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Inspection on 01/12/08 for 3 Prince of Wales Road

Also see our care home review for 3 Prince of Wales Road for more information

This inspection was carried out on 1st December 2008.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 3 Prince of Wales Road 3 Prince of Wales Road Dorchester Dorset DT1 1PW     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Lesley Jones     Date: 0 1 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 31 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 31 Information about the care home Name of care home: Address: 3 Prince of Wales Road 3 Prince of Wales Road Dorchester Dorset DT1 1PW 01305269208 01305269208 3pow@drh.uk.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Dorset Residential Homes care home 8 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 8 The maximum number of service users who can be accommodated is 8. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: Learning Disability (Code LD) Date of last inspection Brief description of the care home 3 Prince of Wales Road is a care home registered to provide accommodation for 8 learning disabled people who may also have physical disabilities and emotional and behavioural needs. The home is operated by Dorset Residential Homes, a registered charitable trust that operates a number of care homes in Dorset. The home is located in Dorchester within easy reach of the town centre. It is a large detached property that has been carefully extended and adapted to meet the needs of service users; the home does not stand out from neighbouring properties. Accommodation is provided on two floors with first floor access via a lift. There are 4 single bedrooms and 2 shared bedrooms for service users. On the ground floor there is a lounge, kitchen and dining room, laundry, utility area and clinic room. There are sufficient bathrooms and toilets on both floors. The home provides a range of equipment to meet the needs of people with disabilities. A team of registered learning disability nurses and care staff provide Care Homes for Adults (18-65 years) Page 4 of 31 Brief description of the care home 24-hour care and support at the home. A copy of the last inspection report is available directly from 3 Prince of Wales or from Dorset Residential Homes head office in Dorchester. Current fees range from 900:00 - 1200 pounds per week, though may vary according to the individuals support needs. Care Homes for Adults (18-65 years) Page 5 of 31 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This is the inspection summary of an unannounced inspection carried out at 3 Prince of Wales Road on 1st December 2008. The inspection consisted of looking at a number of records and discussions with the registered manager, Anna-Marie Gill, staff and residents present during the inspection visit. A tour of the premises was conducted. At the time of the visit two residents were at home and the remaining residents were at their chosen day care activities. Care Homes for Adults (18-65 years) Page 6 of 31 We assessed all the key standards and the majority were met. Some were nearly met. Good quality care is provided to residents. We would like to thank the residents, members of the staff and the registered manager for their co-operation during the inspection. Four comment cards were returned and all were positive with reference to the services provided and the quality of care provided. The AQAA (an annual quality assessment document that all Homes are required to complete) has been used to help form the judgments in the report What the care home does well: The home provides a very pleasant and comfortable environment in which residents can live. Individuals are encouraged to personalise bedrooms with their own furniture and personal belongings. Residents are given opportunities to make decisions about their lives, with assistance as needed. Each resident has regular one to one sessions with his or her key worker group. Residents relatives, representatives, are consulted on all aspects of the home, where possible. Support/care planning documentation is of a good standard and each residents file contains a detailed action plan with clearly defined goals. There is a motivated and established staff team that consists of nurses and support workers. Overall, medication is well managed in the home with relevant procedures in place for the administration of medicines. There is good support for the home by the provider organisation Dorset Residential Homes with effective monitoring in place. Recruitment procedures are thorough with all necessary security checks in place to ensure the protection of residents. Risk assessments are in place that both protect residents from harm and to ensure they are able to maintain and develop their independence. Residents are encouraged and supported to pursue a wide range of activities and two vehicles are available to transport them to different venues of their choice. The staff offer the residents choice in all aspects of their lives and encourage and support them to keep in touch with family and friends who are always welcomed to the home. The staff team are offered a wide range of training courses that includes mandatory health and safety training and specialist courses to ensure they are competent to meet residents needs. Access to healthcare services is well promoted. Staff were friendly and relaxed, and were keen to discuss their work and the residents care needs. Residents live in a home, which is well run and managed. Care Homes for Adults (18-65 years) Page 8 of 31 What has improved since the last inspection? What they could do better: It was evident that care and support plans are well maintained, and that through regular meetings, residents changing needs are discussed. Although minutes of reviews are taken, it was difficult to find evidence to support this review process on individuals care plans. It is recommended that a system is introduced to formally record that care plans