Inspection on 22/02/06 for 6 Harrow View

This inspection was carried out on 22nd February 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 no outstanding requirements from the previous inspection report, but made 12 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

6 Harrow View 29/10/07

6 Harrow View 07/10/06

6 Harrow View 05/10/05

6 Harrow View 04/02/05

6 Harrow View 03/08/04

6 Harrow View 27/02/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 6 Harrow View 6 Harrow View Harrow Middlesex HA1 1RG Lead Inspector Clive Heidrich Unannounced Inspection 22nd February 2006 8:10 6 Harrow View DS0000041653.V283991.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 6 Harrow View DS0000041653.V283991.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. 6 Harrow View DS0000041653.V283991.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service 6 Harrow View Address 6 Harrow View Harrow Middlesex HA1 1RG 020 8723 0660 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) Clover Residents Mrs Deborah Joy Selley Care Home 3 Category(ies) of Learning disability (3) registration, with number of places 6 Harrow View DS0000041653.V283991.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Only service users who can easily negotiate the stairs without physical assistance should reside on the second floor. To accommodate a named service user under the age of 18 years old. Date of last inspection 5th October 2005 Brief Description of the Service: 6 Harrow view is a semi-detached house providing accommodation for up to three people who have learning disabilities. It is part of a local care-providing organisation. At the time of the inspection, there was one vacancy and two male service users. The vacancy had been temporarily filled through the stay of a service user on respite. The home is situated on a busy road in Harrow, near the main Harrow shopping centre. The accommodation comprises of three bedrooms all of which are located on the first and second floor. The ground floor accommodation comprises of a lounge, dining room and kitchen. There is a well-kept garden and converted out-house at the rear of the property. 6 Harrow View DS0000041653.V283991.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place across a cool day in February. It finished at 3:10p.m. Its focus was on assessing the core standards that were not inspected during the October 2005 inspection, and on compliance with the requirements from that inspection. Three service users were present during the inspection, including one recentlyadmitted person on respite care. The inspector met with all of them, to discuss the services provided in the home, but it was not possible to get verbal feedback from two of the service users. The inspector also discussed aspects of the service with a visitor, staff and the manager. Additionally, care practices were observed, much of the environment was checked on, and a number of records were sampled. Concurrent to the inspection, the manager was requested to send out comment cards to involved people, and to complete an inspection questionnaire. Nothing has been received in respect of this, at the time of drafting this report. The inspector thanks all involved in the home for the patience and helpfulness during the inspection. What the service does well: Service users live in a comfortable and pleasant home whose décor is generally upgraded when needed. The home is kept suitably clean and hygienic. There is an additional facility of an art and sensory room located in the garden. There have been no changes of staff since the last inspection. Service users are well supported by staff to uphold reasonable standards of personal hygiene and appearance, and with accessing appropriate healthcare. Service users receive good opportunities for skills development, and good standards of food provision. The leadership of the home is supportive to staff but also sets clear standards of the care expected for service users. One person commented that they have seen very positive changes for service users in this home over time in terms of socially-appropriate behaviour. 6 Harrow View DS0000041653.V283991.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? 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. 6 Harrow View DS0000041653.V283991.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 6 Harrow View DS0000041653.V283991.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): 1, 2 and 3. The service provides reasonable standards of assessing prospective service users’ needs, and adequate standards of information about the home. Minor improvements to the content of the Statement of Purpose are needed. EVIDENCE: The home had accepted their first respite service user a number of days prior to this inspection. This service user’s pre-admission assessment records were checked. The home has a copy of a recently-dated social worker report and other health professional reports. The manager explained after the inspection about the assessment processes undertaken by the home, and these are judged as reasonable. Staff showed a good understanding of established service users’ needs, for instance in terms of food likes and dislikes, about the type of crockery that benefits service users, and in terms of handling service users’ anxieties around food. There was some evidence of understanding the needs of the newly-placed respite service user, for instance in terms of what support he needs in the community, and with his likes and dislikes. The inspector raised concerns with the manager about the suitability of the new placement, in terms of the respite service user having needs that did not fully match with those of the established service users. The manager explained 6 Harrow View DS0000041653.V283991.R01.S.doc Version 5.1 Page 9 that the respite stay was an assessment period, and that a third staff member has been assigned to work with this service user throughout the day. As a suitable assessment procedure was also undertaken, the inspector accepts the reasons given for the suitability of the placement. An undated Statement of Purpose was supplied to the CSCI in advance of the home starting to accept respite care. The document explains many aspects of the service that is to be provided, including aims and objectives, the number and size of rooms, and staff numbers and qualifications. The Statement of Purpose must, to comply with legislation, additionally include a statement about the facilities and services to be provided to service users (clearly stating what is included in standard fees and what will cost extra), the range of needs that the care home intends to meet, the organisational structure of the home, and arrangements in respect of fire, religion, and family and friends’ contact. It is also highly recommended that a clear statement about arrangements for admitting anyone on respite care be included, to show how differences in the mix of short-term and long-term placements would be addressed. 