CARE HOME ADULTS 18-65
Warrington Community Living - Twiss Green 53 Twiss Green Lane Culcheth Warrington Cheshire WA3 4DQ Lead Inspector
David Jones Unannounced Inspection 6th and 20 December 2005 11:15
th Warrington Community Living - Twiss Green DS0000027022.V276661.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 Warrington Community Living - Twiss Green DS0000027022.V276661.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. Warrington Community Living - Twiss Green DS0000027022.V276661.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Warrington Community Living - Twiss Green Address 53 Twiss Green Lane Culcheth Warrington Cheshire WA3 4DQ 01925 766982 01925 766982 leswhittle@hotmail.com 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) Warrington Community Living Leslie Andrew Whittle Care Home 4 Category(ies) of Learning disability (4), Learning disability over registration, with number 65 years of age (4), Mental disorder, excluding of places learning disability or dementia (1) Warrington Community Living - Twiss Green DS0000027022.V276661.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. The home is registered for a maximum of 4 service users to include: * Up to 4 service users in the category of LD (learning disability not falling within any other category. * Up to 4 service users in the category of LD(E) (learning disability over the age of 65) may be accommodated. * 1 named service user in the category MD (mental disorder) may be accommodated. The registered provider must, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection Staffing must be provided to meet the dependency needs of service users at all times and shall comply with any guidance that may be issued through the Commission for Social Care Inspection The registered provider must ensure that Mr Leslie Whittle achieves the Registered Manager’s Award by 1st November 2006 25th July 2005 2. 3. 4. Date of last inspection Brief Description of the Service: Twiss Green is a care home registered with the Commission for Social Care Inspection to provide personal care and accommodation for four adults with learning disabilities. The establishment is a domestic four-bedroom bungalow set within a residential area of Warrington and blends in with neighbouring properties. The premises have been adapted to accommodate the needs of people with a disability. There is level access throughout the bungalow. Preparations are being made to provide additional bathroom, toilet and sluice facilities. Residents have specially adapted transport enabling them to access the local community. Warrington Community Living - Twiss Green DS0000027022.V276661.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place on the 6th of December and a feedback meeting was held on the 20th December 2005 to complete the inspection. In addition to the manager four members of staff, were spoken with during the inspection. Three of the four residents were also spoken with but discussion was limited due to communication difficulties. The inspector observed staff interacting with and supporting residents. The gardens and some parts of the building were looked at, as were some records including the case notes of three residents. What the service does well: What has improved since the last inspection?
The manager has updated and re-drafted the statement of purpose and service users guide to ensure that new and prospective residents and their representatives have the information they need to make decisions about the home. Warrington Community Living - Twiss Green DS0000027022.V276661.R01.S.doc Version 5.1 Page 6 Significant progress has been made to improve the home’s assessment and care planning arrangements. The senior support worker is enthusiastic about developments in “Essential Life Style Planning” and is eager to ensure that staff capitalise on opportunities to involve residents and their representatives in the development of comprehensive care plans. There is more work to do to bring all care plans up to the required standard but two of the three care plans seen had been significantly improved and included guidance on communication provided by the speech therapist. Records of visits to and from health care professionals are recorded in each resident’s daily diary and in illustrated “personal health records” that have recently been introduced. These improve access to information for residents and provide an overview of health care needs and arrangements to address them. The manager has instigated a programme of scheduled supervision for all staff. This will ensure that staff have opportunity to discuss care practice and personal development issues with the manager and the senior support worker and enable them to learn from experience through reflective practice. Polices and procedures have been reviewed and where necessary updated. Magnetic hold open devices have been fitted to bedroom doors to improve fire safety and make access to bedrooms easier. What they could do better:
The Service User’s Guide must be kept in the home available for residents and their representatives. Without immediate access to this information new and existing residents and their representatives are disadvantaged when making decisions about the home. Residents should be provided with documents confirming terms and conditions so they, aided by their representatives, can understand their rights and responsibilities. It is difficult to ascertain how much time the registered manager spends in the home, as there is no written record of his visits. A programme of scheduled supervision has been introduced but further action must be taken to make sure that staff are aware of their roles and responsibilities regarding the maintenance and development of assessments and care plans. Assessments including risk assessments and care plans must be reviewed and updated to make sure that residents’ needs are known and are consistently met by staff. Risk assessments completed by health and social care professionals must be kept in the home for the information and guidance of staff in maintaining a safe living environment. General review meetings should be held at least annually involving residents, their families and other representatives in a review of arrangements for care and plans for future development.
