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Inspection on 07/01/06 for 46a Court Road

Also see our care home review for 46a Court Road for more information

This inspection was carried out on 7th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 12 statutory requirements (actions the home must comply with) as a result of this inspection.

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

What the care home does well

Overall it was found that residents were provided with good standards of care and support from experienced and motivated staff. Residents currently benefit from a stable and experienced staff team. The service promotes residents involvement in their care/life planning and decision making within the home. Relationships between staff and residents were observed to be two-way and friendly. The home has promoted NVQ training resulting in the majority of staff having achieved NVQ level 3 in care. Records examined were well written, resident focussed and made available to residents at the home.

What has improved since the last inspection?

This is the inspector`s first visit to the home. The only comments able to be made regarding improved standards are; all but one of the requirements made at the last inspection have been met.

What the care home could do better:

A letter of serious concern has been sent to the home and to the responsible individual outlining the unplanned admission of the last person to move into the home. An emergency admission has been accepted into this home without consideration made to the current categories of registration or thecompatibility with the current resident group. The CSCI are considering legal action. A review of staffing levels, staff capabilities and training needs will go someway toward ensuring that resident`s needs will be met. Whilst residents are supported to take risks as part of an independent lifestyle all residents must be assured safety whilst in the home environment. Residents` do not benefit from an environment that is clean, safe and well presented. A number of requirements have been made to improve environmental standards for residents and staff. In order for the manager to gain support and feedback on service provision the appropriate monthly regulation visits must take place by the registered provider (RI). Staff and residents will benefit from visits that are unannounced and include interviews with staff and residents in order to form an opinion of the standard of care provided. The premises must equally be assessed alongside any concerns noted.

