CARE HOME ADULTS 18-65
Adam House 21 Ormerod Road Burnley Lancashire BB11 2RU Lead Inspector
Mr Jeff Pearson Unannounced Inspection 09:45a 31 August 2005
st Adam House DS0000009527.V255790.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 Adam House DS0000009527.V255790.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. Adam House DS0000009527.V255790.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Adam House Address 21 Ormerod Road Burnley Lancashire BB11 2RU 01282 830215 01282 414506 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) Mrs Bridget Mary Healy Care Home 6 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (6) of places Adam House DS0000009527.V255790.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 21st February 2005 Brief Description of the Service: Adam House is part of Healy Care Dispersed Home Scheme which in Burnley consists of three terraced properties. The properties are situated upon the same road, in what is mainly a residential area. Each house is staffed separately, but there is some inter-working across the scheme. Adam House is registered to accommodate 6 adults under the age of 65 with a mental illness (excluding learning disability and dementia) The home is to the town centre with its shops, pubs, churches etc. The accommodation available is homely and domestic in style, there is a lounge, dining kitchen and smoking area. There are two shared and two single bedrooms. Staff are on duty to provided support 24 hours per day. Transport is available to enable service users to visit relatives, take short trips and outings within the community. Adam House DS0000009527.V255790.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took 13 hours over 2 days. There were 4 service users accommodated in the home. During the inspection 3 service users, the house manager and staff were spoken with. The files of 2 service users were examined as part of ‘case tracking’, this being a method of focusing upon a representative group of service users. Various records were looked at, including the records of the two most recently employed staff. A tour of the home was carried out; service users’ bedrooms were viewed with their permission. What the service does well:
The atmosphere in Adam House was relaxed, supportive and friendly, relationships amongst every one seemed generally good. “It’s a good service” one service users said. People living in the home were being supported to make decisions and choices within their lives, as individuals and as a group. House meetings were held on a regular basis so people could voice their opinions and make suggestions. Individual Plans drawn up with each person, made sure staff were aware of their needs and knew how to support them. Everyone was being given some opportunity to get out into the local community and join in different activities. People were being encouraged to be as independent as possible. Contact with relatives and friends was good, people said they were keeping in touch with their families. One service user explained “I go over to see my friend most weeks and speak to my mother on the phone a lot” People were getting support with medical needs, such as seeing the Doctor or attending hospital appointments, their mental ill heath was being kept an eye on. Every one was happy with the meals provided and people were involved with choosing menus and cooking. “We have some good food, we all take a turn at cooking” commented one service user. Staff training was ongoing. The staff on duty were enthusiastic about their work, they treated people living in the home sensitively and with respect. The manager was keen to provide people living in the home with a good service and showed a lot of commitment to her job.
Adam House DS0000009527.V255790.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? What they could do better:
The guide to the home needed to be improved, so people are clear what services and accommodation is available. Peoples’ assessment details needed to be available, to show they have been assessed and their needs can be met at the home. To protect peoples’ rights, the contracts of residence should be further developed to specify more clearly in what situations they may be asked to leave. They should also spell out what happens when people don’t keep the house rules. If peoples’ choices are to be controlled, this should be agreed with them in their individual Plans. People living in the home should know about their responsibilities in keeping the rules, staff and residents should be clear about what should happen if rules are broken. More attention must be given to people taking risks and how staff should respond to these situations. When people make requests in meetings, these should be followed up as soon as possible. If they cant be, the reasons why should be explained so everyone knows where they stand. If people raise repeated issues, these should be treated as formal complaints make sure they are dealt with properly. More staff were needed to work at the home, to make sure there are enough
