Inspection on 31/01/06 for 290 Newton Road

This inspection was carried out on 31st January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 no outstanding requirements from the previous inspection report, but made 18 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

290 Newton Road 05/03/09

290 Newton Road 10/10/06

290 Newton Road 14/07/05

290 Newton Road 09/03/05

290 Newton Road 24/11/04

290 Newton Road 20/02/03

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

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

CARE HOME ADULTS 18-65 290 Newton Road 290 Newton Road Great Barr Birmingham B43 6QU Lead Inspector Mr Patrick Wright Announced Inspection 31st January 2006 13:30 290 Newton Road DS0000043211.V262732.R01.S.doc Version 5.1 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 290 Newton Road DS0000043211.V262732.R01.S.doc Version 5.1 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. 290 Newton Road DS0000043211.V262732.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service 290 Newton Road Address 290 Newton Road Great Barr Birmingham B43 6QU 0121 357 7517 0121 357 8417 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) N/K Lonsdale (Midlands) Limited Mrs Diane Falconer Care Home 7 Category(ies) of Learning disability (7) registration, with number of places 290 Newton Road DS0000043211.V262732.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14th July 2005 Brief Description of the Service: 290 Newton Road is a large detached dwelling adapted to be a care home in 2003. The home caters for up to seven people with a Learning Disability, and additional emotional and psychological needs within the autistic spectrum disorder range. The home offers personal care and support to a group of individuals with a range of complex needs and strives to promote ordinary living principles and social inclusion. Staffing levels reflect the level of support required for the individuals accommodated. The home is situated on a busy main road near to local shops, post office, and pubs etc. The home is accessible by public transport and offers limited off road parking, which is shared with the adjacent supported living project. The premises offer a small garden and recreational space at the rear of the property. The accommodation is spread over three levels. Service users bedrooms are located on the ground and first floor. There is a passenger lift available. Office space and staff rooms are on the second floor. The unit has seven single bedrooms, all of which offer ensuite toilet and hand-basin, with one ground floor room also providing an ensuite shower. Communal space includes a lounge and dining area and a `quiet` lounge. Kitchen facilities are domestic in size and there is a separate laundry, which offers commercial equipment. Social and recreational pursuits are provided for the occupants and the home also has its own people carrier vehicle, which is used to transport residents to appointments and for outings etc. 290 Newton Road DS0000043211.V262732.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was conducted over 5.5 hours, and was a statutory unannounced inspection. The purpose of the inspection was to assess progress and compliance in meeting the National Minimum Standards and towards addressing items identified at previous inspection visits. A range of inspection methods was used to make judgements and obtain evidence. The inspection included time spent examining documentation and records, looking at how some of the care packages had been arranged and were being delivered, and having discussions with the Registered Manager and Deputy Manager. In addition two staff were interviewed and a further two staff were involved in informal discussion. Service users were involved in various community activities during the inspection, although some of the residents were spoken with during the afternoon. Formal interviews are not appropriate with the client group. Service users appeared comfortable in their surroundings and the home presented a relaxed atmosphere. For a period of 6 months it was agreed by the Commission for Social Care Inspection that the Registered Manager could be seconded to a senior management post within the organisation and the Deputy manager become Acting Manager in her absence. During this period of time and as a result of this inspection, several practice issues have been raised. For example, staff recruitment and with regard to general care practices, decisions have been in isolation and not as part of a multi agency agreement. There is also a reduction in the evidence of choice offered to service users and how personal support is being offered. The Registered Manager had returned to the service shortly before this inspection. What the service does well: Relatives and friends are encouraged to maintain links with the service users and are welcome to visit at any reasonable time, and the company complaints procedure is readily available should anyone wish to use it. There is a clear complaints procedure for service users and relatives, thereby ensuring individuals views and concerns are listened to and acted upon. The Registered Manager is experienced and qualified to run the home and meet its stated aims and objectives. The system for effective infection control within the home is generally acceptable. 290 Newton Road DS0000043211.V262732.R01.S.doc Version 5.1 Page 6 Arrangements for the protection of service users through policy, staff training and awareness is confirmed. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. 290 Newton Road DS0000043211.V262732.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection 290 Newton Road DS0000043211.V262732.