Inspection on 14/09/05 for 306 Southend Road

This inspection was carried out on 14th September 2005.

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 but made no statutory requirements on the home.

Other inspections for this house

306 Southend Road 23/05/07

306 Southend Road 24/01/06

306 Southend Road 07/03/05

306 Southend Road 12/10/04

306 Southend Road 19/03/04

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

CARE HOME ADULTS 18-65 Southend Road (306) 306 Southend Road Wickford Essex SS11 8QW Lead Inspector Vicky Dutton Unannounced 14 September 2005 th The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Southend Road (306) I56 I06 S18121 Southend Rd V246241 300805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Southend Road (306) Address 306 Southend Road Wickford Essex SS11 8QW 01268 570702 01268 570702 enquiries@hamelintrust.org.uk Hamelin Trust Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Vacant CRH Care Home 4 Category(ies) of LD Learning Disability (4) registration, with number PD Physical Disability (4) of places SI Sensory Impairment (2) Southend Road (306) I56 I06 S18121 Southend Rd V246241 300805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 7th March 2005 Brief Description of the Service: 306 Southend Road is a modern purpose built bungalow providing care and accommodation for up to four people with profound physical, learning and sensory disabilities. The premeses are owned by Mosaic Essex, but managed and run by Hamelin Trust. A webb site is available for the organisation on www.hamelintrust.org.uk The home is located a short distance from Wickford. Local facilities are available in the village of Shotgate where the home is located. The town centres of Basildon and Southend are a short journey away. The home provides residential accommodation on one level and there is adequate space for wheelchair users. Specialist equipment and adaptations such as hoists and bathing aids have been incorporated into the design to enhance the facilities for residents. There is an enclosed garden incorporporating a small patio area to the rear of the property. Limited parking is provided to the front and side of the property. The home is located on public transport routes. The home has their own minibus to facilitate community access. Southend Road (306) I56 I06 S18121 Southend Rd V246241 300805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over a period of seven hours. Residents at the home have complex needs and are unable to express their opinion of the service. The inspection started during the morning when residents were being assisted up, having breakfast and preparing to go off to day care placements. Residents appeared happy and relaxed. Staff had a good understanding of their needs and preferred routines. During the inspection care, medication, staffing and health and safety records were sampled. Time was spent with residents and staff. The acting manager informed all relatives over the telephone that an inspection was taking place. The home was supplied with feedback cards that could be given to any relatives following the inspection. One relative was spoken with during the inspection. What the service does well: What has improved since the last inspection? The homes office has been reorganised and provides more secure storage for records. A new medication cupboard has also been provided that gives more spacious and secure storage for residents medication. Residents are using the community more during their days at home, and have the opportunity to go shopping with staff. Southend Road (306) I56 I06 S18121 Southend Rd V246241 300805 Stage 4.doc Version 1.40 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. Southend Road (306) I56 I06 S18121 Southend Rd V246241 300805 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Southend Road (306) I56 I06 S18121 Southend Rd V246241 300805 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1 A service users guide needs to be developed to assist any future planned admissions. EVIDENCE: Most residents at 306 Southend Road have lived at the home for some years. The most recent admission took place two and a half years ago. The standards under this section were not therefore fully assessed. The home has produced a Statement of Purpose. The acting manager is aware of the need to develop a service users guide for the home. This will then need to be tailored to meet the specific needs of any future planned admissions. Southend Road (306) I56 I06 S18121 Southend Rd V246241 300805 Stage 4.doc Version 1.40 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7, 9. All residents have an in depth care plan in place that has the potential to provide a good basis for care. Development work is needed to ensure that care information is better organised, used by staff and that care plans are kept under regular review. EVIDENCE: All residents at the home have a care file in place. This includes a care plan. Although now in place, the home has been slow to implement up to date care plans and have failed to conduct regular reviews. The care plan on one residents file was dated November 2003. Although a new one had been formulated and was printed out for the inspector, this had not been put in place or been formally agreed and signed by the family. The home aims to conduct quarterly care reviews with relatives, but these have not yet happened on a regular basis. As well as individual care files a ‘handover file’ is maintained that contains all daily observations and records for each resident. Very good daily records are maintained that cover all relevant care and welfare issues. The daily record format allows for the manager to sign to show that she has read the records. None viewed had been signed in this way. All had been signed by staff compiling the record. A wealth of information is available on each resident to assist staff in meeting their care needs. However Southend Road (306) I56 I06 S18121 Southend Rd V246241 300805 Stage 4.doc Version 1.40 Page 10 information is held in different places and can be jumbled. This gives the potential for important information to be missed by staff. An example of this occurred during the inspection. The practice of keeping care plans separate from daily records will not encourage their use. In spite of previous