CARE HOME ADULTS 18-65
Ashtons Cross 2 Tithebarn Road Ashton-in-makerfield Wigan Greater Manchester WN4 0YD Lead Inspector
Mr Mike Perry Unannounced Inspection 17th March 2006 11:00 Ashtons Cross DS0000022412.V287067.R01.S.doc Version 5.1 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 Ashtons Cross DS0000022412.V287067.R01.S.doc Version 5.1 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. Ashtons Cross DS0000022412.V287067.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Ashtons Cross Address 2 Tithebarn Road Ashton-in-makerfield Wigan Greater Manchester WN4 0YD 01942 767 060 01942 767062 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) www.trurehab.com TRU Limited Mrs Karen Connor Care Home 15 Category(ies) of Physical disability (15) registration, with number of places Ashtons Cross DS0000022412.V287067.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Service users to include up to 15 PD Date of last inspection 22nd September 2005 Brief Description of the Service: Ashton Cross opened in June 1992 and is a home, consisting of two separate houses (Woodlands and Beeches), registered to provide personal care and support to 15 service users with physical disabilities. Ages can range between 18 and 65 years. The home specialise in rehabilitation for service users who have acquired brain injuries and aim to assist them back to independent living. The two units offer different levels of support. The home is owned by TRU (Transitional Rehabilitation Unit) and is managed by Mrs Karen Conner. The Responsible Person is Mr Bill Kenyon. Residents of the Home are encouraged to undertake paid work linked to achieving agreed aims and objectives on individual care plans. The home is part of a comprehensive rehabilitation service involving another care home and community services as well as a variety of work based units. The home is located in the rural area of Ashton-in-Makerfield and is set in its own grounds with gardens. The home receives referrals nationwide due to the specialist area of care given. Ashtons Cross DS0000022412.V287067.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection was unannounced and was conducted over a period of 8 hours on one day. Day and recreation areas were seen as well as one bedroom. Records kept in the home were also viewed as well as staff records held at Margaret House [separately on 8.3.06], which is the administration sector for the organisation. In total the inspector spent time with residents and spoke with 4 in more depth. There were no visiting relatives on the day. The manager and 6 care staff were also interviewed [administration staff [at Mgt House] were seen on 8th March]. The inspector also left some comment cards for residents and visitors. 13 of the 20 Core standards that were not reviewed on the previous inspection were covered on this inspection. There were also some outstanding requirements from the previous inspection, which were also reviewed. For a fuller picture of the home this report should be read in conjunction with the previous report from September 2005. What the service does well:
The information available for residents prior to and on admission is very helpful and assists residents in both choosing and settling into the home. The manager aims to update the information further with reference to the recommendations in this report. The care at Ashton’s Cross is very structured around previously agreed goals and targets for each resident. Some of the goals are ‘self determined’. These are personal targets that residents set for themselves in terms of progressing through the care programme. Because these are self determined they are open to choice and the resident exercises some control over the care programme. The aim of the therapy is to try and predetermine any problems that may arise for residents and plan set ways of adapting and dealing with issues. Although the structure of the programmes sets limitations on, for example, going out spontaneously, this can be addressed by preplanning into the programme and this gives residents the opportunity to work through any problems that may arise. The unit takes referrals from all over the country and stress is placed on the importance of family contact being maintained. Residents reported that this is facilitated. The care reviewing system provides for regular feedback to families
Ashtons Cross DS0000022412.V287067.R01.S.doc Version 5.1 Page 6 who can also attend care conferences. One resident who has 1:1 staff support for most of the day has regular planned communication with the family and is transported home on a fortnightly basis. The daily routine is individually planned through the daily diaries in conjunction with coaching staff. Each service user therefore has a routine for the next day, which includes targets and times of activities. For the purposes of experiencing a ‘normal day’ the diaries are written with respect to routine daily activities of living such as getting up, washing, having breakfast etc. There is an excellent range of both work based and leisure activity for residents to choose. This includes workshops at Mgt House and Lyme House. Individual leisure activities are also included when requested. The weekly group trips out on a Sunday are a regular feature. The staff are well trained and were able to discuss residents care with a high degree of competence. Residents reported that staff were attentive and supportative. The training programme at TRU is unique and all staff attend and go through the same system so that they are all aware of the principals and practicality of working with residents. TRU employ a range of professional support including psychology, physiotherapy, medical and nursing input. Psychology input is very well formulated and staff work with residents on a daily basis. The Manager of Ashton’s Cross has been in post for 4 years and displays an understanding of the monitoring systems and developments necessary to further the unit’s aims and objectives. There is a useful range of audits and quality checks to help with this. What has improved since the last inspection?
