CARE HOME ADULTS 18-65
Pendarves (3) 3 Pendarves Road Camborne Cornwall TR14 7QB Lead Inspector
Lowenna Harty Unannounced Inspection 21st September 2006 09:30 Pendarves (3) DS0000009115.V309754.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 Pendarves (3) DS0000009115.V309754.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. Pendarves (3) DS0000009115.V309754.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Pendarves (3) Address 3 Pendarves Road Camborne Cornwall TR14 7QB 01209 610827 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) Spectrum Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Pendarves (3) DS0000009115.V309754.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 6th December 2005 Brief Description of the Service: 3 Pendarves Road is a home providing accommodation and personal care for up to three adults with a learning disability. The registered provider is Spectrum, an organisation that provides specialist services for people with autistic spectrum disorders. Spectrum employs a manager and a team of staff to run the home on a day-to-day basis. External, on-call managers are available to provide specialist input, support and advice where necessary. The home is located in the town of Camborne, within easy reach of all the town’s facilities. There are shops within walking distance of the home and the home has a vehicle to provide transport for service users who require access to resources in the wider community. The home is a two-storey building, set in its own grounds. All of the bedrooms are large single rooms. One has its own lounge and bathroom. There is a shared bathroom on the first floor. The home has a lockable office on the first floor, which also provides accommodation for staff to sleep in. Downstairs there is a communal kitchen, large lounge, smaller lounge, which is currently serving as a storage area and a communal kitchen/dining room. There is a separate laundry area in which service users are able to do their own laundry. The home does not provide specific facilities for people with physical disabilities, but could be adapted for this, if necessary. Fees are £1500 per week, which excludes variable charges for service users’ personal items, off-site entertainment, dry cleaning, private chiropody and alcoholic beverages. Inspection reports are made available to service users if they wish to see them. Pendarves (3) DS0000009115.V309754.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced key inspection, which took place on 21 September 2006 and lasted for approximately six hours. The purpose of the inspection was to ensure that service users’ needs are properly met, in accordance with good care practices and the laws regulating care homes. The focus is on ensuring that service users’ placements in the home result in good outcomes for them. Information received from and about the home since the previous inspection has also been taken into consideration in making judgements about the quality of outcomes for the service users living there. The inspection included interviews with service users, telephone contact with relatives and a social worker representing one of them. A member of staff was interviewed and there were opportunities to directly observe aspects of service users’ daily lives in the home and staff interaction with them. Other activities included an inspection of the premises, examination of care, safety and employment records and discussion with the home’s manager. A representative from Spectrum’s senior management team was also present. Case-tracking of service users involved a more in-depth review of how the home meets their needs, with particular reference to their individual and diverse needs relating to their age, culture and ethnicity, religion, gender, sexual orientation and disabilities. What the service does well:
Service users currently living in the home have been resident there for some years and are very familiar with the services provided to them there. Their initial admissions were on the basis of detailed assessments, to make sure it would meet their needs and re-assessments are arranged, as necessary, as their needs change. Their care needs are clearly set out in individual care plans, which are regularly reviewed with them and their representatives so that they are aware of the goals of their placements in the home. Service users are encouraged to make choices about things that are important to them such as what activities they do during the day, meals and what time to get up in the morning, which was observed during the inspection. Staff support them to take managed risks so that they develop their skills and independence safely.
Pendarves (3) DS0000009115.V309754.R01.S.doc Version 5.2 Page 6 Service users enjoy a good quality of life in that staff take them out and help them to access a range of activities in and out of the home that are culturally and age appropriate. They are supported to maintain valued relationships with their families, can make telephone calls to them in private and at the time of the inspection one service user was getting ready to go for a visit to their family home. Service users are given information about their rights and responsibilities as residents, including their rights to consult with advocates outside of the home, if they wish. They are provided with healthy, home prepared meals that are culturally appropriate and account for their individual tastes and preferences. Service users look smartly and appropriately dressed and staff support them to take care of their personal needs as independently as they can. If they are able, they can make their own routine medical appointments, otherwise staff assist them. Staff help them to access specialist healthcare services as necessary so that they maintain good physical and mental health. Service users are able to raise any concerns they have with staff and there is a key worker system in place so that they can talk to a nominated person, if they prefer. There is a formal complaints procedure, but there have not been any formal complaints made since the previous inspection. The home was clean and tidy throughout at the time of the inspection and provides service users with a safe and comfortable place to live, in a convenient community setting. Staff recruitment is fair, safe and effective so that service users can have confidence that the people working with them are suitable to work with vulnerable adults in a care setting. The home is generally well managed for the benefit of the service users and one relative of a service user described the new manager as “excellent”. Service users are given opportunities to contribute their views to the ongoing development of the service. Safety equipment is regularly tested and checked to make sure the home is safe for them to live in. What has improved since the last inspection?
