for 27a Old Kenton Lane

This inspection was carried out on 7th November 2008.

CSCI found this care home to be providing an Adequate service.

The inspector found no outstanding requirements from the previous inspection report, but made 13 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

27a Old Kenton Lane 19/01/10

27a Old Kenton Lane 24/09/09

27a Old Kenton Lane 30/05/06

Extracts from inspection reports are licensed from CQC, this page was updated on 06/08/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 27a Old Kenton Lane 27a Old Kenton Lane Kingsbury London NW9 9ND The quality rating for this care home is: one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Teferi Degeneh Date: 0 7 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Reader Information Document Purpose Author Inspection report CSCI Page 2 of 32 Care Homes for Adults (18-65 years) Audience Further copies from Copyright General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 32 Information about the care home Name of care home: Address: 27a Old Kenton Lane 27a Old Kenton Lane Kingsbury London NW9 9ND 02089593965 02082010213 unuwatte@aol.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Integrated Care Services Limted care home 4 Number of places (if applicable): Under 65 Over 65 4 0 learning disability Additional conditions: The registered person may provide the following category of service only: Care Home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning disability - Code LD The maximum number of service users who can be accommodated is: 4 Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 32 A bit about the care home 27a Old Kenton Lane is a registered home. The registered manager is Mr Percy Bamunuwatte. Mr Bamunuwatte and his wife jointly run the Integrated Care Services company. They provide a similar service at one other local home. The home is located in a residential area of Kingsbury. The property is detached. There is one bedroom, a bathroom, a toilet, a lounge/diner, an office, and kitchen on the ground floor. Three more bedrooms, and a bathroom with toilet can be found on the first floor. The home has a self-contained back garden of medium size. There is parking space for two cars in the homes own drive and free kerbside parking on a road around the home. There are a few shops in walking distance. More shopping facilities are in Wembley or Harrow, which can be reached through public transport. The home is registered for four residents and is currently fully occupied. Fees for the home start from depend on the assessed needs of the people and the current minimum fee is 850 pounds per week. The service user guide and a copy of this inspection can be obtained from the owner of the home. The inspection report is also available on the internet at the CSCI website. Care Homes for Adults (18-65 years) Page 5 of 32 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home Care Homes for Adults (18-65 years) Page 6 of 32 How we did our inspection: This is what the inspector did when they were at the care home This was a surprise visit, which means that the manager was not told beforehand about the visit. Before the inspection we asked the manager to complete a form known as the annual quality assurance assessment (AQAA). The AQAA is a form which asks the manager about the work being done to improve the service. This form was completed and sent to us and we have looked at it as part of this inspection. We have also spoken to and observed the people who use the service. The care staff who were present during the visit gave us their views of how the service is provided and how the home is managed. We have looked at written evidence of how the home supports the people. Other documents such as health and safety, some staff files, the staff rota and the weekly menus were seen. Some of the rooms including the kitchen, toilets and bedrooms were also seen. Even though the people who use the service have limited verbal communication, they were able to confirm that they are happy with the care they receive. We also observed them to be comfortable on the day of the visit. Care Homes for Adults (18-65 years) Page 7 of 32 What the care home does well What has got better from the last inspection A number of things have been done since the last inspection. For example, the manager has updated the staff training records. The resident service needs have been reviewed and the guttering, which was leaking has been redone. The manager has also completed a risk assessment for each person who uses the service. Care Homes for Adults (18-65 years) Page 8 of 32 What the care home could do better It is important for the home to make sure that it is the residents wish to visit another care home early in the morning. If the residents are to visit another care home, this has to benefit the residents and records of such visits must be kept. This is to make sure that the residents not inconvenienced and not going to another home without a purpose that is not useful for them. The current system of looking after the residents money needs improvement. It is in the residents best interest that their financial accounts are in their names and the records of all transactions are kept. The manager needs to be vigilant about the management of medication. In order to make it safe, it is important that records of receipts, administration and disposal of medication are kept. Medicines must also be audited regularly and the staff must attend refresher medication training. We expect the files of all the staff to be kept securely at the home. The practice of taking away staff files to update them is not a good practice. Also we expect all staff to undergo a criminal bureau check as part of their job when they are employed. Those staff who have a CRB certificate received as part of their previous job need to obtain for their current post. Page 9 of 32 Care Homes for Adults (18-65 years) Even though risk assessments have been completed for the residents, these have not fully protected them from harm. Each incident must be taken seriously and action must be taken to safeguard the wellbeing of all residents. The manager needs to address the recurring incident between two