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): N/A EVIDENCE: None of the standards from this section were assessed as part of this inspection. 290 Newton Road DS0000043211.V262732.R01.S.doc Version 5.1 Page 9 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 the following standard(s): N/A EVIDENCE: No standards from this section were assessed at this inspection. Progress made against requirements issued from the last inspection was reviewed. Where applicable, these will remain outstanding until fully met. 290 Newton Road DS0000043211.V262732.R01.S.doc Version 5.1 Page 10 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 the following standard(s): 15 Staff support service users to maintain relationships with relatives and friends inside and outside the home. EVIDENCE: The home has a visitors’ policy, which has been brought to the attention of the service users relatives /friends. There are details regarding visiting times contained in the policy, which states there is generally open visiting. There is a visitor’s book in the office that all visitors are asked to sign, which is good practice and complies with fire safety. Staff encourage service users to maintain contact with family and friends. Visitors are welcome and service users have opportunities to meet new people through the local community, and activities. Contact with relatives varies between service users, but links are maintained to whatever degree compatible for both parties. No other standards from this section were assessed at this inspection. Progress made against requirements issued from the last inspection was reviewed. Where applicable, these will remain outstanding until fully met. 290 Newton Road DS0000043211.V262732.R01.S.doc Version 5.1 Page 11 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 the following standard(s): 18, 20 The home is not able to fully demonstrate that service users receive personal support in the way they prefer. The systems for managing service users medication are adequate, but parts of the process need updating to protect staff and service users and promote good practice. EVIDENCE: 290 Newton Road DS0000043211.V262732.R01.S.doc Version 5.1 Page 12 The Inspector was unable to sufficiently evidence that personal support is carried out sensitively and maximises residents’ independence. The Registered Manager informed the inspector that all service users are encouraged to make their choices clearly known and as to whom they wish to assist them with their personal care. It was also stated that service users are being facilitated by staff to make informed choices. The records being held in the home did not always support the discussed practice. The home should consider how it can evidence that service users have real choice and control over who assists them with their personal care, their preferred times for getting up, going to bed, baths activities, clothes etc. If technical aids or practices for managing situations are in place these should be supported by professional assessment and agreements from external agencies. Personal support must be carried out in a dignified and sensitive manner and service users should receive a range of additional, specialist support as and when required. The home uses a monitored dosage system, and utilises the services of a local chemist that visits the home to monitor the use of the system. Medication records include a photograph of each service user. Staff signatures for the homes medication policy have been obtained as an acknowledgement of its content/existence, and signatures are available of staff who have received relevant training and deemed competent to administer medication to service users. The training provided has been the subject of review and is currently being updated with `accredited` training through a specialist source. The progress of this part of the training plan will be monitored at the next inspection. None of the service users at Newton Road self medicate and the issue of consent has been explored with service users and an agreement produced in pictorial format. The Management of the home were advised that the value of this exercise should be examined individually and whether the issue of capacity is relevant. The issue of consent from service users must be explored for the administration of their medication. Where consent is not appropriate then a best interest decision must be recorded, which details who was involved, and the outcome. For example at reviews held as part of a multi agency agreement. The practice of service users receiving any form of PRN, (when required) medication, including paracetamol, is the subject of a care plan demonstrating dosage, frequency, maximum dose in any 24 hour period, under what circumstances to be administered/re-administered, and any side effects/contra indications staff should be aware of etc. A protocol for the administration of rectal valium has been implemented, and is included in the relevant service users plan. Staff refresher training in this topic should be provided due to the in-frequency of administration and must be specific to the service user, and include named carers. The Deputy Manager stated that a medication review is to be held shortly and the medication may 290 Newton Road DS0000043211.V262732.R01.S.doc Version 5.1 Page 13 be discontinued, therefore removing the need for further training and protocols to be agreed. Records of stock held are checked daily, and the system of ordering and returning medication has recently been reviewed and amended. The home has a current British National Formula drug reference book and a copy of the Royal Pharmaceutical Society guidelines with regards to managing service users medication, as is good practice. The service