Inspection on 07/04/05 for Ambleside

This inspection was carried out on 7th April 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Ambleside 04/06/07

Ambleside 18/08/06

Ambleside 12/04/06

Ambleside 29/11/05

Ambleside 04/11/04

Ambleside 05/05/04

Similar services:

Claremont House

Coopers Mill Ltd

Sun Court Nursing Home

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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 Jan Sheppard Unannounced 07 April 2005 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 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 Stationary 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 Version 1.10 Page 3 SERVICE INFORMATION Name of service Ambleside Address Wengeo Lane, Ware, Hertfordshire, SG12 OEQ Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01920 46041 01920 466089 hilary.porter@turning point.co.uk Turning Point Southern Area Office Ms Hilary Porter Care Home 6 Category(ies) of LD (Learning Disabilities) 6 registration, with number PD (Physical Disability) 1 of places Ambleside Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: This home may accommodate up to one person with a physical disability when associated with a learning disability. Date of last inspection 04 November 2004 Brief Description of the Service: Ambleside is a residential care home for adults with a learning and physical disability . The secluded house is large ,detached and is located at the end of a private road approximately one mile from the town centre of Ware . It 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 and activities room.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. Ambleside Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first unannounced inspection of the inspection year and took place over one day during which residents were seen and consulted in the best manner possible, as none have any speech, and visitors and staff were spoken with. Discussions were held with the Area Manager with the Homes Manager and with all the staff who came on duty throughout the day. Time was spent looking at care plans and other records maintained by the home. A tour was made of the building its driveway and garden areas. This was a positive inspection during which the inspector was invited to join for part of the homes pre-arranged staff meeting. It was noted that many improvements and changes to the building and its environment had been made since the last inspection and that all the requirements following that inspection have either been met or have work in progress. Three requirements still need to be fully completed from that previous inspection with new timescales agreed following advice from the contractors and three new requirements are made following this inspection. What the service does well: The home offers a warm, secure and homely environment for its residents with facilities and equipment that is appropriate for their physical and emotional needs. All the residents appeared to be relaxed and happy and to be very much “at home” in their own personal spaces. They were observed to be making their likes and dislikes clearly known to the staff and also to the inspector during this inspection visit. The staff are experienced and undertake training on a regular basis. They displayed a through understanding of the residents needs and were seen to be skilled at meeting these in a kind and caring manner. They also demonstrated a good ability to interpret the residents various forms of non-verbal communication. During this inspection the staff demonstrated their ability to work as a team so as to ensure the smooth running of the home in a calm manner. They were assisted with this by the sound example of the homes manager. Ambleside Version 1.10 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 full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Ambleside Version 1.10 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 Standards Statutory Requirements Identified During the Inspection Ambleside Version 1.10 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 standard(s) 1,2,3,4 &5 Appropriate information is available for the service users and their families concerning how the home operates and what procedures are in place to meet their care needs. The atmosphere in the home on the day of this inspection was found to be relaxed with the service users care needs being met in a caring and understanding manner by staff who clearly knew them very well. The inspector was welcomed into the home by both the residents and the staff. EVIDENCE: The Statement of Purpose and Service Users Guide needs to be up-dated to accurately reflect the recent staffing changes in the home. The home has a pre-admission policy and assessment procedure that meets the requirements of this standard. The present group of residents have lived in the home since it opened in 1998 when they transferred from a long stay hospital, which was to close. Records indicate that at that time an assessment of their care needs was made and service users and their relatives, if any, were able to visit and assess the suitability of the home before admission. The contract statement of Terms and Conditions given to every service user gives details of their room, the fees payable, the care and services that they will receive and the terms and conditions of their occupancy including their rights and obligations in the event of any breach of contract. Ambleside Version 1.10 Page 9 Evidence gathered from the service users current care plans demonstrated that their needs and aspirations are kept under review and that the manner in which their care is delivered is altered to meet their changing needs. Ambleside Version 1.10 Page 10 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 standard(s) 6,7,8 and 9 Personal care and assistance offered to the service users is of a high standard, and is given in a manner that maintains their dignity and respect. Care plans are generally comprehensive and are subject to review so that changes to health and social care needs are recognised and met. Detailed risk assessments were kept for all the service users and to be regularly reviewed to accommodate recent changes in their circumstances. EVIDENCE: Care staff are unobtrusive and sensitive in their approach and sudden changes in the wishes of the service users are accommodated smoothly and without fuss. Care plans examined were comprehensive with in-sight-full details as to how each individual service user expressed their wants and wishes and with instructions as to how these care needs