CARE HOME ADULTS 18-65
Apple Blossom Court 1 Falkland Road Wallasey Wirral CH44 8EN Lead Inspector
Daniel Hamilton New Unannounced Inspection 26th September 2007 09:30 Apple Blossom Court DS0000018860.V346678.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 Apple Blossom Court DS0000018860.V346678.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. Apple Blossom Court DS0000018860.V346678.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Apple Blossom Court Address 1 Falkland Road Wallasey Wirral CH44 8EN 0151 637 0988 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) Apple Blossom Lodge Limited Claire Halilogullari Care Home 17 Category(ies) of Learning disability (17) registration, with number of places Apple Blossom Court DS0000018860.V346678.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Ms Halilogullari is to successfully complete the NVQ Level 4 Care/Registered Managers Award by 2005. 12th December 2006 Date of last inspection Brief Description of the Service: Apple Blossom Court is a small care home that is registered to provide personal care and support for up to 17 adults with a learning disability. The home is a large detached property that has been extended. The property is situated in a residential area of Wallasey, close to local shops, community facilities and bus routes. Bedrooms are located over three floors and are all single rooms. There is a separate dining room, a large communal lounge and an activity room on the ground floor. The home does not have a passenger lift. To the rear of the home there is an enclosed patio/garden area that is accessed through patio doors in the main lounge or through the kitchen door. Care Home Fees range from £425.00 to £850.00 Apple Blossom Court DS0000018860.V346678.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place over one day and lasted approximately eight hours. Sixteen people were living in the home at the time of the visit. A partial tour of the premises took place and observations were made. A selection of care, staff and service records were also viewed. The Manager from the sister home Apple Blossom Lodge was present during the visit and assisted in the inspection process. The Acting Manager and support staff were also spoken with during the visit. Likewise, the people living in the home were encouraged to participate in the inspection process using their preferred methods of communication. Survey forms were also distributed to a number of the people using the service and or their representatives prior to the inspection in order to obtain additional views / feedback about the service. All the core standards were reviewed and previous requirements and recommendations from the last inspection in December 2006 were discussed. What the service does well:
The people living at Apple Blossom Court continued to benefit from a well maintained home that was decorated and furnished to a good standard. The environment was clean and service users and staff continued to look after the cleaning of personal bedrooms and the communal parts of the home. Staff demonstrated a good awareness of the diverse needs of the people living in the home and the level of support required by service users. Staff were observed to interact with people in a respectful and friendly manner and service users appeared relaxed and content in their home environment. Service users spoken with confirmed that they were able to exercise choice and control over their lives. For example, comments from three service users included; “I can more or less do what I want”; “I like to stay up until 11.00 at night” and “The foods alright. I get plenty to eat. They have a menu book and you have three choices for each meal.” The people using the service were encouraged to participate in a range of activities and to maintain relationships with their families and friends. Feedback received from the relatives of two service users included; “I keep in touch with my brother on a regular basis by phone and visit him for holidays” and “They always keep me up-to-date on any developments”. Apple Blossom Court DS0000018860.V346678.R01.S.doc Version 5.2 Page 6 The service supported people to take responsible risks as part of an independent lifestyle and risks had been identified as part of the care planning process. Personal and healthcare was well managed. Records showed that the people living in the home had regular access to a range of health care professionals, subject to individual need. Staff working in the home had access to induction and ongoing training and records showed that staff had been correctly recruited. There had been no complaints since the last visit and policies and procedures were in place to safeguard people from abuse. What has improved since the last inspection? What they could do better:
A Statement of Purpose and Service User Guide had been developed in a standard format. This document should be reviewed and developed into an accessible format, to assist people with a learning disability to understand all the information on the service. Records of holidays and day trips were not available on files viewed. This information should be recorded to provide evidence that the people using the service have benefited from the option of an annual holiday. There was no record of the staff responsible for the administration of medication or sample signatures. Furthermore, a service user identification system had not been developed and written assessments of competence had not been undertaken for staff designated with responsibility for medication. These matters should be addressed to ensure accountability, best practice and to minimise the potential for errors when administering / recording medication. The management team had developed a basic induction pack for new employees. Reference should be made to the Skills for Care website, to obtain
