CARE HOME ADULTS 18-65
Arnold House 66 The Ridgeway Enfield Middlesex EN2 8JA Lead Inspector
Rebecca Bauers Unannounced Inspection 13th December 2005 10:30 Arnold House DS0000010574.V265231.R01.S.doc Version 5.0 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Arnold House DS0000010574.V265231.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Arnold House DS0000010574.V265231.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Arnold House Address 66 The Ridgeway Enfield Middlesex EN2 8JA 020 8363 1660 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) Leonard Cheshire Mrs Rita June Stroud Care Home 21 Category(ies) of Physical disability (21) registration, with number of places Arnold House DS0000010574.V265231.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. Four specified service users who are over 65 years of age may remain accommodated in the home. The home must advise the registering authority at such times as any of the specified service users vacates the home. 2nd August 2005 Date of last inspection Brief Description of the Service: Arnold House is a care home registered to provide care to 21 people who have a physical disability. The care home is owned and managed by the Leonard Cheshire Foundation, which is a voluntary organisation providing care services to people with disabilities. The care home is in a beautiful building, which was bequeathed to the Leonard Cheshire Foundation by the Arnold family. There are extensive grounds to the rear of the care home. Accommodation is provided in single bedrooms on the ground floor and there are a number of communal rooms and a physiotherapy area available for service users also on the ground floor. The homes administrative offices are on the first floor, as well as accommodation for staff. The organisational mission is: To work with disabled people throughout the world, regardless of their colour, race or creed, by providing the environment necessary for each individuals physical, mental and spiritual wellbeing. Arnold House DS0000010574.V265231.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The unannounced inspection took place on the 13th of December 2005 as part of the annual inspection programme to identify progress with previous requirements and to check standards of care against the core standards. The inspection took five hours to complete. A partial tour of the home took place; six service users were spoken to individually and as a group. One relative spoke briefly to the inspector. Care records, medication, staff records and health and safety records were examined. Five staff were spoken to. The registered manager was present during part of the inspection. The inspector was accompanied by the designated team leader during the inspection. Feedback was given to the registered manager at the end of the inspection Further information through observation of staff interaction with service users. What the service does well:
The service users benefit from knowing that their assessed needs are reflected in their comprehensive person centred individual plans. Risk assessments are in place to promote service users independence. Service users continue to benefit from the experience of multidisciplinary working to ensure that there personal care; social and emotional health needs are met. Service users continue to benefit from in some cases environmentally controlled bedrooms and a variety of physiotherapy equipment to promote mobility. The environmental conditions are homely and welcoming and the home ensures that service users, relatives and other professional’s views are listened to and addressed to improve service provision. Service user participation is encouraged positively through regular meetings and the disabled peoples forum. Service users are protected from potential abuse, neglect and self-harm. Service users feel able to openly complain. Service users benefit from a well-established staff team who understand their needs and are provided with the support and information to work with service users in a consistent way.
Arnold House DS0000010574.V265231.R01.S.doc Version 5.0 Page 6 The home is well managed and all health and safety checks are carried out to ensure the health welfare and safety of service users. Service users say that the staff are helpful and friendly. All service users said that they felt comfortable in the home and enjoyed the food and indoor activities. What has improved since the last inspection? What they could do better: Arnold House DS0000010574.V265231.R01.S.doc Version 5.0 Page 7 Five requirements were made at this inspection, four were restated. Four recommendations were made. Two restated requirements were made under the heading lifestyle. Service users must be supported to have access to the local community and for this to be facilitated by designated drivers during the weekends. Appropriate leisure activities are an integral part of an individual’s life and must be promoted to enhance the wellbeing of service users. One requirement is restated under the heading environment for the second time was for adequate storage facilities for physiotherapy equipment and wheelchairs to enable more space for service users to mobilise without any potential obstruction. One restated requirement was made under the heading staffing which concerned CRB certificates/copies needing to be available in the home. A new requirement concerned the need for service users to have six monthly in house reviews and for the outcomes to be reflected in the individual plans. Recommendations were made for service users to attend training/talks around their own conditions such as diabetes, strokes and MS to promote a greater understanding of their needs and to enable more informed decision making with regard to their care. Recommendations were also made for willing service users to be trained to become involved in the recruitment of staff. In addition two other recommendations were made with regard to medication and monitoring of pressure mattresses. Please contact the provider for advice of actions taken in response to this inspection.