6 Harrow View DS0000041653.V283991.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, 7 and 9. The service provides reasonable standards of individual risk assessing and care planning. Service users are provided with reasonable support to make choices about their lives, but improvements are needed to ensure that the support is individualised. EVIDENCE: Care plans, dating from within the last six months, were in place for the established service users. Each had a set of goals to progress towards with staff support. There was a brief care plan in place for the newly-placed respite service user. The plan is judged as being suitable to the length of placement. There was particular focus on the planned occupation of the service user. The manager clarified after the inspection that risk assessments of the service user’ needs had been undertaken. There were risk assessments in place within each established service users’ file. These included for community use and for challenging behaviours. The manager stated that they link to individual guidance procedures that clarify 6 Harrow View DS0000041653.V283991.R01.S.doc Version 5.1 Page 11 how staff should provide each service user with support to minimise possible risks. Staff showed awareness of what they have to do to help minimise risks to service users, for instance in terms of kitchen safety, overeating, and community presence. It was observed that the new respite service user was not always able to make choices within the home. For instance, staff had breakfast prepared for him before he arrived downstairs, one staff member prevented him from using the kettle, and he had no door key to his room. The manager rightly explained that this was still their first chance to assess this new service user’s needs, and that in the long term they would make appropriate changes to how this service user is supported. Reasons for these behaviours towards other service users were explained and appear reasonable. The manager must however ensure that each service user is enabled to exercise as much choice and control over their lives as possible, relative to their individual abilities, so as to treat each service user individually and to respect their skills and abilities. Checks of a randomly-sampled service users’ money records and bank statements found nothing concerning. Service users receive significant support from the home to look after their money. 6 Harrow View DS0000041653.V283991.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, 12, 13, 15, 16 and 17. Service users receive good opportunities for skills development, and good standards of food provision. Improvements are needed in respect of ensuring that service users’ daily occupation is based on individual needs and wishes, and that records of occupation are kept fully up-to-date. Improvements are also needed to ensure that service users’ rights in respect of their private bedrooms are respected. EVIDENCE: There were reasonable records of service users skills’ development, particularly around household tasks and socially-appropriate behaviour. One visitor praised the home considerably for success in supporting service users to behave more socially-acceptably. A good standard of activity plan was in place for the new respite service user. It included ensuring that he be supported to continue with key activities that he is already involved in, and made good use of the community at other times. The new service user noted that he had been out to play snooker and eat snacks the previous night, and that he gets support to go to his job. 6 Harrow View DS0000041653.V283991.R01.S.doc Version 5.1 Page 13 The established service users were found to have identical plans of occupation dating from January 2006. The plans showed community presence for each day. Checks of records for the ten days prior to the inspection found that service users went out or had art therapy on five of those ten days according to the activity book. Their daily records found two more days of community activity across this period, but that there was no other discernable activity on the art therapy day. This represents a shortfall on the planned activities, particularly as the service users generally have one-to-one staffing ratios and the service provides for all of their day care. Management stated that service users are supported with activities and occupations daily, and that there are shortfalls with the recording of this that they are addressing as required. The plans must also be individualised, to reflect each service user’s needs and abilities, as the service users do not have to go out together at all times. There was feedback from one service user that they are being supported to stay in touch with family, both by phone and through visits. Records showed that service users are supported to visit, and to receive visits, from parents. There were no locked communal doors seen in the home. Service users’ bedroom doors have a locking device that operates when the door shuts. One service user was seen to borrow the key from the staff bunch, to open their bedroom door. Management confirmed that where a service user is considered capable of handling a door key, the service user would be given the key to look after themselves. One service user was seen during the inspection to be supported by a staff member to hoover another service user’s room. Whilst this is appropriate support of the service user’s skills, it is not appropriate for them to undertake tasks in another service user’s bedroom unless that service user specifically invites them to. The manager accepted this and agreed to address the issue. Some service users have identified needs around handling food intake. The inspector observed how food is handled in the home, and discussed this with staff and one service user. Staff could explain the actions they take to manage food in a way that reduces anxieties for service users. Much of this was documented within individual plans and risk assessments, and the inspector judged that a reasonable system of regular snacks and meals is in place overall. There were reasonable supplies of nutritious food in the home during the inspection. Food records showed that service users receive sufficiently nutritious meals. Where the main meal is known not to be liked by a service user, an alternative is cooked. 