are reviewed on a monthly basis. Leisure activities pursued by individuals should also be recorded, and open to review. The records relating to the management of medication were in good order, however the following recommendations are suggested to further promote good practice:- Care Homes for Adults (18-65 years) Page 9 of 31 The introduction of a periodic competency check for all staff administering medication. Greater information about when PRN (as required) medication is to be used as guidance for staff. There was evidence that the resident who self medicates was risk assessed, and that she was well supported, however there was no evidence that this risk assessment had been reviewed. A system must be introduced that documents regular review of this practice. During this visit it was noted that two rooms are shared by two unrelated residents. Looking at current standards, this is considered unusual and generally outdated practice. It is recommended that when either of the rooms has a vacancy, the remaining person has the option of sole occupancy and consideration is given to reducing the homes registration. Given the client group, and their varying needs, it was evident that the existing communal facilities necessitate certain restrictions, particularly for those people who require mobility equipment. It is recommended that consideration is given to extending the existing or creating another communal area to address some of these issues. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 10 of 31 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 11 of 31 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents needs are thoroughly assessed prior to admission ensuring that staff are prepared for admission and have a clear understanding of the residents requirements. The opportunity to visit the home prior to admission is an integral part of the admission process, which means that resident are orientated to the environment and have met and are familiar with staff and other residents beforehand. Evidence: Dorset Residential Homes has an admission procedure. There is a pre- admission assessment, which is detailed and covers all the necessary information. There have been no recent admissions to the home. However, if there were an admission to the home, the registered manager would be responsible for undertaking and completing the initial assessment. If a potential resident is admitted to the home a review will be undertaken following the first three months and then again after six months. The home works closely with Care Homes for Adults (18-65 years) Page 12 of 31 Evidence: other service providers and regular liaison meetings and shared reviews all benefit the overall quality of the support and lifestyle planning with and for the residents. Residents always have the option to join in any of the meetings / reviews and the manager said that approximately 5 out of the 8 residents regularly chose to join in. Care Homes for Adults (18-65 years) Page 13 of 31 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents make decisions about their lives, with assistance and communication support, which allows them to influence their lifestyle and how the home is run. Staff enable residents to make decisions in relation to their own lives, providing information, assistance and support to maintain their independence. Personal information is handled appropriately ensuring that personal confidences are respected. Evidence: Residents are given opportunities to make decisions about their lives, with assistance as needed. This includes help to make decisions regarding their choice of activity, daily routines, menu planning and preferred lifestyles. The home continues to involve the residents with key decisions about the running of Care Homes for Adults (18-65 years) Page 14 of 31 Evidence: the home, although communication difficulties with some residents can make this a complex area. Irrespective of this all residents are offered opportunities to participate in the day-to-day running of the home as far as they are able to. Residents each have their own bank accounts however apart from one resident who manages their own finances with minimum support all the other residents depend on the staff to access their monies. A balance sheet of all transactions is kept for each resident and any monies either credited or debited are signed for on the residents behalf by staff. Where possible residents are encouraged to sign their own balance sheets, and thereby become more involved in the management of their own money. All balances sheets are regularly sent to the organisations head office for auditing. Guidelines for missing persons and a range of individual risk assessments are in place and these are detailed and informative. Residents records are accurate, secure and confidential. Care Homes for Adults (18-65 years) Page 15 of 31 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff support residents to participate in educational and training activities, which are suited to their age and interests. Residents are supported to join in a wide range of appropriate leisure activities of their choice. The home promotes flexible visiting, which enables residents to maintain contact with their families and friends. A varied and nutritious diet is available. Choice is offered and healthy eating is promoted. Care Homes for Adults (18-65 years) Page 16 of 31 Evidence: The manager and staff are constantly looking at ways to develop the support plans to ensure they remain relevant and comprehensive and in a format that residents can genuinely contribute to. During this inspection visit there was evidence of care plans being changed to a new format. Care within the home focuses on the human givens approach where specific attention is placed on the emotional well being of residents. Records showed that residents attend a range of daytime activities that suit their individual needs and interests. These include regular attendance at various day centres, which provide social and