should best be met. However not all of the care plans were found to be maintained to the same level, some had reviews outstanding, a requirement is made that all plans are regularly reviewed. It was noted that where ever possible families were involved with these reviews. Ambleside Version 1.10 Page 11 The manager reported that the proposed improvements to the care plans had been put on hold because of the recent staff shortages following the company restructuring but that she anticipated that this work, and training for it, would commence during this next year. The records of the residents meetings indicated that they are involved in the decision making processes concerning the running of their home to the greatest extent that it is possible for them to be so involved considering their individual capacity. The manager discussed with the inspector the recent management challenges encountered in putting into place adequate risk assessment and a prevention strategy for one service user whose habit of moving around on the floor on his hands and knees and of his more recent habit of sitting behind another service users wheelchair has put him in danger of being hurt by any movement of this chair. Ambleside Version 1.10 Page 12 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 standard(s) 11,12,13,14,15,16, and 17. The service users day centre activity programmes offer them the opportunity for personal development alongside peers of a similar age and ability .The home has a well developed leisure activities programme which includes visits farther a-field, for example to Southend, as well in the immediate locality so as to promote integration with the local community. For those service users with relatives good liaison with the home is maintained including a regular visiting pattern. A nutritious and varied menu chosen by the residents and supervised by a dietician is offered with fresh ingredients and home cooking being provided on a daily basis. EVIDENCE: The records demonstrated that all the service users have their individual day centre activity programmes covering either three or four days each week. These programmes which are designed to meet their particular needs interests and abilities were seen to be subject to regular multidisciplinary review when clears aims and objectives were determined and recorded. Ambleside Version 1.10 Page 13 The needs of one wheelchair bound resident are currently being further reviewed so that a programme of more challenging day activities that better meet this interests and needs can be put in place for him. Recently introduced individual shopping trips arranged to shops that interest him have proved to be very successful. The use of a local open-air swimming pool is currently being explored for use by all the residents during the summer months. Some of the service users who had been attending day classes arrived home during this inspection, they appeared happy and content to be home and it was noted staff made a point of talking to them individually about their day’s activities. Another service user who had been taken out for lunch also returned in a happy frame of mind. The staff reported that the homes bus and private cars are used for outings in the locality during most weekends. Records also indicated that plans are well advanced for every service user to have a staying away holiday (with a ratio of one service user to two care staff) during the summer months with locations being chosen by the residents and including the New Forest and Norfolk. Four of the six residents have relatives and they all visit or maintain regular telephone/e mail contact. One resident whose family live in Europe and the USA had enjoyed a recent visit from them, which had included a family meal in a local restaurant. Another, whose relatives are elderly and cannot manage the long distance to travel is helped by his key worker to regularly send them cards with updates as to his well being. Staff help the residents with use of pictures to choose the weekly menu and one resident regularly assists the staff with the food shopping at both small local shops, a farm shop and at a supermarket. Records demonstrated that the dietician visits every three months, last visit on 4/4/05, when the resident’s weights are checked the records of the meals actually consumed are inspected and the nutritional composition of the menus chosen was checked. More walking exercise suggested for one large resident is proving very difficult to achieve although one staff member had more success with taking the resident on walking trips using the special pathway created around the homes rear garden. Ambleside Version 1.10 Page 14 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 standard(s) 18,19,and 20. Personal care and health care offered to the service users is of a high standard thus meeting their individual needs. Many of the staff who have worked with these service users for many years have an in depth understanding of their care needs and of their varying moods and can interpret their wishes as to how these needs should best be met on any particular day. The home benefits from having well established professional working relationships with their local GPs, the Community Nursing Team and with the specialist Consultant at the local hospital this ensuring that the residents changing health needs are properly met. The home has a robust medication administration and storage system and all staff who administer medication have been trained to do so. Regular management checks of the medication administration records are undertaken. EVIDENCE: Individual personal care practice observed was commendable. The needs of the residents were seen to be being individually met. One service user seen to be wandering in an agitated state quickly had her needs identified and she was guided to the bathroom in such a manner that her agitation quickly subsided. The records demonstrated that since the last inspection several of the residents had received medical treatment either as in patients or out patients at the local specialist hospital. Ambleside Version 1.10 Page 15 One had been admitted to hospital for a tooth extraction, one was being followed up as an out patient receiving further investigations concerning an allergic reaction whilst another was undergoing tests for a persistent cough. The district nurse was visiting the home regularly to dress another residents injured thumb. The manager discussed with the inspector measures that had been taken to prevent the re-occurrence of his injury, (thumb got stuck in the