CARE HOME ADULTS 18-65
Ashwood Avenue 36 - 38 Ashwood Avenue Kirkby in Ashfield Nottingham Nottinghamshire NG17 7QA Lead Inspector
Joanna Carrington Unannounced Inspection 11th April 2007 10:00
11/04/07 Ashwood Avenue DS0000068816.V333825.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 Ashwood Avenue DS0000068816.V333825.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. Ashwood Avenue DS0000068816.V333825.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Ashwood Avenue Address 36 - 38 Ashwood Avenue Kirkby in Ashfield Nottingham Nottinghamshire NG17 7QA 01623 482702 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.mencap.org.uk Royal Mencap Society Post Vacant Care Home 12 Category(ies) of Learning disability (12) registration, with number of places Ashwood Avenue DS0000068816.V333825.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. The Royal Mencap Society is registered to provide accommodation and personal care at Ashwood Avenue, 36 - 38 Ashwood Avenue, Kirkby in Ashfield, Nottingham, NG17 7QA for a maximum of 12 people whose primary care needs fall within the following numbers and categories: Learning Disabilities (LD) - 12. Not applicable. New Service Date of last inspection Brief Description of the Service: 36/38 Ashwood Avenue is a care home consisting of two purpose built bungalows providing care and support for up to twelve adults with a learning disability. The home was registered with Mencap on 1st November 2006. Nottinghamshire Community Housing Association owns the building. The home is located on the outskirts of Kirkby in Ashfield not too far from shops, pubs, the post office and other local amenities. All of the bedrooms are single; none are en-suite. Residents with mobility difficulties are assessed by an occupational therapist for any equipment they need to be able to live and be supported safely in the home. The home has a garden area, which is accessible and there is car parking available to the front of the bungalows. The manager has applied for registration and is due her fit person interview. The fees for the home are from £334 to £349 per week topped up by individuals’ assessed income support. Ashwood Avenue DS0000068816.V333825.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This is the home’s first key inspection since Mencap became the registered provider on 1st November 2006. The inspection took place over seven hours on 11th April 2007. The main method of inspection was called ‘case tracking’ which meant selecting three residents and tracking their care by checking their records, discussion with them and with staff and observations of care practice. Three residents and three staff members were spoken with during the course of the inspection. Staff files were examined to make sure the staff team is trained to do their job and that checks are carried out before staff are employed. A partial tour of the premises also took place in order to inspect environmental standards. The manager was available for discussion and feedback throughout the inspection. Judgements about a service are also made from information that is received about the service before an inspection. This includes notifications and monthly inspection reports by the registered provider. The pre-inspection questionnaire, used for gathering information for planning the inspection was not returned before the inspection took place. What the service does well:
The admissions procedure for the home stipulates that prospective residents are not considered until their needs have been assessed. This is to make sure that the care home is suitable and that any new residents are compatible with existing residents living at the home. The staff team have a good understanding of residents’ individual needs and level of support, which accurately reflects what is written in the care plans. Care plans are regularly reviewed so to make sure any changes in how support is given can be identified. Healthcare professionals are called on when it becomes necessary in maintaining a resident’s health and wellbeing. The staff team have a good awareness of the individual communication needs of residents and use tools such as pictures and referential items to enable residents to exercise choices and make decisions in their lives. Residents are consulted about the day-to-day aspects of the home, including their involvement over strategies to combat the current vandalism that the home is experiencing. The manager and staff team have taken an inclusive and proactive approach in responding to the vandalism and in supporting residents during this time. The manager is working with the local community and schools in educating children about disability and bullying. The staff team are clearly committed to promoting residents’ quality of life through access to the community, participation in fulfilling activities and enabling contact with family and friends. Meals are healthy, varied and nutritious. Residents are treated with dignity and respect.