assurances that care files will be reviewed and better organised, this has not yet happened in all cases. The home has a key worker/associate key worker system in place to provide consistency of care and assistance with specific tasks. The acting manager reported that work is being undertaken in conjunction with a speech and language therapist and Inclusive Communication Essex (ICE) to explore potential ways to assist residents in making more choices in their daily lives. Residents at the home have very complex needs. Choices are gauged by staff in terms of body language, facial expressions and known likes and dislikes. Two residents at the home have active advocates and it is hoped that all residents will eventually benefit from this service. Risk assessments are in place for some relevant aspects of care and daily living. This provides for residents safety and protection. Risk assessments in relation to moving and handling need to be better developed and in place for all residents to ensure theirs and staff safety. The acting manager said that information relating to slings, hoists etc was available in occupational therapy reports but this information was not readily available to staff. Although not an issue at 306 Southend Road a missing persons procedure is in place. Southend Road (306) I56 I06 S18121 Southend Rd V246241 300805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14, 15, 16, 17. Staff have a good understanding of individual residents likes and dislikes in terms of routines, activities and diet. EVIDENCE: Residents at 306 Southend Road access formal day care at Viking Specialist Day Care Unit and Concorde Day Care Unit. On the day of inspection three residents went to attend day care at Concorde. Records showed that residents access some community facilities such as restaurants, hairdressers and shops. Residents generally have a day at home each week. Since the previous inspection the home seems to have made progress in ensuring that this day always involves some community access. Southend Road (306) I56 I06 S18121 Southend Rd V246241 300805 Stage 4.doc Version 1.40 Page 12 In spite of the residents severe disabilities staff were able to identify that each had their own interests and preferred activities. Care plans and residents rooms reflected their interests such as different music and books that can be read to them. The acting manager said that the home are in the process of developing individual weekly activity programmes for residents to try to provide a more structured approach to their stimulation and occupation. Some activities identified as taking place do not currently happen due to lack of local resources. For example one resident enjoys swimming, but there is no longer a local hydrotherapy pool available. A farm holiday had just been enjoyed by the group. Parents had been given the opportunity to see a video about the venue prior to the holiday. This was to try and allay any concerns and enable them to assess the suitability of the holiday. All residents at 306 Southend Road are strongly supported by their families, who are actively involved via parents management group meetings. There is no restriction on visiting at the home. Residents at 306 Southend Road are totally dependent on staff for all aspects of daily routines and mobility. Staff spoken with had a good understanding of residents non-verbal communications and felt that they could identify service users moods and wishes. This was also observed during the inspection in resident/staff interactions. Food at the home was an area of concern raised by one relative. They felt that menus at the home should be on display, even though this would not be of benefit to residents. The acting manager reported that she is working with a speech and language therapist and other parties to assess if any form of pictorial menus would be meaningful to residents. Currently the home has a four weekly menu in place. These menus are kept in a folder in a kitchen cupboard, and could easily be made available to relatives if required. Good individual daily nutrition records are maintained. These showed that residents eat varied foods. Most residents at the home are under the care of a nutritionalist and regularly monitored. Residents are also regularly weighed. The kitchen at 306 Southend Road is large and residents enjoy being in the kitchen while food is prepared. In a change since the previous inspection foodstuffs are now shopped for rather than ordered on line. This gives residents the opportunity to experience shopping. Southend Road (306) I56 I06 S18121 Southend Rd V246241 300805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19, 20 Staff at the home have a good understanding of individual residents personal support needs. The health needs of residents are well met with a range of other professionals involved in their care. EVIDENCE: The home is well equipped to meet the physical needs of residents. Hoists, specialist beds and other equipment are provided. Records showed that equipment such as wheelchairs are regularly reviewed by the relevant professionals to ensure that they continue to meet resident’s needs. During the inspection staff were observed to provide personal support in a way that supported residents preferences and choices and protected their privacy and dignity. One relative expressed concern that equipment provided some time ago to monitor seizures had not been put into use. The acting manager stated that this was due to licensing issues which she needed to address. Residents are unable to attend to their own personal healthcare needs. Full assistance is required by support staff and relatives. Care records indicated that resident’s health is closely monitored and any concerns acted upon. Residents access a range of healthcare professionals to meet their different medical needs. Residents at the home have recently been transferred to a more local GP’s surgery. This was arranged by parents at the home. The acting manager has reservations about the new practice, and has already encountered some problems. This will need to be monitored to ensure that Southend Road (306) I56 I06 S18121 Southend Rd V246241 300805 Stage 4.doc Version 1.40 Page 14 residents continue to receive proper local care. Residents have their continence needs assessed. The