residents. If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Teferi Degeneh 33 Greycoat Street London SW1P 2QF 02079792000 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning Care Homes for Adults (18-65 years) Page 10 of 32 our order line - 0870 240 7535 Care Homes for Adults (18-65 years) Page 11 of 32 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 12 of 32 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The admission system of the home is good. New residents are confident that they are admitted to the home on the basis of their assessed needs and the ability of the home providing them with appropriate care. Evidence: The files of four people who live at the home were looked at. All these contained evidence of referrals made by social workers and information about the needs of the people who use the service. The written document (AQAA) sent to us by the manager confirmed that the home completes assessments for each person before they are admitted. The document reads: Our home put forward a thorough & completed needs assessment to the service user prior to admission by qualified and experienced staff and we always confirm in writing whether we can or can not meet the prospective residents assessed needs. The AQAA also confirms that new residents are provided with detailed information of the services and facilities available at the home before they are admitted. Care Homes for Adults (18-65 years) Page 13 of 32 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Even though the residents care plans and risk assessments are reviewed, these have not always been good enough to ensure that the residents are free from risk of being harmed. Evidence: Care plans and risk assessments have been updated for most of the residents. However, the file of one resident showed that their care plan was reviewed in 2004. The care plans which have been reviewed contained the details of the needs of the people and how to meet the needs. It was noted in the incident and accident book that two residents did not get on well with the evidence that one resident physically attacked the other on many occasions. Even though documents showed that the staff have taken some steps to address this issue, we have not seen evidence of the home taking strategic steps by involving relevant people to review risk assessments and to solve this problem. Also we have seen in the financial records of the residents that money have been cashed and the owner of the home is the appointee for the residents. We were not able to see from Care Homes for Adults (18-65 years) Page 14 of 32 Evidence: the records why and how the monies have been spent. We have, however, spoken to the manager by telephone after the inspection and have learnt that the monies withdrawn from the accounts were for the benefit of the residents and that there were records to show this. It was not evident in the residents assessments or care plans whether or not the residents are able to look after their money or, indeed, why the owner of the home was an appointee. Care Homes for Adults (18-65 years) Page 15 of 32 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . There are good arrangements for the residents to engage, visit families, practise their faith and enjoy meals that meet their needs. However, the quality of the service could be improved by ensuring the arrangements to visit the other home owned by the providers are for the benefit of the residents. Evidence: The residents files and discussion with the person in charge confirmed that one person has a day activity five days a week. The remaining residents are supported by the staff to go to the shops, swimming; library; public house and social clubs. Discussions also showed that while at home the residents enjoy listening to the music, watching television and painting. The residents also go out with the care staff for car rides. On the day of the inspection none of the residents were at the home when we arrived at 9:30 in the morning. Through a telephone call we managed to trace the residents and the staff at another home owned by the same people. We were concerned how and why this had happened and we were informed by the person in charge that the Care Homes for Adults (18-65 years) Page 16 of 32 Evidence: residents wanted to visit their friends at the other home. We were concerned, however, to learn that there was a shortage of staff (see below under staffing) on the day of the inspection due to a sick leave. While we understand and encourage the residents to visit and be visited by friends and families, we also would like to see the arrangements reflect the choice and wishes of the residents. From records and conversations with the staff we noted that the residents regularly visit their families. On the day of the inspection one person who uses the service was away on a holiday with their family. It was confirmed from discussions that the people who use the service are supported to attend a place of worship. It was clear from discussions that one resident was supported by the staff to read a faith book. The staff were observed addressing the residents in the way they are comfortable. They were seen talking to them with respect. The residents were also seen walking around and accessing all parts of the communal areas. We have noted earlier in this report that the owner of the home was an appointee for the residents and financial records were not clear to show how monies are spent. Shopping for food items was done on the day of the inspection. There was a range of fresh and other foods available at the home. In the AQAA the manager confirmed that people who use the service are consulted about the food. The menu also indicated that the residents are provided with food which reflected their dietary and personal needs. Care Homes for Adults (18-65 years) Page 17 of 32 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Despite the good practice of the home to support the residents to make appointments and see health care professionals, the residents health and safety remains at risk due to the homes unsafe medication management. Evidence: The AQAA states that each resident has a person centred care plan. The files of three residents showed care plans have been reviewed. We