Ashwood Avenue DS0000068816.V333825.R01.S.doc Version 5.2 Page 6 Residents are aware of the complaints procedure and are confident that their concerns are listened to. For those residents that are not able to express their concerns their relatives / representatives use this procedure and their concerns are taken seriously and acted upon. The staff team are aware of the procedures they must follow in the event of any allegations of abuse. This is vital in protecting residents from all forms of abuse. Recruitment procedures are robust and protect residents because new staff members are not employed until references and a criminal record bureau check have been obtained. What has improved since the last inspection? What they could do better:
The Statement of Purpose needs more information specifically about the service otherwise prospective residents and their relatives / representatives cannot make an informed choice about moving there. Communication tools such as photos and pictures could be used to enable residents to choose meals and help in menu planning. The standard of the external property is poor, which is placing residents at risk. Some of the windows are rotting badly, which is potentially encouraging further vandalism and attempted break-ins. This is compromising residents’ safety. New staff members need to have full inductions that include Learning Disability Award Framework (LDAF) training within the first six months of their employment. This is so that new staff members gain a good awareness of the needs of people with a learning disability and understand the principles of care and working with vulnerable people.
Ashwood Avenue DS0000068816.V333825.R01.S.doc Version 5.2 Page 7 There needs to be a homely remedies policy so that over the counter medication such as paracetamol can be given to residents. A homely remedies policy will give greater flexibility in giving residents pain relief while at the same time ensure residents are medicated safely and have medical assistance when needed. 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. Ashwood Avenue DS0000068816.V333825.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 Ashwood Avenue DS0000068816.V333825.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 and 2 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Admission arrangements ensure the home is suitable in meeting prospective residents’ needs but prospective residents need more information specifically about the service in order to decide to move there. EVIDENCE: On residents’ files there was evidence that the placing authority’s community care assessment was obtained before each resident was admitted to the home. This assessment is used initially to decide whether the home is suitable in meeting individuals’ needs. The Statement of Purpose has recently been updated and is now presented in the format of the new registered provider. The document does not contain enough information specifically about the service, as specified under Schedule 1 of the Care Homes Regulations 2001. For example, the document does not say anything about the arrangements for residents to engage in social activities or the range of needs that the care home intends to meet and the age-range and sex of residents that the care home caters for. Ashwood Avenue DS0000068816.V333825.R01.S.doc Version 5.2 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. 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. There are good arrangements in place for ensuring that individuals’ needs and choices are met and that residents can participate in their chosen activities safely. EVIDENCE: On the files of all three residents’ case tracked there are care plans that cover aspects of social, emotional, health and personal care needs. There was evidence that these care plans are evaluated on a regular basis in order to identify if any changes are necessary. The reviews of some care plans show that the care plan has not been implemented for over a year, therefore consideration must be given as to whether this means it is no longer an identified need. A resident spoken with confirmed they are involved in the development and review of their care plans. Staff spoken with demonstrated an understanding of the purpose of care plans and a good awareness of the individual needs of residents, as reflected in the written plans. Ashwood Avenue DS0000068816.V333825.R01.S.doc Version 5.2 Page 11 The care plans are still written in the format of the previous provider and are due to be re-written. Training is being provided to staff on how to use the new registered provider’s risk assessments. This will be worthwhile because there appears to be some confusion with the differences between care plans and risk assessments as these often contain the same information. For example, a care plan and its accompanying risk assessment are both titled ‘burns and scalding’, when the identified need is personal hygiene / bathing. Despite this, there are risk assessments in place for activities such as swimming, smoking and holidays and risk assessments have been used to identify when there is a need to restrict freedom of movement. For example, having to be escorted in the community because of limited road safety awareness. Support plans make reference to residents’ personal preferences and how individual residents are enabled to make decisions about their lives. Staff spoken with explained how they communicate with individuals for example showing items and using visual tools such as photographs and pictures and support plans were seen identifying individuals’ communication needs. Staff were observed communicating with residents effectively and in a respectful manner. Ashwood Avenue DS0000068816.V333825.R01.S.doc Version 5.2 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. 