educational opportunities with the residents peer group. Staff described how residents are supported to make choices about how they spend their time. Feedback from surveys confirmed that staff support residents in their lifestyle choices. It was evident that care and support plans are well maintained, and that through regular meetings, residents changing needs are discussed. Although minutes of reviews are taken, it was difficult to find evidence to support this review process on individuals care plans. It is recommended that a system is introduced that is readily accessible to formally record that care plans are reviewed on a monthly basis. Leisure activities, (specifically evening and weekend) pursued by individuals should also be recorded, and open to review. Families and friends are welcomed into the home and are involved in daily routines and activities if residents wish. Residents can choose whom they see and can see their visitors in their own rooms in private or in any of the communal rooms if they wish. There are no restrictions about families and friends visiting. Staff assist residents to maintain contact with family and friends. Staff were observed knocking on bedroom, toilet and bathroom doors to ensure they maintain the privacy of individual residents. If residents express a wish to have a key to their bedrooms then this is facilitated. The kitchen is accessible to residents, allowing them to take an active part in the preparation of meals. Residents are involved in planning the menu and staff use flash cards and cookery books to help residents identify their favourites. Residents are encouraged to make their own sandwich boxes for the days they go attend the day Care Homes for Adults (18-65 years) Page 17 of 31 Evidence: services. Meal times are flexible and it was evident that staff were very aware of the residents likes and dislikes. Some residents enjoyed a summer holiday in Cornwall whilst others have preferred days out including trips on the Freedom Boat, Steam railway and going to Concerts. Care Homes for Adults (18-65 years) Page 18 of 31 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents physical and emotional health needs are met and monitored by the staff. Medication procedures within the home are robust and staff training good, which ensures that residents are protected by the system in place. Evidence: Super-drug inspected the procedures and practice at the home on 17/07/08 and 24/01/08 and no recommendations were made. In addition to the prescribed medication used in the home some homely remedies are used and it was noted that these are recorded in the same detail as the prescribed medication. Each resident has their own medical file, which contains relevant information and notes from out-patient appointments/clinics and details any treatments etc received at the dentist or optician. Those files looked at on the day of the inspection were well Care Homes for Adults (18-65 years) Page 19 of 31 Evidence: organised with the information clearly set out and good precise recording. The records relating to the management of medication were inspected during this visit and found to be in good order, however the following recommendations are suggested to further improve practice. The introduction of a periodic competency check for all staff administering medication, Greater information about when PRN (as required) medication is to be used as guidance for staff. There was evidence that the resident who self medicates was risk assessed, and that she was well supported, however there was no evidence that this risk assessment had been reviewed. A system should be introduced that documents regular review of this practice. Some residents demonstrate behaviours that can be challenging to manage. It is clear that staff work hard to support residents, and there was evidence of staff trying different plans to overcome particular behaviours. The registered providers employ staff with the appropriate knowledge and experience to provide specialist advice to support staff in meeting these peoples needs. Care Homes for Adults (18-65 years) Page 20 of 31 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Vulnerable adults are protected through a range of policies and procedures, which means that their intrinsic human rights are protected. However, specific training on the issues of abuse and protection should be regularly updated with all staff participating in refresher courses. All new staff receive training in adult protection as part of his her induction. Evidence: Vulnerable adults are protected through a range of policies and procedures, which means that their intrinsic human rights are protected. However, specific training on the issues of abuse and protection should be regularly updated with all staff participating in refresher courses. All new staff receive training in adult protection as part of his her induction. Care Homes for Adults (18-65 years) Page 21 of 31 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The standard of the environment within the home is good, providing residents with an attractive and homely place to live. Bedrooms are personalised and provide the residents with the necessary facilities. Evidence: The home is comfortably furnished, well equipped and well maintained. Residents said they were consulted about the decor and furnishings. The house was very clean and hygienic and evidence was available that appropriate systems are in place for the safe management of infection control. During this visit it was noted that two rooms are shared by two unrelated residents. Looking at current standards, this is considered unusual and generally outdated practice. Given that this is an existing situation to which the residents involved are accustomed , we do not recommend any immediate change. It is however recommended that when Care Homes for Adults (18-65 years) Page 22 of 31 Evidence: either of the rooms has a vacancy, the remaining person has the option of sole occupancy and consideration is given to reducing