Inspection on 07/02/08 for 73 The Marles

This inspection was carried out on 7th February 2008.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 73 The Marles 73 The Marles Exmouth Devon EX8 4NE Lead Inspector Louise Delacroix Unannounced Inspection 7th February 2008 09:00 73 The Marles DS0000071088.V359037.R01.S.doc Version 5.2 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 73 The Marles DS0000071088.V359037.R01.S.doc Version 5.2 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. 73 The Marles DS0000071088.V359037.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 73 The Marles Address 73 The Marles Exmouth Devon EX8 4NE 01395 265276 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) Guinness Care and Support Ltd Mrs Maxine Alexander Care Home 3 Category(ies) of Learning disability (3) registration, with number of places 73 The Marles DS0000071088.V359037.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: 2. Learning disability (Code LD) The maximum number of service users who can be accommodated is 3. Date of last inspection 7th February 2007. Brief Description of the Service: The home provides support and personal care for 3 people with learning disabilities. 73 The Marles is a 4 bed roomed detached family sized house in a residential area of Exmouth. The home is now operated by the Guinness Trust Fees are £942 per week with no extra charges. Reports by CSCI are hung on the home’s notice board for people to read. The manager will also go through the report with those who require help and support. Relatives are provided with a copy of the report on request. 73 The Marles DS0000071088.V359037.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means that the people who use this service experience good quality outcomes. The inspection took place in the morning, was unannounced and lasted five and half hours. Prior to the inspection, the manager completed an annual quality assurance assessment (AQAA), which describes the service, the quality of care of care that it provided and areas for improvement. We have incorporated information from this self-assessment into this report. We also sent out surveys to the people living at the home (three returned), the staff that work there (three returned) and people who have contact with the service, such as relatives and visitors (three returned). We also received two surveys from GPs. During the inspection, we spent time talking with people living and working at the home. We also looked at records relating to care, recruitment and maintenance. We looked around the home to see how it is maintained, and we observed staff practice. What the service does well: People considering moving to the home will be provided with up to date information, and the home’s admission procedure will help ensure it is the right place for them. The home continues to improve the plans of care for each individual living there and promotes the involvement of individuals in making decisions and maintaining their independence. People generally lead the life they choose, maintaining social and family links, as well influencing the style and preparation of meals. The home ensures that people’s health and medication needs are well met. People living at the home feel listened to and able to voice their concerns. Staff are aware of their responsibilities to report safeguarding issues and polices are in place. The building is clean and homely in appearance. There is a competent staff team, who are well recruited and who receive good support and planned training. The home is well run by a committed manager, who has ensures that quality assurance systems are in place and that maintenance checks are carried out to help make the home a safe place to live. 73 The Marles DS0000071088.V359037.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. 73 The Marles DS0000071088.V359037.R01.S.doc Version 5.2 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 73 The Marles DS0000071088.V359037.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): We looked at standards 1 and 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People considering moving to the home are provided with up to date information, and can be assured that the home’s admission process will ensure the service can meet their needs. EVIDENCE: The Guinness Trust has recently bought the home and the statement of purpose was updated as part of the registration process. The manager told us that work has been carried out to create the service user guide using a symbol format but that it had not been suitable for people currently living at the home. The people living at the home have lived there for many years and admission procedures date from this period, and took place to ensure that the service could meet the needs of individual people. The manager explained on the last inspection that there is an admission procedure should a new person move to the home, which will help ensure that they are fully assessed prior to moving to in to ensure that it is the right place for them. 73 The Marles DS0000071088.V359037.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): We looked at standards 6,7 & 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Work continues to improve the quality of information about the support people need. The ethos of the home encourages people to make decisions and maintain their independence. EVIDENCE: We looked at two care plans, and saw that they reflected what people living and working at the home had told us. In the home’s AQAA and during discussion on the day, the manager said that there are plans to review the style of care plans to ensure that they are based on the principles of person centred planning, which will be achieved using independent advocates. A staff member told us that they were always given up to date information about the people they care for. Two people who have contact with the home told us that the people living there either always or usually had their individual needs met. The manager has highlighted in the completed AQAA that people living at the home are included more in decision making wherever