Arnold House DS0000010574.V265231.R01.S.doc Version 5.0 Page 8 The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Arnold House DS0000010574.V265231.R01.S.doc Version 5.0 Page 9 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 Arnold House DS0000010574.V265231.R01.S.doc Version 5.0 Page 10 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 Service users can feel assured that their needs are fully assessed prior to placements to ensure that the staff know their needs and aspirations. EVIDENCE: One service user had moved into the home since the last inspection. All relevant assessments were in place so that the service user can feel assured that the staff are fully aware of her needs and aspirations. A relative of the service user stated ‘the staff are excellent here’ The placement was reviewed on the 23/9/05 with the service user, relative social worker and home. The placement has been confirmed to be suitable to meet the needs of the service user and so will continue living at Arnold house. One service user who was over the age of 65 yrs moved out of the home in October 2005. A variation to the conditions of registration had already been obtained and will remain. Arnold House DS0000010574.V265231.R01.S.doc Version 5.0 Page 11 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,8,9,10 Service users now have comprehensive individual plans that they can feel confident in and feel assured that staff have a holistic view of their lives and needs and changing needs. Effective consultation and participation occurs to benefit service users and appropriate risk assessments are in place. Service users can feel confident that their confidences are kept and respected by staff. EVIDENCE: The individual plans in the home were much improved and demonstrated person centred working with full involvement of the service user as some of the individual plans had been written in the individual’s own words. The plans provide a holistic view of the individual and include a profile that enables staff to know more about the individuals’ life prior to moving into Arnold house, which includes work life, personal relationships and leisure interests. All of the five files examined contained multidisciplinary annual reviews as per the requirement made at the last inspection. However, there were gaps in the number of service users who had had in-house six monthly reviews, this must be rectified to ensure that individual plans are updated six monthly. Issues of confidentiality had been discussed and formed part of the individual plans, so much so that the service users had specified what they wished to be
Arnold House DS0000010574.V265231.R01.S.doc Version 5.0 Page 12 included in their plans and what they wished to keep to themselves. Service user files had been locked away securely. Appropriate risk assessments are in place and included bed rails, manual handling and lifting, swimming, bathing and making snacks. Service users spoke enthusiastically with regard to their participation in meetings to affect their lives in the home and participation in the running of the home. For example, the voluntary donations given were discussed and the decisions with regard to what to spend the money on was entirely decided upon by the service users. They plan to go out for a meal together in the next week or so. Arnold House DS0000010574.V265231.R01.S.doc Version 5.0 Page 13 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13, 14,15,17 Service users are still not accessing the local community nor are they engaging in leisure activities including holidays that they choose due to the lack of funding, transport on weekends and there no longer being a full time activities co-ordinator. Service users are having regular appropriate contact with family and friends. Service users are supported to develop personal relationships. Service users benefit from well-balanced healthy meals and an environment that is conducive to a relaxing experience. Areas for personal development have been suggested to enable informed choices to be made by service users about their lives. EVIDENCE: A requirement made at the last inspection for there to be sufficient drivers available to enable service users to carry out the activities they choose to do particularly during the weekends had been progressed partially. But not resolved. A driver had been appointed a month ago and then decided not to continue with the role. Ongoing recruitment is planned. A new activities coordinator has been appointed who is a driver and several of the staff have now agreed to drive the homes vehicle. The requirement is restated for the reason of needing designated drivers.