pads provided by the continence service have recently been changed and are causing residents discomfort. The home and families are being proactive and working together to try to resolve this issue. Since the previous inspection the home has acquired a larger medicine cupboard which allows for the better organisation of residents medication. The home use a weekly dispensed monitored dosage system of medication administration (NOMAD). Records were sampled and the system was noted to be in good order with no anomalies noted. Comprehensive policies and procedures are available. Staff administering medication have completed training. Advice was given regarding some issues of best practice such as the dating of boxed/bottled medication when opened, information to be available on homely remedies in use, and the need for protocols to be in place for all medicines used ‘as and when required (PRN). At previous inspections the acting manager said that service users consent to medication would be addressed as part of the new care plan format. This has not yet happened in every case. Southend Road (306) I56 I06 S18121 Southend Rd V246241 300805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22, 23 The home has a clear complaints process in place. Relatives are aware of how to raise concerns through the home or CSCI. There is a need to ensure that appropriate complaint records are kept. EVIDENCE: The home has a complaints process in place. This was on display in the home. Relatives, as service users advocates, are fully aware of complaints processes. Since the previous inspection concerns over various issues have been raised with the service provider and with the CSCI. A record of complaints is maintained by the home but this was noted not to be up to date. Some issues raised had not been recorded in the complaints book. Residents are protected by the staff at the home having a good understanding of adult protection issues. Staff training records viewed showed that training had taken place in the protection of vulnerable adults. Care records showed that any unexplained marks or bruises are fully recorded and monitored. Although it is not currently an issue at the home, policies and procedures are available relating to the management of challenging behaviour. Southend Road (306) I56 I06 S18121 Southend Rd V246241 300805 Stage 4.doc Version 1.40 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 25, 26, 27, 28, 29, 30. Residents live in a safe and homely environment that meets their needs. All have their own rooms and there are sufficient shared communal spaces. EVIDENCE: 306 Southend Road is a purpose built and relatively new building. The building is owned by Mosaic Essex and they provide for the overall maintenance of the building and the decoration of communal areas. The home is situated in Shotgate and is very close to local facilities. All residents at the home use wheelchairs. The communal spaces of lounge, dining room, kitchen and garden are fully accessible to them. Furnishings and fittings give the premises a homely feel. Each resident has their own bedroom which is of a sufficient size to meet their needs. All residents bedrooms were viewed at this inspection. They were equipped with adaptations and fittings appropriate to each individual. One bedroom was noted to require redecoration. This is the responsibility of Hamelin Trust and the acting manager said that this was in hand. Other Southend Road (306) I56 I06 S18121 Southend Rd V246241 300805 Stage 4.doc Version 1.40 Page 17 bedrooms were well decorated. All were furnished and personalised according to residents and families requirements. Residents bedrooms were noted to have many personal effects, these included photographs, stereo systems and sensory equipment. Bedrooms at the home do not have en suite facilities. The home has one assisted bath and one assisted shower, which is not currently used by residents. Some tiles are coming off in the shower room and this requires attention. Residents have access to a lounge, dining and kitchen area. The home has a reasonable size garden area. Plans to develop this area have not yet happened but it still provides a useable area for residents. All residents are provided with aids and equipment to meet their individual assessed needs. This includes wheelchairs with adapted and individualised seating, specialist beds, and sleeping systems. Records indicated that equipment is serviced and maintained. The home has a call alarm system, however none of the residents are able to utilise this equipment because of their disabilities. Adequate laundry facilities are provided at the home. On the day of inspection the home appeared to be cleaned to a reasonable standard and was odour free. The acting manager reported that night staff clean the communal areas of the home. Day support staff clean and tidy individual rooms. Residents bedrooms are given a thorough ‘spring clean’ about every two months. Southend Road (306) I56 I06 S18121 Southend Rd V246241 300805 Stage 4.doc Version 1.40 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 33, 35 Residents at the home are looked after by well trained staff. Staffing numbers provide a good level of support for residents. EVIDENCE: One member of staff has achieved NVQ level two. Three further staff are completing NVQ at level three. Staff spoken with demonstrated good communication skills. Southend Road (306) I56 I06 S18121 Southend Rd V246241 300805 Stage 4.doc Version 1.40 Page 19 The home maintains a satisfactory staffing rota, the format of which has just been revised. The rota showed that agreed staffing levels were being maintained. The home has three staff on duty during the day and one awake member of night staff with another on call (but not on the premises). In relation to this at the previous inspection it had been reported that the home are working to produce a lone worker policy. This has not happened yet, although risk assessments are in place. Staffing levels may vary during the day when residents are out attending day care. The acting manager reported that she is currently trying to recruit to weekend staffing hours that will allow a greater flexibility, and enable a better level of outings and activities to take place for residents. Weekend staffing has been an area of concern to