possible. She gives the 73 The Marles DS0000071088.V359037.R01.S.doc Version 5.2 Page 10 example that one person asked for less prompting with a task and that staff have respected this request. People living at the home told us about how they were supported to make decisions and offered choice, and gave us examples. We also observed this during the inspection. A staff member said that people were always offered choice about their daytime routine e.g. when they got up, what they wore and what food they ate. They showed insight into how their role had changed to support people’s independence and to empower them to make decisions. The manager told us that people have been consulted about choice of colours when the home was re-decorated and people living at the home confirmed this. The manager has identified that improving communication skills with one person would enhance their ability to share their needs and choices with the staff group, and she plans to meet this need through training and development programmes. People living at the home told us how they have group meetings to enable them to express ideas about how to improve things and make decisions about the way the home is run, and we saw the minutes for these. One person living at the home said they always make decisions about what they do each day, with two other people saying this sometimes happened. Two people said they could do what they wanted to do during the day, one person said sometimes. The person who helped complete the form with them, explained that this depended on staffing levels as the respondent liked to go out for walks or outings. (See Staffing standards) All three people said they could do what they wanted in the evening and at the weekends. A visitor said that the home always supports individuals to live the life they choose. Where risks have been identified, there is generally guidance in place as to how to reduce these so that people can continue with activities and access the community, as well keeping people safe in their own home. 73 The Marles DS0000071088.V359037.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): We looked at the standards 12,13,15,16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are supported to lead the lives they choose, and are involved in the preparation and choice of food at the home. EVIDENCE: People living at the home explained how they were supported to carry out voluntary work, which was reflected in their plan of care, including guidance for staff. The manager has identified in the home’s AQAA that further work is needed to enable the people living at the home to access a wider range of activities and increasing social links with the community but she said that in the last twelve months this has increased. Visitors to the home told us that the home always supported people to live the life they choose. 73 The Marles DS0000071088.V359037.R01.S.doc Version 5.2 Page 12 Within the home’s AQAA there is reference to the community facilities that people living at the home have access to, which includes the cinema, voluntary work, sports centre, swimming pool and the Gateway club. We talked to people living at the home and they told us about some of these resources and how and when they used them. They also told us about a new interest that they were pursuing. The home recognises the importance of maintaining strong family links and people told us that the home always helped them keep in touch and that they were always kept up to date. People living at the home confirmed this and also told us that if they wished to go out in the evening they could. Staff also confirmed this. During the inspection, we saw that people chose where to spend their time in the home and that people had their own routines spending time together or alone. People voiced their preferences or made these known by their body language. One person had a visitor and they were welcomed and ensured privacy. We spoke about how decisions were made regarding the type of meals at the home and we were told how individuals influence the menu, who told us about their likes and dislikes and how these were catered for. We saw how the menus were displayed, how people ate at different times and were prompted to carry out daily living tasks themselves. 73 The Marles DS0000071088.V359037.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): We looked at standards 18,19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are supported in way they prefer and their health needs are well met, with medication well managed. EVIDENCE: We asked in our survey if people felt that staff listened to them. Two people said this always happened, and a third did not complete the questions on this page of the survey. People told us during the inspection that this was the case. A visitor said that staff had changed their approach after listening to an individual’s request to do so. A visiting professional told us that people’s privacy and dignity was always respected. They told us that the home provides individualised personal care in a respectful manner. In the home’s AQAA, the manager highlights how the home actively encourages people to make their own health appointments and that they aim to increase people’s awareness around health issues including physical health checks. The manager told us that people living at the home had significant involvement with health and social care professionals. A visiting professional told us that the service sought advice and acted upon it to improve people’s 73 The Marles DS0000071088.V359037.R01.S.doc Version 5.2 Page 14 health needs. They said that people’s health needs were always met. People told us that they were able to see a GP if they wanted to. The manager told us that the home had good relationships with health professionals and gave examples of when they would be involved. Two GPs told us that that the care home always seeks advice and acts upon it to manage and improve individuals’ health care needs and that people’s health care needs are generally met by the service. One person commented that the home ‘seems to look after client well and good communication and continuity of care’. We were told that the home does not have controlled drugs on the premises. We advised the manager that should this change, there needs to be appropriate storage facilities as described in guidance on our website. We looked at medication records, the use of homely remedies, and how medication is stored in the home, and saw that these were well managed. The manager described how staff medication practice has been updated, and how she checks that agency staff are suitably qualified. 