Adam House DS0000009527.V255790.R01.S.doc Version 5.0 Page 7 workers to provide the support needed and let the manager to get on with her own job. To make sure peoples’ medication is managed as safely as possible, some staff needed further training and medication guidelines needed updating to provide clear up to date instructions. Guidelines for protecting people from abuse needed changing, to make sure managers and staff do the right things. Work was still needed to improve areas of the home. Some bedrooms needed more things, unless people agreed they didn’t want or need them. One bedroom needed a few things putting right. Better locks should be fit on bedroom doors, so people have more choice about using them. To protect people, proper checks needed to be carried out before letting staff start work in the home. Records proving these checks had been done needed to be available. Staff training needed to continue in first aid, health and safety, food hygiene, mental ill health and NVQ training (National Vocational Qualifications) People living in Adam House, their relatives and others must be formally asked if things are OK, to make sure the home is being run in their best interests. A manager needed to register with the Commission, to take legal responsibility for the day-to-day running of the home. To make sure everything in Adam House is as safe as possible, all areas and routines must be carefully considered to reduce the risk of harm to people living there, staff and visitors. 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. Adam House DS0000009527.V255790.R01.S.doc Version 5.0 Page 8 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 Adam House DS0000009527.V255790.R01.S.doc Version 5.0 Page 9 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 5, The homes service user guide was inadequate; it did not provide accurate and sufficient information to enable current and prospective service users to be clear about the services and facilities provided. Not all service users initial assessment details were available, therefore, it was not clear if their needs had been fully assessed or that they could be met at the home. Progress had been made with developing individual contracts/terms and conditions, but further details were needed clarifying terms of occupancy and safeguarding rights. EVIDENCE: The statement of purpose, service user guide and last inspection report were available in the home. The service user guide did not include enough specific details, about the services and facilities available at Adam House and was not in a ‘user friendly’ format. One of the service users’ files did not included their Social Services assessment details, the house manager said that this information was with the registered provider. There was no evidence to indicate, that new service users had been informed in writing that the home could meet their needs. Adam House DS0000009527.V255790.R01.S.doc Version 5.0 Page 10 Service users had been provided with revised contracts, these included much more appropriate information and good practice matters as specified in The National Minimum Standards for Younger Adults. The contracts did not include in what circumstances a service users may be asked to leave the home, or the consequences of not abiding by the homes’ rules, such as smoking in bedrooms. Adam House DS0000009527.V255790.R01.S.doc Version 5.0 Page 11 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9, Service users support needs and goals were reflected in their individual Plans, but the Plans did not include the restrictions on choice, as specified and agreed in the homes’ terms and conditions of residence. Systems were in place to enable service users to make decisions and choices, as individuals and as a group. Service users were being offered opportunity to participate in life in the home, but their requests and suggestions were not always being responded to, which had caused some frustration. Assessing responsible risk taking needed further attention, to ensure a reasonable balance is achieved between independence, choice, rights and personal safety. EVIDENCE: Service users individual Plans were examined as part of case tracking, they were well written and included details of each persons support needs and activity programme, based upon their assessment. Service users were aware
Adam House DS0000009527.V255790.R01.S.doc Version 5.0 Page 12 of their Plans, some had signed in agreement with their content. Service users were being enabled to add their own comments to their Plans. Reviews had been carried out with Plans being up dated as needed. Restrictions on choice, such as smoking in bedrooms, had not been identified and agreed in service user Plans. The Plans included some risk assessments and risk management strategies. Care notes included comments about service users making their own decisions. Service users said house meetings were being held regularly, and that they felt involved with day-to-day matters in their home. Records were seen of house meetings, one request had taken three months to be resolved. Service users were seen to make decisions and choices about aspects of daily living. Some risk assessments had been completed, others needed updating or defining in response to individual circumstances. Risk assessments had not been completed on service users having access to hot water in their rooms. The risk assessment tool in use did not show all aspects of risk had been fully considered. Adam House DS0000009527.V255790.R01.S.doc Version 5.0 Page 13 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): 12, 13, 15,16,17 Service users were being offered opportunities to engage in a range of activities and were supported to use community facilities. Insufficient staffing arrangements had resulted in support for service users activities/community access and one-to-one support, being limited. Arrangements were in place to enable service users to maintain links with families and friends. Independence living skills and autonomy were being encouraged, but agreed rules were not being kept or enforced, which had resulted in a lack of clarity of boundaries and responsibilities. The meals supplied were sufficient in providing for the residents tastes, preferences and diet. EVIDENCE: During the inspection the service users accessed the local community. Individual activity plans were seen indicating proposed activities.