Arnold House DS0000010574.V265231.R01.S.doc Version 5.0 Page 14 The service users spoken to said that they still were not going out as much as they wished but understood that a new activities co-ordinator had been appointed and were hopeful that once she commences employment they would be enabled to go out more often. This issue has also been identified during the unannounced visits by the registered provider and a conscious effort is being made by the registered manager to address this. Service users said that they continue to occupy themselves in the home and that indoor activities are arranged by the home. Service users said that they enjoyed recent meal out. All spoken to said that they were looking forward to Christmas and that the home went to great efforts to make Christmas a special occasion. Service users must be supported to access the local community so that they can participate in leisure activities that they are interested in and to promote their wellbeing. The registered provider had written to the placing authority to negotiate finance for a one-week service user holiday for 2005/2006 as per the restated requirement. According to the registered manager the situation is still under negotiation for the increase of fees to cover this. Hopefully service users will be able to go on holiday in 2006. Service users do have regular contact with family and friends; this was evidenced through conversation and documented in the case files. Personal relationships are promoted in the home and had been detailed as such in some of the service users files that are currently in relationships. Some service users had been supported to go on holiday together. Service users continue to be positive in their comments about the food provided in the home, menus were seen as providing healthy well-balanced meals that had been developed with a dietician. Some of the service users are diabetic and it would appear in some cases to believe the staff with regard to what is good to eat and what could affect them in a detrimental way. It is recommended that a dietician come to the home to talk to the service users as a group about the condition to enable them to make informed decisions for themselves. This type of intervention to promote personal development could also be applied to those service users who could benefit from having more information with regard to other conditions such as MS or strokes. Arnold House DS0000010574.V265231.R01.S.doc Version 5.0 Page 15 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Service users continue to receive personal support in the way that they prefer. Service users physical and emotional health needs are being met and this is evidenced consistently. Service users are protected by the home medication policy and procedure. EVIDENCE: A restated requirement for the details of health appointments attended by service users and the outcomes of these appointments to be recorded in the service user file had been fully complied with. Details of health appointments attended such as GP, chiropodist, hospital appointments and blood tests had been documented and the outcome of these appointments had been completed in all five cases examined. This is a vast improvement since the last inspection and must continue. In the five individual plans examined service users preferences with regard to personal care support needed had been fully documented. One service users individual file stated ‘I need assistance with everything I do but I would like to be asked before anybody tries to do anything for me’. Service users spoken to acknowledged that staff are always courteous in the way in which they support them with their personal care needs. There was documented information under support and mobility with regard to specific interventions to prevent pressure sores. All service users have variable posture beds and pressure
Arnold House DS0000010574.V265231.R01.S.doc Version 5.0 Page 16 mattress. It is recommended that these be checked routinely to ensure that they are holding the correct pressure for individual and that these checks are recorded. Twelve service users currently see the district nurse for a variety of health needs for example pressure sores, catheters, stoma care and peg feeds. These health needs are documented in separate care plans developed and completed by the district nurse. All staff have now been trained in stoma care and have been deemed by the district nurse to be competent as per the requirement made at the last inspection. Medication records were seen and found to be complete with no gaps as per the requirement made at the last visit, the service users are protected by the homes medication policy and procedures. The controlled drugs register was completed and signed by two staff. The team leader on duty was concerned that in some instances the new pharmacist insisted that they should write prescribed medication on the MAR sheets instead of them always being printed automatically by the pharmacist. This is not good practice as it could allow for errors, for example what the medication is, the dose and time the medication needs to be taken. It is recommended that this be discussed with the pharmacist. Service users physical health needs are met by regular physiotherapy sessions and Speech and language therapy. Arnold House DS0000010574.V265231.