Service users’ written risk assessments, which set out any restrictions necessary to protect them, were up-to-date at this inspection. They appeared to be accurate had been agreed with their representatives outside of the home. Pendarves (3) DS0000009115.V309754.R01.S.doc Version 5.2 Page 7 Service users are able to access their personal files if they wish and their rights to information are respected. Service users said that they are satisfied with the food provided to them and at this inspection, did not complain about restrictions on portion sizes. Information to guide staff on how to safely handle and administer service users’ medicines is readily available to them now, so service users have improved protection from medication errors. Systems to protect service users from abuse have improved and staff now have clear written guidance on what they should do to protect them. Improvements have been made to the home’s environment, which service users and their representatives appreciated and remarked upon, particularly the re-painting of the outside of the building. 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.
Pendarves (3) DS0000009115.V309754.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Pendarves (3) DS0000009115.V309754.R01.S.doc Version 5.2 Page 9 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2&5 Quality in this outcome area is adequate. Service users’ needs are assessed and re-assessed, when necessary to ensure that the home can continue to properly provide for their health, personal and social care needs, including their individual and diverse needs. Service users need to be provided with improved information about the terms of their placements in the home, though, so that they are fully informed about their decision to live there. EVIDENCE: No new service users had been admitted to the home since the previous inspection and current service users are very familiar with the services provided there, through their experience of having lived in the home for several years. There is clear assessment information relating to each of the service users living in the home, held on their personal files. Multi-disciplinary assessments, involving external specialist professionals are arranged in response to individual service users’ needs, according to the home’s manager, which records confirmed. Service users’ records show that information on their fees is not provided to them in their individual service users’ guides, which also function as contracts, neither is there clear information on their welfare benefits and personal contributions to the costs of their placements in the home. The social work representative of one of them said that they are satisfied contracts are fair and clear and that services are provided to the relevant service user in line with their local authority contract. Pendarves (3) DS0000009115.V309754.R01.S.doc Version 5.2 Page 10 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): 6, 7 & 9 Quality in this outcome area is good. Service users’ care plans address their personal, health and social care needs so that they are aware of the goals of their placements in the home and appropriately address needs relating to their ages, religion and cultural backgrounds, disabilities, sex and sexual orientation. Service users are provided with opportunities to make decisions about things that are important to them and supported to take managed risks so that they develop their skills and independence. EVIDENCE: A service user confirmed that they attend care plan reviews on a regular basis. Relatives and a social worker of one of the service users confirmed that they are invited to attend reviews regularly. Care plan formats are detailed and include specific headings related to service users’ personal, health and social care needs including their individual and diverse needs. The manager said that service users are actively encouraged to participate in their care plan reviews and contribute to the agenda. Service users, staff and the home’s manager were able to provide examples of how service users are enabled to make choices about things that are important to them including the activities they participate in, when they get up in the mornings and go to bed at night and menu planning. Service users’ Care plans
Pendarves (3) DS0000009115.V309754.R01.S.doc Version 5.2 Page 11 contain consideration of service users’ abilities to make decisions for themselves. The home’s manager said that service users are able to access their personal files if they wish and that one does so regularly. Service users have detailed written risk assessments, which are shared with their representatives. These set out how staff support service users to take managed risks in order to develop their skills and confidence. The social worker of one service user said that are not unduly restrictive and are provide creative strategies to support service users to develop their independence in safe ways. Pendarves (3) DS0000009115.V309754.R01.S.doc Version 5.2 Page 12 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): 12, 13, 15, 16 & 17 Quality in this outcome area is good. Staff assist service users to access a range of age, peer and culturally appropriate activities in and out of the home and to maintain appropriate contact with their families so that they enjoy a good quality of life. Their rights and responsibilities are set out clearly for them so that they are well informed about what is expected of them as residents of the home. They are provided with a healthy diet so that they stay well and enjoy their meals. EVIDENCE: Service users gave examples of activities they enjoy taking part in, during interviews held with them at the time of the inspection. Copies of their activity rotas are held on the notice board in the kitchen and their daily care records confirm that they take part in a range of activities in accordance with their individual care plans. Staff confirmed that they help service users to access a range of local community facilities, which their records confirmed. Service users said that they enjoy going on trips out of the home. Appropriate transport is provided for them.