door) risk assessments were seen to have been undertaken and investigation about a different sort of door frame were being explored. The care plans demonstrated that the service users have annual reviews of their medication undertaken by their GP. The manager also discussed with the inspector the measures that were being taken (the purchase of a softer mattress that moulds to the body shape), to assist the comfort of one resident who suffers a painful hip condition, which might eventually require surgery. The home continues to use the, monitored dosage medication system that is supplied from a local Boots the chemists. This medication system was found to be well organised with individual residents non blistered medication stored separately and with opening / commencement dates recorded on all loose packets and bottles of liquid medication. The Medication Administration Record sheets were seen to be properly recorded and that the accuracy of these was routinely checked by the homes manager. Following a requirement from the last inspection a Controlled drugs cupboard and register have been purchased. Ambleside Version 1.10 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 standard(s) 22 and 23 Visiting relatives were confident that the home manager could resolve issues before they became complaints. The home has Policies and Procedures concerning Adult Protection and Whistle Blowing, which ensure that residents are protected from abuse, neglect and self-harm. EVIDENCE: The home has a Complaints policy and procedure that meets the requirements of this standard a copy of which has been given to all the service users families. There have been no Complaints nor any incidents concerning Adult Abuse since the last inspection. A copy of the complaints procedure in a visual pictorial format has been prepared for and shown to all the service users although it is unclear how much of this would be understood by them. Visiting relatives spoken with by the inspector during a previous inspection were fully aware of the complaints procedure but expressed their confidence that the homes manager would beable to sort out any problems informally if they were encountered. Another relative living abroad spoken with by the inspector on the phone indicated that he would have no hesitation in voicing any complaints but said that on the contrary he wanted to compliment the home on the progress that they had enabled his son to achieve. Ambleside Version 1.10 Page 17 Staff confirmed that they had received training on adult abuse, four had recently attended a Vulnerable Adults Awareness course and others had studied this subject as part of their LLADF training. The inspector noted that this subject was mentioned during the staff meeting the particular vulnerability of these residents who have no speech making the very close observation of their mood swings and behaviour patterns essential. Information concerning the Hertfordshire Adult Protection joint agency procedures was seen displayed on the staff notice board and staff questioned were fully aware of this. Ambleside Version 1.10 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 standard(s) 24,25,26,27,28,29 and 30. Ambleside Home is spacious well designed and well appointed and the building and its environment meet the space requirements of this standard and provide suitable safe and comfortable accommodation for its service users. EVIDENCE: On the day of this unannounced inspection the home was found to be clean tidy and hygienic. Since the last inspection a good deal of refurbishment work has been carried out to meet the previous requirements made and to ensure a homely appearance and the safety of the home for its residents and staff. These include the fitting of new kitchen units, oven, hob and work surfaces, the dining room floor has been renewed and repair work to the external plaster and woodwork has commenced. The front entrance and driveway has been completely renewed including the levelling out of the steep entrance slope, the provision of a new boundary wall and the hard paving of the whole area. Not only does all this improve the appearance of the entrance to the home it also eliminates previous safety hazards and gives a much better surface than the previous loose stones provided for aiding mobility for the residents who use mobility aids and wheelchairs. Ambleside Version 1.10 Page 19 The manager showed the inspector the work programme to begin shortly for the redecoration of the entire building both inside and out. Service users and their families have been involved with the choice of colours and the residents key workers have involved them with shopping and choosing new items of furniture, wardrobes, beds chairs and chests etc. The residents rooms are already personalised to reflect their individual choices and interests. One was seen to contain a collection of soft toys whilst another had many car posters on the walls reflecting the particular interest of that resident. Specialist equipment, a rise and fall bed, a hoist and mobility aids determined following an OT assessment has been purchased where required to meet the individual needs of the service users. Requirements have been made that this refurbishment works programme is completed but following advice from the builder and surveyor longer time scales have been given so that works can be carried out in the dry summer months this particularly necessary where external woodwork has been found to be too wet to currently work on. Ambleside Version 1.10 Page 20 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,,35 and 36. The staff in post are experienced and well trained to meet the needs of the service users However, recent changes have caused difficulties for the staff team. EVIDENCE: Over recent months since the last inspection the home has undergone a company restructuring that involved the redundancy of three senior carers and for every other member of staff the acceptance of a new job with a wider role. Whist this may have bought a better clarity of staff roles and responsibilities the continuance of three vacant day staff posts is putting considerable strain on the remaining members of staff. and this is beginning to result in other adverse effects in the home see the new requirements from this inspection. All the staff on duty were spoken with and without exception they spoke with pride of their united staff team who constantly work for the good of the service users whom many have cared for many years. Whilst they all said that they felt very well supported by the managers and could turn