Inspection on 19/01/06 for 68 Milton Road (Welcome House)

This inspection was carried out on 19th 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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 21 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

68 Milton Road (Welcome House) 20/06/06

68 Milton Road (Welcome House) 06/12/05

68 Milton Road (Welcome House) 14/12/04

68 Milton Road (Welcome House) 10/08/04

68 Milton Road (Welcome House) 08/01/04

Similar services:

1 Marten Road

Daubeney House

Three Gables

Aldwick House

49 Glendale

The Springs Community

Crossways Community

Belle Vue Country House

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

CARE HOME ADULTS 18-65 68 Milton Road (Welcome House) 68 Milton Road Gillingham Kent ME1 3AE Lead Inspector Sarah Montgomery Announced Inspection 19th January 2006 09:30 68 Milton Road (Welcome House) DS0000028991.V268179.R01.S.doc Version 5.0 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 68 Milton Road (Welcome House) DS0000028991.V268179.R01.S.doc Version 5.0 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. 68 Milton Road (Welcome House) DS0000028991.V268179.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service 68 Milton Road (Welcome House) Address 68 Milton Road Gillingham Kent ME1 3AE 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 Care Home 3 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (3) of places 68 Milton Road (Welcome House) DS0000028991.V268179.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14th December 2004 Brief Description of the Service: 68 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 one service user lives at the home. The home offers a support package, which comprises the sharing of 56 staff hours with 4 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. 68 Milton Road (Welcome House) DS0000028991.V268179.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Sarah Montgomery conducted this unannounced inspection on January 19th 2006. Evidence was gathered by speaking with the service user 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 the service user’s needs were correctly identified or met. 68 Milton Road (Welcome House) DS0000028991.V268179.R01.S.doc Version 5.0 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. 68 Milton Road (Welcome House) DS0000028991.V268179.R01.S.doc Version 5.0 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 68 Milton Road (Welcome House) DS0000028991.V268179.R01.S.doc Version 5.0 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 and 2. Service users cannot be sure they have the information they need to make an informed choice about where to live. Prospective service users’ care is compromised due to their individual needs and aspirations not being assessed prior to admission. EVIDENCE: The Service User Guide and the Statement of Purpose remain unsatisfactory documents. They are not specific to the service at 68 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 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. Services described in the homes statement of purpose and the business plan were not evidenced. Welcome House must consider these documents and make necessary changes to service provision. 68 Milton Road (Welcome House) DS0000028991.V268179.R01.S.doc Version 5.0 Page 9 The inspector requested assessment documentation gathered prior to admission and following admission. No assessments were undertaken. The service user had moved from a home within the Welcome House Group. Lack of assessment prior to a move from a less independent fully staffed environment, to a semi-independent project is a serious error. No formal thought has been given to the appropriateness of the move, and no evidence could be shown to the inspector, which would indicate the move was in relation to assessment of skills. The failure to address these key issues demonstrates that the statement of purpose, service user guide, and Welcome House’s business plan are not referred to or taken note of when considering service users. 68 Milton Road (Welcome House) DS0000028991.V268179.R01.S.doc Version 5.0 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 are not supported appropriately as their assessed and changing needs and personal goals are not reflected in their individual plan. Service users safety is compromised, as they are not adequately support to take risks as part of an independent lifestyle. EVIDENCE: The service user’s care plan was inspected. All care plans were based around increasing independent living skills. However, information gathered from discussion with the service user and the manager pointed to the care plans being limiting, and suggested a lack of movement. Many of the care plans were focussed on retaining skills already gained. The inspector questioned why the service user was not being encouraged to increase independence by (for example) doing his own weekly shopping, menu planning, and learning how to cook healthy and nutritious meals. The manager acknowledges that the service user was keen to learn, and had ‘blossomed’ since living at the house. She commented that he picked up skills in independent living very quickly. 68 Milton Road (Welcome House) DS0000028991.V268179.R01.S.doc Version 5.0 Page 11 It was clear from looking at the rota, at the budget allocated for food and provisions, and at the managers job description, that staffing hours required to enable staff to actively support service users to move forward by way of care planning and conducting skills assessments linked to teaching tasks, is not possible. The service user’s needs are not being met. He is being limited in what he does, not because of he wants to, but because there is insufficient staffing, insufficient money, and a lack of systems in place to assist service users through assessment and teaching plans to reach and fulfil their potential. From the evidence collected, the inspector concluded that current care plans are based around limits on staff availability rather than the needs of the service user. The home is staffed from 9am – 5pm Monday to Friday, and 3 hours on a Saturday and a Sunday. Outside these hours, the service user is alone. No risk assessments were in place regarding the service user being alone. No risk assessments were in place ascertaining risk should an emergency occur. No documents were available to demonstrate the service user’s health and welfare had been assessed or even acknowledged regarding risks to living alone. The service user has had an emergency and did not know what to do. No care plan or risk assessment was put into place following this emergency. Conversation with the service user indicated that he remains unsure of what to do if there is an emergency when staff are not there. This not only indicates that the service user remains at risk of harm, but strongly suggests neglect on the part of the registered person in not conducting thorough assessments prior to admission, or any assessments following admission. The home has an immediate requirement to address this issue, and to ensure that systems to ensure the safety of the service user are put into effect from the date of inspection. 