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Service users do feel that their views are listened to and acted upon. Appropriate records substantiate this. Service users are protected from potential abuse, neglect and self-harm through adequate adult protection procedures that safeguard service users. EVIDENCE: There have been two complaints since the last inspection, one concerned the call bell response times, which was investigated and found to be partially substantiated. 80 of call bells had been recorded as being answered within four minutes. The outcomes of the investigation had been recorded appropriately. This is now being monitored monthly to ensure that service users are getting their needs met. The second complaint concerned some service users helping others at breakfast. This was discussed during a service users meeting and resolved. Service users stated that they didn’t min helping out. Service users continue to feel that their views are listened to and acted upon. There continues to be good attendance at the service user meetings. The registered manger stated that usually any issues are brought up openly during service users meetings and resolved quickly. All staff have completed POVA training and feel confident that they are able to protect service users from abuse and are clear with regard to the correct reporting procedures in the event of a disclosure being made. Arnold House DS0000010574.V265231.R01.S.doc Version 5.0 Page 18 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,29,30 Service users do live in a homely, comfortable and safe environment. There are still no adequate facilities to store specialist equipment. The home is clean and hygienic. EVIDENCE: Service users continue to live in a homely, comfortable and safe environment. Redecoration occurs periodically usually be volunteers. The home has a range of equipment for service users including overhead tracking hoists, mobile hoists and assisted bathrooms, there was evidence of regular maintenance checks. Wheelchair servicing and maintenance records were also available to ensure the safety of service users. New purchases have included commodes for each individual, new mobile hoist and pedals to encourage exercise and to improve and promote mobility. A requirement made at the last inspection for adequate safe storage facilities to be provided to store mobility equipment and for the storage and recharging of wheelchairs had still not been progressed and the requirement is restated for the safety of staff and service users. The home is clean and hygienic.
Arnold House DS0000010574.V265231.R01.S.doc Version 5.0 Page 19 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 34,35,36 Service users are supported by a competent consistent staff team. The homes recruitment policy and practices are not protecting service users fully. Service users benefit from well supported care staff to promote continuity for service users. EVIDENCE: There have been some changes to the staffing in the home since the last inspection although these have been recruited to. These posts are the care supervisor and the activities co-ordinator both are full time posts. Employment checks are in the process of being carried out to ensure the service users are protected. Records of supervision were seen for the registered manager and care supervisor as per the requirement made at the last inspection, these must continue to ensure consistent practice and monitoring of service provision to service users. The requirement made concerning the need for the copies of CRB certificates for two newly recruited staff to be held on file had not been progressed. The CRB information on file had been sent via e-mail from the organisations human resources department stating the name of the person, the disclosure number and the date the check was carried out. This issue will be discussed with the Head of Standards for Leonard Cheshire. The requirement is restated.
Arnold House DS0000010574.V265231.R01.S.doc Version 5.0 Page 20 Staff have been trained by the district nurse to change stoma bags and deemed competent, a record of this is held on the service users file and the training file of named staff deemed competent by the district nurse to carry out such a task to safeguard service users and staff. The home has a training co-ordinator in place that is able to identify staff training needs, gaps and refresher statutory training. Staff have recently completed individual support planning to enable them to fully understand how the individual plans work and the importance of them for service users in the service they receive and the importance of consistency. Team leaders have recently undertaken supervision training to enable more effective and well documented supervision to take place. Team leader spoken to stated that the training has been very helpful in clarifying exactly what they need to discuss and cover during supervision. Further training is planned for February 2006. A recommendation made for the long shift patterns to be reviewed and reduced had been addressed and no changes have been made but will be monitored. The registered manager stated that work performance had not been affected, nor had there been any increase in the number of accidents or incidents. Agency staff are not used in the home. The home have a bank of staff that they call on when required so service users are supported by a consistent staff team. Service users spoke positively about the staff stating that they were ‘caring and kind.’ Staff spoken to say that morale continues to be good, that they receive supervision on a regular basis and that they have received training in manual handling and lifting and health and safety training. Service users spoken to state that they would be very interested to become involved in the recruitment of staff, it is recommended that this be facilitated for willing individuals. Arnold House DS0000010574.V265231.R01.S.doc Version 5.0 Page 21 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 38,39,41,42 Service users benefit from a management approach that is open and can feel confident that their views are listened to and are used in the development of the service they receive. The health, safety and welfare of service users are promoted and protected. EVIDENCE: Staff and service users continue to talk positively about the registered manager and senior managers and felt that they were approachable and supportive. This has had a positive effect on staff morale, which benefits service users. The registered manager has achieved NVQ level 4 and the registered manager award. In addition, she has just started a diploma in management studies (DMS). The registered provider continues to carry out quality assurance monitoring and produces written reports with clear action to be addressed. Copies of these reports are sent to the Commission. Arnold House DS0000010574.V265231.R01.S.doc Version 5.0 Page 22 The homes risk assessment; fire risk assessments and an emergency plan had all been reviewed and were satisfactory. All relevant certificates were in place following safety checks to protect the health, safety and welfare of service users. The home will be having an internal health and safety audit on the 14/12/05. A recommendation made at the last inspection for all policies and procedures that had not been reviewed in the last two/three years to be reviewed had been progressed. Arnold House DS0000010574.V265231.R01.S.doc Version 5.0 Page 23 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 3 X X X Standard No 22 23 Score 4 4 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 X 3 3 3 Standard No 24 25 26 27 28 29 30
STAFFING Score 3 X X X X 2 3 LIFESTYLES Standard No Score 11 3 12 3 13 1 14 1 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score X X X 1 3 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Arnold House Score 4 3 3 X Standard No 37 38 39 40 41 42 43 Score X 3 3 X 3 3 x DS0000010574.V265231.R01.S.doc Version 5.0 Page 24 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA14 Regulation 16(2)(n) Requirement Timescale for action 31/01/06 2. YA29 3. YA13 The registered person must ensure that there are sufficient drivers available to enable service users to carry out the activities they choose to do particularly during weekends. This requirement is restated from the last two inspections. Timescale for action was 1/6/05 and 1/10/05. 23(2)(m)(3)(a)(ii) The registered person must ensure that adequate storage facilities are provided to store mobility equipment and for the storage/recharging of wheelchairs. This requirement is restated from the last two inspections. Timescale for action was 1/8/05 and 01/11/05. 16(2(m)(n) The registered person must ensure that all service users are given the opportunity to access the community on a regular basis. This requirement
DS0000010574.V265231.R01.S.doc 01/02/06 01/01/06 Arnold House Version 5.0 Page 25 4. YA34 17(2) Sch 2 (7) 5 YA6 15(2)(b) is restated from the last inspection. Timescale for action was 1/9/05. The registered person must ensure that copies of CRB certificates for staff recently employed are held on their personal files. This requirement is restated from the last inspection. Timescale for action was 1/9/05. The registered person must ensure that all service users receive in house six monthly reviews. 01/01/06 01/02/06 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 YA11 Good Practice Recommendations It is recommended; to enable personal development for service users who are diabetic to receive/attend a talk by the district nurse to enable them to make informed choices about their diets and how to minimise the risk of being hypo or hyper glycaemic. This approach could also be used to inform service users of their own conditions such as MS and strokes for example. It is recommended that weekly periodic checks be made of the pressure mattresses to ensure that they are all fully functioning. This should be recorded. It is recommended that the registered person discuss with the new pharmacist the need to ensure that prescribed medication is always printed on the MAR sheets and that the home is not required to write on the MAR sheets, this will prevent errors. It is recommended that willing service users are trained and involved in the recruitment of staff. 2 3 YA19 YA20 4 YA34 Arnold House DS0000010574.V265231.R01.S.doc Version 5.0 Page 26 Commission for Social Care Inspection Southgate Area Office Solar House, 1st Floor 282 Chase Road Southgate London N14 6HA 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 Arnold House DS0000010574.V265231.R01.S.doc Version 5.0 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