relatives, so, if achieved this will be a positive step. The home does not employ any domestic staff so support workers undertake cleaning and laundry tasks. At the previous inspection the management of Hamelin trust were considering the provision of on site administration support for the home. This has now been agreed but the post has not yet been appointed to. The home utilises specialist professional support i.e. social workers, community nurses, community psychiatrist, nutritionalist etc. The staff team at the home provide a mixture of ages and gender. No new staff have been recruited since the previous inspection. This standard was not therefore inspected. Previous inspections of the home have shown that thorough recruitment processes are followed by Hamelin Trust. Hamelin Trust have their own training organisation, VOICE (Vocational Opportunities in Care). The previous inspection identified that new staff have a seven day initial induction off site. This is followed by a four week in house induction programme. Staff training files sampled on this occasion showed that a range of training is undertaken by staff. Staff spoken with confirmed that training provided by Hamelin Trust was good. On the day of inspection senior staff were undertaking an in house training session on finance issues. Southend Road (306) I56 I06 S18121 Southend Rd V246241 300805 Stage 4.doc Version 1.40 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 42 The home is generally well managed and provides a safe environment for residents and staff. However areas identified in previous reports had not been addressed. EVIDENCE: The current acting manager has worked at the home for nearly two years. An application for registration has been submitted to CSCI and is being processed. The acting manager is experienced and has undertaken relevant training for the role. She holds a Diploma in Management Studies, and City and Guilds 325 – 2 and 3 for management in care. She hopes soon to undertake NVQ level four in care. The home is generally well managed and residents receive good care. However it is concerning to note that some areas identified in this report such as care planning, reviews and other issues have been identified at previous inspections, and are slow to be dealt with and resolved. Standard 39 was not fully assessed but visits undertaken by the registered provider (regulation 26) were discussed. Previous requirements have Southend Road (306) I56 I06 S18121 Southend Rd V246241 300805 Stage 4.doc Version 1.40 Page 21 highlighted the need for copies of the reports from these visits to be regularly sent in to CSCI. This has not happened. Copies of some of the relevant reports were given to the inspector at the inspection. Staff training records sampled showed that residents are protected by staff being trained in health and safety and core areas such as first aid, moving and handling and food hygiene. Aspects of health and safety procedures were sampled. Appropriate documentation was in place to show that systems and equipment are regularly serviced. At previous inspections the acting manager has been advised that the homes gas certificate should be of a type that shows what maintenance has been carried out on the system. The acting manager reported on this occasion that the current company used seem unable to provide this. The previous inspection advised the acting manager that current guidelines require that a risk assessment in respect of legionella be developed for the home. This has not yet been actioned. It was reported that they are awaiting information/guidance from another home in regard to this. Fire records were satisfactory and show that regular checks and drills are carried out. Southend Road (306) I56 I06 S18121 Southend Rd V246241 300805 Stage 4.doc Version 1.40 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x x x x Standard No 22 23 ENVIRONMENT Score 2 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 x 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 x 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score x 3 3 x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Southend Road (306) Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score 2 x x x x 2 x I56 I06 S18121 Southend Rd V246241 300805 Stage 4.doc Version 1.40 Page 23 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 1 Regulation 5 Requirement A service users guide must be produced and a copy of this document supplied to the National Care Standards Commission. Previous requirement of 01/06/05 not met. 2. 6 15 As far as possible or practical service users care plans must evidence the involvement of service users supporters. Care plans must be regularly reviewed. Previous requirement of 01/05/05 not met. 3. 9 12 Risk assessments must be in place for all relevant aspects of care. This includes moving and handling. 01/11/05 01/11/05 Timescale for action 01/12/05 4. Southend Road (306) I56 I06 S18121 Southend Rd V246241 300805 Stage 4.doc Version 1.40 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. 2. 3. 4. 5. 6. 7. 8. Refer to Standard 6 17 19 20 22 32 42 42 Good Practice Recommendations All relevant care plans and information relating to individual residents should be maintained in one place so that it is readilly accessable to staff providing the care. If relatives wish to have access to the homes menus, these should be made easily available to them. Tiling in the homes shower room and any other maintenance issues should be addressed. the best practice issues identified in respect of medication practices should be addressed. The complaints record should be maintained and up to date. 50 of care staff to be trained to NVQ level two or above by 2005. The homes gas certificate should be of a type that shows any maintenance undertaken on the system. A risk assessment in respect of legionella should be undertaken for the home Southend Road (306) I56 I06 S18121 Southend Rd V246241 300805 Stage 4.doc Version 1.40 Page 25 Commission for Social Care Inspection Kingswood House Baxter Avenue Southend-on-Sea Essex, SS2 6BG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Southend Road (306) I56 I06 S18121 Southend Rd V246241 300805 Stage 4.doc Version 1.40 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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