Inspection on 04/06/08 for 76-78 Hampstead Road

This inspection was carried out on 4th June 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 15 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

76-78 Hampstead Road 26/11/08

76-78 Hampstead Road 05/06/07

76-78 Hampstead Road 06/07/06

76-78 Hampstead Road 15/11/05

76-78 Hampstead Road 13/07/05

76-78 Hampstead Road 13/01/05

76-78 Hampstead Road 18/06/04

Similar services:

2 Perhaver Park

The Vicarage

7 Hyde Road

St George`s

5 Seafield Road

Credence House

Radfords

Trevaylor Manor

Extracts from inspection reports are licensed from CQC, this page was updated on 27/09/2008.

CARE HOME ADULTS 18-65 76-78 Hampstead Road 76-78 Hampstead Road Brislington Bristol BS4 3HN Lead Inspector Sandra Jones Unannounced Inspection 4 & 5th June 2008 09:30 th 76-78 Hampstead Road DS0000026628.V366305.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 76-78 Hampstead Road DS0000026628.V366305.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. 76-78 Hampstead Road DS0000026628.V366305.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 76-78 Hampstead Road Address 76-78 Hampstead Road Brislington Bristol BS4 3HN 0117 9728513 0117 9699000 judi.lorentz@brandontrust.org www.brandontrust.org The Brandon Trust 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) Ms Judi Lorentz Care Home 12 Category(ies) of Learning disability (12), Physical disability (12) registration, with number of places 76-78 Hampstead Road DS0000026628.V366305.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 providing personal care only- Code PC to service users of either gender whose primary care needs on admission to the home are within the following categories: Learning disability- Code LD 2. Physical disability- Code PD The maximum number of service users who can be accommodated is 12. 5th June 2007 Date of last inspection Brief Description of the Service: The Brandon Trust operates 76/78 Hampstead Road and their philosophy is supporting and enabling people to live the lives they choose. The care home is registered to provide accommodation and personal care to twelve younger adults with learning and/or physical disabilities. The property was purpose built to accommodate people with physical impairments. As the property is purpose built to accommodate people with physical impairments, there is level access and wide corridors. It blends well with its local residential environment and close to shops, park and bus routes. There are three staff rostered in each house throughout the day, with ancillary staff to maintain the home clean. At night there are two staff awake and one sleeping-in. 76-78 Hampstead Road DS0000026628.V366305.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 0 star. This means the people who use this service experience poor quality outcomes. This key inspection was conducted unannounced in over two days in June 2008 and focused on the assessment of key standards. The main purpose of the visit was to check on the welfare of the people who use the service, ensure the premises are well maintained and to examine health and safety procedures. During the site visit, the records were examined and feedback was sought from individuals and staff. Prior to the visit some time was spent examining documentation accumulated since the previous inspection and this information was used to plan the inspection visit. The Annual Quality Assurance Assessment (AQAA) was sent to the home and the manager failed to return the AQAA within the timescale given. “Have your say” surveys were sent to people who use the service, their relatives, staff and health care professionals. Surveys were not returned to the Commission. There are twelve individuals currently living at the home and four people were case tracked. Case tracking is the method used to assess whether people who use services receive good quality care that meets their individual needs. The inspection included looking at records such as care plans and reviews of the care of people using the service and other related documents. The home’s policies and procedures were also used to confirm the findings. The views of the people living at the home and staff were gathered through face-to-face discussions. What the service does well: What has improved since the last inspection? There are no improvements since the last inspection 76-78 Hampstead Road DS0000026628.V366305.R01.S.doc Version 5.2 Page 6 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. 76-78 Hampstead Road DS0000026628.V366305.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 76-78 Hampstead Road DS0000026628.V366305.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): (2) Quality in this outcome area is (poor) This judgement has been made using available evidence including a visit to this service. The home fails to admit individuals whose needs can be met by the skills of the staff. Individuals must be reassured that the home will have the skills and resources to meet their assessed needs. EVIDENCE: The registered manager last reviewed the home’s Statement of Purpose on 29/08/07. The Admission criteria and procedure clearly states that for any new admission, the manager will demonstrate how the home can meet the assessed needs, introductory visits will be arranged and a written costed contract will be developed and agreed. One person was admitted to the home since the last inspection and the case records were examined to determine the pre-admission assessments conducted. From the documentation in place it is evident that the home does not follow its own procedures. Assessments that show the individual is suitably placed were not available and documentation demonstrates that staff are not clear about meeting the needs identified. An Immediate Requirement was issued for the home to provide evidence that the individual’s needs can be met by the skills of the staff. 76-78 Hampstead Road DS0000026628.V366305.