Warrington Community Living - Twiss Green DS0000027022.V276661.R01.S.doc Version 5.1 Page 7 Staff training records should be updated and staff must be given appropriate training in adult protection, moving and handling and the prevention of fire. All staff should hold NVQ 2 or 3 or should be working to obtain one of these qualifications by an agreed date. Appropriate toilet and sluicing facilities must be provided and the recommendations of the Occupational Therapist to provide a resident with an appropriate bed and bed rails must be addressed. The registered manager must acquire “the registered manager’s award” by the 31st November 2006 to meet the conditions of his registration and demonstrate he is appropriately qualified to run the home. The registered persons should establish an appropriate quality assurance system. The views of residents, their relatives and associated care professionals should be sought as to the standards of care facilities and services provided and action taken on quality issues should be confirmed in an open report. 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. Warrington Community Living - Twiss Green DS0000027022.V276661.R01.S.doc Version 5.1 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Warrington Community Living - Twiss Green DS0000027022.V276661.R01.S.doc Version 5.1 Page 9 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 and 5. The statement of purpose and service user’s guide has been redrafted. The service users guide must be available in the home for the information of residents and their representatives. Assessment, risk assessment and care planning processes need further development to make sure that residents changing needs are identified and planned for. Residents have not been provided with terms and conditions relating to their placement at the home. Without this document residents and their representatives do not have confirmation of the their rights and responsibilities. EVIDENCE: The manager of the home has redrafted the statement of purpose and service users guide but staff were unable to make the service users guide available for inspection. Both these documents must be made available to residents and their representatives and copies should be sent to the Commission for Social Care Inspection. See requirement 1. Reading of case records confirms that some progress has been made to improve the home’s assessment and risk assessment procedures. However, the assessment and care plan relating to one resident had not been updated in accordance with the resident’s changing needs and a risk assessment relating to another resident is not available in the home for the information and guidance of staff. Assessments introduced by the manager before the last inspection have not been completed. See requirements 2 and 3. Warrington Community Living - Twiss Green DS0000027022.V276661.R01.S.doc Version 5.1 Page 10 Residents and their representatives are not provided with documents confirming terms and conditions of residence. See recommendation 1. Warrington Community Living - Twiss Green DS0000027022.V276661.R01.S.doc Version 5.1 Page 11 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9. Care plans, and care planning systems require further development to make sure that that residents’ needs are known and met. Risk assessments completed by other professionals must be available in the home for the guidance of staff and to make sure that residents are safe. Staff seek to involve residents in decision making but annual general reviews have not been held for three of the four residents. EVIDENCE: Reading of case records indicates that significant progress has been made to improve the home’s assessment and care planning arrangements. The senior support worker is enthusiastic about developments in “Essential Life Style Planning” and is eager to ensure that staff capitalise on opportunities to involve residents and their representatives in the development of comprehensive care plans that address all aspects of need. Warrington Community Living - Twiss Green DS0000027022.V276661.R01.S.doc Version 5.1 Page 12 Two of the three care plans seen were reviewed and updated on a regular basis. Each of these provides detailed guidance on meeting the respective resident’s primary care needs including where appropriate the recommendations of the speech therapist on communication and eating and drinking. Discussion with senior staff and the manager indicates that these care plans would benefit from further development to reflect the whole person including personality, sexuality and aspirations. See recommendation 2. The assessment and care plan relating to a resident who had moved into the home in April 2005 are the ones produced by the placing social worker. The resident’s needs had changed significantly with additional assistance required regarding intimate personal care and mobility. Neither the assessment nor the care plan had been updated to confirm how these needs are being addressed. See requirements 2 and 3. Staff said that an occupational therapist (OT) had completed a risk assessment regarding the possibility of a resident falling out of bed. They said this concludes that a specialised bed and bed rails are required. A new bed is being ordered and in the interim staff have been given guidance by the OT as to the use of pillows to bolster the resident and keep her safe as possible. The care plan provides guidance in this regard but there is no indication that this accords with the advice of the OT and the risk assessment is not