needs to be provided with a medication fridge and ensure that the appropriate temperatures are maintained and recorded. Copies of prescriptions obtained for service users medication should also be held. It is recommended that arrangements are made to manage controlled drugs should the situation arise within the home. Progress made against requirements issued from the last inspection was also reviewed. Where applicable, these will remain outstanding until fully met. 290 Newton Road DS0000043211.V262732.R01.S.doc Version 5.1 Page 14 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 the following standard(s): 22,23 There is a clear complaints procedure for service users and relatives, thereby ensuring individuals views and concerns are listened to and acted upon. Arrangements for the protection of service users through policy, staff training and awareness are confirmed. The system for managing service users finances is acceptable, but minor elements of the homes current practices need to be reviewed to protect staff and service users and promote good practice. EVIDENCE: 290 Newton Rd operates Lonsdale Midlands Ltd complaints procedure and records will be kept of any complaint or issues raised. No formal complaints had been received by the home since the last inspection. An anonymous complaint received by the Commission for Social Care Inspection was unresolved at the time of this inspection. The complaint procedure contains details of the Commission for Social Care Inspection, and the procedure is available to service users and representatives, in appropriate formats. The company’s complaints procedure details how to make a complaint, to whom and the timescales involved. The organisation has an Adult Protection policy, which has been referenced to the Department of Health guidance ‘No Secrets`. The policy has been brought to the attention of all staff, and staff that have been trained in Adult Protection issues. The organisation has policies in place with regard to managing Physical and verbal aggression. Physical intervention is only to be used as a last resort by 290 Newton Road DS0000043211.V262732.R01.S.doc Version 5.1 Page 15 trained persons, in accordance with Department of Health guidance and is the minimum consistent with safety. The vast majority of staff have received the `NVCPI` training but it was not possible to confirm all staff have received refresher training in the appropriate techniques. The Registered Manager stated that the programme of training was to continue in the new financial year. The homes policy and practices regarding service users money/financial affairs was examined at this inspection. The Registered Manager is not an agent or appointee for any of the service users. Access to personal monies is through the service users appointee, (either the Local Authority or relatives). Money is held in safekeeping at the home for service users to use with support from the staff team. The records are regularly audited and balances checked. It was noted that a safe is provided for the safekeeping of monies and valuables. Money is held separately, (not pooled), with restricted access by senior staff only, and is the subject of a daily balance check. Receipts were available for items/monies in safekeeping. It was identified that some of the receipts held are handwritten and were not itemised. Three sets of expenditure records were selected at random for examination, and were found to be managed appropriately. The Registered Manager must consider how the home and staff can evidence choice and control has been exercised by service users when purchases are made with or on behalf of a service user, and that this is with their agreement and in their interests. 290 Newton Road DS0000043211.V262732.R01.S.doc Version 5.1 Page 16 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 the following standard(s): 30 The system for effective infection control within the home is generally acceptable but minor aspects of current practice need to be amended, to further promote good practice. EVIDENCE: Laundry facilities are appropriate and are sited in a separate area designated for the purpose. Walls and floors are readily cleanable. Facilities do not intrude on service users routines, and washing machines have a specified programme to ensure soiled laundry is washed at appropriate temperatures. The commercial washing machine provided has appropriate sluicing facilities. A hand-washing facility is provided, and a supply of liquid soap and paper towels are available in this area and personal protective clothing, to reduce the risks involved with regards to cross infection. Training for staff in infection control as identified in standard 42 of the National Minimum Standards for Younger Adults has been provided for some of the staff. The home was found to be clean, and free from odour. 290 Newton Road DS0000043211.V262732.R01.S.doc Version 5.1 Page 17 The Registered Manager should obtain a supply of disposable laundry bags for use when dealing with soiled linen. In addition, laundry baskets with lids should be used for transporting individual’s linen from bedrooms and bathrooms to the laundry area. Colour coded mop heads should be washed after use at appropriate temperatures and left to dry inverted. 