Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 13/01/06 for 66 Milton Road (Welcome House)

Also see our care home review for 66 Milton Road (Welcome House) for more information

This inspection was carried out on 13th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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 23 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

Service users deem the manager approachable.

What has improved since the last inspection?

Staff files have been updated to include all information as required by Schedule 2. A new manager has been appointed.

What the care home could do better:

The inspection process evidenced non-compliance in a number of areas. Most notably; the statement of purpose and service user guide; service user assessment; care planning; risk assessment; staffing numbers; training; supervision; diet (both quantities and quality of food) and lifestyle. There was insufficient evidence to suggest that service users needs were correctly identified or met.

CARE HOME ADULTS 18-65 66 Milton Road (Welcome House) 66 Milton Road Gillingham Kent ME7 5LW Lead Inspector Sarah Montgomery Unannounced Inspection 13th January 2006 12.30 66 Milton Road (Welcome House) DS0000029000.V277982.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 66 Milton Road (Welcome House) DS0000029000.V277982.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. 66 Milton Road (Welcome House) DS0000029000.V277982.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service 66 Milton Road (Welcome House) Address 66 Milton Road Gillingham Kent ME7 5LW 01634 574644 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) Dr Toqeer Aslam Vacant Care Home 3 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (3) of places 66 Milton Road (Welcome House) DS0000029000.V277982.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: 66 Milton Road is a registered care home for three adults with mental health problems. It is one of nine homes owned and managed by the Welcome House Group. At present two service users live at the home. The home offers a support package, which comprises the sharing of 56 staff hours with 3 other service users living in two homes nearby. Staff are not on duty in the evening or overnight. During these times service users have access to an on-call staff member. The home is situated in a residential area with easy access to public transport and local shops. Gillingham town centre is approximately one mile away. 66 Milton Road (Welcome House) DS0000029000.V277982.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Sarah Montgomery conducted this unannounced inspection on January 13th 2006. Evidence was gathered by speaking with service users and the home manager, and by reading a selection of documents relating to provision of care and services offered by the home. What the service does well: What has improved since the last inspection? What they could do better: The inspection process evidenced non-compliance in a number of areas. Most notably; the statement of purpose and service user guide; service user assessment; care planning; risk assessment; staffing numbers; training; supervision; diet (both quantities and quality of food) and lifestyle. There was insufficient evidence to suggest that service users needs were correctly identified or met. 66 Milton Road (Welcome House) DS0000029000.V277982.R01.S.doc Version 5.1 Page 6 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. 66 Milton Road (Welcome House) DS0000029000.V277982.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 66 Milton Road (Welcome House) DS0000029000.V277982.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. Service users are unable to make an informed choice about where to live. Service user care may be compromised due to insufficient assessment of needs and skills. Service users cannot be sure that the home they choose will meet their needs and aspirations. EVIDENCE: The Service User Guide and the Statement of Purpose remain unsatisfactory documents. They are not specific to the service at 66 Milton Road, but relate to 4 homes known as the ‘Gillingham Homes’. Furthermore, both documents continue to describe the service offered as respite, short term and longer-term. Standard 1 clearly states; ‘The registered person produces an up-to-date statement of purpose setting out the aims, objectives and philosophy of the home, its services and facilities, and terms and conditions; and provides each service user with a service users’ guide’. Regulation 6 talks about review of the statement of purpose and service user’s guide and states; ‘The registered person shall keep under review and, where appropriate, revise the statement of purpose and the service users guide’. The statement of purpose and service user guide for 66 Milton Road is not upto-date. It does not describe the service currently offered at Milton Road, instead it describes a philosophy of care which, while the inspector understands the thinking behind it, could find little evidence of the service users at the home fitting the description of ‘who comes to live at the Gillingham Homes’ section. 