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): (6), (7), & (9) Quality in this outcome area is (poor) This judgement has been made using available evidence including a visit to this service. The care planning system in place is not effective and the home fails to provide an individualised and consistent service. The home fails to support people living at the home to make decisions about all aspects of their care EVIDENCE: Individual case records contain daily routine plans that guide the staff on meeting the person’s personal care. Support plans in place for meeting the individuals assessed need supplement the daily routines. For example, there are support plans for communication, mobility and health care needs. It is evident from the case records examined that the majority of the care plans have not been reviewed in over a year. The senior member of staff said that previously there was a keyworker system in operation. It was the responsibility of the senior staff for updating care 76-78 Hampstead Road DS0000026628.V366305.R01.S.doc Version 5.2 Page 10 plans and organising six monthly reviews and Keyworkers would then monitor the care plans monthly. Support workers named the people they had keyworker responsibility for and said the role included purchasing clothing, toiletries and organising holidays. Personal care plans describe the means used by the person to make decisions. There is little recorded evidence to support that people living at the home make choices and the “best interest” decisions made by members of staff. For example, an operation was cancelled for one person because a “best interest” meeting was not organised before the date of the operation. One member of staff said the people living at the home make decisions about where to sit and body language is used to determine the decisions made by the person. For example, refusal to eat. Overall, members of staff have attended the Mental Capacity Act training. However, practices within the home have not changed as a result of the training. Daily reports and communication books were examined to determine the progress of care plans and to assess the consistency of care provided at the home. Entries made by staff raised concern and show that members of staff are not always acting professionally. Risk assessments for activities that may involve an element of risk are not up to date and must be reviewed. 76-78 Hampstead Road DS0000026628.V366305.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): (12), (13), (15), (16) & (17) Quality in this outcome area is (poor) This judgement has been made using available evidence including a visit to this service. The support systems in place for people to lead active and interesting lifestyles and to be valued members of the community are poor. People at the home have a poor diet. EVIDENCE: Supporting individuals with leisure activities form part of their personal care plans and activities to be arranged include trips to cafes, shops, monthly outings, 1:1’s snoozelem sessions. Attending church services and swimming is included in the package of activities on offer at the home. It is evident from the daily reports that activities are not taking place. The staff at the home made the following comments about the lack of activities. “ Activities are not taking place, because staff are not motivated and we are short staffed and levels of need for some people have increased,” “Activities have dwindled to a 76-78 Hampstead Road DS0000026628.V366305.R01.S.doc Version 5.2 Page 12 quick snoozelem session,” “ We organise trips and ask the manager to change the rota to accommodate the outing, but the rotas were never changed,” “There is one person here that should go out monthly but has only left the home twice since their admission in March” and “Three people are not allowed to go out together not even to a carol service.” The home recognises the importance of supporting people to maintain links and relationships with family. For this reason there is open visiting and visits can take place in bedrooms for additional privacy. Comments made by members of staff indicate that visitors are made welcome and the visitor’s book supports that families visit the home. The Privacy and Dignity policy endorses a commitment to respecting people as individuals and, this is not currently included within the Statement of Purpose. The organisation’s values are listed within the Statement of Purpose and confirm that the Trust listens and respects the person. Also the rights of the people accommodated at the home are included within the agreements for living at the home and copies of the agreements are kept in personal files. People at the home have single bedrooms and the interaction observed between staff and individuals was respectful and friendly. Members of staff were observed explaining to individuals the tasks that they were about to undertake. One member of staff said that she took responsibility for devising the menus, which are based on healthy eating. However, staff were critical about the food budget. The staff made the following comments about the food. “ Halfway through the week there is nothing left,” “the budget is £260.00 per week and from that we also buy cleaning materials, we scrape around for what to have, we do make sure that we can fill people up with something else”. “ There is just not enough to eat” Food stores were checked during the inspection and minimal food stores were found. A further visit was conducted to check that the home has adequate quantities of food for people at the home to have a food in sufficient quantities. 76-78 Hampstead Road DS0000026628.V366305.