CARE HOME ADULTS 18-65
29/30 Dominion Road 29/30 Dominion Road. Twerton Bath BA2 1DW Lead Inspector
Gillian Underhill Announced 27 June and 1 July 2005 09:45am
th st 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 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 Stationary 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. Version 1.30 D56_D05_S8186_DominionRd_V226746_270605_Stage4.doc Page 3 SERVICE INFORMATION
Name of service Dominion Road Address 29/30 Dominion Road Twerton Bath BA2 1DW Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01225 332396 01225 427261 roy.woods@rnid.org.uk RNID Mr Lee Bull Care Home Only 3 Category(ies) of Sensory Impairment (3) registration, with number of places Version 1.30 D56_D05_S8186_DominionRd_V226746_270605_Stage4.doc Page 4 SERVICE INFORMATION
Conditions of registration: May accommadate up to 3 people of either gender with dual sensory impairment aged 18-64 who require personal care only. Date of last inspection 10th March 2005 Unannounced Brief Description of the Service: 29 & 30 Dominion Road is registered for 3 persons with sensory loss.The house is in a residential setting in Twerton,which is a suburb of Bath,and is on a bus route and close to all local amenities. The house has 4 single bedrooms,(one bedroom for staff} all with ensuite facilities, plus additional WCs. The rear garden is being developed into an area where service users can spend time relaxing, or gardening, if they so wish. Ramps and rails have been provided in order to aid service users mobility. The Statement of Purpose outlines the ethos of the home, where every opportunity is offered through staff quidance and support to ensure service users maintain or develop independant living skills. Each service user has a designated key worker. Version 1.30 D56_D05_S8186_DominionRd_V226746_270605_Stage4.doc Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The evidence of the inspection was gathered by observation of a number of the home’s policies and procedures, discussion with the manager and six of his staff team, and by observation of the interaction between residents and staff. Six staff were consulted during the two-day inspection about their experience of working in Dominion Road. There has been one recent admission to Dominion Road, and this resident was able to communicate through sign language that she was very happy in the home. Two other residents were unable to express their views or opinions articulately but were seen to be happy in the presence of staff, and were energetic and interested in the occurrences within the home. What the service does well:
Staff work very hard to ensure opportunities are made available for residents to participate in the day-to-day functioning of the home. This occurs through residents meetings, an effective key-worker system, along with a philosophy of care, which promotes the maintenance of independence whatever the level of the resident’s ability. Staff were observed to assist residents in structuring their day, and help them plan for immediate forthcoming events, which include attendance at Education Development Studies on the main Poolemead site. From the six staff consulted, most expressed a level of concern regarding the conflict, which tends to disturb the equilibrium in the home. Apart from this feedback was generally positive, with everyone enjoying their contact and work with the residents. The RNID also has an excellent training programme which staff are able to access. Version 1.30 D56_D05_S8186_DominionRd_V226746_270605_Stage4.doc Page 6 What has improved since the last inspection? What they could do better:
Regular one to one supervision for all staff, along with team meetings, which focus on the home’s development and successes, would provide staff with the support and guidance that would enhance their individual and team performance. The care planning infrastructure can be improved by detailing the residents’ strengths and abilities, in order to effectively measure levels of independence at the point of their review. All staff who administer medication should be trained to do so. Currently this is not the case at Dominion Road, where relief staff are involved in this task, without the required training. Conflict amongst the staff in the home has been a growing concern over the past few months; therefore effective steps must now be taken to deal with this conflict. For residents referred through a Care Management process, the registered manager must obtain a summary of the single Care Management assessment, along with a copy of the Care Plan. The manager needs to confirm in writing to the relevant funding authority of the resident recently admitted to the home that the home is suitable for the purpose of meeting the resident’s needs in respect of her health and welfare. . A copy of the resident contract between the RNID and the resident must be made available to the manager.