The grounds at Ashton’s Cross have been developed to include an activity area. Some recommendations from the previous inspection have been actioned including a review of the pharmacy arrangements to include auditing by the supplying pharmacy. TRU have had a high turnover of staff in the recent past. This is now more settled with the turnover of care staff reduced. Ashtons Cross DS0000022412.V287067.R01.S.doc Version 5.1 Page 7 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Ashtons Cross DS0000022412.V287067.R01.S.doc Version 5.1 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 Ashtons Cross DS0000022412.V287067.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1 The information available describing the purpose and activity of the home is generally quite comprehensive and assists residents in their choice of whether to accept admission. EVIDENCE: The homes Statement of Purpose and Service User Guide is part of the information given to each resident prior to admission to the home. This was discussed with the manager with respect to a recommendation made on the last inspection asking for the tight structure of the daily routine, including house rules such as set times for retiring to bedrooms, be included in the guide. This had not yet been completed although the manager stated that she is currently in the process of reviewing the document as a whole and will incorporate the recommendation. The resident interviews revealed that the information supplied by Ashton’s Cross is generally quite comprehensive. Ashtons Cross DS0000022412.V287067.R01.S.doc Version 5.1 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 the following standard(s): 7 Staff agree a structured care programme with residents that also includes setting personal goals and targets so that residents are able to exercise some choice and control over the overall care strategy. EVIDENCE: The care at Ashton’s Cross is very structured around previously agreed goals and targets for each resident. The therapy team sets some goals although this follows discussion. Some of the goals are ‘self determined’. These are personal targets that residents set for themselves in terms of progressing through the care programme. Because these are self determined they are open to choice and the resident exercises some control over the care programme. The aim of the therapy is to try and predetermine any problems that may arise for residents and plan set ways of adapting and dealing with issues. Staff interviewed felt that frustrations generally arose from lack of adequate planning. Although the structure of the programmes sets limitations on, for
Ashtons Cross DS0000022412.V287067.R01.S.doc Version 5.1 Page 11 example, going out spontaneously, this can be addressed by preplanning and residents are asked to complete an ‘outings form’ so that such an event can be planned into the programme and this gives residents the opportunity to work through any problems that may arise. Some residents interviewed were frustrated by some of the limitations of the care plan but could see benefits from the programme overall and were able, to varying degrees, state how they had progressed. The home together with the other sites under the TRU banner operate an internal token economy system aim at rewarding met targets agreed on the care plan. All residents interviewed had a clear concept of this and were able to understand how it worked. Ashtons Cross DS0000022412.V287067.R01.S.doc Version 5.1 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 the following standard(s): 12, 15, 16 There is a very good range of work based and leisure activities planned on an individual and group basis so that residents are able to socialise and practice social skills appropriately. Residents report appropriate links with family and the inclusion of relatives in the feedback from the home ensures that relationships are maintained. The daily routine in the home is organised around individual daily care plans prompted by written diaries so that individual responsibilities for residents are identified. EVIDENCE: Residents reported that they did not always benefit from unplanned visits due to the wide variety of structured activities which they participate in. Many of the activities are often away from the unit. Residents reported regular contact with their families however including visits home. Ashtons Cross DS0000022412.V287067.R01.S.doc Version 5.1 Page 13 An example of this was one resident who has 1:1 staff support for most of the day and has regular planned communication with the family and is transported home on a fortnightly basis although does not live locally [unit takes referrals country wide]. Staff reinforced the idea that family support and awareness is vital to progress made by residents and so contact is facilitated. Relatives are also given a lot of feedback through reviews and formally through reports. One resident reported that his programme has progressed so that he now visits the unit during the day but goes home at night time to be with family. Staff reported that relationships on site do occur although the implications of this are discussed in detail with respect to the needs of the overall rehabilitation programme. The manager was able to give an example