CARE HOME ADULTS 18-65 46a Court Road Kingswood South Glos BS15 9QG Lead Inspector Karen Walker Unannounced Inspection 7th January 2006 09:30 46a Court Road DS0000003380.V276112.R01.S.doc Version 5.1 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address 46a Court Road DS0000003380.V276112.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. 46a Court Road DS0000003380.V276112.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service 46a Court Road Address Kingswood South Glos BS15 9QG 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) 0117 909 5459 0117 970 9301 admin@aspectsandmilestones.org.uk Aspects and Milestones Trust Christopher Gerald Horgan Care Home 5 Category(ies) of Learning disability (5), Learning disability over registration, with number 65 years of age (5) of places 46a Court Road DS0000003380.V276112.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9th May 2005 Brief Description of the Service: 46a Court Road is one of a number of homes operated by Aspects and Milestones Trust. The home is registered to provide accommodation and personal care to five service users with learning disabilities. The current service users are all over the age of 65 years. The property is situated in Kingswood, five miles from the centre of Bristol. Shops are a few minutes walk from the home. There are local bus services and the home also has its own minibus. Accommodation consists of a main house with four bedrooms. Two bedrooms are situated on the ground floor. There is a purpose built bungalow to the rear of the property that accommodates one service user who is supported to live semi-independently. 46a Court Road DS0000003380.V276112.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The purpose of this inspection was to assess the standards not previously assessed this year, to review the requirements and recommendations made at the last inspection and to ensure good service provision. Two residents were ‘case tracked’ and records were examined in respect of them. Staff and residents at the home on the day of this inspection were spoken with and their comments used to inform this inspection. Staff members spoken with were motivated and knowledgeable. They had a good rapport with residents and were both friendly and respectful. What the service does well: What has improved since the last inspection? What they could do better: A letter of serious concern has been sent to the home and to the responsible individual outlining the unplanned admission of the last person to move into the home. An emergency admission has been accepted into this home without consideration made to the current categories of registration or the 46a Court Road DS0000003380.V276112.R01.S.doc Version 5.1 Page 6 compatibility with the current resident group. The CSCI are considering legal action. A review of staffing levels, staff capabilities and training needs will go someway toward ensuring that resident’s needs will be met. Whilst residents are supported to take risks as part of an independent lifestyle all residents must be assured safety whilst in the home environment. Residents’ do not benefit from an environment that is clean, safe and well presented. A number of requirements have been made to improve environmental standards for residents and staff. In order for the manager to gain support and feedback on service provision the appropriate monthly regulation visits must take place by the registered provider (RI). Staff and residents will benefit from visits that are unannounced and include interviews with staff and residents in order to form an opinion of the standard of care provided. The premises must equally be assessed alongside any concerns noted. 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. 46a Court Road DS0000003380.V276112.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection 46a Court Road DS0000003380.V276112.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 4,5 Prospective residents or existing residents have little or no choice as to where they live or whom they live with. Residents have a statement of terms and conditions. EVIDENCE: Staff confirmed that normally prospective residents could ‘test drive’ the home before moving in. The manager and staff members however confirmed the last placement was an emergency and a formal review had not yet taken place. The home has acted illegally by breaching the conditions of registration and placing a younger person below the age of 65 years at the home without requesting a ‘variation’ to registration from the CSCI. This has been addressed with the manager and with the service provider and requirements have also been made separately to this report. The CSCI will expect to receive information requested alongside the application to assess and vary the conditions of registration. After consultation with Lyn Davis Regulation Manager it has been agreed that this information is to be received no later than Friday the 20th January 2006. This is to include an updated and revised statement of purpose that must also include the policy on emergency admissions. 46a Court Road DS0000003380.V276112.R01.S.doc Version 5.1 Page 9 The last resident to move into the home was given the terms and conditions of occupancy these were signed and dated by the resident in question and the homes manager. 46a Court Road DS0000003380.V276112.R01.S.doc Version 5.1 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): 6,9,10 Residents know of their assessed needs and associated risks and are confident that staff store their personal records securely. EVIDENCE: Whilst there are support plans and associated risk assessments in place for a resident who moved into the home in October 2005 these were formulated at the last placement and need to be reviewed and rewritten where necessary to ensure they reflect the current placement. There was evidence to show that the team have discussed recent ‘care issues’ with the resident and a rough action plan put in place. The manager said he was ‘getting to know’ the resident before making changes to the care plan. There was a ‘reactive’ strategy in place written at the last placement that details how to deal with ‘behaviours that challenge’. It is recommended that this be replaced with a ‘pro-active’ strategy that includes all known triggers to behaviours seen as challenging and instructs staff in how to avoid certain situations. 