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): (18), (19) & (20) Quality in this outcome area is (poor) This judgement has been made using available evidence including a visit to this service. Individuals can expect sensitive and prompt support for their personal care. The home fails to meet individual’s health care needs and medication systems are not safe. EVIDENCE: Routines for daily living specify the individual’s preferences for meeting their personal care needs. The preferred times for tasks to be completed by the staff must be included to develop a person centred approach to meeting needs. For example, the times for personal care to take place and the preferred times to rise or retire. Daily reports completed by the staff show that people rise and retire at different times, which indicates that individuals make some choices. Documentation held in files confirms that people at the home access Occupational therapists and physiotherapists through the Community Learning 76-78 Hampstead Road DS0000026628.V366305.R01.S.doc Version 5.2 Page 14 Disabilities team (CLDT). Specialist input through GP’s and NHS facilities for dental, optician and chiropody care is accessed for people at the home. Records show that people at the home attend hospital appointments and regularly visit the dentist, chiropodist and optician. Within case records Maintaining Healthy Lifestyles and addressing health issues is identified as a need for people living at the home. There is an expectation that members of staff complete medical reports for health care visits, this includes the reason for the request and outcome of the visits. However, daily reports show that members of staff are not always following requests to arrange for GP’s visits. For example, a member of staff requested for a GP’s visit to be arranged because an individuals toe nail had fallen off and questioned whether this was the reason for this individual making distressed vocal sounds and falling. However, a GP’s visit was not arranged. Risk assessments for Moving and Handling are in place for individuals with mobility needs. Pictorial risk assessments are used for a number of individuals to guide the staff on using correct lifting techniques. Generally, moving and handling risk assessments are up to date, members of staff assess the risk and where possible use equipment and aids to reduce the level of risk. Medication profiles in place include the best way to administer medication, its purpose and compatibility with homely remedies. The home sought agreement from the psychiatrist to administer medication in conjunction with food. Documentation in place also shows that people are prescribed, “ When required” sedatives to be administered before health care appointments. However, these “best interest” decisions are not recorded. The home must record why this medication is being administered. Medication is administered through a monitored dosage system and the records of medication administered were checked against the medication held. It is evident from the gaps in the recording that staff do not use the correct codes when medications are not administered or sign the records immediately after medication has been administered. A record of medications no longer required is maintained which is signed by the pharmacist to indicate receipt of the medication for disposal. Two people are prescribed Buccal Midazolam and the staff do not follow the protocols for the safe administration of these medications. An Immediate Requirement was issued for the staff to determine the correct protocol and follow its instructions. 76-78 Hampstead Road DS0000026628.V366305.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): (22) & (23) Quality in this outcome area is (poor) This judgement has been made using available evidence including a visit to this service. Individuals can expect family and staff to raise concerns on their behalf. Individuals must be protected from abuse. EVIDENCE: The Trusts’ Complaints procedure is symbolised with words and pictures to ensure that individuals can understand it. One complaint was received at the home about members of staff that accompany individuals on trips. The complaint was logged and appropriate action was taken to prevent a reoccurrence of the incident. The Safeguarding Adults and Whistleblowing policy endorse a commitment to safeguarding adults from abuse. The Safeguarding Adults policy lists the factors of abuse and the actions to be taken and follow “No Secrets” guidance. The Whistleblowing policy confirms that it’s the staff’s duty to report poor practice. Three members of staff were consulted about Safeguarding Adults training and they stated that they had not attended the training. A Safeguarding Adults referral was made to the lead agency about practices at the home, which may be perceived as institutional abuse. A strategy meeting will be held to discuss the findings, introduce measures and change practices to protect individuals from abuse. 76-78 Hampstead Road DS0000026628.V366305.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): (24) & (30) Quality in this outcome area is (adequate) This judgement has been made using available evidence including a visit to this service. Alterations continue to be made to provide a homely and comfortable environment for people that live at the home. EVIDENCE: Hampstead Road was purpose built to accommodate people with physical and sensory impairments that have learning disabilities. The accommodation is arranged into two separate dwellings, which is linked by shared space and an office upstairs. There are six single rooms, lounge and kitchen/dinner in each house. Other shared space consists of a laundry, Snoozelem and activity room. It is located close to shops, places of worship, amenities and bus routes. The home is clean and free from offensive smells. 