of this in the past. Sexual relationships would not be allowed on site but are supported off site. There are currently no policy statements or guidance for staff around the issue of intimate relationships and this should be addressed. A general statement should also be included in the service user guide. The unit admits both male and female residents. The female residents are admitted to the Woodland unit [home has 2 residential units] The inspector recommended a publication that might be useful in terms of any future planning for safe integration of both sexes. The publication offers good practice guidance in the field of mental health and the unit could draw some parallel ideas from it. The inspectors spoke to residents who explained that the daily routine is individually planned through the daily diaries in conjunction with coaching staff. Each residents therefore has a routine for the next day, which includes behavioural targets and times of activities. For the purposes of experiencing a ‘normal day’ the diaries are written with respect to routine daily activities of living such as getting up, washing, having breakfast etc with the purpose of reinforcing accepted social norms and behaviours. There is however an excellent range of work based and leisure activities for residents to choose from which can then be planned into individual programmes. There are workshops at Mgt House and at Lyme House as well as a variety of outings planned. Every Sunday, for example, there is an outing planned and residents can participate as part of a larger group. Ashtons Cross DS0000022412.V287067.R01.S.doc Version 5.1 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 the following standard(s): 18,19 Personal care is offered on an individual basis, which encourages independence and helps ensure appropriate standards so that residents are supported. Health care is well managed including regular liaison with referring agencies so that health care needs are met. EVIDENCE: Most residents are able to attend to their own personal hygiene needs and the staff role tends to be helping to set agreed goals and prompts in this area. Two residents were discussed however who require some degree of personal care to be carried out by staff. Staff were clear that only female staff would attend to female residents although this was not as clear when discussing the personal care of male residents [same sex staff carrying out care]. There was understanding of the need to preserve both dignity and privacy. The staff were not aware of any policy guidance in this area and the manager should address this following discussion with both staff and residents. The unit takes referrals from all over the country and many receive funding from health authorities that then review progress made on the unit through
Ashtons Cross DS0000022412.V287067.R01.S.doc Version 5.1 Page 15 regular case conferences. One resident discussed how this worked and how ongoing communication with the referring Neuropsychiatrist is maintained. The home offers in house medical support via a visiting GP, physiotherapy as needed and a nurse employed to give advice on medication management as well as medical issues. The referral of residents in cases of emergencies was discussed with reference to an incident involving the self harm of a resident some months ago. Immediate medical attention was delayed and the importance of such prompt referrals [to casualty in this instance] was highlighted. Ashtons Cross DS0000022412.V287067.R01.S.doc Version 5.1 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 the following standard(s): 23 The policies around adult protection procedures in the home are not clear and the manager needs to update them so that residents can receive clear protection from locally agreed protocols. EVIDENCE: TRU’s Policies around adult protection were reviewed at Lyme House on 8th March and similar comments apply at Ashton’s Cross. The policy file is accessible to staff and information is available. This is a bit confusing as two policies/ procedures are referred to – one written by TRU and the other is the locally agreed policy from St Helens Social Services – which seem to contradict each other. The TRU policy talks about an ‘investigation’ being carried out by TRU management which is contrary to the St Helens Procedure which advises that the Adult Protection Team, through Social Services, are contacted at an early stage so that a ‘strategy meeting’ can determine the course of events in terms of an investigation. It is important that the locally agreed joint procedures are followed in all allegations of abuse and this should be reinforced. The St Helens document is dated 2001 and the inspector advised that Social Services be contacted and any updating of this policy be acquired. The manager should also enquire about any training that may be available regarding the policy. To reinforce this the staff interviewed, although confident that any allegations would be acted on, were unclear as to the overall policies and the role of statutory bodies in any investigation. Staff did report that some training was conducted on induction although this is not present on the timetable seen by the inspector and perhaps needs to be reinforced in more depth.
