Inspection on 18/08/06 for Ambleside

This inspection was carried out on 18th August 2006.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Ambleside 04/06/07

Ambleside 12/04/06

Ambleside 29/11/05

Ambleside 07/04/05

Ambleside 04/11/04

Ambleside 05/05/04

Similar services:

Claremont House

Coopers Mill Ltd

Sun Court Nursing Home

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

15 Bramble Close

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

CARE HOME ADULTS 18-65 Ambleside Wengeo Lane Ware Hertfordshire SG12 OEQ Lead Inspector Mrs Jan Sheppard Unannounced Inspection 18th August 2006 10:00 Ambleside DS0000019267.V308085.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 Ambleside DS0000019267.V308085.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. Ambleside DS0000019267.V308085.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ambleside Address Wengeo Lane Ware Hertfordshire SG12 OEQ 01920 460415 01920 466089 hilary.porter@turning-point.co.uk 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) Turning Point Southern Area Office Ms Hilary Porter Care Home 6 Category(ies) of Learning disability (6), Physical disability (1) registration, with number of places Ambleside DS0000019267.V308085.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. This home may accommodate up to one person with a physical disability when associated with a learning disability. 12th April 2006 Date of last inspection Brief Description of the Service: Ambleside is a residential care home for adults with a learning and physical disability. The secluded house is spacious, detached and is located at the end of a private road approximately one mile from the town centre of Ware. The building is owned by Hertfordshire County Council but the home is run by Turning Point Ltd, which is a voluntary organisation. The building was renovated and first registered as a Care Home in 1998. It comprises six single bedrooms, offices and a staff sleeping- in room, and has communal spaces consisting of a large hall, lounge, dining room, kitchen, activities room and two assisted bathrooms. The home has a well designed and accessible rear garden with a large patio accessible from the lounge. Adequate parking space is provided to the front of the building. The current fee for the residents, who are all sponsored by Hertfordshire County Council, is £511.40 per week. Information concerning the services offered by this home along with previous inspection reports are securely held in the office and are available to visitors and relatives. Ambleside DS0000019267.V308085.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second unannounced inspection of this current inspection period and took place over one day during which two inspectors spent nine hours in the home. All six residents were communicated with using various methods best suited to each individual as none of the residents has any speech. Discussions were had with all the staff on duty and with the homes manager and a tour of the building was undertaken. A visiting relative was also spoken with. Comment questionnaires were sent to four relatives and the replies indicated an overall very good level of satisfaction as to the care being given, “our son is so well looked after in a wonderful house by caring loving people”; “our relative is happy and is very well looked, “two replies did however indicate that more staffing would sometimes be beneficial. The comments in this report reflect the findings made by the inspectors during that time and also take account of information gathered from the homes manager and from social services since the last inspection. Twenty one key standards were examined during this visit. All the key standards were examined during the last inspection on 12th April 2006 to which reference may be made. Two of the requirements made during that inspection have not been met. Three requirements are made following this inspection. Since the last inspection various works of refurbishment and improvement to the fabric of the building internally have been completed and the home now has a very much improved decorative appearance and provides for its residents a bright and attractive environment with a homely atmosphere in which to live. What the service does well: The staff on duty were seen to be working well together as a team and were offering a seamless service to ensure that the residents physical and emotional needs were met. The long established staff understand the needs of the residents thoroughly and have an ability to communicate with each non verbally and to interpret their signs and requests and these skills improve the lives of the residents. Ambleside DS0000019267.V308085.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Ambleside DS0000019267.V308085.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 Ambleside DS0000019267.V308085.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home has the required policies and procedures concerning pre-admission assessment and information sharing so that prospective residents have good information about the home in order to make an informed decision about admission. EVIDENCE: There have been no changes to the pre-admission assessment procedures since the last inspection. There have been no new admissions to the home since it opened in 1998. The home Statement of Purpose and Service Users Guide was revised in 2005 and a copy of this document is retained on file with each residents care plan. Ambleside DS0000019267.V308085.