Version 1.30 D56_D05_S8186_DominionRd_V226746_270605_Stage4.doc Page 7 The care plan for the resident recently admitted needs to reflect her level of independence at the point of admission, outlining her strengths and ability to self care. The resident should also be given a copy of this document, and be invited to sign her care plan. Two other care plans should be reviewed to ensure there is clear information outlining the residents’ level of ability. Care plans should be reviewed 6 monthly, and details of any agreed changes need to be recorded and actioned. Generic and individual risk assessments must be developed on residents travelling in the home’s mini bus. Relatives and if appropriate residents need to be given a copy of the home’s policy and procedure on confidentiality. Those staff who have not renewed their food hygiene certificate need to do so within the next 4 weeks. All staff who administer medication to receive accredited training. The Vulnerable Adults policy still needs to be amended to give reference to the Care Standards Act 2000, rather than the Registered Homes Act 1984. Staff training file to be up dated and maintained in good order. Training on the support and care of people with learning disabilities to be arranged. Regular staff supervision for all staff to be maintained, with dates and agreed decisions recorded. Manager to complete NVQ level 4 by December 05.Conflict management also needs to be accessed again and completed within the next 3 months. 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. Version 1.30 D56_D05_S8186_DominionRd_V226746_270605_Stage4.doc 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 Standards Statutory Requirements Identified During the Inspection Version 1.30 D56_D05_S8186_DominionRd_V226746_270605_Stage4.doc 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,3,4,5. Evidence of thorough pre-admission assessment of each person was not present. Although the RNID provides excellent training opportunities for staff, training for staff on working with residents with Learning Disabilities must be arranged so that staff awareness of needs in this area is established. The manager then needs to confirm that the home can meet the assessed needs. Although there are resident contracts they are not given to the home by the RNID: this must happen so the manager knows what is expected contractually. EVIDENCE: The case file of a resident recently admitted did not contain an up to date Care Management assessment, or a copy of the funding agency’s care plan. When asked, the manager said he hopes to receive this documentation soon. When
Version 1.30 D56_D05_S8186_DominionRd_V226746_270605_Stage4.doc Page 10 asked about the assessment of need undertaken by the provider, the response was that this paperwork had been mislaid in the home, but could be provided in due course. All other documentation held on behalf of residents was in good order, and up to date. Training on working with residents with Learning Disabilities has not been provided, even though two people resident in the home have been diagnosed with this condition. When asked, the manager said he had not written to the funding agency to confirm the suitability of the recent admission to the home. Although information is given to relatives on the RNID’s terms and conditions of occupancy, the manager has yet to receive the contract between the RNID and the funding agency. This has been an ongoing requirement from previous inspections. Version 1.30 D56_D05_S8186_DominionRd_V226746_270605_Stage4.doc 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7 & 8 Care plans do not yet reflect changing needs and personal goals. Residents are enabled to make decisions about their lives and are regularly consulted with about life in the home. The new handbook is a very good idea. EVIDENCE: Care plans for all three-residents have been developed, and the manager has recently incorporated housekeeping responsibilities for each individual resident in the home. Care plans are currently reviewed yearly, with the involvement of the relevant funding agency, and even though the manager said that six monthly reviews
Version 1.30 D56_D05_S8186_DominionRd_V226746_270605_Stage4.doc Page 12 are undertaken there was no detailed written evidence to support this statement. The manager is working toward the development of care plans in a format, which the residents can understand. This should be discussed at the next inspection. Residents are able to make decisions, and are assisted to do so by being offered support by staff who are able to use sign language to communicate choices and opportunities. Residents meeting are held, with the most recent dates recorded as being 19/4/05, 9/5/05 and 22/5/05. Individual risk assessments have been developed, but were not examined in detail .To date there are no risk assessments on all three residents who use the home’s mini bus. It is important that this requirement is addressed urgently, particularly with the admission of a third resident. When asked, the manager said that the relative of the resident recently admitted to the home had not yet been given a copy of the home’s policy on confidentiality. Version 1.30 D56_D05_S8186_DominionRd_V226746_270605_Stage4.doc 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11, 13, 14, 15, 16 & 17. Residents have opportunities for social and educational development and appropriate leisure activities. Their rights are respected and they are made aware of their responsibilities. Family contact is supported, as is meaningful participation in the local community. Weekend staff cover arrangements need to be kept under review, in order to ensure that staff time with residents outside of the home continues to be flexible. EVIDENCE: Version 1.30 D56_D05_S8186_DominionRd_V226746_270605_Stage4.doc Page 14 All three-residents attend Educational Development Studies at the main Poolmead site. Practical life skills are taught both in-house and during the development studies if assessed as being necessary and requested by that resident. The Coordinator on the Poolmead site has developed risk assessments, and care plans, with the assistance of the key staff at Dominion Road. The inspector did not examine these. Each of the residents accesses facilities in the wider community, and during the inspection various trips out to the shops etc were made. Currently