Ashtons Cross DS0000022412.V287067.R01.S.doc Version 5.1 Page 17 Residents interviewed felt that staff were supportative and would listen to any concerns that they had and would act appropriately if needed. Ashtons Cross DS0000022412.V287067.R01.S.doc Version 5.1 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): Not assessed. EVIDENCE: Although the inspector conducted a brief tour of the home these standards were not assessed in any depth. There were no issues arising regarding the environmental standards. It was noted that continuing work on the development of the grounds includes new fencing and activity area. Ashtons Cross DS0000022412.V287067.R01.S.doc Version 5.1 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): 32,34,35 There are appropriately trained and experienced care staff employed so that residents feel supported and that their needs are understood and met. The recruitment processes in the home are not robust in that they do not record the necessary checks required prior to employment and therefore do not provide sufficient protection for residents. EVIDENCE: The staffing on the day of the inspection consisted of 9 care staff of different grades, the manager and 2 psychology staff. There is also admin support and ancillary staff. This for 14 residents. The staff ratio is very high and is important to carry out the coaching role that plays a vital part of the care system at TRU. The high turnover of staff which has been a feature of previous inspections has been reduced and staff now report a higher level of consistency. Staff interviewed were very knowledgeable about the residents in their care and displayed a high level of competence in discussing the care programmes. Residents expressed a high level of satisfaction when talking about the ability of the staff.
Ashtons Cross DS0000022412.V287067.R01.S.doc Version 5.1 Page 20 The training programme in the home is very well structured, particularly around the clinical background of acquired brain injury and the behavioural techniques used by staff to work with residents. All staff go through the same training programme, which is ongoing, and covers staff needs at different levels of clinical competence from induction to primary coaching and advanced training. The training programme includes a prolonged ‘shadowing’ component which staff reported as being particularly useful. The recruitment processes were reviewed with respect to requirements made in the last report around ensuring that all staff receive necessary checks with the Protection of Vulnerable Adults [POVA] register as well as the Criminal Records Bureau [CRB]. Staff records were viewed at Mgt House with the administration staff [inspection 8.3.06]. Again it was not clear whether the required checks had been made as only one file out of three inspected of recent staff recruitments had the information recorded. There was again some discussion about the importance of thorough checking and vetting of all staff employed by the company in order to protect vulnerable service users and such information being recorded on file. The inspector was assured this is the case but the staff files need to be arranged so that the information is recorded satisfactorily. It was agreed that administration would review all staff records and send an updated list of all staff POVA reference numbers to the Commission. Following discussion with the manager it is apparent that some trainees are commencing the ‘shadowing’ process on the unit without first being POVA cleared. This can be addressed by ensuring that the CRB request form is applied for and sent of at the interview stage of the recruitment process. Ashtons Cross DS0000022412.V287067.R01.S.doc Version 5.1 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): 37,39,42 The manager of the home has the experience and qualifications to ensure that Ashtons Cross is run satisfactorily and that residents best interests are maintained. The quality systems in place ensure good monitoring and ongoing improvements take place so that resident care can be progressed and procedures are appropriately managed to ensure smooth running of the home. EVIDENCE: The Registered Manager of Ashtons Cross is Karen Conner. Karen has been in post for 4 years. She is currently undertaking an NVQ qualification in management. She cited that one of her current projects is the reviewing of the homes service user guide and information supplied to residents prior to and following admission. She is also involved with staff training initiatives in the organisation. As with all staff that work for TRU she has come through the organisation experiencing all staff roles and training in order to become the manager of Ashton’s Cross. Ashtons Cross DS0000022412.V287067.R01.S.doc Version 5.1 Page 22 The manager