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The residents care plans and risk review documents were seen to be comprehensive and up to date. The home works closely with the relatives of its service users to ensure that decisions made about their lives meet with their approval. EVIDENCE: The recording and maintenance of the care plans had improved since the last inspection. The improvement in the quality of these care plan records should ensure that the outcome for the service users is also improved. All six care plans were read with three examined in greater detail. These were found to contain good detail of the identified care needs of each resident and to give directions as to how these needs should be best met. Particular behaviour patterns, which give non verbal clues as to the residents wishes, were identified; for example “when x sits on the floor in the kitchen doorway and gestures he is asking for a new piece of string”. Ambleside DS0000019267.V308085.R01.S.doc Version 5.2 Page 10 Risk assessments were seen to contain detail as to potential risks and to give clues concerning trigger behaviours and of suggestions as to how these may be avoided and/or handled safely. Risks assessments had been completed for all the residents recent staying away holidays. As it is not possible to consult directly with the residents, none of whom have any speech, the home works closely with the residents relatives to ensure that the decisions made about their lives meet with their approval. Ambleside DS0000019267.V308085.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home provides a varied day activity and programme of community visits, which enhances the lives of the residents. The home provides a variable menu of home cooking which follows a healthy eating plan. EVIDENCE: The quality in this outcome area has been maintained, with some improvements made, since the last inspection when these standards were met and no requirements were made. Each resident continues to have an individually planned day activity programme designed to meet their interests and assist with the development of their social and life skills. Several examples of paintings completed in their art classes were seen displayed in their individual rooms and staff reported that practical examples from their cookery classes are sometimes bought back to the home. Ambleside DS0000019267.V308085.R01.S.doc Version 5.2 Page 12 The programme for one resident whose needs were judged to not previously be being fully met have been reviewed with his local social services worker and a change to his programme offering him a one to one service led by staff from the local day centre to take him on visits in the community and to accompany him to attend classes at a local college are being introduced. This has resulted in an improvement in the life experience for this resident. It is planned that all the residents will have a staying away holiday over the summer months. The staff and residents who had already been away showed the inspectors photographs of these holidays which evidenced happy and relaxed looking residents one enjoying piano playing another experiencing the fragrance given from a field of lavender and a third actively enjoying swimming in the small private pool of their holiday cottage in the Cotswolds. The residents were observed taking lunch, all ate heartily and assistance was given sensitively by staff to those who needed their help. The menus evidenced that a varied diet following a healthy eating programme is provided this being supervised at regular intervals by a visiting dietician who also monitors the residents weights. Since the last inspection the home has acquired some sit on scales, which staff reported considerably assists with this weighing process. Currently there are no under or over weight problems being experienced by the residents. However because of the lack of verbal feedback from the residents a daily record of food actually consumed is maintained. A weeks supply of food and provisions was delivered to the home during this inspection and the receipts of this evidenced that over £220 is spent weekly and that this order included a number of particular items that meet individuals particular likes and tastes, For example Cranberry juice and a particular brand of spread. Low fat and healthy eating products were seen with yogurts and fresh fruit freely available. Fresh meat and vegetables are shopped for separately and staff reported that they would sometimes be accompanied by one of the more able residents whose life experience will be enriched by such a shopping trip. Food was seen to be appropriately stored in the fridge with opening dates marked where needed and records of the fridge temperature and of the temperatures of cooked food are also maintained. The home assists all its residents who have family and friends to maintain contact with them by helping them to make phone calls send e-mails and compose post cards when they are away on holidays and outings. A relative, who visited during this inspection to take her brother out, spoke positively of all the care the home gives him and was also most appreciative of all the help and support recently shown to her and to him over the bereavement of their father and sister. She said that “my brother has always been happy at Ambleside, he moved here from hospital in 1998,and he has never seemed happier than he does now, he loves it here” Ambleside DS0000019267.V308085.