available in the home for the information and guidance of staff. See requirements 3 and 4. Three of the four residents are unable to express themselves verbally and rely on other means to communicate their needs. It is very positive that care plans have been developed to confirm advice and guidance provided by the speech therapist in this regard and it is evident that staff seek to involve residents in decision making, as far as they are able. Arrangements for care and plans for the future have previously been developed and agreed via “Individual Personal Planning” meetings known as IPPs, which aim to involve the resident, their family members and other representatives. There have been no IPPs or general review meetings for three of the four residents since 2002. See recommendation 3. Warrington Community Living - Twiss Green DS0000027022.V276661.R01.S.doc Version 5.1 Page 13 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): 15, 16 and 17. Residents are supported to maintain family links and daily routines promote individual choice and freedom of movement. Residents are offered a varied and nutritious diet. EVIDENCE: Staff support residents to maintain family links subject only to restrictions detailed in the care plan. Residents’ rights to see who they wish to see are respected. Staff support residents to correspond with relatives who receive Christmas cards and are informed of significant events in the home. Discussion with staff and observation confirms that staff engage residents in the day to day domestic routines associated with running the home including cleaning and tidying the house and making shopping trips to the local community. Residents greet all visitors at the front door and staff interact with residents on a frequent basis engaging them in two-way communication. Reading of care records confirms that staff are working with health care professionals to develop communication in the home.
Warrington Community Living - Twiss Green DS0000027022.V276661.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, 19 and 20. Residents receive personal support according to their individual needs. Health care needs are monitored and contact is maintained with health and social care professionals on an ongoing basis. Medication is stored, administered and recorded appropriately. EVIDENCE: Discussion with staff and observation of their interactions with residents indicates that each individual’s personal preferences as to how they wish to receive personal care are known and complied with. The senior support worker is enthusiastic about developments in “Essential Life Style Planning” and is eager to ensure that staff capitalise on opportunities to involve residents and their representatives in the development of comprehensive care plans that address all aspects of need and help to ensure that all staff adopt the same approach to care. Reading of records and discussion with staff indicates that residents’ health care needs are monitored and contact is maintained with health and social care professionals on an ongoing basis. All residents are registered with a local GP. Records of visits to and from health care professionals are recorded in each resident’s daily diary and in illustrated “personal health records” that have recently been introduced. These provide an overview of health care needs and arrangements to address them.
Warrington Community Living - Twiss Green DS0000027022.V276661.R01.S.doc Version 5.1 Page 15 Arrangements for the storage recording and administration of medicines are satisfactory. All staff have received training in the administration of medication within the previous 12 months. Warrington Community Living - Twiss Green DS0000027022.V276661.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): 22 and 23. Appropriate arrangements are in place for making complaints and the protection of vulnerable adults. EVIDENCE: No formal complaints have been received since the last inspection. The home’s complaints procedure provides appropriate guidance and information as to how to make a complaint. Robust procedures for responding to suspicion or evidence of abuse or neglect are in place including whistle blowing as in accordance with the Public Interest Disclosure Act 1998. Information provided by the manager confirms that all staff have received guidance in the implementation of adult protection procedures but not all have received formal training. The registered persons must ensure that staff members’ identified training needs in adult protection are addressed. See requirement 5. Warrington Community Living - Twiss Green DS0000027022.V276661.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, 25, 26, 27, 28, 29, and 30 The home provides comfortable, bright and cheerful accommodation of a design and layout that reflects the needs of the residents. Magnetic closing devices have been fitted to bedroom doors and some progress had been made to provide appropriate toilet and sluice facilities. This work must be completed to ensure the safety of staff and the safety, privacy and dignity of residents. EVIDENCE: Twiss Green Lane is a bungalow in keeping with the local community. It provides comfortable, bright and cheerful accommodation that reflects the needs of the residents. Adaptations have been made to the building over time to meet the changing needs of residents, including the provision of overhead hoist tracking and level access throughout the home. Automatic hold openclosing devices have been fitted to bedroom doors as in accordance with the recommendations of