Inspection on 12/11/07 for 3 Cherry Tree Close

This inspection was carried out on 12th November 2007.

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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 9 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

3 Cherry Tree Close 06/11/08

3 Cherry Tree Close 29/09/06

3 Cherry Tree Close 06/01/06

3 Cherry Tree Close 08/02/05

3 Cherry Tree Close 07/04/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 3 Cherry Tree Close 3 Cherry Tree Close Nailsworth Stroud Gloucestershire GL6 0DX Lead Inspector Ms Lynne Bennett Key Unannounced Inspection 12 and 13th November 2007 15.00 th 3 Cherry Tree Close DS0000038186.V349318.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address 3 Cherry Tree Close DS0000038186.V349318.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. 3 Cherry Tree Close DS0000038186.V349318.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 3 Cherry Tree Close Address 3 Cherry Tree Close Nailsworth Stroud Gloucestershire GL6 0DX 01453 835023 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) Gloucestershire Group Homes Mr Jeffrey Michael Bird Care Home 2 Category(ies) of Learning disability (2) registration, with number of places 3 Cherry Tree Close DS0000038186.V349318.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 29th September 2006 Brief Description of the Service: 3 Cherry Tree Close is a detached house with accommodation for two adults with Aspergers Syndrome. The home is situated in Nailsworth, providing people living at the home with access to local community facilities. They have access to transport that is provided by the home. The home is staffed 24 hours a day, seven days a week. The organisation offers a very specialised, individual service for people with Aspergers syndrome, and staff receive training to support people living at the home appropriately. A copy of the Statement of Purpose and Service User Guide are kept in the home and further copies are available from Head Office. Fees for the home are negotiated according to each individual’s specific needs. 3 Cherry Tree Close DS0000038186.V349318.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The judgements contained in this report have been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. This inspection took place in November 2007 and included two visits to the home, a visit to Head Office and to the day service. People living at the home were spoken with and observed during the visits. Two members of staff were spoken with briefly and time was spent with the Responsible Individual, Registered Manager and Service Co-ordinator. The registered manager completed an AQAA (Annual Quality Assurance Assessment) as part of the inspection, providing considerable information about the service and plans for further improvement. Surveys were received from relatives. A selection of records were examined which included care plans, medication and financial records, staff files and health and safety systems. A walk around the home was conducted with one of the people living there. What the service does well: What has improved since the last inspection? The kitchen has been refitted. 3 Cherry Tree Close DS0000038186.V349318.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. 3 Cherry Tree Close DS0000038186.V349318.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection 3 Cherry Tree Close DS0000038186.V349318.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 2. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The needs of people wishing to move into the home would be fully assessed before deciding whether to offer them a place there. EVIDENCE: The Statement of Purpose and Service User Guide had been reviewed and a copy sent to the Commission. A copy of this document was available in the office at the home. The certificate of registration displayed in the home was an old version produced by the National Care Standards Commission. It appears the Commission for Social Care Inspection had not provided a new certificate. This will be forwarded to the home in due course. There have been no new admissions to the home. There is an admissions process in place that includes obtaining an assessment from the placing authority, an assessment by the home and where appropriate visits. The management team recognise the importance of ensuring that the home is right for the individual taking into consideration the needs of the other person living there. 3 Cherry Tree Close DS0000038186.V349318.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 and 9. People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People’s wishes and aspirations are identified in their care plans. They are supported to make decisions about their day-to-day lives and risks are managed to safeguard them from harm. Records do not always reflect this. EVIDENCE: An annual assessment of skills was being completed each year that formed the basis for the annual review of care plans and risk assessments. Copies of annual reviews included a contribution from each person living at the home. This is good practice. Care plans were being developed involving people living at the home, their relatives and other health care professionals involved in their care. These plans indicated current needs, the development of skills and their aspirations and wishes. Individual Programme Plans provided a structure by which people would develop skills with the support of staff where appropriate. All documents had been regularly reviewed. 