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. The planning and delivery of care to meet the residents needs was seen to be being carried out in a kind sensitive and calm manner by staff who were able to communicate with the non verbal residents and could interpret their requests and wishes. The homes medication is appropriately stored and its administration is properly managed there by affording proper protection for the residents. EVIDENCE: The home has a robust medication storage and administration system to Which there have been no changes since the last inspection. All the staff who administer medication have been trained to do so .The recordings on the MAR, (medication administration record) sheets were found to be accurate with no omissions. The manager carries out regular audits of this system and identified one error made during the period between inspections. The records evidenced that this matter had been appropriately managed during staff supervision and the residents GP had been consulted. Care was seen to be being delivered in a calm and kindly manner. Ambleside DS0000019267.V308085.R01.S.doc Version 5.2 Page 14 Staff were seen to patiently support one resident with his preparations for going out on a visit with his sister until he felt ready and then happily went off with her when another member of staff came on duty after lunch one resident went up to welcome her as she entered the home he laid his head on her shoulder very pleased to see her and clearly comfortable with her and she able to respond positively to his greeting. The residents physical and emotional needs were being adequately met by the staff on duty during the time of this unannounced inspection but more staff would have enabled a better quality of service to have been delivered given that on that day the residents were all unexpectedly at home because of the breakdown of their day care transport. The manager explained that because of the current staffing difficulties she did not have the staff or budgets to call upon extra resources to cover this unplanned situation. See comments also in the Staffing section. Ambleside DS0000019267.V308085.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. The home has policies and procedures concerning complaints and adult protection that should safeguard the residents. As far as could be judged from this inspection visit and from information received from the homes manager these standards are adequately met. However investigations concerning allegations made against some staff are being undertaken. EVIDENCE: There have been no complaints since the last inspection. A copy of Turning Points complaints policy, which has some sections portrayed visually, was seen in the residents care plans and staff said that where this is possible a copy of this document has been shared with the residents relatives. The home has the required policies and procedures concerning adult protection and staff spoken with were familiar with these and clear as to what actions they should take if abuse was suspected. Several staff commented that extra care and surveillance is required, as these vulnerable residents have no speech. The homes records evidenced that adult protection training was offered and kept up to date. The residents records evidenced that daily records including where appropriate body mapping illustration is maintained. Issues of concern as to the protection of the residents and of some staff which are currently the subject of police, social services and Turning Point investigation have not yet been resolved and the staff spoken with during this inspection did not have any detailed knowledge about these. Ambleside DS0000019267.V308085.R01.S.doc Version 5.2 Page 16 These matters are being investigated under the Local Authority Adults at Risk Procedures and no conclusions have yet been reached. Ambleside DS0000019267.V308085.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home is essentially domestic in scale but offers good sized accommodation, which provides a comfortable and safe environment for its residents. EVIDENCE: Various improvements have been made to the home since the last inspection. The home was clean and well presented with no malodours. The works of redecoration and provision of new furniture, carpeting and soft furnishings which have been completed since the last inspection have greatly enhanced the visual appeal of the home which now presents as bright and cheerful with comfortable and appropriate seating providing a homely environment for the residents. Several of the residents showed the inspectors their rooms and these were found to be individually personalised in a manner that reflected their own tastes and interests. Appropriate pictures ornaments and electrical lighting video and musical equipment was seen in all rooms. Ambleside DS0000019267.V308085.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Staffing levels are adequate to meet the basic needs of the residents but the continuing high level of staff vacancies linked with recent staff suspensions is putting considerable stain on the existing permanent staff team and is hindering the improvement in the quality of service delivered to the residents. The homes recruitment policies and practices provide the residents with protection. The staff are appropriately trained. EVIDENCE: The home continues to carry a number of permanent staff vacancies (6), which are covered by staff working extra hours, and by the use of regular agency staff some of whom have now worked at the home for many years and who therefore have good knowledge of the residents needs. The numbers of staff on duty matched the planned staffing rota although as all the residents had to unexpectedly be at home on the day of this unannounced inspection and one staff member had called in sick this meant that the manager had to abandon her management role in the office and do hands on caring work. Ambleside DS0000019267.V308085.R01.S.doc Version 5.2 Page 19 She explained that following the recent suspension of two experienced senior care staff pending an investigation the arrangement of the staffing rotas and the funding of any extra staffing had become very difficult and because of this she had not tried, at such short notice, to obtain other staffing to cover this unexpected situation. The manager also explained that the suspension of the staff had resulted in great strain on the existing staff and on herself who were all working extra hours trying to maintain standards for the residents. As long as the home remains without its compliment