290 Newton Road DS0000043211.V262732.R01.S.doc Version 5.1 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33 34 The home has made minimal progress in working towards providing a staff team of whom 50 are qualified to at least NVQ level 2. Staffing levels are higher than average and the staff team is stable with regards to turnover. Shift times/patterns can be flexible in order to deliver a needs led service. Recruitment practice lacks consistency and potentially places people who use the service at risk. EVIDENCE: According to the duty rota examined, the home employs fourteen care staff. Three have achieved an NVQ level 2 qualification. Eight staff are enrolled or working towards the award. The home generally provides in excess of the minimum staffing numbers as recommended by the Department of Health, but this is required due to the service offering specific packages of care, which include/require a higher ratio of staffing levels to meet the assessed needs of the service users. The ratios of staff to service user are dependant upon need but may include 1:1 or 1:2. Staffing levels within the service are therefore set at seven support staff per shift during the day, including a senior support worker. For the majority of the working week the Registered Manager is supernumerary to the staffing levels. 290 Newton Road DS0000043211.V262732.R01.S.doc Version 5.1 Page 19 Night staffing levels are maintained at two support staff and a sleep in staff. The staffing levels above are the minimum the home must operate within. The staff duty rota was inspected and showed that the staffing levels occasionally fluctuate. The Registered Manager is advised of the need to monitor and adjust staffing levels to ensure the needs of service users are being met and where necessary contact the appropriate health professional to conduct a reassessment. A random sample of staff recruitment files was viewed as part of this inspection. The home should operate the company recruitment procedure, which includes taking two written references prior to appointment. Information contained in the staff files examined did not include all of the required information. The sample of staff files examined indicated there was a lack of consistency in terms of the recruitment practice. The Registered Manager was reminded to examine application forms thoroughly and explore the applicant’s employment history, (including previous care `related posts) and reasons for leaving previous employment. In addition, the Registered Manager was advised that records of all staff interviews should be held and available. This should include who is on the interview panel, questions asked of candidates and the outcome. The manager was also advised in respect of action required for all new employees who are employed on the basis of a Protection of Vulnerable Adults `first` check. For example, ensure all other relevant checks/clearances are secured, (including 2 written references, one from the last employer), ensure that a record/evidence is kept at the home that an enhanced CRB check has been applied for, appoint a member of staff suitably qualified and experienced to supervise the employee, and conduct a documented risk assessment. Subsequently provide a robust induction as referenced to the `Skills for care` standards. There was evidence to confirm this practice had not been adhered to. This shortfall was brought to the attention of the Registered Manager. Progress made against requirements issued from the last inspection was reviewed. Where applicable, these will remain outstanding until fully met. 290 Newton Road DS0000043211.V262732.R01.S.doc Version 5.1 Page 20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37 The Registered Manager is experienced and qualified to run the home and meet its stated aims and objectives. EVIDENCE: The Registered Manager has appropriate qualifications and experience for the post. She holds the NVQ level 4/Registered Managers Award qualification. Since the last inspection the Registered Manager has been seconded to the post of Service Manager within the organisation. In her absence the deputy Manager was appointed Acting Manager. At the time of this inspection the Registered Manager had recently returned to her substantive post. Progress made against requirements issued from the last inspection was reviewed. Where applicable, these will remain outstanding until fully met. 290 Newton Road DS0000043211.V262732.R01.S.doc Version 5.1 Page 21 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 X 2 X 3 X 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 2 ENVIRONMENT Standard No Score 24 X 25 X 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 2 33 2 34 1 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X X X X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 3 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 X 2 X 3 X X X X X X 290 Newton Road DS0000043211.V262732.R01.S.doc Version 5.1 Page 22 NO 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 YA6 Regulation 5 Requirement Timescale for action 30/06/06 2 YA7 12 1) Ensure that service user plans cover all areas of assessed need and include emotional needs, healthcare, social needs, financial assistance, personal care etc. 2) To demonstrate attempts have been made to produce care plans in a format suitable for service users. 3) Ensure that the care plans are compiled with the service user and/or their representative, and are dated/signed. 