66 Milton Road (Welcome House) DS0000029000.V277982.R01.S.doc Version 5.1 Page 9 The Regulations require the registered provider to keep under review and revise the statement of purpose and service user guide to ensure these documents describe the actual service. The service users living at the home have lived there for several years. To describe the service as respite or short-term is inaccurate. The inspector also questions the validity of the term ‘semi-independent’ as the inspection process evidenced that a staff member undertakes all the shopping for the home, prepares meals, assists with personal care, carries out cleaning tasks, and supports attendance of appointments. Because the statement of purpose and service user guide is not specific to the home, service users cannot be confident that the home they choose will meet their needs and aspirations. Currently, the needs of the service users living at the home are not fully documented. There is no evidence of a skills based assessment to determine the ‘semi independence’ of individual service users, nor are assessments or teaching plans available to continue to assess and teach living skills to service users. The home cannot confirm whether service users are suitably placed in a semiindependent service. The home is required to undertake formal assessments of both service users to assess levels of independence. 66 Milton Road (Welcome House) DS0000029000.V277982.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 and 9. Service users cannot be confident that their assessed and changing needs are reflected in their care plans. Service users cannot be sure that the risks they take as part of an independent lifestyle are acceptable, safe or appropriate. EVIDENCE: Care plans of both service users were inspected. On both there was evidence of review. Although obvious care and thought has been taken by the manager in developing care plans, including involving individual service users, care plans did not contain enough detail to be considered sufficient. More information about supporting service users to achieve goals set in care plans needs to be added. The care plans do not detail sufficiently levels of independence in daily living skills. For a project that is based on the principles of semi-independent living, there are no additional assessment tools or teaching plans for staff or service users to follow. Information gathered during the inspection regarding the levels of support required by individual service users, strongly indicated that care plans are not a true reflection of levels of support needed. 66 Milton Road (Welcome House) DS0000029000.V277982.R01.S.doc Version 5.1 Page 11 Care plans are intended as a working tool for both service user and staff to facilitate the process of meeting current and changing needs, including fulfilling aspirations and achieving goals. The current care plans maintain a status quo, and do not provide any evidence that service users are moving forward or setting goals. Based on information gained during inspection, from both service users and the manager, risk assessments pertaining to independent living skills are either absent or insufficient. More detail concerning strengths and needs with regard to assessment of risk is required. Thought must be given to skill levels of individual service users, particularly when considering risk in preparing food and accessing the local community. 66 Milton Road (Welcome House) DS0000029000.V277982.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, 13 and 17. Service users have limited opportunities for personal development. Service users may feel isolated from the local community. Service users are not offered a healthy diet, and quantities of food are insufficient. EVIDENCE: At present service users eat their main meal at lunchtime (usually between 12.00 and 12.30). The home manager prepares this. The inspector was informed that the service users are unable to prepare a main meal for themselves, as they do not have the skills required to do so. The meal is cooked for all service users in the Gillingham Homes (5 service users), and usually prepared in the kitchen of 66 Milton Road. The inspector asked if teaching opportunities presented when cooking the meal, and was informed that they did not due to lack of space and lack of time. Although a semi-independent unit, evidence gathered throughout the inspection indicated significantly higher levels of needs (particularly one service user) than would be expected in such a service. Given this, and given the nature of the service, the absence of any assessment pertaining to maintaining or developing independent living skills is unacceptable. Service users are given no opportunities to enhance or learn these skills. 66 Milton Road (Welcome House) DS0000029000.V277982.R01.S.doc Version 5.1 Page 13 One service user relies heavily on the other service user. This includes, only going out if the other service user goes, making drinks and snacks, going to the shop. This situation is not acceptable. The service user is undertaking an informal staff member role and responsibilities. The inspector questioned whether the more dependent service user could (in the manager’s opinion) manage to live at the home without the other service user. The answer was not at all. The inspector spent some time talking to both service users and asked them about making breakfast and a meal in the evening. Both didn’t have breakfast, and admitted that they didn’t often eat in the evenings. The cupboard contained tins of soup and beans where the lid had been opened slightly. The contents were mouldy. The inspector was informed that the service users couldn’t open the tins. When questioned about evening food, the service users were not sure what they might prepare. Sometimes toast. I questioned whether they were hungry given that they did not eat breakfast and had lunch quite early. They said they were sometimes hungry. The manager always ensures that the service users have milk and bread in the house. There is usually food