73 The Marles DS0000071088.V359037.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): We looked at standards 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at the home feel protected, although a minor improvement to the home’s complaints and safeguarding policies will ensure that up to date information is available to them. EVIDENCE: CSCI has not received any complaints since the last inspection. The manager also told us in the home’s AQAA that there have been no complaints or concerns raised since the last inspection but that there is a system in place to ensure that they would be recorded appropriately and the action taken. Two people who live at the home told us they know who to speak to if they are not happy. One person felt they always knew how to make a complaint and one person said they sometimes knew. For a third person, a staff member told us that they interpret body language to gauge their mood and to respond accordingly i.e. offer reassurance when the person becomes anxious. This was seen on the day of the inspection, and the manager also confirmed this approach. Visitors to the home told us they knew how to make a complaint and that the service had always responded appropriately if they had raised concerns about care. One person commented that the home always talked through any problems with their relative. However, the home’s complaints leaflet has out of date information on it regarding contact numbers for CSCI, as does the organisation’s safeguarding policy. 73 The Marles DS0000071088.V359037.R01.S.doc Version 5.2 Page 16 A staff member was clear about their responsibility to report safeguarding issues, where to look for guidance and told us that they had received recent training. The manager confirmed that this information was accessible to staff, including agency staff. We spot-checked how the home supports people with their finances, and we could see that records were clear, could be audited, and that individual finances were correct. 73 The Marles DS0000071088.V359037.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): We looked at standards 24 and 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People benefit from a clean and homely environment, although further maintenance work is needed to help improve the home’s appearance. EVIDENCE: In the home’s AQAA, the manager said that they aimed to provide a homely environment, which is clean and safe. A staff member explained how people were supported to clean their own rooms, as well as communal areas, through prompts and guidance. The people living at the home told us in their surveys that the home was always clean and expressed satisfaction with their surroundings. When we visited the home was clean but the bathroom had a large patch of mould on the external wall. There was also mould on the wall tiles. The manager explained that steps had been taken by the previous provider to 73 The Marles DS0000071088.V359037.R01.S.doc Version 5.2 Page 18 address this issue but that they had been unsuccessful. She told us that a regular routine of cleaning is maintained but that the bathroom is damp. We also saw that the front door has mould on it, as has the dining room window and sliding door. The manager told us that she had made a request in January 2008 for new double-glazing to be fitted to help combat this problem. In the last twelve months, the manager told us that communal areas have been redecorated and that one bedroom has been refurbished, which people living at the home confirmed. The kitchen has been refurbished recently, although further work is needed to complete this, including re-papering an archway in the kitchen/diner. On the day of the inspection, we saw that the dining room carpet was marked in places and were told that it was ten years old. The wardrobe door in one person’s bedroom was in need of repair and the thread in one bedroom carpet was thin in places. Maintenance records are kept. 73 The Marles DS0000071088.V359037.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): We looked standards 32,33,34 and 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People benefit from a competent and appropriately recruited staff team but recent staff changes have the potential to negatively impact on people’s chosen routines. EVIDENCE: Currently the home is working towards ensuring that appropriate numbers of staff are trained to NVQ level. This was identified as an area for the home to improve on in the last inspection. A member of staff told us that there were plans for them to begin this form of training. Two people living at the home told us that staff always treated them well, and a third person did not complete the questions on this page of the survey. A visitor to the home said that new staff sometimes lacked experience but are appropriate people to be recruited and are supported by the manager and long serving members of staff. A member of staff said they felt well supported. A staff member told us that there was sometimes enough staff to meet the needs of the people living at the home. In the home’s AQAA, the manager told us that the home was always staffed to its required levels. When we inspected, 73 The Marles DS0000071088.V359037.R01.S.doc Version 5.2 Page 20 we were told that a permanent member of staff had recently left and so agency staff were being used until new members of staff had been recruited. The staff rota confirmed this, although people who live at the home told us that they knew the people working each shift. We saw from records that on one occasion, and on the day of the inspection that staffing levels impacted