the homes registration. Where two individuals share a room the provider must be able to demonstrate that it is in the individuals best interest, that the individuals concerned understand and consent to this arrangement, and that this arrangement is regularly reviewed. The home provides a service for a group of residents with disparate needs. Some of the residents are very vulnerable, whilst others can demonstrate behaviour that is challenging to manage. The manager and staff group know the residents very well, and use this knowledge and their skills to diffuse and minimise conflicts and incidents. Communal areas comprise of a lounge, quiet room and dining room. Given the client group, and their varying needs, it was evident that the existing communal facilities necessitate certain restrictions. Specifically, there is inadequate space in communal areas for the clients who are wheelchair users to come out of their chairs and spread out and relax in communal areas. Consequently, they have to go to their room to do this and be isolated from the rest of the group. These residents have reduced choices as a result of this lack of communal space. It is recommended that consideration is given to extending the existing communal areas to address some of these issues. Care Homes for Adults (18-65 years) Page 23 of 31 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from an effective staff team, with sufficient numbers and skills to support residents at all times. The staff team are well trained to enable them to provide good care to the residents. Evidence: Staff have the skills and experience necessary for the tasks they are expected to do. The staff communicate with the residents at the home and have a good understanding of individual communication needs. The numbers and skill mix of the staff team ensure that uninterrupted work with individual residents can be achieved providing quality one to one time. The administration, organisation and day-to-day running of the home are carried out effectively. Sufficient staffing allows for the management of emergencies. There are 14 staff in total and the rotas demonstrated that there is a mix of trained nurses and support staff on duty in the mornings and the afternoon. There are two waking staff on duty throughout the night. Care Homes for Adults (18-65 years) Page 24 of 31 Evidence: Staff meetings are held monthly. There are recorded minutes of the staff meetings and there is evidence that issues raised in the staff meetings are actioned. The staff on duty confirmed that they receive regular training to enable them to meet the individual needs of the residents. The staff on duty were observed interacting well with the residents and very good relationships were observed. Staff described the individual needs of each resident in a competent and caring manner. Care Homes for Adults (18-65 years) Page 25 of 31 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The registered manager is qualified, competent and experienced to run the home and meet its stated purpose, aims and objectives. The overall management of the home ensures the effectiveness, financial viability and accountability of the home. The residents benefit from a way run home and both staff and residents are encouraged to express their opinions. Well-trained staff promote the health and safety of the residents and appropriate risk assessments are in place. Evidence: The registered manager has the overall responsibility for ensuring the homes written aims and objectives are achieved, the homes budget is properly managed, policies and procedure implemented, certificates displayed and that the home complies with the Care Homes for Adults (18-65 years) Page 26 of 31 Evidence: Care Standards Regulations. The staff receive regular training in health and safety issues and all accidents and incidents are recorded and monitored. Monthly staff meetings are held and all aspects of the running of the home are discussed and the lifestyle and support plans of two residents are discussed at these meetings on a monthly basis. This information is recorded in the minutes of the meetings and the formation specific to the residents is entered directly into their own records. Risk assessments are carried out on the premises. The fire log was examined and all necessary tests were up to date. Fire instruction to staff was up to date and clearly recorded allowing the records to be easily audited. Care Homes for Adults (18-65 years) Page 27 of 31 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 28 of 31 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 7 Staff need to continually demonstrate how residents have made individual choices and particularly residents should be encouraged and supported to sign their own financial records . A periodic competency check should be introduced for all staff administering medication. Staff should be provided with increased guidance regarding medication that is given on an as required basis. Risk assessments relating to the self administration of medication must be reviewed on a regular basis. 2 3 18 20 4 22 It is recommended that all staff receive refresher trainign in the Protection of Vulnerable Adults. Please note that since this inspection a series of workshops have been arranged. 5 25 It is recommended that those people who share a room are regularly consulted regarding this, and that should a vacancy occur in the home that they are given the opportunity to move into a single room. Page 29 of 31 Care Homes for Adults (18-65 years) 6 28 It is recommended the provision of communal space be reviewed to ensure that this meets the needs of all of the people living at the home. It is recommended that records are appropriately updated to reflect the outcomes from review meetings. This is with regard to care plans and the range of activities proivded for each person. 7 41 Care Homes for Adults (18-65 years) Page 30 of 31 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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