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. There is a commitment from the staff team in promoting residents’ rights and enabling residents to experience a fulfilling quality lifestyle. EVIDENCE: On the day of the inspection two residents were out at day centre while all other residents were at home on their Easter holidays. A resident spoken with said that she goes to college and does writing there which she enjoys. All of the residents spoken with expressed what their favourite activities are such as playing football, gardening and going to discos. Daily records of the three residents case tracked showed various activities are provided on a daily basis, which include going out shopping, bowling, pub and helping out in the kitchen. Since the home has been registered with another provider it has not had its own accessible vehicle. The manager reported that funding has been approved for the home to again have its own vehicle. It is evident that in the meantime Ashwood Avenue DS0000068816.V333825.R01.S.doc Version 5.2 Page 13 the staff team are making every effort to ensure all residents have the same opportunities to go out by hiring wheelchair accessible taxis. Daily records and the visitors book also indicate residents’ have regular contact with their families and friends. Some residents are able to choose if they wish to go out with their parents every weekend. The staff team will inform the parents who then pick the resident up. It was apparent from observation that staff promote residents’ right to choice. Residents spoken with confirmed they can choose to do an activity or spend time to themselves in their bedroom. Staff spoken with gave good examples on how they ensure residents’ privacy is maintained, for example always closing the door when assisting with personal care. Residents spoken with confirmed that staff treat them with dignity and respect. Resident meetings have started up at the home and the minutes show that residents have been asked for their suggestions on how to tackle vandalism (See outcome areas Environment and Conduct and Management) and consulted on what their favourite activities and meals are. The menu records show that residents always have a choice and that varied healthy nutritious meals are offered and that dietary needs are catered for. It is recommended that communication tools such as photos and pictures be used to enable residents to choose and plan meals. Ashwood Avenue DS0000068816.V333825.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ healthcare needs are met and they receive personal support in the way they prefer and require. Improvements to medicine management promote the safety of residents. EVIDENCE: For the three residents that were case tracked the care plans for assistance with personal care refer to individuals’ preferences, for example “[the resident] likes to have a bath or shower twice a day.” The care plans also include how to promote independence and the right to make choices for example with clothing and developing self-image. The residents’ files seen demonstrate that specialist healthcare professionals such as psychiatrists and clinical psychologists are accessed when necessary and that residents go to well woman and well man clinics for regular health checks. All healthcare appointments are recorded on a chart, which shows that residents have access to chiropody, dentist and to practice nurses.
Ashwood Avenue DS0000068816.V333825.R01.S.doc Version 5.2 Page 15 The storage of medication appeared well organised and each medication administration record (MAR) contains a medication profile for each resident and any possible side effect that maybe experienced. The procedure for what to do in case an error is discovered is also displayed in the medicine cupboard. Most medicines are already pre-dispensed in monitored dosage systems (MDS). Instructions for the administration of medication were clear and all medicines audited in MDS have been given as prescribed. Some residents are being given over the counter paracetamol for pain relief. Over the counter medicines are referred to as homely remedies. To ensure that homely remedies are used safely and appropriately the home must have its own homely remedies policy, which is signed by a GP. Ashwood Avenue DS0000068816.V333825.R01.S.doc Version 5.2 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. 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. Residents are protected from abuse and are assured that their complaints and any allegations of abuse are taken seriously and acted on. EVIDENCE: There is an appropriate complaints procedure, which is presented in using plain English and pictures so that it is more accessible to residents. Since the home has been registered there have been three complaints made by relatives recorded in accordance with the complaints procedure. Two of these complaints have already been followed up and records indicate that appropriate action was taken within reasonable timescales. The third complaint is in the process of being responded to. A resident spoken with said they would go to the manager if they were unhappy about something and they feel confident that their concern would be listened to and dealt with. There have been no safeguarding adults investigations since the home has been re-registered. Staff spoken with demonstrated an awareness of the local safeguarding adults procedures and understand their responsibility to alert the manager of any allegations of abuse and to whistle blow. Ashwood Avenue DS0000068816.V333825.R01.S.doc Version 5.2 Page 17 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25 and 30 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Residents live in a clean and homely environment however outstanding maintenance work to the property externally means the home is not a safe place and puts residents at risk. EVIDENCE: The home has for some time now been the victim of ongoing vandalism and attempted break-ins. Since the home has been re-registered the manager has notified the Commission of thirteen incidents. Some of these incidents have placed residents at serious risk of harm. Bedroom windows have been smashed and an iron bar was thrown through the lounge window. An urgent action letter was sent to the registered provider in respect of these incidents because of concerns that further action was needed to make sure residents are safe. It is evident that the manager and the registered provider have been proactive in dealing with this situation (See outcome area Conduct and Management)