have spoken to staff who demonstrated good knowledge and experience of working with residents. The staff were observed talking to the residents in a respectful manner. Observations of the residents indicated to us that they were well and comfortable on the day of the inspection. From the residents files it was evident that they have regular medical checks. There were a general practitioner and other health care professional appointment letters in the residents files. Records and discussion with the person in charge showed that the residents have attended their appointments. The home has a medication policy. The person in charge said that only staff who are trained administer medication. The medicines are kept in a locked cupboard. The Care Homes for Adults (18-65 years) Page 18 of 32 Evidence: medicines and medication administration record sheets (MARS) were checked. These showed some inaccuracies in recording of administration, receipt and disposal of medicines. There were two instances where MARS were not signed by the staff. We also found that some tablets were too many and far greater in number than what should be in the home on the day of the inspection. This means that the number of tablets in the MARS did not match the actual number of tablets. We will ask the manager to tighten the homes quality assurance and medication auditing systems. Care Homes for Adults (18-65 years) Page 19 of 32 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Even though the home has policies and procedures on complaints and safeguarding, people who use the service are not confident that their concerns are listened to and they are sufficiently safeguarded by these policies and safeguarding systems. Evidence: The home has a policy on complaints. A copy of the complaints procedure is displayed in the home. From discussion with the staff it was clear that they are aware of the homes complaints procedures and how to deal with complaints. There is a complaints book but no complaints have been received or recorded. The manager confirms in the AQAA that the residents and their relatives know about the homes complaints policy. The home has a safeguarding policy and has also received a copy of the local authoritys policy and procedure on safeguarding. The staff spoken to have good understanding of how to safeguard the residents. They are clear about the homes policies including the whistle blowing policy. We have noted earlier that the owner of the home is an appointee for the residents and we have also said that residents financial recordings were not available or clear. We were also not able to see evidence that the home is taking the incidents between the two residents seriously by reporting to social workers, the Commission for Social Care Inspection and by arranging appropriate meetings to address the issue. This is a safeguarding issue which must be addressed. We mentioned earlier that the manager is an appointee for the residents. From the Care Homes for Adults (18-65 years) Page 20 of 32 Evidence: records we checked we were not able why some expenses have been made. We were also not able to see evidence of how the residents could access their money if the manager was not around. There was no written evidence to show whether or not the residents could open a bank or postal office account in their names. Care Homes for Adults (18-65 years) Page 21 of 32 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The people who use the service have benefited from the quiet and comfortable accommodation they live in. Evidence: The home is situated in a quiet residential area. From the AQAA we confirmed that the facilities and equipment are well maintained and are safe for the residents and the staff. The residents have their own bedrooms all of which have windows with restrictors. The communal areas include the lounge and the kitchen area. All the residents have access to these areas. The premises were clean and bright. During the tour of the rooms we noticed that a toilet seat on the first floor was not in working order. The person in charge said the home was aware of this problem and has already bought a new toilet seat, which was waiting to be fixed. Care Homes for Adults (18-65 years) Page 22 of 32 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Even though the arrangements for training staff are good, people who use the service are not confident with the service due to lack of clarity of the rota and due to the absence in the home of staff files. Evidence: The rota, which was checked, showed that there are two members of staff on duty during the days. However, according to the rota only one member of staff (the person in charge) was on shift on the day of the inspection. The name of the second care worker was not on the rota. The person in charge said this was because of sick leave, which meant that the second care worker, who was employed to work at the other home owned by the same provider, had to be called to cover the shift. We tried to check the staff files but we were able to see only two of them. The person in charge said the owner took the files to his home to update them. We were concerned that the files of the staff were taken away from the home were not available for inspection. From the available staff records it was noted that one member of staff had a copy of their previous CRB they obtained while they were employed to do a job different from their present role. From discussion with the person in charge, and from checking the AQAA and the previous inspection report we note that there is a good training system for the staff. The AQAA states that three quarters of the staff have completed a national vocational Care Homes for Adults (18-65 years) Page 23 of 32 Evidence: qualification level 2 in care. It also indicates that the staff have attended other relevant training programmes such as basic food hygiene. Care Homes for Adults (18-65 years) Page 24 of 32 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The people who use the service can benefit more when the manager fully implements the quality assurance system and keeps up-to-date staff records and rotas. Evidence: The manager was not present when this inspection was carried out. However, from the