Apple Blossom Court DS0000018860.V346678.R01.S.doc Version 5.2 Page 7 detailed information / material on the ‘Common Induction Standards’ for use with new employees. The home did not have a manager in post that was registered with the Commission for Social Care Inspection. The Company should continue to advertise and recruit a manager and / or ensure a completed application form to register the Acting Manager is forwarded to the Commission for Social Care Inspection as a matter of priority, to ensure the best interests of the people using the service. A summary of results from quality assurance surveys was not available for inspection. The results of quality assurance surveys should be developed and made available to service users and their representatives, to demonstrate that the home is run in the best interests of the people using the service. Risk Assessments should be produced for all Safe Working Practice topics to safeguard the health and safety of the people using the service. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Apple Blossom Court DS0000018860.V346678.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Apple Blossom Court DS0000018860.V346678.R01.S.doc Version 5.2 Page 9 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 and 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Information on the service and the needs of the people living in the home has been developed to enable service users and their families to make an informed choice regarding the suitability of the service. EVIDENCE: A Statement of Purpose / Service User guide and Contract had been developed in a standard format to provide information on the service provided. No changes had been made to the documentation since the last visit. A separate brochure on the National Minimum Standards had also been developed using pictures, signs and symbols. Copies of the documentation were available on files viewed and feedback received from the people using the service and / or their representatives confirmed they had received sufficient information on the service. A local multi-disciplinary team is responsible for liaising with the Acting Manager about potential admissions. People who are considering moving into the home are given the opportunity to undergo a twelve-week trial period. During this time, either party can decide whether the placement is suitable or not. Social Services and the Primary Care Trust regularly review the placement. Apple Blossom Court DS0000018860.V346678.R01.S.doc Version 5.2 Page 10 The management team reported that an assessment of needs is undertaken prior to people moving into the home. The assessments completed by the service formed part of a ‘Proposed Person Centred Care Plan’ and copies were available for reference on files viewed. Copies of assessments completed by other professionals e.g. social workers had also been obtained for some people using the service. Staff spoken with during the visit demonstrated a good knowledge of the individual needs of the people living in the home and how to provide personcentred care. Apple Blossom Court DS0000018860.V346678.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. 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 this service. A care planning system has been developed to ensure the needs of the people using the service are identified and planned for. EVIDENCE: The files of three people living in the home were viewed during the visit. Each file contained a Person Centred Care Plan and Risk Assessment that had been drawn up on admission and kept under regular review in partnership with family members and other relevant professionals including social workers, the primary care trust and / or community nurses. Care plans contained information on the personal, social and health care needs of the people using the service and outlined the level of intervention required from staff. Potential risks and hazards had also been identified to enable staff to understand how to provide care and support to service users, whilst supporting them to take appropriate risks as part of an independent lifestyle. Staff spoken with confirmed they had read each person’s care plan and that they were of the opinion that the information and detail provided in the plan was appropriate for the complexity of the service to be provided.
Apple Blossom Court DS0000018860.V346678.R01.S.doc Version 5.2 Page 12 The people using the service were observed to be following their preferred routines on the day of the visit. Feedback received from service users via discussion and / or survey forms confirmed they were able to make their own decisions about what they did each day. One person reported; “I can more or less do what I want.” Likewise, another service user said; “I like to stay up until 11.00 at night.” Apple Blossom Court DS0000018860.V346678.R01.S.doc Version 5.2 Page 13 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. 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 this service. Meals, activities and routines were flexible and varied to enable the people using the service to have choice and control over their lives. EVIDENCE: At the time of the visit, none of the people using the service were in employment however one person worked on a voluntary basis in a luncheon club for older people. Furthermore, none of the service users attended local colleges as their ‘Passports’ had expired (as they were more than three years old). The management team reported that they would continue to try and support the people using the service to access opportunities at local colleges. Five people continued to attend day services at four different locations. On the day of the inspection 11 service users were out of the home engaging in different activities and 5 were at home. Each person using the service had a person centred activity programme and an optional list of activities was available. Personal files viewed contained an Activity Sheet and Chart, which detailed that service users had participated in a range of community-based
Apple Blossom Court DS0000018860.V346678.R01.S.doc Version 5.2 Page 14 activities such as visiting local pubs, churches, shops, leisure and recreational facilities. Staff were observed to be supporting people to prepare for and engage in different activities on the day of the visit. Some service users reported that they had also participated in day trips, for example a boat trip during June. There was no evidence in care files viewed that service users had benefited from the option of an annual holiday in order to broaden their life experiences. This was discussed with the Management team during the visit. Feedback received from the people using the service and / or their representatives confirmed service users were assisted to keep in touch with their family and friends. The relative of one person reported; “I keep in touch with my brother on a regular basis by phone and visit him for holidays etc”. Likewise, another family member reported; “They always keep me up-to-date on any developments”. Records detailed that the dietary needs and choices of service users were catered for. Service users spoken with reported they had a choice of meals at each sitting from a menu plan. One person reported; “The foods alright. I get plenty to eat. They have a menu book and you have three choices for each meal.” No concerns were noted regarding the standard of catering however one person reported; “I like the food but would like a change from Chicken.” Meals were served in the dining room and staff were observed to be present to offer support and assistance as required. Since the last visit a Cook has been employed, however service users are able to access the kitchen with staff support, to develop their cooking / daily living skills and to promote independence. A smaller kitchen is also available where the people living in the home can prepare their own drinks and snacks. The home does not employ any cleaning staff and service users are encouraged to participate in general housework tasks with support from staff. Apple Blossom Court DS0000018860.V346678.