of permanent staff she said we have no chance of delivering an improved quality of care for the residents. This was confirmed by the one other permanent member of staff spoken with during this inspection who said that whilst she was very well supported by the homes manager she felt that the Company was not as supportive as it could be and that she personally felt very demoralised, “ but we are all trying to carry on for the residents sake but I do not know how much longer I can carry on “ she said. The two agency staff on duty who were spoken with both said that they were happy working in the home, one had been there for only four weeks but the other who had worked at the home frequently over the past two years spoke very positively of the support she received and said “ I like working here I have got to know the residents and understand their needs. this is really just like a big family” The homes recruitment practices were seen to have been correctly carried out following interviews held in May; but unfortunately none of the staff appointed then had yet commenced their duties in the home. The manager explained that she understood that some CRB checks were still outstanding but that these were dealt not by her but by the company head office and that she had just to wait. She commented that the recruitment tracker system recently introduced by the company was an improvement, but she voiced her frustration at the length of time it was taking for the new staff, several of whom are experienced and qualified workers to start, “ we really do need them working in the home now, she said, it would boost the morale of the existing staff who would not have to continue working so many extra hours.” The homes records evidenced that staff are continuing to attend training courses although the NVQ programme has been interrupted by the staff suspensions. The manager said that she still expects to commence her NVQ level 4 Registered Managers Award in the autumn. A training needs profile is compiled for all staff from which an annual training programme for the whole home is planned. Ambleside DS0000019267.V308085.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37 and 39 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to the service. The manager and staff team continue to endeavour to run this home well with the best interests of the residents constantly in mind but the continued lack of a full compliment of permanent staff is unsatisfactory and is hindering the development of desire-able improvements in the quality of the service being delivered to the residents. The home does not have a Quality Assurance programme. A representative of the company management is still failing to make regular Regulation 26 visits to the home there by leaving Ambleside and its manager lacking the support that is required by statute. A requirement concerning this is outstanding from the past two inspections. EVIDENCE: The requirement made at the last inspection concerning the monthlyunannounced management visits to the home as required under Section 26 of Ambleside DS0000019267.V308085.R01.S.doc Version 5.2 Page 21 the Act has still not been met. The manager explained that the last visit made in February 2006 following several months gap was carried out by her then immediate line manager who has now left his post and the home has not yet received any visits from the new manager or indeed from any other of the company representatives. A further requirement is made. The continued lack of a full compliment of permanent staff is putting a great strain on the remaining staff who are having to work many extra hours. This deficiency along with the recent suspension of two other members of the permanent staff team means that the home is having to rely heavily on agency and bank staff and although many of these have good knowledge of the homes routines and of the residents needs this continued deficiency is unsatisfactory and must be rectified quickly. A requirement is made. The home is still not operating a Quality assurance programme as was required following the last inspection. The manager explained that this subject was a topic for discussion at a recent managers seminar run by Turning Point and that following this she had had this as an agenda item for discussion at a recent staff meeting in the home. A further requirement is made. Ambleside DS0000019267.V308085.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 x 2 3 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 2 33 x 34 3 35 2 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 2 2 x 2 x 2 x x x 2 Ambleside DS0000019267.V308085.R01.S.doc Version 5.2 Page 23 yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 2. Standard YA32 Regulation 18 (1) (a) Requirement Timescale for action 30/09/06 30/11/06 YA35 YA37 YA39 The home must appoint new staff to fill long standing permanent vacancies quickly. 24(1)(a)&(b) The home must establish routine quality checks the results of which can be evidenced in the home. This requirement is still not met. New time scales are set. It is a requirement that unannounced monthly visits are made to the home by the registered provider and that a report of these visits is sent to the CSCI This requirement is out standing from the previous two inspections. Further action will be taken if this standard is not met. New time scales are set. 3. YA43 26 30/09/06 Ambleside DS0000019267.V308085.R01.S.doc 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 Ambleside DS0000019267.V308085.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Hertfordshire Area Office Mercury House 1 Broadwater Road Welwyn Garden City Hertfordshire AL7 3BQ 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 Ambleside DS0000019267.V308085.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. 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