in the cupboards. The manager always asks the service users if they want her to open anything for them to eat later. Again, this is not an example of semi-independence. It is apparent that the service users do not have sufficient skills to prepare food, which is nutritious, varied, balanced and wholesome. This area must be addressed immediately, with concentrated teaching programmes put into place. It would be expected in a semi-independent unit that service users are supported and encouraged to take an active part in all areas of independent living. However, neither service user is included in budgeting skills for household items and food, or goes shopping. There are no care plans, assessments, or teaching aids on supporting service users to shop, budget or cook for themselves. The food that service users eat is either tinned or frozen. Service users never eat fresh vegetables or meat. Their diet is limited to cheap frozen foods – often pies and sausages. The budget for each service user per day is £1.42 per day. None of the performance indicators in Standard 17 are met. 66 Milton Road (Welcome House) DS0000029000.V277982.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): THESE STANDARDS WERE NOT ASSESSED. EVIDENCE: 66 Milton Road (Welcome House) DS0000029000.V277982.R01.S.doc Version 5.1 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Service users can be confident that their views are listened to and acted on. Service users cannot be confident that they are protected from abuse, neglect and self-harm. EVIDENCE: Conversation with service users evidenced they are confident and comfortable about raising any concerns or complaints with the home manager. This is usually done informally by just having a chat over a cup of coffee. Any concerns are usually resolved, and they have confidence and trust in the manager to sort out the more difficult complaints. Service user meetings are monthly. One of the standing items on the agenda is complaints. No formal complaints have been made. The manager displayed adequate knowledge of Adult Protection protocols. She was able to answer questions regarding actions to take if concerns are raised, and satisfied the inspector that any such matters would be dealt with professionally and in keeping with the Kent and Medway multi-agency adult protection protocols. The inspector is concerned that service users may be at risk from harm due to neglect. Staff hours are insufficient, and service users needs are not being met or adequately addressed. Diet is poor, and with current inadequate staffing levels, improvements in standards of care are questionable. 66 Milton Road (Welcome House) DS0000029000.V277982.R01.S.doc Version 5.1 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 and 28. Service users benefit from having a bathroom which meets there individual needs, and a lounge, which is cosy and homely. EVIDENCE: The bathroom and lounge were inspected. It was noted that the bathroom, which required significant work at the previous inspection, had been repaired and redecorated. The service users expressed satisfaction with the result, but remain concerned at the crack in the wall behind the door. Outside the bathroom (adjacent to the back door) there is a dip in the floor. The flooring in this area is slippy and considered hazardous. This needs to be addressed. The lounge is homely and comfortable, and the service users are clearly proud and happy in their home. It is decorated pleasantly and contains several personal items. The carpet is very stained and needs replacing. 66 Milton Road (Welcome House) DS0000029000.V277982.R01.S.doc Version 5.1 Page 17 66 Milton Road (Welcome House) DS0000029000.V277982.R01.S.doc Version 5.1 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 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): 33, 34, 35 and 36. Service users are not supported by an effective staff team. Service users cannot be sure that staff supporting them are appropriately trained, well supported, or supervised. Service users can be confident they are protected by the home’s recruitment policy and practices. EVIDENCE: From information gathered and the observations made during the inspection, staffing is not adequate to meet the present needs of the current service users in the home. Based on figures from the residential forum, this home should have 72.66 support hours per week. The present support hours are significantly less, with 56 support hours for 5 service users in 3 care homes. Welcome House must address these staffing shortfalls as a matter of urgency, and ensure that 66 Milton Road is appropriately staffed to enable service users to receive the support required. When asked to view staff meeting minutes, the inspector was given transcripts of telephone conversations, and was informed that staff meetings occur by telephone only. The Commission for Social Care Inspection does not regard contact by telephone an acceptable substitute for staff meetings. Until this week, the home had two members of staff – the manager, who works Monday to Friday, 9am – 5pm, and a support member of staff who works for 3 hours on a Saturday and Sunday. Welcome House must ensure that regular staff meetings take place (minimum 6 per year) in the home, and that staff attend 66 Milton Road (Welcome House) DS0000029000.V277982.R01.S.doc Version 5.1 Page 19 as part of their agreed working hours. These meetings must be recorded and actioned. The home manager stated that she receives regular supervision, and added that she finds it a very helpful and useful process. However, the support worker