Inspection on 14/09/05 for Dimensions 47-48 Chichester Court

This inspection was carried out on 14th September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Dimensions 47-48 Chichester Court 09/11/07

Dimensions 47-48 Chichester Court 28/10/06

Dimensions 47-48 Chichester Court 23/02/06

Dimensions 47-48 Chichester Court 01/02/05

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 47-48 Chichester Court 47-48 Chichester Court Stanmore Middlesex HA7 1DX Lead Inspector Clive Heidrich Unannounced Inspection 14th September 2005 07:30 47-48 Chichester Court DS0000062639.V249838.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 47-48 Chichester Court DS0000062639.V249838.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. 47-48 Chichester Court DS0000062639.V249838.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service 47-48 Chichester Court Address 47-48 Chichester Court Stanmore Middlesex HA7 1DX 020 8905 0442/031 020 8343 8876 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) PentaHact Miss Eugenia Delgado Palacios Care Home 8 Category(ies) of Learning disability (8) registration, with number of places 47-48 Chichester Court DS0000062639.V249838.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 1/2/05 Brief Description of the Service: 47 and 48 Chichester Court are two homes within a purpose-built complex previously managed by Hillstream Care but now by Pentahact following a merger during the late summer of 2004. The homes are specifically managed by one person, but otherwise function individually. The homes provide longterm care and accommodation for up to 8 adults with learning disabilities, 4 per home. There were no vacancies at the time of the inspection. The building is maintained by the Metropolitan Housing Association. All service users have their own bedroom. The bedrooms are spread across two floors. Each house has its own lounge and dining area as well as bathrooms on each floor. There is a garden to the rear of each house. The homes are fully wheelchair accessible downstairs. Access to the first floor is by stairs only. The homes are quite close to shops, leisure facilities and local transport. A minibus is shared with the other houses in the same complex. Unrestricted parking is available on the road leading to the house. 47-48 Chichester Court DS0000062639.V249838.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place across a cool day in September. It lasted until 2pm. The inspector met with seven service users during the visit, from which various amounts of feedback about the service was obtained. Most service users then went out to their various day services by 10am. Issues were also discussed with staff, some records were checked, care practices were observed, and most of the home’s environment was inspected. The manager was at the time on leave. One issue was left as an immediate requirement notice. Pentahact have dealt with the issue very effectively and promptly. The inspector thanks all at the home for their patience and helpfulness throughout the inspection. What the service does well: What has improved since the last inspection? There are now very informative individual service user risk assessments. These are generally backed with Person Centred Plans that overall prove good information about service users’ needs and how staff should work to address the needs. The support of service users with skills development work is now more evident and effective. Service users are also now very well supported to take part in appropriate and needs-led weekday activities including day centres, college and work. The home now has two established deputy managers. 47-48 Chichester Court DS0000062639.V249838.R01.S.doc Version 5.0 Page 6 There are good training standards from the organisation, including relevant courses in autism and Makaton, plus refresher training where needed. Maintenance issues from the previous inspection, including bedroom redecorating, were seen to have been addressed. Almost all other requirements from that inspection were also addressed. 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. 47-48 Chichester Court DS0000062639.V249838.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection 47-48 Chichester Court DS0000062639.V249838.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 4, and 5. The manager assesses the needs of prospective service users before inviting them to visit the home. Prospective service users can then make both brief visits and evening and/or weekend stays, to try out the home before deciding to move in. Service users receive a detailed contract when they move in. EVIDENCE: Two new people have moved into the home since the last inspection. There are now no vacancies. Service users and staff reported that the new service users had visited the home a few times prior to moving in, and that current service users were consulted about the move. Service users’ meeting minutes showed that the process of settling in is ongoing. Staff confirmed that the manager visited prospective service users and assessed their needs so as to decide whether this home could meet these needs. There were records of pre-admission information about the new service users within their files. Their files also contained the standard detailed Pentahact contracts. One was signed by the service user and the manager. The process should be completed for the other service user. 47-48 Chichester Court DS0000062639.V249838.