a visiting Occupational Therapist and further improvements are planned. Warrington Community Living - Twiss Green DS0000027022.V276661.R01.S.doc Version 5.1 Page 18 Residents’ bedrooms are comfortably furnished and decorated in styles that reflect their characters. A risk assessment recently completed by an OT indicates that a resident requires an adjustable bed fitted with bed rails in the interests of safety. This reinforces a risk assessment completed by a member of staff in 2004 that also indicated this resident’s requirement for a special bed. The manager said an appropriately designed bed is to be ordered in the near future. See requirement 6. The home is equipped with an assisted bathroom with WC, overhead hoist and specialised bathing equipment. Unfortunately the only other WC in the home is in a resident’s on-suite facility. The manager said that appropriate toilet facilities would be provided by April 2006. See requirement 7. The home is clean and free from malodours. Clinical waste is collected and disposed of. The home is not provided with a sluice or sluice facility on the washing machine. See requirement 7. The manager said that appropriate sluice facilities would be provided by April 2006. Warrington Community Living - Twiss Green DS0000027022.V276661.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, 32, 34, 35 and 36. Scheduled supervision is offered to staff at appropriate frequencies. This has improved the staffs’ understanding of their roles and responsibilities in relation to care planning, monitoring and review but further development is needed to ensure residents needs are consistenly met. Thorough recruitment procedures are employed for the protection of residents. Some staff require training in adult protection, fire prevention and moving and handling, to ensure the health safety and protection of vulnerable adults. The home’s staff training records need updating to make sure that staff training needs are known and met. EVIDENCE: Discussion with the senior support worker confirms that she is clear about her responsibilities in relation to the maintenance and development of care plans and the supervision of staff. One staff member said that care plans are not used on a daily basis and generally staff get to know and understand residents needs verbally and by notes in residents’ daily diaries. See the section of this report on “Individual needs and Choices” for further details. It is evident that further work needs to be done with staff to ensure that care plans are used as working documents for the guidance of staff and the development of appropriate and consistent arrangements to meet residents’ identified needs. See recommendation 4. Warrington Community Living - Twiss Green DS0000027022.V276661.R01.S.doc Version 5.1 Page 20 Information provided by the manager confirms that Warrington Community Living operates effective recruitment procedures in the interests of the protection of vulnerable adults. Discussion with staff confirms that a programme of schedule supervision has started and all are expected to receive formal supervision at least six times per year. Staff training records were seen but staff and the manager confirmed these are not up to date. See recommendation 5. The manager stated that he is not in a position to say which staff had received appropriate training in adult protection, fire prevention and moving and handling and agreed to provide CSCI with updated information in this regard. He said that he is aware that some staff required training in these areas. See requirement 5.Of the nine support staff employed at the home four had achieved NVQ level 3, one had NVQ level 2 and two were working towards NVQ level 3. See recommendation 6. Warrington Community Living - Twiss Green DS0000027022.V276661.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): 37, 39, 40, and 42. New management arrangements have been made to make sure that staff are appropriately supervised. However, further action is required to make sure that the home’s assessment and care planning arrangements are monitored and evaluated as the needs of residents’ change. Progress must be made with the home’s quality assurance systems and action must be taken to ensure that staff recive training on health and safety topics including fire prevention and moving and handling. EVIDENCE: The registered manager is a Registered Nurse Learning Disabilities and an experienced manager and practitioner in the field of learning disabilities with many years experience. He does not have an appropriate management qualification and is pursuing a “registered manager’s award” as in accordance with a condition of registration. See requirement 9. Warrington Community Living - Twiss Green DS0000027022.V276661.R01.S.doc Version 5.1 Page 22 As noted at the last inspection the home’s management structure has been strengthened with the appointment of a Senior Support Worker. Information provided by the manager indicates that these arrangements are to continue. It is difficult to ascertain how much time the registered manager spends in the home, as there is no written record of his visits. A programme of scheduled supervision has been introduced but further action must be taken to make sure that staff are aware of their roles and responsibilities regarding the maintenance and development of assessments and care plans. See recommendations 5 and 7. Information provided by the manager confirms that no further progress has been made to introduce effective quality assurance processes in the home. The