negatively on people being able to access community resources on an individual basis. When we looked at the staff rota we saw that in one week there were seven different agency staff on duty. The manager told us that she aimed for consistency amongst the agency staff and explained that in the last twelve months there had been a more stable staff team. Another staff member said that regular agency staff now worked at the home. They both recognised that a consistent approach from regular staff was important for the people living at the home. A visitor felt that the home could be improved ‘by a modest increase in permanent staff’ rather than using agency staff. Staff told us that higher wages might attract more permanent staff with the appropriate commitment. They told us that the current staff team were very dedicated. The manager identified in the home’s AQAA that the home has a good recruitment process and training. A staff member confirmed in their survey that their employer had carried out checks, such as references, before they started working at the home. We were told that since the last inspection, only one person has been recruited. We checked this file and saw that appropriate checks and references were in place, although gaps in the person’s employment history need to be explained and recorded, which the manager said they would address in the future. A staff member told us that their induction was good and covered everything they needed to know. They said that their training was relevant and gave us examples of course they had undertaken, which helped them understand the individual needs of people living at the home such as faith and age, and kept them up to date with new ways of working. They told us that they usually had the right support and the knowledge to meet people’s differing needs. The manager said that training was staggered once people’s commitment had been established. Visitors to the home told us that care staff either usually or always had the right skills and experience to look after people properly. 73 The Marles DS0000071088.V359037.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): We looked at standards 37,39 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People benefit from a well run home which takes into account their views and wishes. However, a minor improvement will help make the environment a safer place. EVIDENCE: The manager is a trained nurse in learning disabilities and has many years of experience working with and managing homes for people with a learning disability. The manager has not yet started the registered manager’s course but the home is well run with staff who value the people living there. A staff member told us that they met regularly with their manager, and said that ‘this is a very happy, well-run home and we all work well together’. This was confirmed during the inspection, when we told by staff that they felt well supported and benefited from regular supervision. 73 The Marles DS0000071088.V359037.R01.S.doc Version 5.2 Page 22 The manager monitors the quality of care through care plan reviews, listening to people’s views at meetings, which take place throughout the year, and general day to day conversations. Staff training and regular supervision ensures the quality of care is delivered in the best interest of people living at the home. The manager told us how she kept people living at the home and their relatives up to date with proposed changes to the service. The manager told us in the home’s AQAA that all staff had training in safe food handling, infection control, which a staff member confirmed, and told us that written assessments on hazardous substances were in place. We saw that safety checks are maintained, such as the central heating being serviced, portable electrical appliances being checked and legionella safety checks taking place. While window restrictors are in place to help ensure people’s safety, current risk assessments for uncovered radiators are inadequate. For example in one care plan, the risk assessment was ‘little awareness of safety regarding radiators’ and in another care plan there was no reference to a medical condition which may increase the risk of being burnt by uncovered radiators, this needs to be addressed. 73 The Marles DS0000071088.V359037.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 3 ENVIRONMENT Standard No Score 24 2 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 2 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 2 x 3 x x 2 x 73 The Marles DS0000071088.V359037.R01.S.doc Version 5.2 Page 24 No. 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 YA24 Regulation 23 (2) (b) Requirement Timescale for action 06/06/08 2. YA42 13 (4) (c) The home must be kept in a good state of internal repair. (The problem of mould in the bathroom must be resolved. Repairs and refurbishment must be undertaken to furniture, décor and carpets). Unnecessary risks to the safety 06/04/08 of people living at the home must be eliminated wherever possible. (Individual risk assessments must be in place for uncovered radiators). RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard YA22 YA32 YA33 Good Practice Recommendations The home’s complaints and safeguarding policies should have up to date contact numbers for CSCI At least 50 of care staff should obtain qualifications in a NVQ 2 in care. Staffing levels should be monitored to ensure people living DS0000071088.V359037.R01.S.doc Version 5.2 Page 25 73 The Marles 4. 4. YA37 YA42 at the home are able to take part in their preferred activities/routines. The manager should obtain a suitable qualification in management. If risk assessments indicate a medium to high risk, radiators should be covered to help reduce the risk of burning. 73 The Marles DS0000071088.V359037.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Colston 33 33 Colston Avenue Bristol BS1 4UA National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 73 The Marles DS0000071088.V359037.R01.S.doc Version 5.2 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. 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!