3 Cherry Tree Close DS0000038186.V349318.R01.S.doc Version 5.2 Page 10 Each file contained a personal profile and information specific about their autism spectrum disorder or aspergers syndrome. In addition to this other information about health care issues were identified. Staff spoken with appeared to have a sound awareness of people’s needs. Comments from a relative indicated “they look after and understand my son as well as I do.” There were some restrictions in place for people living at the home including supporting one person to monitor their diet and another person to manage their alcohol consumption. The rationale for this must be provided in greater depth in the care plans. It was apparent that these were in place in their best interests. Financial records were examined. Receipts were being kept for expenditure. The Senior Co-ordinator stated that records could be more robust showing individual purchases rather than the total amount withdrawn. For instance one entry for £160 indicated television and weekend spending. Receipts confirmed the amount paid for the television. Records for one person indicated that there had been no income between July and October 2007 and no expenditure. The bank statement for this period of time was not available. The Senior Coordinator thought that a date had been entered wrong and that one payment into the account had been omitted. Each person had a risk policy in place that outlined hazards and support needed such as for the administration of medication, support with diet and support with personal care. These documents were dated May and September 2006 and appeared to be due for review. Other risk assessments were in place that had been reviewed in July this year covering areas such as life skills and self-harm. One person had a risk assessment stating that they were not to be left alone in the home. The other person was left alone during one of the visits but there was no risk assessment in place. Management explained that over the years this person had developed the skills to cope with being left alone and would know how to cope in an emergency. This had not however been recorded in their care plan. 3 Cherry Tree Close DS0000038186.V349318.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15,16 and 17. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who live at the home make choices about their lifestyle, and are supported to develop life skills. They have the opportunity to take part in social, educational and recreational activities and keep in touch with family and friends. People are offered a healthy and nutritional diet. EVIDENCE: Both people had an activities schedule indicating a range of activities within the community and at home. One person described their neighbours and appeared to have developed positive relationships with them. Another person used the local shop and post office regularly. The home had a vehicle that it shared with another home in the group. People were also being encouraged to walk to local facilities. 3 Cherry Tree Close DS0000038186.V349318.R01.S.doc Version 5.2 Page 12 One person was involved in two work placements locally and another person attended the organisation’s day centre. People were being supported to follow their own interests. One person loved trains and had a train set in a spare room at the home. They said that they also enjoyed going to charity shops and craft shops in Gloucester to purchase kits of sailing ships. Sky television had been provided and both can access computers at the day centre. Records confirmed that they also regularly go out for lunch to a café or garden centre; go for walks and to local towns. People were being supported to maintain close contact with family and friends. The registered manager said that one person spent time following shared hobbies with their family who live locally. They also visit them at the home. The Board of Trustees provides family members with the opportunity to become involved in the wider organisation. People were being supported to take responsibility for their home helping to do the recycling, take the rubbish out, and clean their rooms. They also helped with the shopping. There were times when people did not wish to participate in these activities or others offered and this was recorded. People were being involved in the choice of menu. A healthy and nutritional diet was offered to people including fresh vegetables and fruit. Staff were supporting one person, who would choose to eat cheese or processed meat and water biscuits, to eat a healthy diet. There was evidence of some success in this area. Records indicated that lunch at a garden centre was often a salad and that more potatoes, vegetables and fruit had been introduced into their diet. Monitoring charts were in place and the dairy confirmed that the person had occasional access to their chosen diet albeit on a limited basis. 3 Cherry Tree Close DS0000038186.V349318.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People’s health and wellbeing are monitored and they have regular access to healthcare professionals. Improvements in the administration of medication are needed to safeguard people from the risk of error or possible harm. EVIDENCE: The way in which people wish to be supported was clearly identified in their care plans. Guidance was in place for staff indicating levels of support needed by each person with their personal care. There were a range of checklists in place providing evidence that staff were monitoring people’s health and wellbeing. The management team stressed the importance of a consistent approach by staff. Records were in place providing staff with guidance. Observation of and discussions with staff confirmed their understanding of people’s needs. 3 Cherry Tree Close DS0000038186.V349318.R01.S.doc Version 5.2 Page 14 Robust records were in place detailing appointments with a range of healthcare professionals. Records indicated the date and the outcome of the appointment. There was evidence that people were having regular appointments with their Doctor, Dentist, Chiropodist and Optician. People also had access to their local Community Learning Disability Team. Systems for the administration of medication were examined. Certificates confirmed that staff were completing a BTEC in Medicines - Principles of administration and control. Care plans indicated people’s consent to have medication administered to them and provided a summary of the medication they were prescribed. Medication reviews were in evidence. The following issues were noted: • Some medication was being provided in a monitored dosage system. There were no procedures in place to monitor stock levels of medication not dispensed in this way. • Creams were not labelled with the date of opening. • Homely remedies were in use but there was nothing from the pharmacist or doctor to give permission for this. • The administration records were handwritten and there was no indication of the author. • All prescribed medication for each person was entered into a summary box on one sheet. Staff were signing once to say that medication had been given. This practice is unsafe and could lead to error. (As stock records were also not kept it was not possible to check whether all medication had been given as prescribed.) • Staff described the process for administering medication and indicated that at times medication was put into containers labelled with people’s names to give to them later. Wherever possible medication must be given directly from the containers issued by the pharmacy to people living at the home. 3 Cherry Tree Close DS0000038186.V349318.