manager had introduced a “residents’, relatives” and other interested parties satisfaction questionnaire prior to the last inspection. Information from the returned questionnaires has not been collated and a report identifying quality matters and any action taken to address issues raised has not been produced. See requirement 10. Information provided by the manager indicates that Warrington Community Living maintain a comprehensive range of policies and procedures for the guidance of staff. An occupational therapist (OT) has been consulted regarding the potential hazards of a resident falling out of bed. The OT had completed a risk assessment and the need for a special bed fitted with bed rails has been identified. This reinforces a risk assessment conducted by a member of staff in 2004 that also concludes that this resident requires an appropriately designed bed. Information provided by the manager indicates that arrangements are been made to acquire an appropriate bed. Staff advised that the OT recommends the continued use of pillows to bolster the resident until the appropriate bed is acquired but the risk assessment confirming this guidance is not available in the home for the guidance of staff. See requirements 4 and 6. A broken door closer had been removed and replaced with an automatic closure as in accordance with the OT’s recommendations. Staff training records are not up-to date. Information provided by the manager indicates some staff still require training in health and safety topics including moving and handling and fire prevention, as outlined above. See requirement 5. Warrington Community Living - Twiss Green DS0000027022.V276661.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 2 2 2 3 X 4 X 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 2 25 3 26 2 27 2 28 3 29 2 30 2 STAFFING Standard No Score 31 2 32 2 33 X 34 3 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 1 3 X 2 X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 2 X 2 3 X 2 X Warrington Community Living - Twiss Green DS0000027022.V276661.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 YA1 Regulation 4&5 Requirement The registered persons must ensure that the service users guide is made available to residents and copies of both the service users guide and the statement of purpose are sent to the Commission for Social Care Inspection. The registered persons must ensure the assessment of residents needs are kept under review and revised at any time when it is necessary to do so having regard to any change in circumstances.(Previous timescale 05/09/05 not met) The registered persons must ensure care plans are updated to reflect changing needs. (Timescales 03/08/04, 25/02/05 and 05/09/05 were not met) The registered persons must ensure that copies of risk assessments completed by health and social care professionals are kept in the home for the advice and guidance of staff. Timescale for action 31/01/06 2. YA3 14 31/01/06 3. YA11 15 31/01/06 4. YA9 13 (1) (4) 31/01/06 Warrington Community Living - Twiss Green DS0000027022.V276661.R01.S.doc Version 5.1 Page 25 5. YA35 18 6 YA26 16 7. YA30 23 8. 9 YA37 YA39 9 24 The registered persons must ensure that staff receive training appropriate to their individual needs and responsibilities including, Adult Protection. (Timescales 031004, 30/03/05 and 30/11/05were not met) The registered persons must provide furniture and equipment suitable to the needs of service users. (Timescales 03/10/04, 20/02/05 and 30/09/05 were not met) The registered persons must ensure that appropriate toilet and sluice facilities are provided. (Timescale 03/11/04 and 30/06/05 were not met) The manager must achieve the registered managers award by 31/11/06 The registered persons must establish and maintain a system for reviewing at appropriate intervals and improving the quality of care provided at the care home. 31/01/06 27/02/06 30/04/06 30/11/06 27/02/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard YA5 YA6 Good Practice Recommendations The registered persons should provide each service user with a written “terms and conditions document”. The registered persons should ensure that care plans are reviewed and updated at least once per month unless circumstances change and a higher frequency of review is required and that over time they are developed to reflect the whole person. Warrington Community Living - Twiss Green DS0000027022.V276661.R01.S.doc Version 5.1 Page 26 3. 4. 5. 6. 7. The registered persons should convene general review meeting or IPPs involving residents, their families and other representatives in a review of arrangements for care and plans for future development. YA31 The registered persons should make sure that staff are clear about their roles and responsibilities in relation to the maintenance and development of care plans. YA32YA35 The registered persons should make sure that staff training records are kept up to date. YA32YA35 The registered persons should ensure that all staff hold NVQ 2 or 3 or are working to obtain one of these qualifications by an agreed date. Alternatively the registered manager should demonstrate that staff without an NVQ 2 or 3 can meet the required standard through past work experience. YA37 The registered persons should ensure that the manager confirms in writing on the staff rota the time he spends in the home. YA6 Warrington Community Living - Twiss Green DS0000027022.V276661.R01.S.doc Version 5.1 Page 27 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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