68 Milton Road (Welcome House) DS0000028991.V268179.R01.S.doc Version 5.0 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 are part of the local community. Service users are not offered a healthy diet. EVIDENCE: Although no formal assessments have been undertaken, conversations with the service user and the manager indicated that the service user has so far ‘thrived’ at 68 Milton Road, and has responded positively and enthusiastically to learning new skills which have enabled him to prepare snacks, undertake household cleaning, use the washing machine, attend doctors appointments independently and visit the local shops. The inspector questioned why care plans were not more proactive, and would expect them to be focussed on increasing the service user’s knowledge and skills towards independence. Indeed, the mission statement of Welcome House says ‘To promote independence through supporting and encouraging our service users to lead as normal a life as possible and to reach their full potential’. 68 Milton Road (Welcome House) DS0000028991.V268179.R01.S.doc Version 5.0 Page 13 It is disappointing and unacceptable that the Mission Statement is not being realised for this service user. Skills such as managing his own budget, doing his own weekly shopping, and cooking main meals are the natural step forward. Inadequate staffing and an insufficient budget for food do not allow for this service user to ‘lead as normal life as possible and reach his full potential’. The food that the service user eats is either tinned or frozen. Service users never eat fresh vegetables and rarely has fresh fruit. His diet is limited to cheap frozen foods – This is of particular concern as the service user is vegetarian. No information on dietary needs of vegetarians was available. The budget for food and cleaning products is £100 every two weeks and is shared between three homes and five service users. For each service user per day this is £1.42. None of the performance indicators in Standard 17 are met. 68 Milton Road (Welcome House) DS0000028991.V268179.R01.S.doc Version 5.0 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 INSPECTED. EVIDENCE: 68 Milton Road (Welcome House) DS0000028991.V268179.R01.S.doc Version 5.0 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 are not sure if their views are known. Service users cannot be confident that they are protected from abuse, neglect and self-harm. EVIDENCE: The inspector spoke with the service user about what he would do if he had a concern or complaint. He did not seem to have an awareness of any formal complaints procedure, or what issues he might complain about, but did say that he got on very well with the manager, and felt if he had a problem he would talk to her. The inspector is concerned that the service user is not aware of the complaints procedure or of what could constitute a complaint. He appeared very contented and relieved to be living at the home, and gave the impression that he would not consider raising a concern. The registered person must ensure that all service users are aware of their rights, including their right to raise concerns or complaints. Management must be satisfied that service users are not only aware of the complaints procedure, but feel able and confident to use it. The inspector is concerned that the service user may be at risk from harm due to inadequate assessment of risk regarding health and welfare. The service user had an accident recently in which he fell down the stairs and suffered an injury to his ankle. This accident occurred after 5pm. No staff were on duty and were not due back in the home until the following morning. The service user did not know what to do, and did nothing. Prior to this accident no risk assessment was in place regarding the service user being alone. Nor was there any assessment regarding the service user’s skill or knowledge in what to do 68 Milton Road (Welcome House) DS0000028991.V268179.R01.S.doc Version 5.0 Page 16 following an emergency or contacting on call staff. Following the accident no risk assessment or skills assessment was undertaken. When the inspector asked the service user about using the telephone, he informed her he did not know how to use it. The inspector questions whether this service user is at risk from neglect given the above information. It is imperative that Welcome House undertakes with urgency assessments regarding all skills in independent living, and accompanying risk assessments. 68 Milton Road (Welcome House) DS0000028991.V268179.R01.S.doc Version 5.0 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. Service users benefit from living in a homely, comfortable and safe environment. EVIDENCE: The service user showed the inspector around his home. It was clear that he felt very proud of where he lives, and told the inspector he feels happy and comfortable, preferring to live on his own than with a group of people. The home is comfortable. Downstairs is a kitchen, bathroom, dining room, lounge and office. All are decorated and furnished to an acceptable standard. The upper floor has three bedrooms. One bedroom (the service user’s) was inspected and found to be adequate. A payphone is located on the floor just outside the bedroom. This needs to be in a more accessible area, and at a height suitable for the service user to use. 68 Milton Road (Welcome House) DS0000028991.V268179.R01.S.doc Version 5.0 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, 35 and 36. Service users care is compromised due to an ineffective staff team who are not appropriately trained, supported or supervised. EVIDENCE: Information gathered from care plans, discussions with the service user and manager, and the observations made during the inspection, evidenced that staffing is not adequate to meet the present needs of the current service user in the home. Based on figures from the residential forum, this home should have 40.25 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 68 Milton Road is appropriately staffed to enable the service user to receive the support required. Staff meetings are not held. The manager speaks to her colleagues by telephone approximately once a month. 