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 Service users all have individual plans based on both their assessed needs and from goals agreed at their formal review meetings. These plans are supported by detailed risk assessments that provide clear guidance. Service users are supported to develop independent lifestyles and to make decisions about their lifestyles. EVIDENCE: Staff feedback and records showed that all service users have had formal review meetings (mostly PCP (Person-Centred Planning) meetings), across the last 6 months, or else that dates have been set for such meetings. Individual files had both individual plans and detailed risk assessments that, combined, provide good information about the support needs of each service user and how staff are expected to address these. The organisation’s behavioural support team had additionally provided recent guidelines for some service users in some key areas of need. Staff were generally able to answer the inspector’s questions about these guidelines appropriately. Service users were generally observed to make decisions about their lives. One service user chose not to attend their day service during the visit, which staff 47-48 Chichester Court DS0000062639.V249838.R01.S.doc Version 5.0 Page 10 respected. One service user explained their breakfast choices of that morning, whilst another confirmed that they chose the new paint colour of their bedroom. Staff also prompted service users to attend to their responsibilities, such as with tidying their rooms before going out, and provided appropriate support to service users to complete such tasks. Records also showed that some service users will stay up quite later if they so wish. Service users’ meeting minutes were available for viewing in both houses. They showed that these meetings are held monthly, either for individual houses or as a joint meeting, and that issues that directly effect service users are discussed. The views of some service users were quite apparent from these minutes. Monthly summaries for service users have restarted. Daily records now prompt for information within key areas of the service user’s life on each shift, which allows better capturing and evidencing of service users’ needs and developments by the staff team. 47-48 Chichester Court DS0000062639.V249838.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16, and 17. Good emphasis is placed on personal development of service users. They take part in appropriate weekday activities, have a community presence, and engage in appropriate leisure activities. Family relationships and friendships are strongly encouraged within the home. Service users’ rights and responsibilities are respected by staff. Healthy diets are promoted. EVIDENCE: Particular strengths under this section are for the supporting of key relationships of service users. Service users fedback that they are supported to keep in contact with family and friends by both visits and phone calls. Staff were observed to provide re-assurance to some service users that they would be able to contact family and friends later in the day, which generally reassured the service users. Service users in both homes were seen to answer the house phones, and staff coached them positively on how to handle this process. Records and staff feedback also provided evidence of family and friend contact, including for upholding of the friendships for the two new service users. 47-48 Chichester Court DS0000062639.V249838.R01.S.doc Version 5.0 Page 12 All service users have day centre placements. Arrangements have been made through the home to ensure that one particular service user is supported to attend despite some difficulties in getting there, and that another service user is re-introduced to a day service, which is positive work. A number of service users also have established days off from these services, for key staffsupported activities, to have family visits, for work placements, or for college attendance. There was improved evidence, through plans, observations, and records, of skills-development work in the homes. A particular focus was for household tasks. Some service users were also seen to be able to freely use the kitchen area to make drinks, and to come and go from their rooms. A number of service users have bedroom keys, and some are starting to use front door keys. The bedroom door lock has been changed for one person in support of their needs. The evidence suggests that service users are being supported to have more say, and to do more, within the home. Feedback from service users about the food was positive. There was sufficient food available in the home. Detailed records of the food eaten are kept, and samples of these were judged as sufficiently healthy. Service users choose meals with the support of specifically-designed photo-books of many meals. Feedback from staff explained that service users have mostly been on holiday this year with staff support. Venues for individual holidays include Blackpool and Berlin. Where service users have chosen not to have a holiday or whose behaviours away from the routines of the home present significant risks, daytrips have instead been organised and actioned. Guidelines for service users who can be challenging in the community showed good awareness of addressing individual needs. Daily records about community activities beyond day service attendance was generally reasonable, but in the case of house #48 did not always match activity plans. This is referred to further under the staffing levels standard (#33). 47-48 Chichester Court DS0000062639.V249838.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 and 20 Service users are appropriately supported to address personal care needs. A minor improvement was identified for the medication systems within the home. EVIDENCE: Observations, of staff prompting service users to address personal care needs, and of service users’ appearance, were generally very positive. One good example was of a staff member checking whether or not some moredependant service users needed coats before going out, as the weather was changeable. Medication standards were checked in house #47. A monitored-dosage blisterpack system is now in use. Staff stated that they have received training on this system from when it was first used in the home. The administration and recording systems were found to be appropriately followed. Some medication stock was old, and staff noted that it is no longer used for the specific service users whom it is prescribed for. A system must be set up to ensure that regular checks of the medication cupboard are made and that any medications that are no longer needed are returned to the supplying pharmacist. Appropriate records of this must be kept. This should help to minimise the risks of medication errors. 