Adam House DS0000009527.V255790.R01.S.doc Version 5.0 Page 14 Service users spoke of the various activities, both in and out of the home, including pubs, shops, church, sports centres, cooking and baking. One service user attended an interview at a nearby college and explained that he was hoping to join a fitness club. Service users explained they were keeping in touch with members of their families and friends, by telephone, visits, or short breaks away. Discussion with service users and staff, along with observation of care practices, showed staffing levels did not provide sufficient support for the service users. Only the house manager was able to drive the company mini bus. Independence living skills were being encouraged, service users kept their rooms tidy and did their own laundry, they had freedom of movement in the home. Rules stating service users must not smoke in their rooms, were displayed in the home, this rule was being ignored. Staff were unsure how to respond to this situation. Service users said they were generally happy with the variety and quality of the meals provided. They were being consulted about the weeks’ menu within house meetings and on a daily basis. The service users were taking turns to cook and different meals were being tried out. Mealtimes were flexible, but some preferred a set time. Service users were seen to make drinks and snacks for themselves. Adam House DS0000009527.V255790.R01.S.doc Version 5.0 Page 15 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20 Arrangements were in place to monitor the service users’ general health and wellbeing and to access appropriate health care services. Some progress had been made with medication management, but policies and practices for managing medication remained insufficient and potentially placed service users at risk. EVIDENCE: Service users spoken with confirmed they had received attention from health care professionals including GPs, Consultants and Dentists. Records showed general health was being monitored and support was being provided for appointments. Service users were receiving annual health care checks. Medication storage was secure and tidy. Service users consent to medication had been recorded. Risk assessments had been completed for service users self–medicating. Criteria on when to offer ‘when required’ medication had not been defined. The medication management policies had been updated but still did not included all necessary guidelines. Not all staff responsible for managing medication had received accredited training. Adam House DS0000009527.V255790.R01.S.doc Version 5.0 Page 16 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 The service users had access to a clear complaints procedure which included appropriate details. Not all issues raised had been effectively managed and responded to, causing some frustration for service users. Progress had been made in amending the protection of vulnerable adults policies and procedures to trigger a proper response to any suspicion or allegation of abuse. Inappropriate guidelines on obtaining consent might place service users at risk. EVIDENCE: The home’s complaints procedure was included in the service user guide. The procedure was written in a user a ‘user friendly’ and provided clear details of how to go about making a complaint, including timescales and the contact details for the Commission. Service users had an awareness of the procedure and knew how to raise concerns. The inspector was made aware of a specific issue raised by a service user, which had not been responded to as a complaint. The house meetings were providing the opportunity for open discussion, but records seen did not include notes of any follow up action, or explanations as to why requests could not be met. Adam House DS0000009527.V255790.R01.S.doc Version 5.0 Page 17 The protection/abuse policies and referral procedures were available; they had been updated to include contact details for the various agencies. A ‘whistle blowing’ policy had been made available to staff, records indicated they had read and understood all protection and abuse guidelines. The responding to incidents/allegations of abuse policy made reference to obtaining service users consent to proceed. Adam House DS0000009527.V255790.R01.S.doc Version 5.0 Page 18 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, 26, 27, 30 The living environment was generally satisfactory; some areas were in need of attention to provide a more comfortable, pleasant, living environment for service users. EVIDENCE: The home was in reasonable decorative order. Attention had been given to improving the outside of the building. One empty bedroom was due to be decorated. The furnishings and decor was domestic in style and provided a homely environment. Service users had brought with them items to personalise their bedrooms. The bathroom was of a good standard; a thermostat had been fitted to the shower and bath. The home was adequately clean. The laundry area was easily cleanable and contained appropriate washing equipment. There was no planned maintenance and renewal programme for the decoration or refurbishment of the home. Some of the furnishings in communal areas were looking worn. Identified repairs were not being followed up promptly. One window in a bedroom could not be opened, there was only one double electrical socket and the washbasin was in need of replacement. Bedroom door locks did not offer a choice of whether or not to use this facility.
Adam House DS0000009527.V255790.R01.S.doc Version 5.0 Page 19 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, Staff training and development was ongoing, this needed to continue to ensure all staff are appropriately trained. Staffing arrangements were insufficient in providing appropriate support for the service users. Changes within the staff team had caused some disruption for the service users. Staff recruitment practices suggested full attention was not being given to protecting the service users. EVIDENCE: Staff on duty interacted well with the service users, they appeared well motivated and were enthusiastic about their work. Service users spoken with expressed an appreciation of the staff team. Staff training was ongoing, 2 support workers had recently completed NVQ level 2 another had finished NVQ level 3. There were 3 part time and 1 full time support workers employed at the home. Staff rotas indicated that on several occasions the house manager had covered support workers shifts. There had been changes in the staff team since the last inspection, staff recruitment was ongoing. There were no senior support workers/deputy managers.