employed to work weekends has never received supervision. This is unacceptable, and does not promote a professional approach to managing staff, or in assisting staff in their role as keyworker. Staff at the home have not received adequate training. Another staff member who is not an accredited trainer conducted adult protection training. There is no training available on mental health issues, and basic training in first aid is absent. To compound this shortfall, staff are not paid when they attend training courses. This leads to low staff motivation regarding attending training, identifying their own training needs, and being proactive in making sure their training needs are addressed. Significant shortfalls in training, inadequate staffing numbers, lack of supervision, and total absence of staff meetings indicate that there are not systems in place to show that staff and service users are valued. Staff files were inspected. Improvements have been made in this area. All files now conform to Schedule 2. 66 Milton Road (Welcome House) DS0000029000.V277982.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): 37. Service users benefit from having a home manager who is committed and professional. Service users cannot be confident that the home is well run. EVIDENCE: The home manager Michelle Jeffrey presented as competent, professional, committed and knowledgeable about her role and responsibilities. She has developed a management style and approach, which is open, fair and welcoming. She clearly works hard in trying to ensure the home is run smoothly, and that service users are cared for in line with current care plans and company policies and procedures. Given all that, the inspector could not conclude that the home is well run. Evidence in the majority of standards inspected indicates non-compliance with standards and regulations. Service users have not been adequately assessed, their care plans do not reflect their support needs, staff numbers are unacceptably low, and service users do not receive adequate support in being semi-independent or in achieving or maintaining an adequate diet. 66 Milton Road (Welcome House) DS0000029000.V277982.R01.S.doc Version 5.1 Page 21 66 Milton Road (Welcome House) DS0000029000.V277982.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 1 2 1 3 1 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 1 ENVIRONMENT Standard No Score 24 X 25 X 26 X 27 3 28 2 29 X 30 X STAFFING Standard No Score 31 X 32 X 33 1 34 3 35 1 36 1 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 1 X X 1 X LIFESTYLES Standard No Score 11 1 12 X 13 1 14 X 15 X 16 X 17 1 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X X X 1 X X X X X X 66 Milton Road (Welcome House) DS0000029000.V277982.R01.S.doc Version 5.1 Page 23 Yes. Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA1 Regulation 4(1)a,b,c Requirement Timescale for action 31/03/06 2 YA1 4(2) 3 YA1 3(a) 3(b) The registered person shall compile in relation to the care home a written statement (in these Regulations referred to as “the statement of purpose”) which shall consist of – (a) a statement of the aims and objectives of the care home; (b) a statement as to the facilities and services which are to be provided by the registered person for service users; and (c) a statement as to the matters listed in Schedule 1. 31/03/06 The registered person shall supply a copy of the statement of purpose to the Commission and shall make a copy of it available on request for inspection by every service user and any representative of a service user. Nothing in regulation 16(1) or 31/03/06 23(1) shall require or authorise the registered person to contravene, or not to comply DS0000029000.V277982.R01.S.doc Version 5.1 66 Milton Road (Welcome House) Page 24 4 YA1 5(1)a,b,c, d,e,f 5 YA1 5(2) 6 YA1 5(3) any other provision of these Regulations; or (b) the conditions for the time being in force in relation to the registration of the registered person under Part 2 of the Act. The registered person shall 31/03/06 produce a written guide to the care home (in these Regulations referred to as “the service user’s guide”) which shall include – (a) a summary of the statement of purpose. (b) The terms and conditions in respect of accommodation to be provided for service users, including as to the amount and method of payment of fees; (c) A standard form of contract for the provision of services and facilities by the registered provider to service users; (d) The most recent inspection report; (e) A summary of the complaints procedure established under regulation 22; (f) The address and telephone number of the Commission. The registered person shall 31/03/06 supply a copy of the service user’s guide to the Commission and each service user. Where a local authority has 31/03/06 made arrangements for the provision of accommodation, nursing or personal care to the service user at the care home, DS0000029000.V277982.R01.S.doc Version 5.1 Page 25 with – (a) 66 Milton Road (Welcome House) 7 YA1 6(a) 6(b) 8. YA2 14(1)a,b,c 9 YA2 14(2)(a) 14(2)(b) 10. YA3 14(1)(d) the registered person shall supply to the service user a copy of the agreement specifying the arrangements made. The registered person shall – (a) keep under review and, where appropriate, revise the statement of purpose and the service user’s guide; and (b) notify the Commission and service users of any such revision within 28 days. The registered person shall not provided accommodation to a service user at the care home unless, so far as it shall have been practicable to do so – (a) needs of the service user have been assessed by