46a Court Road DS0000003380.V276112.R01.S.doc Version 5.1 Page 11 Other planning for life folders were examined and it was noted that actions taken to meet resident’s needs were signed and dated to demonstrate how they were met. Things that were essential or important to each resident were also clearly written and person centred. At the last inspection it was noted that diary events had been reviewed with residents on a monthly basis, this enabled each person to discuss whether or not they were happy with life in the home and with their routines/activities and to make any changes. This is commendable. One resident was very happy with the care provided and was able to discuss her assessed needs with the inspector and a home support worker. The support worker was knowledgeable of all the residents needs and said she was just getting to know the newest arrival. To ensure resident’s safety, risks arising out of care/life planning such as risks associated with bathing, kitchen tasks, money, taking medication, road safety and behaviour had been assessed and included actions to minimise the risks. Risk assessments were signed by staff to demonstrate they had read them. The risk assessments for the newest resident need renewing and updating to reflect her current environment. This was discussed with members of the staff team and the manager. Resident’s care records and other records were held in a domestic style cabinet that has now been fitted with a lock. The cabinet was locked on the day of this inspection and records stored securely. There is a confidentiality policy in place that staff confirmed they were aware of. 46a Court Road DS0000003380.V276112.R01.S.doc Version 5.1 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): 11-17 Residents are supported to take part in activities of their choice and make and maintain relationships. Residents are able to enjoy a varied balanced diet that they have chosen. EVIDENCE: The menu plans were examined. Residents were observed making their own choices regarding lunch and confirmed their input with the main meals. Meals were varied and balanced and fridge and freezer temperatures were recorded daily. Three residents confirmed they use the facilities of the local community and are well supported by staff. Other daily activities included education or work-oriented activities such as attendance at college and supported farm work or services specialising in supporting people with learning disabilities. The Occupational therapist assessed the environment for the last resident to move in and noted, “existing residents are all over 65years and may have difficulty adjusting to the new resident. Current residents all have different interests and it may be difficult to accommodate needs alongside those of an 46a Court Road DS0000003380.V276112.R01.S.doc Version 5.1 Page 13 older group”. This was confirmed by staff who also added that they were getting used to her and she seemed to be fitting in ok. The resident herself said “I like it here”. The home has recently obtained a new vehicle, which staff confirm has improved residents attendance in social activities. Staff did comment that the last resident to move in has an electric wheelchair and this cannot be accommodated in the new bus. Staff confirmed a taxi service is used that can accommodate this equipment. Two residents confirmed that friends and family can visit the home and that staff support them to make visits to others. One resident said ‘ I see my friend in Weston’. 46a Court Road DS0000003380.V276112.R01.S.doc Version 5.1 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): 18-21 Residents are supported in a way in which suits them and their physical and emotional healthcare needs are assessed. Medication practices are sound and medication is appropriately stored. EVIDENCE: The last resident to move into the home was subject to an Occupational Therapy assessment of the environment. It was noted that there was poor wheelchair access to the home and that there were a number of risk assessments needed to ensure minimum risk whilst moving around the home. It was noted that the radiators had no coverings and this required attention. This resident is prone to frequent falls and the covering of radiators must be made a matter of priority. Records show that the appropriate healthcare facilities are accessed and the consultant psychiatrist regularly reviews medication. One resident is to be referred to the physiotherapist due to the number of falls recorded. There is input at the Burden institute and the general practitioner has regular input. 46a Court Road DS0000003380.V276112.R01.S.doc Version 5.1 Page 15 Staff members were seen speaking respectfully to residents in a friendly manner and residents confirmed they were supported in a way, which suits them. Staff were observed knocking on doors and offering choices in many aspects of care. The opportunity was taken to examine the medication system and all was in order. Records show that discussions are held with residents to try and ascertain their wishes in the event of their death. There are a number of policies and procedures available to help staff in the event of death. 46a Court Road DS0000003380.V276112.R01.S.doc Version 5.1 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): X EVIDENCE: These standards were fully assessed and met at the last inspection. Residents spoken with confirmed that they felt empowered to make their concerns known. 46a Court Road DS0000003380.V276112.R01.S.doc Version 5.1 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 Although residents’ live in a homely friendly environment it is neither totally safe or clean and hygienic. Shared spaces are cluttered but personal bedrooms are individualised. EVIDENCE: There were patches of metal exposed on the base and side of the bath. The staff confirmed that the bath had been recently replaced. The apparent cause of the rusting is the hoist which staff feel does not meet the needs of the residents. Staff are concerned that the hoist must be manoeuvred manually and one resident is particularly heavy causing some staff discomfort. However it was confirmed that manual handling training has taken place. Staff agreed that the lap strap is not used on the hoist, as it is ill fitting and stained. The flooring around the base of the hoist is in need of repair and there is staining around the toilet base. It is a requirement to access the appropriate specialist to assess the type of equipment needed in the bathroom. A risk assessment is needed to reduce any risk with the current equipment. The bathroom door is broken due to one resident falling against it. This needs replacing. 46a Court Road DS0000003380.V276112.R01.S.doc Version 5.1 Page 18 In the lounge the wallpaper is ripped and hanging off and the dado rail has fallen off on one side. This room was unsightly and is need of redecoration. This room appeared ‘cluttered’ and one staff member moved a chair to the side of the wall to create space. This room leads to the conservatory, which was used as a wheelchair storage area. This room would also benefit from attention. A radiator has been recently removed from the hallway but two pipes remain jutting out on the bottom of the wall. Staff are concerned that these are a health and safety risk especially to one resident who has frequent falls without warning. The manager must assess this risk and have them removed if necessary. The wallpaper around the area is ripped and dirty, this requires attention. It was noted that there were 5 large boxes of continence aids stored on the upstairs landing. Whilst it is appreciated that storage space is a problem due consideration must be taken to the risk of falls through tripping and the risk of fire. A staff member suggested a storage area in the garden and this is recommended. One resident was happy to show the inspector her bedroom. It was noted to be individualised and full of personal belongings, paintings and pictures. The room was in need of a ‘deep clean’ there was an unpleasant odour and the sink, toothbrush and mug etc all required cleaning. This was dealt with by a staff member on the day of inspection. The resident confirmed that her key-worker helped with the cleaning of the room but it was evident that this was not often enough. This room requires cleaning on a daily basis. A bedside cabinet in this room had its door hanging off. This requires attention. Another resident who provided a tour of her bedroom was happy with the room saying ‘I like it, there’s my things’. This room was clean, tidy and individualised. 