6 Harrow View DS0000041653.V283991.R01.S.doc Version 5.1 Page 14 One service user was able to convey to the inspector that they like the food provided in the home. Observations suggested that another service user is supplied with food that they like. The manager noted that at the last staff meeting, it was agreed to acquire adapted crockery that supports service users to carry food from the kitchen to the dining area. Based on spillages that occurred during the inspection, this is seen as appropriate planning. 6 Harrow View DS0000041653.V283991.R01.S.doc Version 5.1 Page 15 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 and 19. The service provides service users with good standards of health and personal care support. EVIDENCE: Service users were seen to be wearing appropriate, coordinated, and wellfitting clothes from the start of the visit. The manager at one stage prompted a service user to change some clothing due to the clothing needing a wash. This was done respectfully. There was evidence, from recent staff meeting records, that management have clear standards about the support service users should receive to uphold appropriate appearances. Good standards of health care planning, and recording of appointment outcomes, were in place within established service users’ files. They showed details of timely appointments with, for example, psychiatrists, GPs, dentists, chiropodists and opticians. Weight monitoring records were also in place. 6 Harrow View DS0000041653.V283991.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 The home has adequate standards of complaints and protection procedures. Improvements are needed to ensure that there is clear, consistent, and up-todate guidance in respect of staff providing positive support to service users’ challenging behaviours. EVIDENCE: A picture/text complaints procedure was on display in the home. The home’s complaints book was seen to be empty. Established service users are unable to express complaints verbally. Consideration should be given to recognising situations where service users express dissatisfaction with the service as a complaint, communicating recognition of this to the service user in question, and finding ways to address the issue. The manager stated that management staff have attended recent training in adult protection through a local council’s training provision. This will influence the organisation’s training. One staff member said that they have had recent adult protection training. The inspector observed an incident of physical aggression from one service user. Staff and the manager responded reasonably but assertively towards the service user, which ultimately stopped the behaviour. There were inconsistencies between verbal feedback and recorded guidance in respect of service users’ individual challenging behaviours. The manager must ensure that there is clear, consistent, and up-to-date guidance to staff in respect of positively supporting service users to minimise challenging behaviours. 6 Harrow View DS0000041653.V283991.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 and 30. The home generally provides service users with a comfortable and clean environment, including within bedrooms. Some minor improvements are needed to uphold suitable standards of homeliness. EVIDENCE: The home was seen to generally be in a good state of repair. It has received upgrades to specific areas across recent inspections. The art and sensory room in the out-house was seen to be fully used on this occasion. This room would benefit from having an inbuilt radiator rather than relying on a portable heater. The home is also cleanly maintained, with no offensive odours. Staff were seen to undertake cleaning, and to support service users with hoovering and roomtidying, during the visit. It was noticeably cold near the back door. This was found to be due to a combination of the door being used often, and the radiator next to the door being ineffective. The radiator was cool despite the heating being on and the valve at maximum. The manager noted that they have recently had the boiler flushed by a professional. The radiator must nonetheless be checked and fixed. 6 Harrow View DS0000041653.V283991.R01.S.doc Version 5.1 Page 18 The dining room table was found to have just two chairs. This prevented all service users sitting together at meals. Management must ensure that there is sufficient suitable seating available at the dining table. The dining table was also seen to be starting to warp on its surface. There were a few holes in its laminate. This prevents the table from being kept suitably clean, and so must be addressed. There was a significant amount of paperwork on display in the kitchen. Some was on a notice-board, but there was also much stuck to the fridge and some on the walls. The manager agreed that this compromises the homeliness of the kitchen area, and so will minimise the display of paperwork there. The new service user kindly showed the inspector their bedroom. It was suitably spacious and had most expected furniture in place. It also has an ensuite toilet and bath, which provides good standards of privacy and comfort. 6 Harrow View DS0000041653.V283991.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): 32 and 33. Service users are suitably supported by a competent staff team. Improvements are needed to ensure that appropriate night care is planned for. EVIDENCE: There have been no changes to the staff team since the last inspection. Those present showed good knowledge of individual service users’ needs. Some positive feedback about staff was received. Staffing levels previously agreed at the home are of two staff working in the home generally between 9am and 9pm, with one person sleeping-over. A third staff was however rostered on for the period of the new respite service user, according to both feedback and records. One staff member said that they get up twice during the night to support one service user with continence routines, and that another service user had a wakeful month recently. The manager stated that one service user can wake up at around 5am with support needs, and that another service user can have support needs in the night. There were no obvious individual care plans or risk assessments in this respect, which must be addressed, to show that appropriate and consistent care is being planned for and provided. 