to them for supervision whenever needed the homes supervision records did not demonstrate that regular formal pre arranged supervision meetings were taking place. A requirement is made. Ambleside Version 1.10 Page 21 The manager demonstrated that an appropriate supervision plan had been drawn up at the end of last year but the homes failure to recruit any new staff to fill the vacant posts caused by the redundancies had meant that these plans had not yet be carried out. The vacant day staff posts are currently being covered by agency staff. Only one agency is used and these staff know the home and the residents needs well this providing continuity of care for them. A Recruitment Day has been planned for the beginning of May this because of the total lack of any suitable applicants being received following previous formal advertisements. All the staff spoken with confirmed that despite the disruption that the company restructuring had caused them their individual training programmes had continued. Courses recently attended include a two day course Skip Training how to manage challenging behaviour, a one day refresher course on Moving and Handling techniques, and a course on Adult Protection. All staff are to commence a course to be run over ten weeks concerning the Management of Stress. The manager explained that it has been arranged for all the existing day staff to commence an NVQ level 2 course later in the summer. This follows the redundancy of the other staff members who were studying this course leaving the home with only one carer, a night worker, currently holding this qualification. (It is now, by 2005, an expectation that 50 of the care staff hold this qualification). Ambleside Version 1.10 Page 22 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39, and 42. The home is well run by a competent and experienced manager who leads exceptionally dedicated staff who work very well together as a team. Every aspect of the health safety and welfare of the service users are given the highest priority by all the staff this resulting in a warm caring environment where the service users seemed relaxed and happy. EVIDENCE: The manager communicates a clear sense of leadership within the home and is very well thought of by the whole staff group. Comments such as “ she (the Manager) has always supported us and has fought very hard for our rights and those of the service users” and “ she never stops working for the benefit of this home that is why we have such a supportive and cohesive staff group despite the devastating changes that the company imposed upon us.” were made to the inspector by individual members of staff. Ambleside Version 1.10 Page 23 One staff member who is currently undergoing a course of out patient treatment said that he feels very well supported by the manager and it is only with her assistance and flexible approach to his working hours that he has been able to continue with his duties. Records of the staff meetings demonstrated that all staff participate in these discussions and staff confirmed to the inspector that their views were listened to and acted upon. The manager is proactive in compiling risk assessments for both the service users and for the building and those examined were seen to be current and to be regularly reviewed. The need for a risk assessment for all service users concerning the risks of choking which had recently been completed was recognised following a death from choking of a resident in another home near by. The records demonstrated that regular fire alarm checks are carried out with times taken to evacuate the building clearly recorded. None of the service users are able to handle their own pocket monies; the homes records demonstrated that sound financial management procedures are in place with receipts and records of all monies logged in and out maintained. The accounts examined by the inspector were all found to tally. Periodic quality questionnaires are sent to the service users relatives and other stakeholders involved with the home. 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. Where there is no score against a standard it has not been looked at during this inspection. 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) Ambleside Version 1.10 Page 24 “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 3 3 3 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 3 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score 3 3 3 x 3 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x x 3 x x 3 x Ambleside Version 1.10 Page 25 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 YA24 Regulation 23 (2) (b) Requirement The registered person must ensure that the requirement that repairs are made to the exterior of the building including the wooden window frames the roof tiles, replastering of some exterior walls and the clearing and repairing of the guttering according to the recent surveyors report is carried out. This requirement has been partially met but new timescale has been agreed following advice from the builder . The registered person must ensure that the requirement that new carpeting is provided on the stairs and landing is fulfilled. This requirement from the previous inspection has been partially met but the new carpeting will not be fitted until the works of redecoration are completed. The registered person must ensure that works to meet the requirement that all the boundary fencing is made secure this to ensure the security of the Version 1.10 Timescale for action by 31st June 2005 2. YA 24 23 (2) (b) by 31st June 2005 3. YA 24 23 (2) (o) by 31st June 2005 Ambleside Page 26 4. YA 36 18 (2) 5. YA6 15 6. YA1 6 (a) home at all times. This is a requirement from the previous inspection. The registered person must ensure that all staff receive formal recorded supervision at least six times a year and an annual appraisal. The registered person must ensure that the service users care plans are regularly reviewed and kept up to date. The registered person must ensure that the homes Statement of Purpose and Service Users Guide is updated so as to accuretely reflect the current position in the home. by 31st May 2005 by 31st May 2005 by 31st May 2005 7. 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 Good Practice Recommendations Ambleside Version 1.10 Page 27 Commission for Social Care Inspection Mercury House 1 Broadwater Road Welwyn Garden City Herts 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 Version 1.10 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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