46a Court Road DS0000003380.V276112.R01.S.doc Version 5.1 Page 19 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): 31-36 A well-supervised staff team who are aware of their roles and responsibilities supports residents. Resident’s needs are changing and they will benefit from a review of staffing levels. EVIDENCE: All staffing records relating to recruitment were unavailable in the absence of the manager. Staff confirmed that they provided personal identification for the purpose of Criminal Record Bureau checks. Personnel records are mainly stored at the Trust HQ. Staff confirmed they have regular supervision and staff meetings and were aware of their roles and responsibilities within the home. Two staff confirmed they had received job descriptions. Staff members have opportunities for training and those on duty had an NVQ. One staff member was the Health and Safety representative for the Trust and had attended various training days necessary for the role. She also confirmed that the manager was good at completing staff personal development plans and identifying training needs. Staff confirmed that they had attended statutory training required by legislation but some of the certificates were either at home or locked away 46a Court Road DS0000003380.V276112.R01.S.doc Version 5.1 Page 20 with the supervision records. 3 staff members confirmed they hadn’t attended protection awareness training since November 2004. It was recommended that this be added to the rolling programme of statutory training. Staff were happy with the current staffing levels however there are some concerns regarding the support of the newest resident to move into the home. Two part time staff said they were soon to be leaving and there are no replacements planned. The home must review its staffing levels. This review must include staff’s training needs and capabilities including epilepsy care, manual handling and behaviours that challenge. 46a Court Road DS0000003380.V276112.R01.S.doc Version 5.1 Page 21 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): 39,40,41,43 Residents are confident that they have an input into the running of the home and policies and procedures are in place to safeguard their best interests. Staff and residents will benefit from regulation 26 visits that are unannounced and include interviews with staff and residents in order to form an opinion of the standard of care provided. EVIDENCE: Staff and residents confirmed monthly resident meetings where many aspects of the running of the home were discussed. Residents said they made choices about where to go and what to eat. Staff were able to evidence that although there were many organisational policies available in the home they had devised some in-house policies that were more appropriate to the home and needs of the resident group. Examples seen included smoking, changing light bulbs, use of the minibus and bathing. 46a Court Road DS0000003380.V276112.R01.S.doc Version 5.1 Page 22 Records were appropriately stored and the cabinet in the lounge area now had a lock on it. Staff were observed to relock it after each use. On examination of records and through talking to staff it was noted that the regulation 26 visits that must be carried out by the service provider were minimal. Only 3 reports were noted on file for 2005. This is a requirement. The liability insurance certificate was displayed, as was the registration certificate. 46a Court Road DS0000003380.V276112.R01.S.doc Version 5.1 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 X 3 X 4 1 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 X 23 X ENVIRONMENT Standard No Score 24 1 25 3 26 3 27 3 28 2 29 1 30 2 STAFFING Standard No Score 31 3 32 3 33 2 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 X X 2 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 X X 3 3 3 X 2 46a Court Road DS0000003380.V276112.R01.S.doc Version 5.1 Page 24 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 YA6 Regulation 17(3)(a)(b) Requirement An updated care plan with associated risk assessments must be sent to the CSCI paying particular attention to the frequent falls and epilepsy care. Consideration must also be taken regarding the provision of social care and the integration with an older client group. Timescale for action 20/01/06 2. YA33 18(1)(a) The home must review its 20/01/06 staffing levels. This review must include existing staff’s training needs and capabilities including epilepsy care, manual handling and behaviours that challenge. An updated and revised statement of purpose must be put in place and forwarded to the CSCI. This must also include the policy on emergency admissions. Ensure the grounds and garden are appropriately maintained. Second DS0000003380.V276112.R01.S.doc 3. YA4 4(2) 20/01/06 4. YA28 23(2)(o) 31/01/06 46a Court Road Version 5.1 Page 25 requirement. 5. YA9 13(4)(a)(b)(c) The risk assessments for the newest resident need renewing and updating to reflect the current environment. Assess and prioritize the covering of the radiators to reduce the risks of burns and scalds for one person. Add to maintenance plan. 14(1)(a) Access the appropriate specialist to assess the type of equipment needed in the bathroom (hoist). 13(4)(a)(b)(c) A risk assessment is needed to ensure reduce risk regarding use of the current hoist and lap strap. 23(2)(b)(d) The lounge is in need of redecoration. 13(4)(a)(b)(c) Assess the risk to residents regarding the pipes jutting out of the wall in the hallway and remove if necessary. 23(2)(b)(d) The downstairs bathroom door needs replacing. 16(2)(k) Ensure all bedrooms remain 23(b)(d) free from odour and clean. Repair or replace the broken bedside cabinet. 26 Monthly-unannounced regulation 26 visits must take place and reports forwarded to the CSCI. 23/01/06 6 YA29 31/01/06 7. YA29 23/01/06 8. 9 YA24 YA24 31/01/06 23/01/06 10 11 YA24 YA30 23/01/06 23/01/06 12 YA43 31/01/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations 46a Court Road DS0000003380.V276112.R01.S.doc Version 5.1 Page 26 1. 2 3 YA6 YA24 YA33 Put in place a proactive strategy including ‘triggers’ to potential behaviours that may challenge and how staff can best diffuse them. Provide a secure shed for storage. Add protection training to the annual rolling programme plan. 46a Court Road DS0000003380.V276112.R01.S.doc Version 5.1 Page 27 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos BS32 4RG 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 46a Court Road DS0000003380.V276112.R01.S.doc Version 5.1 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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