AQAA and other documents such as the last inspection report it is clear that the manager has a long experience of managing a care home. The manager has also completed a higher level of training in the management of care homes. The staff spoken to said the manager is supportive and approachable. We mentioned above that we were able to check only two staff files. We were concerned to hear from the person in charge that the manager had taken the staff files to his home to update them. We were also concerned that the name of a care worker on shift was not on the staff rota. We have looked at the incident and accident records and found that there have been seven incidents recorded since the last inspection. Many of these incidents were related to a physical attack of one resident against the other. An examination of risk Care Homes for Adults (18-65 years) Page 25 of 32 Evidence: assessments and care plans did not show to us that these incidents have been taken seriously and addressed by the home. We discussed the issue with the person in charge and asked (see concerns, complaints and protection above) that they should take more steps to address this problem and safeguard the resident who is subjected to a physical abuse. From the AQAA we confirmed that the facilities and equipment are well maintained and are safe for the residents and the staff. However, during the tour of the premises we noticed that a toilet seat on the first floor was not in working order. We have asked the person in charge to repair or to replace this facility so that it can be used safely. From discussions with the person in charge and from the AQAA it is clear that the home consults with the residents to improve the quality of the service. For example, the AQAA states: Through residents, staff and management meetings we continually appraise the care service we offer. We have continuous improvement cycle by which services reviewed regularly. Changes are implemented. Residents are sent questionnaires and on their feedback we tend to review the quality of service. As requested at the last inspection the home has stopped shredding leaves of paper from records. It was mentioned earlier under personal and healthcare support section that there have been errors in medication recording. We also noted that there are some tablets which were too many and far greater in number than what should be in the home on the day of the inspection. This indicated to us that the auditing system was not fully implemented or was not working. Care Homes for Adults (18-65 years) Page 26 of 32 Are there any outstanding requirements from the last inspection? Yes  No  Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 27 of 32 Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No Standard Regulation Description Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set No Standard Regulation Description Timescale for action 1 7 15 Care plans must be updated regularly for all residents. 30/01/2009 This ensures that their needs are identified and met by the home. 2 9 13 Any unnecessary risks to the 30/01/2009 health and safety of the residents must be identified and eliminated. This ensures that risks to the residents are minimum and they live without fear and without being uncomfortable. 3 15 16 Residents must be consulted 30/01/2009 who, where, and when to visit friends. Records of the consultation or decisions about the visits must be kept in the files. This ensures that the Care Homes for Adults (18-65 years) Page 28 of 32 residents visit the other home owned by the provider only on a planned basis and not early in the morning. 4 20 18 Staff who administer medication must attend a refresher training. 20/03/2009 This will ensure that the staff have up-to-date skills to administer medication. 5 20 13 Records of all medicines 30/01/2009 received, administered or disposed of must be kept in the home. Medicines that are not used must be returned or disposed of. This ensures that the there is a proper medication recording to safeguard the the residents. 6 23 20 Any money belonging to a resident must not be paid to or taken from the bank unless it is in the residents name. Records of all transactions must be kept. 30/01/2009 This ensures that the residents finances are protected and used by the residents only. 7 23 20 The registered person must consult the residents and their representatives and ensure that the bank accounts are opened in the residents names. 20/02/2009 This empowers the residents Care Homes for Adults (18-65 years) Page 29 of 32 and ensures that they use their money. 8 23 13 The incidents between two people who use the service must be addressed. 30/01/2009 This will ensure the health and safety of one resident who is the subject of a physical attack by another resident. 9 30 23 The toilet seat on the first floor must be fitted with a seat. 25/12/2008 This will reduce risks to the residents and will enable them to use the bathroom. residents to use the bath 10 34 17 The files of staff who work at 30/12/2008 the home must be available at the home for inspection. Rotas must be clear and must show the names, days and hours of the staff working at the home. In this way the people who use the service know who is working at the home. 11 34 19 Criminal Record Bureau 15/01/2009 checks must be done and certificates must be received when new staff are recruited. The registered person must ensure that a CRB certificate is obtained for a care worker who has a CRB certificate from a previous employer. This ensures that the Care Homes for Adults (18-65 years) Page 30 of 32 residents are supported by people who are appropriately vetted. 12 37 17 Staff records and duty 30/01/2009 rosters must must contain all information required and must be maintained at the home. This is to ensure that the residents receive service from staff who are appropriately employed, deplyed and managed. 13 39 24 The quality assurance system must be fully implemented. This must including the auditing of medication. 30/01/2009 This ensures that health and safety of the residents. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 31 of 32 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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