76-78 Hampstead Road DS0000026628.V366305.R01.S.doc Version 5.2 Page 17 A tour of the premises was conducted during the site visit and it is evident that some action was taken to maintain a comfortable and homely environment for the people that live at the home. Since the last inspection the kitchen in house 1 was replaced, and the replacement kitchen in house 2 is outstanding. Showers, bathrooms and toilets are functional and equipment was updated in the smoozelem for the people at the home to use. In each house there is a bathroom, shower room and toilet with six bedrooms arranged into a circle. Bedrooms are single and lockable and members of staff ensure rooms are decorated to their perception of the individual. Bedrooms have furniture and fittings that reflect their lifestyle and needs. There is a lounge in each house and there is sufficient seating for the residents in the house to sit together. The laundry is away from the kitchens and shared by both houses. The walls are painted and there is vinyl flooring for easy cleaning. There are two small washing machines with specific programmes for sluicing and tumble dryers. 76-78 Hampstead Road DS0000026628.V366305.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): (34) & (35) Quality in this outcome area is (adequate) This judgement has been made using available evidence including a visit to this service. The recruitment process and skills of the staff could not be examined at this key inspection. EVIDENCE: The personnel files of the staff were not available at this key inspection. It was not possible to check that staff employed are suitable to work with vulnerable adults or have the skills and experience to meet the needs of the people at the home. 76-78 Hampstead Road DS0000026628.V366305.R01.S.doc Version 5.2 Page 19 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): (37), (39)& (42) Quality in this outcome area is (poor) This judgement has been made using available evidence including a visit to this service. The home fails to provide a safe environment and individuals must be re-assured that standards will be the subject of ongoing monitoring. EVIDENCE: The registered manager resigned with immediate effect on the 30/05/08. An Immediate Requirement was issued to the Trust because the Commission had not been informed of the arrangements for the day-to-day management of the home. Another manager within the Trust has been appointed to manage the care home. 76-78 Hampstead Road DS0000026628.V366305.R01.S.doc Version 5.2 Page 20 Members of staff were consulted about the consistency of care at the home. It was stated that senior support workers conduct regular individual supervision, undertake handovers when shift changes occur and convene staff meetings. Members of staff giving feedback made critical comments about the management and conduct of the home, which are included within the body of the report. The Annual Quality Assurance Assessment (AQAA) sent to the home was not returned to the Commission within the timescale given. Fire Risk Assessments were devised on 7/09/2006 and must be reviewed to ensure that measures in place prevent the outbreak of fire. Communication book and records show that fire checks are not conducted at the required intervals. Documentation that evidence that the home meets associated legislation were not available. 76-78 Hampstead Road DS0000026628.V366305.R01.S.doc Version 5.2 Page 21 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 X 2 1 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 3 23 1 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 X 33 X 34 2 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 1 1 X 2 X LIFESTYLES Standard No Score 11 X 12 1 13 1 14 X 15 3 16 1 17 1 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 1 1 X 1 X 2 X X 1 X 76-78 Hampstead Road DS0000026628.V366305.R01.S.doc Version 5.2 Page 22 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 Attend to repairs to the property (Partially Met) 2. YA1 6 The Statement of Purpose must be reviewed to specify the category of needs including the age range and the way their needs are to be met by the staff at the home. Previously Required 05/06/07 The staffing levels at night must be assessed to ensure members of staff can evacuate the home safely at night in the event of a fire (Not followed-up at this inspection) (Not Checked) Individuals at the home must participate in in-house and community based activities. Previously Required 05/06/07 5. YA16 12 (4) (a) The rights of the individuals at the home must be respected. DS0000026628.V366305.R01.S.doc Timescale for action 30/11/08 30/08/08 3. YA41 18 (1) (a) 30/08/08 4. YA12 16 (2) (m) 30/07/08 30/07/08 76-78 Hampstead Road Version 5.2 Page 23 Previously Required 05/06/07 6. YA17 16 (2) (i) Individuals at the home must have a varied and nutritious diet in sufficient quantities. Previously Required 05/06/07 The manager must ensure the records that evidence a robust recruitment process are up to date. Previously Required 05/06/07 8. YA1 14 (1) (d) The home must ensure that the needs people wishing to live at the home, is suitable to meet their needs. Care plans must be kept under review Records must be clear about “best interest” decisions made on behalf of the people at the home The people at the home must visit health care professionals for medical advice and support. 1. Correct medication protocols must be followed at the home 2. Members of staff must sign records immediately after administering medicines People at the home must be safeguarded from abuse Staff records must be made available for inspection. Risk assessments must be developed and fire checks must be conducted. DS0000026628.V366305.R01.S.doc 30/06/08 7. YA34 7,9,19 Sch.2 30/07/08 30/06/08 9. 10. YA6 YA7 14 (2) (a) 12 (1) (a) 30/08/08 30/07/08 11. 12. YA19 YA20 13 (1) (b) 13 (2) 30/06/08 30/06/08 13. 14. 16. YA23 YA34 YA42 13 (6) 17 (3) (2) (b) 13 (4) (c) 30/06/08 30/06/08 30/06/08 76-78 Hampstead Road Version 5.2 Page 24 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 76-78 Hampstead Road DS0000026628.V366305.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection South West 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 76-78 Hampstead Road DS0000026628.V366305.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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