a suitably qualified or suitably trained person; (b) the registered person has obtained a copy of the assessment; (c) there has been appropriate consultation regarding the assessment with the service user or a representative of the service user; The registered person shall ensure that the assessment of the service user’s needs is – (a) kept under review; and (b) revised at any time when it is necessary to do so having regard to any change of circumstances. The registered person shall not provided accommodation to a service user at the care home unless, so far as it shall have DS0000029000.V277982.R01.S.doc 31/03/06 28/02/06 28/02/06 28/02/06 66 Milton Road (Welcome House) Version 5.1 Page 26 been practicable to do so – (d) the registered person has confirmed in writing to the service user that having regard to the assessment the care home is suitable for the purpose of meeting the service user’s needs in respect of his health and welfare. 15(1) Unless it is impracticable to carry out such consultation, the registered person shall, after consultation with the service user, or a representative of his, prepare a written plan (“the service user’s plan”) as to how the service user’s needs in respect of his health and welfare are to be met. 15(2)a,b,c, The registered person shall – d (a) make the service user’s plan available to the service user; (b) keep the service user’s plan under review; (c) where appropriate and, unless it is impracticable to carry out such consultation, after consultation with the service user or a representative of his, revise the service user’s plan; and (d) notify the service user of any such revision. 12(1)(a) The registered person shall 12(1)(b) ensure that the care home is conducted so as – (a) to promote and make proper provision for the health and welfare of service users; (b) to make proper provision for the care, and where appropriate, treatment, education DS0000029000.V277982.R01.S.doc 11. YA6 28/02/06 12 YA6 28/02/06 13 YA6 28/02/06 66 Milton Road (Welcome House) Version 5.1 Page 27 14. YA9 13(4)(b) 13(4)(c) 15. YA11 12(1)(b) 16 YA13 16(2)(m) 17 YA17 16(2)(i) 18 YA23 13(6) and supervision of service users. The registered person shall ensure that – (b)any activities in which service users participate are so far as reasonably practicable free from avoidable risks; and (c) unnecessary risks to the health or safety of service users are identified and so far as possible eliminated. The registered person shall ensure that the care home is conducted so as – (b) to make proper provision for the care and, where appropriate, treatment, education and supervision of service users. The registered person shall having regard to the size of the care home and the number and needs of service users – (m) consult service users about their social interests, and make arrangements to enable them to engage in local, social and community activities and to visit, or maintain contact or communicate with, their families and friends. The registered person shall having regard to the size of the care home and the number and needs of service users – (i) provide, in adequate quantities, suitable, wholesome and nutritious food which is varied and properly prepared and available at such time as may be reasonably required by service users. The registered person shall make suitable arrangements, by training staff or by other DS0000029000.V277982.R01.S.doc 28/02/06 28/02/06 31/03/06 08/02/06 08/02/06 66 Milton Road (Welcome House) Version 5.1 Page 28 19. YA28 16(2)(c) 20. YA33 18(1)(a) 21 YA35 18(1)c(i) 18(1)c(ii) 22 YA36 18(2) measures, to prevent service users being harmed or suffering abuse or being placed at risk of harm or abuse. The registered person shall having regard to the size of the care home and the number and needs of service users – (c) provide in rooms occupied by service users adequate furniture, bedding and other furnishings, including curtains and floor coverings, and equipment suitable to the needs of service users and screens where necessary. The registered person shall, having regard to the size of the care home, the statement of purpose and the number and needs of service users – (a) ensure that at all times suitably qualified, competent and experienced persons are working at the care home in such numbers as are appropriate for the health and welfare of service users. The registered person shall, having regard to the size of the care home, the statement of purpose and the number and needs of service users – (c)ensure that the persons employed by the registered person to work at the care home receive – (i) training appropriate to the work they are to perform; and (ii) suitable assistance, including time off, for the purpose of obtaining further qualifications appropriate to such work. The registered person shall DS0000029000.V277982.R01.S.doc 31/03/06 28/02/06 28/02/06 28/02/06 Page 29 66 Milton Road (Welcome House) Version 5.1 23 YA37 10(1) ensure that persons working at the care home are appropriately supervised. The registered provider and the 28/02/06 registered manager shall, having regard to the size of the care home, the statement of purpose, and the number and needs of the service users, carry on or manage the home (as the case may be) with sufficient care, competence and skill. 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 66 Milton Road (Welcome House) DS0000029000.V277982.R01.S.doc Version 5.1 Page 30 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 66 Milton Road (Welcome House) DS0000029000.V277982.R01.S.doc Version 5.1 Page 31 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!