47-48 Chichester Court DS0000062639.V249838.R01.S.doc Version 5.0 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Service users’, and their representatives’, views are listened to and acted on. Service users are protected from all forms of abuse through the complaints process, staff training, and appropriate specialist support. EVIDENCE: The accident and incident records for house #47, and for individual service users in house #48, were checked through. There were occasional acts of aggression from one service user to another, but records and individual care plans showed that the issues are being appropriately addressed. In particular, the ongoing input and written guidance of the organisation’s behavioural support specialist was evident across both houses. Staff were able to explain about the needs of service users in this respect. Training records for house #48 showed that staff have undertaken a recent course in the protection of service users from abuse. Staff showed awareness of good practice in this area. There have been no complaints in house #47 in 2005, but seven since the last inspection for house #48. The majority were made by service users about the behaviour of other service users, and include details of the actions taken in response to the complaint. It is encouraging that actions are taken to address service users’ distress when they may not be able to formally label the issue as a complaint. 47-48 Chichester Court DS0000062639.V249838.R01.S.doc Version 5.0 Page 15 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, 28 and 30 Service users live in what is generally a homely and comfortable environment, both communally and in respect of their bedrooms. A number of minor maintenance issues must however be addressed throughout the homes. The home is kept clean and hygienic by service users and staff. EVIDENCE: The inspector was informed during the visit that the whole set of houses in the complex had been lacking hot water due to a faulty boiler since the previous day. Staff were seen to make continual efforts to acquire professional help to address this. The water was consequently available at hot temperatures just before the inspection finished. The tumble drier in house #47 was faulty at the time of the visit. Staff explained that the appropriate people had been notified to have it fixed, and that it was due to be fixed shortly. The downstairs hallway flooring was similarly torn and in need of replacement at the start of the visit, but was in the process of being replaced by professionals in that field by the end. The outside table and surrounding ground in house #47’s garden needed cleaning of rice at midday, from the birthday party of one service user of the 47-48 Chichester Court DS0000062639.V249838.R01.S.doc Version 5.0 Page 16 previous evening. The home was otherwise kept in a good state of cleanliness through the efforts of the care staff and service users (the home has no designated cleaner). Maintenance issues from the previous inspection, including bedroom redecorating, were seen to have been addressed. Service users all spoke positively about the home environment. The curtains in the lounge in house #48 had been recently pulled off of the wall fixings. This must be addressed, to uphold homely standards. The walls outside of a couple of service users’ bedrooms in house #48 were seen to each have a crack from floor to ceiling. Staff stated that this had been reported to the maintenance department. The issue must be addressed. The floor of one service user’s bedroom was seen to have a noticeable ingrained stain on it. Staff explained that the flooring in three service users’ bedrooms was about to be changed following consultation with them, which would address this issue. One service user’s bedroom chest of drawers completely lacked one drawer. Whilst staff explained that the service user caused this themselves, the drawer must nonetheless be replaced. It is recommended that a head-board be bought and used for the bed that one service user upstairs in house #47 uses. It is recommended that the ability of the fire door to be wedged against the carpet if fully pushed open, at the top of the stairs in house #47, be considered in terms of sufficient fire safety. 47-48 Chichester Court DS0000062639.V249838.R01.S.doc Version 5.0 Page 17 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 and 35. Service users are supported by a competent and effective staff team who receive good standards of training. There were however insufficient staffing levels for house #48 in terms of meeting the needs of service users. Following the issuing of an immediate requirement notice during the inspection, this issue has been addressed. EVIDENCE: Rosters since the start of September were analysed. There were a couple of occasions for house #47 where only one morning staff member was scheduled to work (2nd and 8th), levels at all times otherwise being of two staff members when service users are at home. The similar roster for house #48 found similar problems with the early morning shift (on the 5th, 6th, and 7th). Two care staff must be assigned to work each morning in each house so as to provide service users with sufficient support at that stage of the day. An immediate requirement notice was issued for house #48 in terms of its staffing levels. It required that a brief staffing review be written, to explore the needs of service users individually and as a group across a typical week, both in terms of the risks that their behaviours can present and in terms of the established activities that they should be supported with by staff according to their care plans. This followed feedback and records that suggested that most service users have can have high levels of support needs in terms of 47-48 Chichester Court DS0000062639.V249838.R01.S.doc Version 5.0 Page 18 challenging behaviour, and that community access for service users outside of day centre provision was not meeting identified care