none of the residents vote. Various leisure pursuits have been arranged for residents, and two people attended the Bath Festival on the 19th May. There have also been barbeques, and a day trip to Weymouth. Holidays are also being planned for later this year. Until recently only two residents were resident at Dominion Road, and therefore weekend trips were flexible and spontaneous, however with the admission of a third person this may limit those opportunities for such spontaneity, particularly if one resident does not want to go out. Each resident has regular contact with their relatives, and staff assist with letter writing and telephone calls in order to help with maintaining family contact. All three-residents have a key to their bedroom, and staff will only enter with their consent. All meals are cooked in the house, and residents assist with the shopping, food preparation and cooking. They are able to select meals of their choice, but with staff intervention when appropriate. All staff assist with food preparation and cooking meals, but at least two permanent staff do not have an up to date basic food hygiene certificate. Version 1.30 D56_D05_S8186_DominionRd_V226746_270605_Stage4.doc 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 & 20 Residents will be fully protected by the home’s policies and procedures once all staff who administer medication are properly trained to do so. Residents receive personal support which is flexible and responsive to their changing needs. EVIDENCE: All three residents choose their own clothes, hairstyle and make-up. No technical aids are currently required by the residents to enable a greater level of independence. The same also applies to psychiatric support. The home’s policy and procedure on medication makes for easy reading, and is concise in its advice to the reader. The document contains detailed information on home remedies, and on reporting a medication discrepancy or mistake in administration. No controlled medication is used by residents, and currently
D56_D05_S8186_DominionRd_V226746_270605_Stage4.doc Version 1.30 Page 16 no-one self medicates. All MAR sheets were examined and had been signed by two staff. The home last had contact with their local pharmacist on the 24th May 05. There was no residual medication in the home for disposal. Although the medication policy states that only experienced/trained staff administer residents medication, this is currently not the case in Dominion Road. Whilst all permanent /contracted staff have received accredited training in the administration of medication, this does not apply to relief staff, who are also responsible for this task. D56_D05_S8186_DominionRd_V226746_270605_Stage4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 & 23 Although no complaints have been made by residents, the information and processes in place would be supportive in such an event. The manager must make sure each staff member knows how to keep or make residents safe if an allegation of abuse is made when they are on duty. EVIDENCE: The home’s complaints policy and procedure is comprehensive in detail, and the residents handbook also fully explains in symbol format how complaints are dealt with, along with the action residents can take if they remain dissatisfied with the way their complaint has been investigated. No complaints have been made by residents, or their relatives since the last inspection in March 2005. When asked staff were aware of the action to take, should a complaint be made while they were on duty. There is an Adult Protection policy & procedure, which was last reviewed in June 2005. When consulted three staff were not confident with the action they should take if an allegation of abuse was made while they were on duty. Training records show that a number of staff have completed the “Alerters” training, and the manager has completed both the “Alerters”, and the
D56_D05_S8186_DominionRd_V226746_270605_Stage4.doc Version 1.30 Page 18 “Investigators” course. All other staff will complete this training on 21st July 2005. The home’s written policy and procedure regarding residents money was updated on 1st June 2005, and now reflects the amount of money the home can hold on behalf of the residents. Cash sheets were not examined. On 8th March 2005 a Whistle Blower informed the inspector of an incident in the home, which alleged the abuse of a resident by a member of staff. This incident was investigated, and facilitated by the POVA Team, the outcome of which identified some concern regarding the way two staff interact and deal with conflict in front of residents. There was no evidence of abuse, but requirements for improved leadership and staff management were made, which will be identified in the requirement section of this report. D56_D05_S8186_DominionRd_V226746_270605_Stage4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 0 EVIDENCE: Above standards were not examined. D56_D05_S8186_DominionRd_V226746_270605_Stage4.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32,33, 35 & 36, Because of the staff conflict a team building exercise needs to be planned and delivered to staff; team meeting agendas need to consist of relevant issues which influence service delivery; and staff supervision needs to become properly structured and to happen regularly for everyone. EVIDENCE: There have been three recent incidents in the home which indicate that a small number of staff experience difficulty in maintaining cordial working relationships with their colleagues, and that the key values of Dominion Road are being affected by this. The majority of staff appear to have the skills necessary for the tasks they are expected to do, and said they were happy in the role, but for the conflict which has continued for some months. Two senior support workers are currently working towards completion of NVQ level 3 award, whilst 3-4 other staff will enrol later this year. D56_D05_S8186_DominionRd_V226746_270605_Stage4.doc Version 1.30 Page 21 Currently the home has 2.5 vacant posts to be filled by fixed term contracts. The interview dates have been set for 18/7/05. During the week of the inspection a number of shifts had been covered by agency staff. Team meetings are held and minutes of outcomes agreed are maintained. Meetings tend to focus on the individual, and joint work responsibilities of staff, rather than relevant issues