Pendarves (3) DS0000009115.V309754.R01.S.doc Version 5.2 Page 13 Service users are able to contact their families by telephone in private, which their relatives confirmed. At the time of the inspection a service user was preparing to return to their parental home for a visit and daily care records provided further evidence that they are supported to maintain valued relationships outside of the home. Spectrum’s senior managers are available to support and advise to staff on more complex issues relating to service users’ personal relationships and one was present at the time of the inspection. The home’s service users’ guide clearly sets out what service users can expect and what is expected of them in return. It is provided to them in a suitable format so that they can understand it. They are also informed of their rights to access independent advocates if they wish. Service users said that they like the food provided to them at the home. They were observed accessing the kitchen and are able to prepare their own breakfasts and lunches. They help to plan the main evening meals, which are suitably varied, home prepared and appropriate to service users’ cultural backgrounds and preferences. Pendarves (3) DS0000009115.V309754.R01.S.doc Version 5.2 Page 14 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, 19 & 20 Quality in this outcome area is adequate. Service users are appropriately supported with their personal care and to access the healthcare services they need so that they can live comfortably and appropriately in a community setting. Further improvements are needed to protect them from medication errors. EVIDENCE: Service users are able to access bathrooms in private and staff guide, support and assist them as necessary, to help them maintain their independence and dignity. Staff have clear written guidance on how service users need and want support, so that they provide assistance appropriately. Service users looked smart and fashionably dressed at the time of the inspection. Service users’ healthcare needs are considered as part of the care planning process and regularly reviewed. Service users, staff and their relatives stated that they access external healthcare providers, including specialists, when they need to and service users’ healthcare records provided further evidence of this. Some improvements have been made to medicines management in the home, since the previous inspection. The written procedures to guide staff on the safe handling of medicines were readily available to them. These allow for service users to administer their own medicines, subject to their individual risk assessments. Records of administration appeared to be mainly up-to-date and
Pendarves (3) DS0000009115.V309754.R01.S.doc Version 5.2 Page 15 accurate, with one exception, that the manager was preparing to correct. There is lockable storage for medicines in the office, but more space is needed so that staff have room to properly manage them. Insufficient numbers of care staff have attended training in the safe handling of medicines. This needs to improve so that service users have improved protection from medication errors. Pendarves (3) DS0000009115.V309754.R01.S.doc Version 5.2 Page 16 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 Quality in this outcome area is good. Service users have opportunities to make their views known and complaints are taken seriously. There are sound systems in place to protect them from abuse so that they can feel safe in the home. EVIDENCE: Service users can make their views known, informally, to staff. There is a key worker system in place so that they can discuss any concerns with a nominated individual if they prefer. They are invited to contribute to their care plan reviews and can access the home’s formal complaints procedure if they feel they need to. There have not been any formal complaints since the previous inspection, according to the home’s manager. Service users’ representatives said that they are mainly satisfied with the care and services the home provides and are confident about approaching the home’s manager or Spectrum’s senior managers, if necessary. Written procedures to guide staff on how to protect service users from abuse, neglect and self-harm are posted on the wall in the office, including the local multi-agency procedures. The home’s manager said that he has applied and is on the waiting list for local multi-agency training. In the meantime, most care staff have undertaken internal training with Spectrum. Staff records show they are recruited on the basis that they are suitable to work with vulnerable adults in a care setting and the required checks are made before they commence work in the home. Service users’ representatives all said that they are satisfied with the systems in place to manage their personal finances. Pendarves (3) DS0000009115.V309754.R01.S.doc Version 5.2 Page 17 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): 24 & 30 Quality in this outcome area is good. The home’s environment has been improved since the previous inspection, so service users have a safe, comfortable environment in which they can develop their skills and independence. There are systems in place to protect service users from risks due to cross-infection. EVIDENCE: Service users and their representatives remarked on the improvements to the home’s environment, particularly the painting of the outside of the building so that it appears more attractive. Visual inspection of the premises provided evidence that the home is a comfortable, well-maintained, non-institutionalised setting that meets service users’ needs. Repairs highlighted at the previous inspection have been completed. The home was clean and tidy throughout at the time of the inspection and staff have written guidance on maintaining good hygiene in the home. Pendarves (3) DS0000009115.V309754.R01.S.doc Version 5.2 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 & 36 Quality in this outcome area is adequate. There are insufficient numbers of qualified staff and some lack essential training for service users to have confidence in their competence and skills. Staffing numbers at night need to be reviewed so that lone care staff and service users are not put at risk and excessive staff turnover is resulting in a lack of consistency for service users. The home’s recruitment policies and practices are fair, safe and effective so that service users can be assured that staff are suitable to work in a care setting but they lack regular, formal supervision. EVIDENCE: The home’s records that only one is qualified to NVQ level 2 or above, which is far less than the recommended level of 50 . The home’s manager and a staff member who was interviewed confirmed that this was the case, although most of the staff are working towards achieving formal qualifications. Staff recruitment records indicate that they are recruited on the basis that they are suitable to work with vulnerable adults in a care setting. According to the home’s records, some staff lack essential training needed to work safely and effectively with service users, including basic food hygiene and emergency aid, for example. Duty rotas show that there is a single member of staff sleeping in the home at night and some of these do not have basic safety training. Records indicate that service users do get up at night and night time staffing arrangements need to take risks to service users in their current situations fully into account. Service users and their representatives expressed concerns about the recent high turnover of staff.