plan needs. A service manager consequently responded on behalf of the organisation with an analysis of the needs of house #48. This identified that for afternoons, evenings and weekends, a further staff member was needed. Rosters supplied showed that this extra staffing was immediately put in place. This represents a prompt, positive, and needs-led response from the organisation. There were a few staffing vacancies within the homes, principally in house #48. Staff noted that a new staff member had just started, and that others had been recruited but were awaiting employment check clearances. There was good evidence of recent autism, Person-Centred Planning, and Makaton training for all staff. This allows greater understanding and a better service to some of the service users. Checks of the training profiles of two permanent staff from house #48 confirmed that staff attend regular training courses in relevant areas, as organised through the organisation’s training department, and that refresher training in generally provided to established staff. Service users spoke positively about the staff in the home. Communication book entries show that staff work as a team to address issues and to ensure that they keep each other informed of developments. Staff showed commitment to meeting service users’ needs. 47-48 Chichester Court DS0000062639.V249838.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 38 and 42 Service users benefit from the experience of an established manager who leads the staff team competently and openly. Health and safety issues in the home are managed to the benefit of anyone involved in the home. EVIDENCE: Staff meeting minutes for July 2005 showed that the manager sets out the roles and responsibilities expected of staff, and that staff can discuss care practices both at a theoretical and individual level. Records of the fire checks by staff in the homes were seen to be up-to-date and suitable. Fire drills are also recorded about at suitable intervals. Professional checks for fire safety, including of the fire system and for gas appliances, were seen to be up-to-date. The fire safety risk assessment for house #47 was seen to have been reviewed and updated in 2005. 47-48 Chichester Court DS0000062639.V249838.R01.S.doc Version 5.0 Page 20 There are now clear internal records of the hot water from the sinks that are accessible to dependant service users. These records include remedial action where necessary. The homes received an external health and safety audit in June 2005. The report of this states that there are good overall standards in the homes. Health and safety issues within the homes are audited by weekly written checks. 47-48 Chichester Court DS0000062639.V249838.R01.S.doc Version 5.0 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 3 X 3 3 Standard No 22 23 Score 4 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 X 4 X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 X 2 3 3 X 3 LIFESTYLES Standard No Score 11 3 12 4 13 3 14 3 15 4 16 3 17 Standard No 31 32 33 34 35 36 Score X 3 2 X 3 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 47-48 Chichester Court Score 3 X 2 X Standard No 37 38 39 40 41 42 43 Score X 3 X X X 3 X DS0000062639.V249838.R01.S.doc Version 5.0 Page 22 Are there any outstanding requirements from the last inspection? Yes 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. Standard Regulation Requirement A system must be set up to ensure that regular checks of the medication cupboard(s) are made and that any medications that are no longer needed are returned to the supplying pharmacist. Appropriate records of this must be kept. The manager must ensure that garden tables and surrounding grounds in house #47 are cleaned up promptly after use. The curtains in the lounge in house #48 had been recently pulled off of the wall fixings. This must be addressed. The walls outside of a couple of service users’ bedrooms in house #48 were seen to each have a crack from floor to ceiling. This must be addressed. The floor of one service user’s bedroom (house #48) had a noticeable ingrained stain on it. The stain must be removed, or the flooring replaced. One service user’s (house #48) bedroom chest of drawers completely lacked one drawer. The drawer must be replaced. DS0000062639.V249838.R01.S.doc Timescale for action 1 20 13(2) 01/12/05 2 24 23(2)(d) 01/11/05 3 24 23(2)(b) 15/10/05 4 24 23(2)(b) 01/12/05 5 26 23(2)(d) 01/12/05 6 26 16(2)(c) 01/11/05 47-48 Chichester Court Version 5.0 Page 23 7 33 18(1)(a) The manager must ensure that two staff are always assigned to work the early shift in house #47. This must not include the night staff under ordinary circumstances. (Previous timescale of 15/3/05 not fully met) Similar applies from this inspection to house #48. 01/11/05 8 33 18(1)(a) A brief staffing review for house #48 must be written, to explore the needs of service users individually and as a group across a typical week, both in terms of the risks that their behaviours can present and in terms of the established activities that they should be 20/09/05 supported with by staff according to their care plans. Findings of this review must then be implemented. (Requirement put as an immediate requirement, and has been addressed) RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard 24 Good Practice Recommendations It is recommended that the ability of the fire door to be wedged against the carpet if fully pushed open, at the top of the stairs in house #47, be considered in terms of sufficient fire safety. It is recommended that a head-board be bought and used for the bed that one service user upstairs in house #47 uses. DS0000062639.V249838.R01.S.doc Version 5.0 Page 24 2 26 47-48 Chichester Court Commission for Social Care Inspection Harrow Area office Fourth Floor Aspect Gate 166 College Road Harrow HA1 1BH National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI 47-48 Chichester Court DS0000062639.V249838.R01.S.doc Version 5.0 Page 25 - 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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