which influence service delivery. Staff are able to communicate with residents by sign language, and most have completed BSL training to level 1, and senior staff level 2. Staff training files were not up to date but evidence suggests that the core training values of the RNID are being addressed. Restraint training [NAPPI] will be made available to all staff in the near future. As referred to earlier, 2 residents have been diagnosed with learning disabilities but training on this topic has not been provided. Two staff members have not received supervision since their commencement into post, other staff have received this support, but dates recorded are not consistent with good practice. D56_D05_S8186_DominionRd_V226746_270605_Stage4.doc Version 1.30 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 38, 39 and 40 The development by the manager of the home of a wider range of management styles and skills through training and NVQ is a key need for the home so that unhelpful staff dynamics can be properly addressed and the home’s strengths be fully used. Policies and procedures are well on the way to being meaningful to residents. EVIDENCE: The registered manager has completed various training courses which complement his role and responsibilities, however he has yet to complete NVQ
D56_D05_S8186_DominionRd_V226746_270605_Stage4.doc Version 1.30 Page 23 level 4, and now needs to re-register because of the length of time which has elapsed between completion of some modules. A conflict management course was recently cancelled due to staff shortage [conflict management along with team building was a requirement from the recent POVA meeting.] The atmosphere in the home tends to ebb and flow and some staff still feel that a different management style would help to create a more positive and inclusive atmosphere. Two residents comment cards were returned to the Commission, and their comments regarding the service delivery (which were recorded by staff on their behalf) were positive. Although there are currently no formal quality assurance and quality monitoring systems in place, the manager said that residents reviews, house meetings, and P.I.C monthly visits go some way in measuring the home’s success in achieving the aims and statement of purpose of Dominion Road. The Commission has been advised that the statement of purpose will in due course have an attached questionnaire, which will be sent to funding agencies, seeking their view on quality assurance issues. Also the RNID’s web site [E – Connect] will be used for providing carers with results of residents’ surveys. This should be followed up at the next inspection. Most of the home’s policies & procedures are `house specific` and hard copies of the RNID’s policies can be accessed from the intranet. The manager said that in due course some information will be developed into a pictorial format for easy access to residents. All in-house policies should be signed and dated by the manager. Although safe working practices and health & safety issues were not fully examined during the inspection, there was evidence that some staff need to update their basic food hygiene certificate as soon as possible. D56_D05_S8186_DominionRd_V226746_270605_Stage4.doc Version 1.30 Page 24 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 2 2 3 2 Standard No 22 23
ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10
LIFESTYLES Score 2 3 3 x x
Score Standard No 24 25 26 27 28 29 30
STAFFING Score x x x x x x x Standard No 11 12 13 14 15 16 17 3 x 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score x 3 3 x 2 1 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 x 2 x Standard No 37 38 39 40 41 42 43 Score 2 2 2 3 x x x D56_D05_S8186_DominionRd_V226746_270605_Stage4.doc Version 1.30 Page 25 yes Are there any outstanding requirements from the last inspection? 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 2 Regulation 14 Timescale for action Summary of Care Management From assessment, along with care plan 27/6/05 to be accessed from funding agency, prior to any admission. Manager to confirm in writing to From the funding agency, that the 27/6/05 home is able to meet the service users needs. Training for staff on the 5/12/05 management of service users with learning disabilities to be arranged Copy of the contract between the From RNID & funding agency to be 27/6/05 made avaialble to the manager Service user recently admitted to From the home to receive a copy of 27/6/05 her care plan. Each care plan to be reviewed at least 6 monthly and details recorded. Risk assessments to be carried From out on service users who use the 27/6/05 homes mini bus. Staff to update food hygiene 2/9/05 certificates where necessary All staff who administer 2/9/05 medication to receive accredited training. All staff to be conversant with From the RNID,s Adult Protection 27/6/05
Version 1.30 Page 26 Requirement 2. 3 14 3. 3 12 4. 5. 5 6 5 5 6. 7. 8. 9. 9 17 20 23 13 18 13 13 D56_D05_S8186_DominionRd_V226746_270605_Stage4.doc 10. 11. 12. 13. 32 35 36 37 18 17 18 9 14. 39 24 policy & procedure.Also Policy to be amended to reflect the Care Standards Act 2000,rather than Registered Homes Act. Team building exercise to be arranged within the next 3 months Staff training file to be up dated, and maintained in good order. Regular supervision to be made available to all staff Manager to complete NVQ level 4 by December 05.Conflict management training also to be completed. Quality assurance methos to be introduced in order to track the homes success in achieving the aims,objectives,and Statement of Purpose. 5/9/05 From 27/6/05 From 27/6/05 30/12/05 30/12/05 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. 2. 3. 4. Refer to Standard 6 10 33 33 Good Practice Recommendations Care plan of service user recently admitted needs to reflect her level of ability in order to measure her dependancy levels during reviews. Relatives, and service users to be given a copy of the homes policy on confidentiality Weekend staff cover to be kept under review. Team meeting agenda to consist of relevant issues which influence service delivery. D56_D05_S8186_DominionRd_V226746_270605_Stage4.doc Version 1.30 Page 27 Commission for Social Care Inspection 300 Aztec West Almondsbury South Glos BS32 4RG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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