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Systems are in place to enable people to express their concerns. People are safeguarded from possible harm or abuse. EVIDENCE: People have access to a complaints procedure. One person was observed interacting with staff and voicing opinions. Staff responded appropriately. It appeared that any concerns would be dealt with as they arise. People living at the home also have the opportunity to express any concerns in preparation for their annual review and during unannounced visits to the home by the management team or board of trustees. Staff have attended training in the protection or safeguarding of adults. The Responsible Individual stated that she provides training internally focussing on the people living at the home. Staff have also attended the alerters guide training with the local adult protection team. Some staff had received training in the management of challenging behaviour but this was some time ago. The provision of this training should be reviewed. The management team confirmed a “low arousal approach” and that physical intervention would not be used in the home. Behavioural assessments were being completed annually. Behaviour protocols had been reviewed this year and indicated triggers that might upset a person or cause anxiety resulting in behaviour that might challenge staff. Records indicated that staff had a good understanding of these and what their appropriate response would be. All incidents were being recorded. Over the past six months there had been four incidents none of which needed reporting to us. 3 Cherry Tree Close DS0000038186.V349318.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People live in a home that meets their needs and lifestyles. A safe and clean environment is provided. EVIDENCE: Each person has a bedroom, one with a hand washbasin, which they have decorated to reflect their interests and lifestyles. The spare bedroom contains a large model railway. Communal spaces include a lounge with two sofas and a kitchen/dining room. There was a shared bathroom on the first floor. Grounds to the rear of the home were pleasantly landscaped. An area under the stairs in the lounge was screened off to provide additional storage. Staff must make sure that no flammable materials are stored in this space. At the time of the visits the home was clean and tidy. 3 Cherry Tree Close DS0000038186.V349318.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): People who use the service experience poor quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Peoples’ needs are met by a competent staff team, who have access to a satisfactory training programme that provides staff with knowledge about the diverse needs of people living at the home. Improvements in recruitment and selection procedures are needed to safeguard people from possible harm. EVIDENCE: Staff at the home work alone. There were three staff in the team who were being supported on occasions by bank staff. Two of the staff members have worked at the home for over three years and the other person had recently returned to work there. Staff said that they work a 24-hour shift including a sleep in. At the time of the first visit a handover was taking place. The organisation does not have a policy and procedure in place for lone working. The management team said that they have regular contact and communication with staff at the home. Senior team meetings were being scheduled every two months. 3 Cherry Tree Close DS0000038186.V349318.R01.S.doc Version 5.2 Page 18 Staff files were kept at Head Office. Two files for bank staff were examined and the following issues were identified: • • • • • • The application form requests the last four employers. This does not provide a full employment history. Reference requests do not ask why the person left their former employment (when working with adults or children). There was no evidence that a povafirst check had been obtained prior to employment. There was no risk assessment in place for people starting work before their Criminal Records Bureau check had been obtained. Staff were lone working before their Criminal Records Bureau check had been obtained. There was no evidence that a photograph or proof of identity had been obtained. The application form currently used requests that any gaps in employment history be explained. This is good practice. Two references were in place for each person and were being received prior to appointment. Any original Criminal Records Bureau checks can now be destroyed. Staff confirmed that an induction programme was in place and that mandatory training was being provided, with refresher training when necessary. Copies of certificates were kept on their personal file. The training folder in the home had not been kept up to date. Staff said that they complete training that is specific to the needs of people living at the home. This included the Certificate in Autistic Spectrum Disorders and a degree in Autism Studies from Birmingham University. The annual management report for the organisation confirmed that 75 of staff have a recognised autism qualification. Staff confirmed they had completed training in epilepsy and safeguarding of adults. Management had obtained information about the mental capacity act but had not attended training in this area. Management stated that each year they hold a training/team event. This year the topics were Aspergers Syndrome and Equal Opportunities. 