was able to discuss the various quality audits that are conducted on a regular basis including facilities audits, health and safety and staffing. The manager conducts a 4 weekly audit of staff responsibilities and this is also reinforced through the mentoring system. Staff reported regular mentoring on site. The organisation as a whole has Investors in People status. Care reviews are held monthly and form part of not only clinical update but also act as a quality assurance tool in terms of ensuring that the service is able to demonstrate development for each resident set against measurable targets and goals. The review process is attended by the resident and all concerned with the care and support. Both verbal and written feedback is given to all parties including family and funders of the care. Case conferences are also held 3 monthly and referring health professionals, social workers and family can all attend. Yearly objectives are identified in the development of the organisation and the unit and an annual report is produced outlining achievements and targets for the forthcoming year. There remain some outstanding issues from the last CSCI inspection report that the management must now address although some of the last recommendations have been addressed including a review of the pharmacy arrangements. The health and safety management and records reviewed included fire safety records, accident recording and the gas and electrical maintenance. Fire records were good although it was noted that emergency lighting is not routinely tested on a monthly basis [see schedules as discussed on the inspection]. The electrical test certificate seen was due for renewal in March 2005 and therefore needs reviewing urgently. The unit has a good system of accident reporting which is well monitored and followed through. Ashtons Cross DS0000022412.V287067.R01.S.doc Version 5.1 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 Standard No Score 1 3 2 X 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 X 23 3 ENVIRONMENT Standard No Score 24 X 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 4 33 X 34 2 35 4 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X 3 X X X LIFESTYLES Standard No Score 11 X 12 4 13 X 14 X 15 3 16 3 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 X X 3 X 3 X X 2 X Ashtons Cross DS0000022412.V287067.R01.S.doc Version 5.1 Page 24 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 YA34 Regulation 19 Requirement All staff employed by TRU must undergo routine POVA and CRB checks to ensure fitness to work with vulnerable people. All existing files must be updated with the necessary checks and information listed in schedule 2 of the Care Home Regulations. A list of all staff and the date and reference of CRB checks must be forwarded to the Commission. [Last requirement date 30.10.05 not met]. Trainees must not start ‘shadowing’ staff on the units without first being POVA cleared. 2 YA42 23 Fire records must be updated to include testing of emergency lighting [monthly] as indicated on the ‘fire schedules’ in the fire logbook. 01/05/06 Timescale for action 01/05/06 Ashtons Cross DS0000022412.V287067.R01.S.doc Version 5.1 Page 25 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 YA1 Good Practice Recommendations The Homes Statement of Purpose and Service User Guide should contain reference to the tight structure of the daily routine in the home and house rules such as set times for retiring to bedrooms should be included. There should be some policy / guidance available to staff and residents on the issue of intimate relationships. The inspector recommends consulting the document ‘Safety, Privacy and Dignity in Mental health units’ in terms of any future planning and caring of residents on the unit. There should be some policy guidance around the principals involved in carrying out personal care for residents including guidance around the need for carers of the same sex. In the case of all health related incidents the resident should receive appropriate referral and medical assessment. The policies for reporting and managing allegations of abuse should be reviewed in the light of the comments in the report. Social Services adult protection team should be contacted regarding updating policies and providing any training. The induction programme for staff should contain clear reference to adult protection policy and procedure. The electrical safety certificate needs to be updated. 2 3 YA15 YA15 4 YA18 5 6 YA19 YA23 7 YA42 Ashtons Cross DS0000022412.V287067.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection Knowsley Local Office 2nd Floor, South Wing Burlington House Crosby Road North Liverpool L22 0LG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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