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The people using the service receive support with their personal and healthcare needs to ensure a healthy lifestyle. Systems and practice in relation to the management of medication are in need of review, to fully safeguard the health and welfare of service users. EVIDENCE: Care plans viewed provided information regarding the personal care needs of service users and staff spoken with demonstrated a good understanding of the principles of good care practice, including the need to be respectful and to promote privacy, dignity and independence when assisting with personal care. Records of health care appointments were available on each person’s file and provided evidence that service users had accessed a range of health care professionals including; hospital consultants, community psychiatric nurse, district nurse, general practitioner, chiropodist, dentist and / or optician appointments subject to individual needs. Each visit to / from a member of the multi-disciplinary team was recorded with an outcome and each resident’s weight had been monitored on a monthly basis. Staff spoken with reported that they had been kept up-to-date on each service user’s current health care needs. Service users were given the opportunity to
Apple Blossom Court DS0000018860.V346678.R01.S.doc Version 5.2 Page 16 use the well person clinics provided by the community and all were encouraged to follow a healthy eating plan. There were health promotion leaflets available in the home to encourage service users to follow healthy lifestyles. The home had a brief medication policy in place. The Senior Manager reported that all staff responsible for the administration of medication had completed both in-house and additional training from the pharmacist. At the time of the visit the home did not have a record of the staff who were designated with responsibility for administering medication or sample signatures. Likewise, there was no service user identification system or evidence that assessments of competency had been carried out on staff responsible for handling medication. The home used a Venalink blister pack system that was dispensed by a local pharmacist. None of the service users were self-administering medication at the time of the visit. Medication was securely stored in a medication cabinet. Medication Administration Records examined had generally been completed to a satisfactory standard however one significant recording error was brought to the attention of the management team during the inspection. It was noted that staff had signed that they had administered Simvastatin 40 m/g at the incorrect time of day between the period 17/09/07 to 23/09/07. Staff received guidance from the Acting Manager on the need to follow the home’s medication policy and to maintain accurate medication administration records during the inspection. Since the last visit, the management team had made arrangements to ensure staff were aware that all handwritten entries on medication records were to be witnessed by a second person. Apple Blossom Court DS0000018860.V346678.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Systems have been developed to listen and respond to complaints and to safeguard and protect people from abuse. EVIDENCE: A ‘Comments, Suggestions and Complaints’ policy had been developed to provide people with information on how to complain. Records showed that no complaints had been received by the home’s management team or the Commission for Social Care Inspection since the last visit. Policies and procedures were also in place to ensure a satisfactory response to suspicion or evidence of abuse. These included an Adult Protection and Prevention of Abuse policy and a Whistle blowing procedure. A copy of the local authority safeguarding adults procedure was also in place for staff to reference. The Senior Manager on duty reported that all staff had completed training in the Protection of Adults from Abuse and staff spoken with demonstrated a good understanding of how to recognise abuse, reporting procedures and their duty of care to protect vulnerable adults from abuse. One adult protection incident was being investigated at the time of the inspection. This concerned an allegation made by a resident in the home. Apple Blossom Court DS0000018860.V346678.R01.S.doc Version 5.2 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. 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 this service. The home is pleasant and well maintained. This provides the people using the service with a safe, clean and comfortable environment. EVIDENCE: The service employed a full-time handyman who was responsible for gardening and basic maintenance. All other maintenance work was completed by contractors as required. A maintenance and refurbishment plan had not been developed as the home received ongoing investment and maintenance as required. The senior manager reported that the owner attended meetings with the management team on a monthly basis, to discuss work in need of attention. Since the last visit, new dining room furniture had been purchased. Areas viewed during the inspection were maintained to a satisfactory standard and appeared to be free from hazards. The home was clean and tidy and there were no offensive odours. Records received prior to the inspection detailed that