Adam House DS0000009527.V255790.R01.S.doc Version 5.0 Page 20 Service users said they had been more involved with the recruitment of staff. Staff spoken with confirmed they had been interviewed and that had been provided with a job description prior to this. The records of the two most recently recruited support staff were examined, written references were not available for one person and the POVA (protection of vulnerable adults) check was not available for the other. Adam House DS0000009527.V255790.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 Although the management and leadership approach was satisfactory, the house manager was unable fulfil her designated role. Some quality assurance processes were in place, but improvements were needed to show the home was being properly reviewed and developed. Some arrangements had been made to maintain health and safety; further safeguards were needed to promote the well being of residents and staff. EVIDENCE: The atmosphere in the home was found to be relaxed and welcoming. Positive interactions were observed between the service users, staff and manager. An application for registered manager had not been forwarded to the Commission. The house manager was enthusiastic and expressed commitment in providing
Adam House DS0000009527.V255790.R01.S.doc Version 5.0 Page 22 a good service for the people living at Adam House, but due to the lack of staff, senior/deputy support, was unable to effectively manage the home. The home had attained IIP (Investors In People) accreditation. Service users had been consulted about the quality of the service, but the results of the survey had not been collated or formally responded to. Other people, such as Social Workers, Consultants, relatives and staff had not been approached. There was no development plan available. Other than some service users were smoking in their bedrooms, the home was found to be free from any obvious hazards to health and safety. A safety monitoring checklist had been completed on the home, but proper risk assessments were yet to be carried out. The house manager and 3 support staff had undertaken First Aid and Food Hygiene training. Adam House DS0000009527.V255790.R01.S.doc Version 5.0 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 2 X X 2 Standard No 22 23 Score 2 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 3 2 2 X Standard No 24 25 26 27 28 29 30
STAFFING Score 2 X 2 3 X X 3 LIFESTYLES Standard No Score 11 X 12 3 13 2 14 X 15 3 16 2 17 Standard No 31 32 33 34 35 36 Score X 2 2 2 X X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Adam House Score X 3 2 X Standard No 37 38 39 40 41 42 43 Score 2 X 2 X X 2 X DS0000009527.V255790.R01.S.doc Version 5.0 Page 24 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 4,5,6 Requirement The statement of purpose and service user guide, must include clear factual information about the services and facilities provided. A copy of the revised service user guide must be given to each service user. Records of service users initial assessment must be kept available in the home. Prospective service users must be informed in writing, following assessment that the home can meet their needs. (Timescale of 21/2/05 not met) Risk assessments/management strategies must be completed, on service users engaging in activities which may affect their health or well being (Timescale of 31/3/05 not fully met) Staffing arrangements must be flexible and responsive to meet service users needs. All staff responsible for dealing with medication must receive accredited medicines management training. Medication management policies and procedures must be in
DS0000009527.V255790.R01.S.doc Timescale for action 02/12/05 2 YA2 14,17 31/10/05 3 YA9 13 31/10/05 4 5 YA13 YA20 16,18 13 31/10/05 31/12/05 6 YA20 13,17 31/12/05 Adam House Version 5.0 Page 25 7 YA26 12,16,23 8 YA26 12,16,23 9 YA33 18 10 YA34 17,19 11 YA37 8 12 YA39 24 13 YA42 13 accordance with current recgnised guidelines and legislation. All Service users bedrooms must include the minimum furnishings as outlined in standard 26, of the National Minimum Standards, unless otherwise agreed. (Timescale of 29/10/04 not met) In the ground floor bedroom additional electric sockets must be provided. Both windows must be made to open. The washbasin must be replaced and additional lighting supplied. Sufficient numbers of staff who are trained and competent to meet the needs of the service users, must be availble to work in the home at all times. Staff must not work in the home untill satisfactory written references have been obtained and a POVA clearance check has been conpleted. These records must be readilly available for inspection. A completed application form in respect of a registered manager, must be forwarded to the Commission. (Timescale of 31/3/05 not met) A formal system for reviewing and improving, the quality of care provided at the home must be implemented. Risk assessements for safe working practices must be completed. 31/12/05 30/11/05 31/10/05 16/09/05 30/11/05 31/12/05 31/10/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. Adam House DS0000009527.V255790.R01.S.doc Version 5.0 Page 26 No. 1 Refer to Standard YA5 Good Practice Recommendations Contracts/terms and conditions of residence should provide a clear indication of in what circumstances a service users may be asked to terminate the placement. Contracts/terms and conditions of residence should make clear reference to the outcome to service users who do not abide by the homes’ rules. Any limitations on choices should be agreed with service users and incorporated in their individual Plans. Service users should be clear of their role and responsibility in keeping the homes rules; all staff should know how to respond to situations where service users do not abide by the rules. Matters raised during house meetings should be responded to as soon as possible. Records of meetings should indicate expected timescales and clarify reasons for not acting upon requests/matters raised. Should service users continue to raise specific issues about particular aspects of their care and lifestyle, these should be responded to as part of the complaints procedure. The protection of vulnerable adults policy should be amended regarding the service users consent issue. (Not addressed from last inspection) Plans should be made and put into practice, to improve the areas of the home in need of redecoration (Not fully addressed from last inspection) Service users’ bedrooms should be fitted with more suitable locks, which are operated as a suite, with master keys being available as appropriate. Staff training and development in National Vocational Qualifications and the subjects specified in the National Minimum Standards for Younger Adults, should continue to be provided. 2 3 YA6 YA16 4 YA22 5 6 7 8 YA23 YA24 YA26 YA32 Adam House DS0000009527.V255790.R01.S.doc Version 5.0 Page 27 Commission for Social Care Inspection East Lancashire Area Office 1st Floor, Unit 4 Petre Road Clayton Business Park Accrington BB5 5JB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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