Pendarves (3) DS0000009115.V309754.R01.S.doc Version 5.2 Page 19 The home’s staff recruitment records indicate that staff are appointed on the basis of written application forms and equal opportunities interviews. Appropriate checks are made of their suitability to work with vulnerable adults in a care setting. A staff member interviewed at the time of the inspection confirmed that they were fairly recruited and have a clear job description and contract of employment. Because of staff and management changes in the home, staff have not received 1:1 supervision on a regular basis of late, although the new manager for the home is starting to address this. Pendarves (3) DS0000009115.V309754.R01.S.doc Version 5.2 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, 39 & 42 Quality in this outcome area is good. The home is mainly well managed for the benefit of service users. There are formal and informal systems in place to ensure that service users’ views are accounted for in the day-to-day running and ongoing development of the home. There are systems in place to protect service users from avoidable harm and injury. EVIDENCE: The current manager said he is relatively new to the home and is in the process of submitting his application to be registered with the Commission. He has experience of working for Spectrum but not formal qualifications relevant to the care industry. He stated that he is working towards achieving a management qualification. When interviewed he demonstrated a good understanding of the service users’ needs and service users’ representatives said that they feel the home is generally well managed. The new manager has plans to undertake a forma quality assurance exercise with service users. In the meantime, they are invited to reviews and able to provide their views about the home in that setting. Informally they are able to discuss any concerns they may have with staff or the home’s manager and the
Pendarves (3) DS0000009115.V309754.R01.S.doc Version 5.2 Page 21 manager said that he has an ongoing dialogue with them and their representatives in this respect. At the time of the inspection a senior Spectrum manager was undertaking a monitoring visit and providing advice, support and guidance to the manager. Reports of regular monitoring visits are sent to the Commission. The home’s fire safety records and environmental risk assessments are completed and up-to-date. There are records of regular tests and checks of safety equipment and procedures in the home to ensure service users’ safety. Pendarves (3) DS0000009115.V309754.R01.S.doc Version 5.2 Page 22 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 3 3 X 4 X 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 2 33 1 34 3 35 X 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 X 2 3 X 3 X X 3 X Pendarves (3) DS0000009115.V309754.R01.S.doc Version 5.2 Page 23 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 YA5 Regulation 5(1)(bb) Requirement Timescale for action 01/11/06 2. YA20 13(2) 3. YA33 18(1)(c) 4 YA33 18(1)(a) Service users must be informed of their total fees payable and the method of their payment so that they can make an informed decision to live in the home. 01/11/06 Staff must undergo training in the safe handling of medicines so that service users are better protected from medication errors. This requirement is renotified from 01/06/06. It is of concern to the Commission that this requirement has not been met within the required timescale. Further time has been provided to the new manager to fully comply. Staff must be provided with 01/11/06 essential training so that they are safe to work with service users, with particular reference to training in emergency aid. There must be a review of the 01/11/06 risks attached to the employment of a lone worker in the home at night so that service users are not placed at risk. Pendarves (3) DS0000009115.V309754.R01.S.doc Version 5.2 Page 24 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 YA5 Good Practice Recommendations Service users should be given clearer information in their individual contracts about their welfare rights, including how their benefits and any contributions they make are calculated, so that they can make fully informed decisions about their placements in the home. Storage facilities for medicines should be improved so that staff have more space in which to work and are less likely to make errors. 50 of the staff should be qualified to at least NVQ 2 so that service users can have confidence in the skills of the people working with them. Staff changes in the home should be reduced so that service users benefit from a more consistent team of people working with them. Staff should be provided with regular, recorded individual supervision and more regularly held staff meetings. 2. 3. 4. 8. YA20 YA32 YA33 YA36 Pendarves (3) DS0000009115.V309754.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection St Austell Office John Keay House Tregonissey Road St Austell Cornwall PL25 4AD National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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