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 as part of their agreed working hours. These meetings must be recorded and actioned. 68 Milton Road (Welcome House) DS0000028991.V268179.R01.S.doc Version 5.0 Page 19 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. This consisted of showing a DVD. 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. One staff file was inspected. Although Welcome House have made improvements in that, all staff files have information as required by Schedule 2, the staff file inspected was deemed inadequate. Both references were from friends and cannot be considered as either objective or reflective of working practice. By not obtaining professional references and relying on references from friends, Welcome House is not conducting robust recruitment and cannot assure service users they are protected from harm. The file did not contain a CRB check. This has been applied for, and the staff member is not working alone with service users. The inspector does not find that the current application forms are in line with equal opportunities, and would recommend that future forms are adjusted and do not ask for marital status or number of children. The inspector further recommends that more detail is included in reference request forms, and that Welcome House should consider asking questions pertaining to performance issues, specifically; disciplinary, investigation, suspension, and whether they would re-employ the person again. 68 Milton Road (Welcome House) DS0000028991.V268179.R01.S.doc Version 5.0 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 and 43. Service users cannot be sure they live in a well run home. 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 the service user is 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. The service user has not been assessed, care plans do not reflect support needs, staff numbers are unacceptably low, and the service user does not receive adequate support in being semi-independent or in achieving or maintaining an adequate diet. 68 Milton Road (Welcome House) DS0000028991.V268179.R01.S.doc Version 5.0 Page 21 68 Milton Road (Welcome House) DS0000028991.V268179.R01.S.doc Version 5.0 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 1 1 X X X Standard No 22 23 Score 2 1 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 1 1 X X X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X X X X X LIFESTYLES Standard No Score 11 1 12 X 13 1 14 X 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X X 1 X 1 1 CONDUCT AND MANAGEMENT OF THE HOME 1 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 68 Milton Road (Welcome House) Score X X X X Standard No 37 38 39 40 41 42 43 Score 2 X X X X X 1 DS0000028991.V268179.R01.S.doc Version 5.0 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 4(3)(a) 4(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 a statement as to the matters listed in Schedule 1. The registered person shall 31/03/06 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 with – DS0000028991.V268179.R01.S.doc Version 5.0 68 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 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; 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, the registered person shall supply to the service user a copy of the agreement specifying the arrangements DS0000028991.V268179.R01.S.doc Version 5.0 Page 25 (a) 68 Milton Road (Welcome House) made. 7 YA1 6(a) 6(b) The registered person shall – (a) keep under review and, where appropriate, revise the statement of purpose and the service user’s guide; and 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; 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 revised at any time when it is necessary to do so having regard to any change of circumstances. 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. DS0000028991.V268179.R01.S.doc 31/03/06 8 YA2 14(1)a,b,c 28/02/06 9 YA2 14(2)(a) 14(2)(b) 28/02/06 10 YA6 15(1) 28/02/06 68 Milton Road (Welcome House) Version 5.0 Page 26 11 YA6 12 YA6 13 YA9 14 YA11 15 YA17 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; to make proper provision for the care, and where appropriate, treatment, education and supervision of service users. 13(4)(b) The registered person shall 13(4)(c) ensure that – (b)any activities in which service users participate are so far as reasonably practicable free from avoidable risks; and unnecessary risks to the health or safety of service users are identified and so far as possible eliminated. 12(1)(b) 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. 16(2)(i) The registered person shall DS0000028991.V268179.R01.S.doc 28/02/06 28/02/06 20/01/06 28/02/06 08/02/06 Page 27 68 Milton Road (Welcome House) Version 5.0 16 YA23 13(6) 17 YA33 18(1)(a) 18 YA35 18(1)c(i) 18(1)c(ii) 19 YA36 18(2) 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 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, 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 suitable assistance, including time off, for the purpose of obtaining further qualifications appropriate to such work. The registered person shall ensure that persons working at the care home are appropriately DS0000028991.V268179.R01.S.doc 08/02/06 28/02/06 28/02/06 28/02/06 68 Milton Road (Welcome House) Version 5.0 Page 28 supervised. 20 YA43YA37 10(1) The registered provider and the 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. 28/02/06 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 Refer to Standard YA34 Good Practice Recommendations The registered person operates a recruitment procedure ensuring the protection of service users, in that references from previous employers are sought, and information regarding working practice is asked for. The registered person operates a recruitment procedure based on equal opportunities, in that, applicants are not asked questions regarding their marital status or number of children. The complaints procedure is fully explained to the service user. 2 YA34 3 YA22 68 Milton Road (Welcome House) DS0000028991.V268179.R01.S.doc Version 5.0 Page 29 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 68 Milton Road (Welcome House) DS0000028991.V268179.R01.S.doc Version 5.0 Page 30 - 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!