3 Cherry Tree Close DS0000038186.V349318.R01.S.doc Version 5.2 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 and 42. People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. A quality assurance system that formalises processes already in place would provide evidence of the monitoring and review of the home. Health and safety systems need to be improved on to ensure that people are safeguarded from possible harm. EVIDENCE: The registered manager has considerable experience in this area of care. He was registered manager for three small homes in the group with day-to-day tasks being delegated to a senior carer in the home. He has a Diploma in Social Work, Certificate in Management Studies and is a Bachelor of Philosophy in Autism Studies. 3 Cherry Tree Close DS0000038186.V349318.R01.S.doc Version 5.2 Page 20 A formal quality assurance system was not in place for the home. We had received copies of two unannounced visits for the current year under Regulation 26. The management team said that they frequently visit the home along with quarterly visits by the Board of Trustees. These had not however been recorded. Copies of an annual report prepared by the Responsible Individual for the Board of Trustees indicated that a quality assurance process was in place. There was also evidence that the registered manager provides a report for the committee at regular intervals. People living at the home were involved in giving feedback for their annual reviews. Positive comments were recorded about their home and lifestyle. Systems were in place to monitor health and safety within the home. Fire records were examined and found to be satisfactory. A fire risk assessment was being put in place. This must be completed. The following issues were identified as needing action: • • • Water temperatures were regularly above 59°C and records did not indicate which outlet was being tested. Several items of food had been opened in the fridge. These were not resealed and did not have a label indicating when they had been opened. Portable appliance stickers on equipment in the home indicated that these were overdue for testing – they stated May 2006. It was evident that cooked food temperatures and the temperature of the oven were being recorded. An environmental risk assessment and HACCP analysis were in place. 3 Cherry Tree Close DS0000038186.V349318.R01.S.doc Version 5.2 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 3 2 3 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 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 1 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 2 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 2 X X 2 X 3 Cherry Tree Close DS0000038186.V349318.R01.S.doc Version 5.2 Page 22 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 YA7 Regulation 17(1)(a) Sch 3.3(q) Requirement Where there are limitations or restrictions to choice or freedom to make decisions these must be recorded giving the rationale for these. This is in respect of restrictions to diet and alcohol consumption. Systems for the administration of medication must safeguard people from possible harm. Each medication must be dispensed directly to the person and the record signed for each individual medication. A system for monitoring stock levels of medication must be put in place so that any drug omissions or errors can be monitored. Any creams or liquids used must be labelled with the date of opening and disposed of appropriately. The area under the stairs must be kept free of flammable materials in case of fire. Staff must not be employed in the home without a full employment history, under exceptional circumstances a DS0000038186.V349318.R01.S.doc Timescale for action 31/12/07 2. YA20 13(2) 30/11/07 3. YA20 13(2) 30/11/07 4. YA20 13(2) 30/11/07 5. 6. YA24 YA34 13(4) 19(1)(b) Sch 2 30/11/07 30/11/07 3 Cherry Tree Close Version 5.2 Page 23 7. YA39 26 povafirst check, a Criminal Records Bureau check and proof of identity. This is to safeguard people from possible harm. The manager must ensure that 31/03/08 regulation 26 visits are completed as prescribed in the regulations. (This requirement has been repeated from the last inspection-timescale for action 30/11/06). Water temperatures over 43°C need to be investigated. This is to protect people living at the home from possible harm. Portable appliance tests must be carried out regularly. 30/11/07 8. YA42 13(4) 9. YA42 13(4) 31/12/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard YA6 YA7 Good Practice Recommendations A care plan should include strategies in place for the person left home alone for short periods of time. Financial records should be regularly audited. The person doing this should sign and date the records. Receipts should be clearly numbered and cross-referenced with the record. Risk policies should be reviewed alongside risk assessments. Health action plans should be introduced for people living at the home. Two people should countersign handwritten entries on medication records. Permission to use homely remedies should be obtained from the Pharmacist or Doctor. Staff should have access to refresher training in the management of challenging behaviour. A lone working policy and procedure should be put in place. DS0000038186.V349318.R01.S.doc Version 5.2 Page 24 3. 4. 5. 6. 7. 8. YA9 YA19 YA20 YA20 YA23 YA32 3 Cherry Tree Close 9. 10. 11. 12. 13. 14. YA34 YA34 YA35 YA35 YA42 YA42 Evidence that a povafirst check has been obtained should be kept on the staff file. A risk assessment should be put in place for staff starting work in the home without a Criminal Records Bureau check in place. Training records should be kept up to date. Staff should be aware of the Mental Capacity Act and the implications for the people they support. Food in fridges, which is open, should be sealed and labelled with the date of opening. Water temperature records should indicate which outlet has been tested. 3 Cherry Tree Close DS0000038186.V349318.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection South West Regional Office 4th Floor, Colston 33 33 Colston Avenue Bristol BS1 4UA National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI 3 Cherry Tree Close DS0000038186.V349318.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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