4) The home should implement a system of Person Centred Planning or similar, such as Essential Lifestyle Planning and Life Story books. (Previous timescale of 31/12/05 partly met) The home needs to expand on its 30/06/06 evidence to support how individual choices are being made by service users, and to be able to show when decisions are made by staff on behalf of the service users and why. (Previous timescale of 31/12/05 partly met) DS0000043211.V262732.R01.S.doc Version 5.1 290 Newton Road Page 23 3 YA12 12,16 4 YA12 16 5 YA18 12 6 YA19 12 7 YA20 13 The manager must ensure that structured activity/plans are in place and continue to demonstrate that opportunities for day care and education have been explored and are available with records of evaluation. (Previous timescale of 31/12/05 partly met) The home must demonstrate that the service being offered is as flexible as possible in terms of general routines of daily living. (Previous timescale of 31/7/05 partly met) The home must demonstrate how service users are afforded individual choice and freedom of movement, and are enabled to exercise control over their lives, subject to restrictions only as agreed in the individual Plan and Contract. Individual working records should clearly set out residents preferred routines, likes/dislikes etc. Healthcare assessments must be completed and supporting information/evidence must be available in each residents file for tracking information from the healthcare matrix of appointments. (Previous timescale of 30/11/05 partly met) • All staff assisting with the administration and recording of service users medication must be provided with `accredited` training in the safe handling of medicines. A plan of training should be devised. (Previous timescale of 31/10/05 partly met) • Staff refresher training in DS0000043211.V262732.R01.S.doc 31/05/06 30/06/06 30/06/06 30/05/06 30/05/06 290 Newton Road Version 5.1 Page 24 8 YA23YA7 13 specific invasive practice should be provided, the agreement updated and must be specific to the service user, and include named carers. • The issue of consent from service users must be explored for the administration of their medication. Where consent is not appropriate then a best interest decision must be recorded, which details who was involved, and the outcome. • The service needs to be provided with a medication fridge and ensure that the appropriate temperatures are maintained and recorded. Expenditure receipts should be itemised and not be handwritten. The Registered Manager must consider how the home and staff can evidence choice and control has been exercised by service users when purchases are made with or on behalf of a service user, and that this is with their agreement and in their interests. 30/06/06 9 YA30 23,13 10 YA33 18 The Registered Manager should obtain a supply of disposable laundry bags for use when dealing with soiled linen. In addition, laundry baskets with lids should be used for transporting individual’s linen from bedrooms and bathrooms to the laundry area. Colour coded mop heads should be washed after use at appropriate temperatures and left to dry inverted. The Registered Manager must DS0000043211.V262732.R01.S.doc 31/05/06 31/05/06 Page 25 290 Newton Road Version 5.1 11 YA34 19,18 ensure the minimum staffing levels are maintained and to monitor and adjust staffing levels to ensure the needs of service users are being met. The Registered Manager must ensure that staff application forms are examined thoroughly and explore the applicant’s employment history/reasons for leaving previous employment. A record of all staff interviews must be held and be available. The Registered Manager must conduct a documented risk assessment for any new employees who are employed on the basis of a Protection of Vulnerable Adults `1st check`. All records held with regard to the fitness of workers must adhere to Regulation 19/Schedule 2 of the Care Homes Regulations 2002, (as amended 2004). 1) To ensure all staff are provided with a) awareness training with regards to Autism and the range of Autistic Spectrum Disorders and b) Vulnerable adults/abuse awareness training. 2) The manager should update/produce a training needs assessment for the staff team as a whole and produce a training and development plan for the home. 3) To ensure that relevant staff are registered and commence on a `Learning Disability Award Framework` accredited training course. 4) To ensure that induction and foundation training is delivered as required, and is in accordance DS0000043211.V262732.R01.S.doc 31/05/06 12 YA35YA23 13,18 30/06/06 290 Newton Road Version 5.1 Page 26 13 YA36 18 14 YA39 24 15 YA41YA23 17,13 with guidance issued by the `Skills for Care` organisation. (Previous timescales of 30/11/05 & 31/12/05 partly met) To ensure the system of staff supervision provides a minimum of 6 formal/recorded sessions per year, in addition to day to day contact, and an annual appraisal (Previous timescales of 31/12/05 partly met) 1) To produce an annual development plan, which is based on a systematic cycle of planning-action-review and reflects the aims and outcome for service users. 2) To explore ways in which the service users, staff and stakeholders can be included in the homes chosen quality assurance system. (Previous timescale of 31/12/05 partly met) Personal inventories of service users belongings and items of value, must be held and maintained appropriately. (Previous timescale of 30/11/05 partly met) 30/06/06 30/06/06 31/05/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA20 Good Practice Recommendations Copies of prescriptions obtained for service users medication should also be held. It is also recommended that arrangements are made to manage controlled drugs should the situation arise within the home. DS0000043211.V262732.R01.S.doc Version 5.1 Page 27 290 Newton Road 2 YA32 That the home continues to work toward meeting Sector skills workforce targets of 50 of care staff having achieved an NVQ level 2 or above. 290 Newton Road DS0000043211.V262732.R01.S.doc Version 5.1 Page 28 Commission for Social Care Inspection Halesowen Record Management Unit Mucklow Office Park, West Point, Ground Floor Mucklow Hill Halesowen West Midlands B62 8DA National Enquiry Line: 0845 015 0120 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 290 Newton Road DS0000043211.V262732.R01.S.doc Version 5.1 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!