6 Harrow View DS0000041653.V283991.R01.S.doc Version 5.1 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 38 and 39. There are good standards of management providing staff with support at this home. There are reasonable standards of self-monitoring, but improvements must be made to ensure that this regularly includes all people involved with the home. EVIDENCE: From records supplied during and after the inspection, it was clear that staff meetings are held every other month. Most staff are recorded to have attended. Appropriate discussions and instruction, especially about service users’ needs, take place. The organisation successfully completed the Investors in People award, a national standard for good employment practices. A certificate to this effect was on display dating from January 2006. The service development plan for the organisation, for 2005-06, was seen. It plans to meet CSCI requirements, environmental needs, staff development 6 Harrow View DS0000041653.V283991.R01.S.doc Version 5.1 Page 21 needs, and specific service user needs. It shows clear planning and progress for the home. The provider’s monthly regulation 26 report was seen for January 2006. It noted appropriate considerations of how the home is operating. The last formal, annual audit of people involved in the home, about their views on the care provided, took place in 2004. A further audit is needed, to help providers to establish what works well and what can be improved with the care provided, and to allow for the overall results to be made available all relevant people. The provider must address this. 6 Harrow View DS0000041653.V283991.R01.S.doc Version 5.1 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 2 3 3 3 4 X 5 X 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 3 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 2 34 X 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 2 X 3 X LIFESTYLES Standard No Score 11 3 12 2 13 2 14 X 15 3 16 2 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 X X X 3 2 X X X X 6 Harrow View DS0000041653.V283991.R01.S.doc Version 5.1 Page 23 Are there any outstanding requirements from the last inspection? No 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. Standard Regulation Requirement The Statement of Purpose must include: • a statement about the facilities and services to be provided to service users (clearly stating what is included in standard fees and what will cost extra), • the range of needs that the care home intends to meet, • the organisational structure of the home, and • arrangements in respect of fire, religion, and family & friends’ contact. The manager must ensure that each service user is enabled to exercise as much choice and control over their lives as possible, relative to their individual abilities, so as to treat each service user individually and to respect their skills and abilities. Service users’ activity plans must be individualised, to reflect each service user’s needs and abilities. The manager must ensure that DS0000041653.V283991.R01.S.doc Timescale for action 1 YA1 4(1)(b, c) 01/08/06 2 YA7 12(2, 3) 15/05/06 3 4 YA12 YA13 12(3), 16(2)(m, n) 10(1), 01/06/06 01/05/06 Page 24 6 Harrow View Version 5.1 18(1)(a) 5 YA16 12(4) 6 YA23 13(6), 15(2), 18(1a) 23(2)(c, p) 16(2)(c), 23(2)(e,i) 16(2)(j) 7 8 YA24 YA24 9 YA24 10 YA24 12(4), 23(2)(d) 11 YA33 13(4), 15, 18(1)(a) 12 YA39 24 records of service users’ activities are consistently and appropriately kept, rather than there being gaps in the recording. The manager must ensure that service users do not undertake tasks in another service user’s bedroom unless that service user specifically invites them to. The manager must ensure that there is clear, consistent, and up-to-date guidance to staff in respect of positively supporting service users to minimise challenging behaviours. The radiator next to the back door must be checked and fixed. The manager must ensure that there is sufficient suitable seating available at the dining table. The manager must ensure that the warping surface on the dining table is fixed or replaced. The manager must ensure that excess paperwork on display in the kitchen area is minimised to only that which is needed there, and that it then be displayed in an appropriate manner, to uphold a suitably homely appearance. There must be individual care plans and/or risk assessments in respect of service users’ nightcare needs, to show that appropriate and consistent care is being planned for and provided. A further quality-of-care audit is needed, to help the provider to establish what works well and what can be improved with the care provided, and to allow for the overall results to be made available all relevant people. DS0000041653.V283991.R01.S.doc 01/05/06 15/05/06 15/05/06 01/06/06 01/07/06 01/05/06 01/06/06 01/08/06 6 Harrow View Version 5.1 Page 25 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 YA1 Good Practice Recommendations It is highly recommended that a clear statement about arrangements for admitting anyone on respite care be included in the home’s Statement of Purpose, to show how differences in the mix of short-term and long-term placements would be addressed. Consideration should be given to finding ways of enabling service users to eat meals whenever they want, without it affecting other service users. Consideration should be given to recognising, as a complaint, situations where service users express dissatisfaction with the service, communicating recognition of this to the service user in question, and finding ways to address the issue. The art and sensory would benefit from having an inbuilt radiator rather than relying on a portable heater. 1 2 YA17 3 YA22 4 YA24 6 Harrow View DS0000041653.V283991.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection Harrow Area office Fourth Floor Aspect Gate 166 College Road Harrow HA1 1BH 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 6 Harrow View DS0000041653.V283991.R01.S.doc Version 5.1 Page 27 - 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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