Apple Blossom Court DS0000018860.V346678.R01.S.doc Version 5.2 Page 19 the home had a good allocation of housekeeping time and infection control polices and procedures were in place. Service user’s rooms had been decorated and personalised to their own choice. Please refer to the ‘Brief Description of the Service Section’ for more information on the premises. Apple Blossom Court DS0000018860.V346678.R01.S.doc Version 5.2 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 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The welfare of the people using the service is safeguarded as staff are appropriately recruited and receive training to undertake their role effectively. EVIDENCE: Training records showed that staff had access to Induction, Safe Working Practice and Care related training opportunities including specialised training and National Vocational Qualifications. Advice was given to the Senior Manager on how to obtain up-to-date induction information / training material from the Skills for Care website. The Annual Quality Assurance Assessment completed by the Senior Manager prior to the inspection detailed that all staff had either completed, were in the process of completing or had enrolled on a National Vocational Qualification (NVQ) in Care at level 3. At the time of the visit, the Senior Manager reported that 7 staff including the Acting Manager had completed a NVQ level 3 in Care but no certificates were available on files. Staff spoken with during the visit confirmed they had completed the award but had not received their certificates to date. Apple Blossom Court DS0000018860.V346678.R01.S.doc Version 5.2 Page 21 The home employed an Acting Manager and 13 care staff. Vacancies existed for one full-time and one part-time care staff. Rotas viewed detailed that the home had three support workers and a senior support worker on duty from 7.30 am to 10.00 pm. During the night, the home was staffed with one waking night staff and one staff member provided a sleep-in service. The home had a recruitment policy in place. Advice was given to the Senior Manager on how the policy could be further developed. The Senior Manager reported that only one new employee had commenced employment at the home since the last visit. Through reviewing the employee’s file it was evident that there was a good recruitment procedure operating at the home. All the necessary records required under the Care Home Regulations 2001 had been obtained for the new employee and were available for inspection. Staff spoken with confirmed they had access to induction, ongoing training opportunities and one to one supervision. Records were kept of each session. Apple Blossom Court DS0000018860.V346678.R01.S.doc Version 5.2 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 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home does not have a manager who is registered with the Commission. Quality assurance systems and practice are in the process of being developed to demonstrate the views of the people using the service and / or their representatives are listened to and acted upon. EVIDENCE: The home does not have a manager who is registered with the Commission for Social Care Inspection. The Senior Manager reported that the Company had continued to advertise for a Registered Manager since the post had become available (approximately 3 years ago) however no suitable applicants have been received to date. An Acting Manager is in day-to-day charge of the home and is being supported by the Senior Manager from the sister home.
Apple Blossom Court DS0000018860.V346678.R01.S.doc Version 5.2 Page 23 The Company did not employ an external consultant to undertake a quality assurance assessment. The Senior Manager reported that questionnaires were sent out to residents and / or their representatives annually and that they had been distributed during September 2007. No surveys were available for inspection as they had been returned to the sister home and no results / summary of findings had been produced. Records detailed that the home had a health and safety policy for staff to reference and information contained in the Annual Quality Assurance Assessment for the service provided evidence that equipment and / or services within the home had been serviced or tested. Examination of fire records confirmed the fire alarm system, emergency lights and extinguishers were tested or visually checked on a weekly basis. A fire risk assessment had been completed however there were no risk assessments in place to address all the Safe Working Practice topics. Apple Blossom Court DS0000018860.V346678.R01.S.doc Version 5.2 Page 24 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 3 2 3 3 X 4 X 5 3 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 3 33 X 34 3 35 3 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 3 3 2 X 2 X 2 X X 3 X Apple Blossom Court DS0000018860.V346678.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? No 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 Timescale for action 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 2 Refer to Standard YA1 YA14 Good Practice Recommendations The Statement of Purpose and Service User Guide should be developed into an accessible format, to assist people with a learning disability to understand the information. Records of all holidays and day trips should be maintained to provide evidence that the people using the service have benefited from the option of an annual holiday in order to broaden their life experiences. A record of all staff responsible for the administration of medication should be established, together with sample signatures, to ensure accountability and best practice. A service user identification system should be established to minimise the potential for errors when administering medication. Assessments of Competence should be undertaken prior to staff being authorised to administer medication and at appropriate intervals thereafter, to ensure staff understand how to record, handle, store, administer and dispose of medications correctly.
DS0000018860.V346678.R01.S.doc Version 5.2 Page 26 3 4 5 YA20 YA20 YA20 Apple Blossom Court 6 YA35 7 YA37 8 YA39 9 YA42 The Acting Manager should refer to the Skills for Care website, to obtain detailed information/ material on the ‘Common Induction Standards’ for use with new employees. The Company should recruit a manager and / or ensure a completed application form to register a manager is forwarded to the Commission for Social Care Inspection as a matter of priority, to ensure the best interests of the people using the service. A summary of the results from the recent quality assurance surveys should be developed and made available to service users and their representatives, to demonstrate that the home is run in the best interests of the people using the service. Risk Assessments should be produced for all Safe Working Practice topics to ensure best practice. Apple Blossom Court DS0000018860.V346678.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Merseyside Area Office 2nd Floor, South Wing Burlington House Crosby Road North Waterloo L22 0LG National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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