Ashwood Avenue DS0000068816.V333825.R01.S.doc Version 5.2 Page 18 however there are still environmental issues that are not resolved and continue making the home vulnerable to further vandalism. Bedroom windows of Bungalow 38 do not have protective film on them to prevent the windows from shattering and there are window frames that are rotting badly and are not adequately secure. The wooden slats in the front door of Bungalow ? are coming off. The manager reported to have done a maintenance schedule prioritising external work to the property, which has been sent to the housing provider but there was no copy to evidence this. On a partial tour of the premises the environment appeared clean and hygienic throughout. There is a cleaning rota that staff follow so that all essential cleaning tasks are regularly carried out. Staff spoken with understand the importance of hygiene and controlling infection. The bedrooms seen are pleasantly decorated and personalised with residents’ pictures and items. Residents spoken with reported they chose the colours their bedrooms are decorated in. Ashwood Avenue DS0000068816.V333825.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 and 35 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staffing arrangements have improved, which helps ensure residents are protected and are supported by an effective and competent staff team. This is compromised however if new staff are not adequate inducted into their new roles. EVIDENCE: Staff members spoken with reported that training opportunities have increased since being re-registered. The staffing records seen indicate that staff are getting all of their mandatory health and safety training such as First Aid and Moving and Handling and other courses such as supervision training and person centred planning to enable individual staff to carry out their role and meet the needs of residents. There is a training plan for the first half of 2007 / 2008 identifying various courses, which staff need to attend. A staff member that commenced employment over six months ago still requires Learning Disability Award Framework (LDAF) induction and foundation training, and has not started the induction that meets with Skills for Care common induction standards. Ashwood Avenue DS0000068816.V333825.R01.S.doc Version 5.2 Page 20 All four staff files selected had evidence of a criminal record bureau disclosure and for the two new staff these checks were obtained before the staff commenced their employment. Two staff members that transferred over from the previous employer did not have two written references on their file, which is a legal requirement therefore references must be obtained. Ashwood Avenue DS0000068816.V333825.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from a home that is run well and in their best interests. The health, safety and welfare of residents is promoted and protected. EVIDENCE: The manager has applied for registration and will shortly be attending a fit person interview. Both staff and residents spoken with praised the manager for being supportive, approachable and “always on the ball”. The manager has been keeping the Commission informed of any further incidents of vandalism at the home and of what action is being taken. The manager and registered provider are handling the situation professionally and proactively. Regular meetings with the police, social services and the Primary Care Trust are taking place and the manager is working with the local schools and community on anti-bullying. Residents have been consulted throughout and one resident has been involved in a community anti-bullying group. Residents have recently
Ashwood Avenue DS0000068816.V333825.R01.S.doc Version 5.2 Page 22 been on holiday to the Peak District, which gave them time away from the home. On the day of the inspection two staff members of another MENCAP service were visiting the home as part of its quality review to speak with residents and ask them their views about their home. The home has had its full service review with MENCAP, which was carried out by an internal quality auditor and a manager from another region. The report from this review indicates a commitment from the registered provider to provide a quality service to residents and make improvements to the service. Unannounced monthly visits are also undertaken for monitoring the management and conduct of the service. The fire log shows that all the required fire safety testing and fire drills have been undertaken and the fire risk assessment has been reviewed and updated. Fridge and freezer temperatures are recorded on a daily basis. Environmental health and safety checks are carried out regularly to make sure that there are no hazards and that residents and staff are safe. Ashwood Avenue DS0000068816.V333825.R01.S.doc Version 5.2 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 2 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 1 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 2 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 3 X X 3 X Ashwood Avenue DS0000068816.V333825.R01.S.doc Version 5.2 Page 24 No 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 YA1 Regulation 4 Requirement Timescale for action 01/08/07 2 YA24 23 3 YA34 19 4 YA35 18 Ensure the Statement of Purpose contains information specific to the home, including information specified under Schedule 1 of the Care Homes Regulations 2001. This is to ensure prospective residents have enough written information about the service. Carry out urgent maintenance 01/07/07 work to the property externally. This is to make the environment more comfortable, safe and secure for residents. Ensure two written references 14/05/07 are obtained before staff members commence their employment. This is to ensure residents are protected from harm. Ensure all new staff members 01/05/07 are given a full induction that meets with Learning Disability Award Framework (LDAF) and Skills for Care standards, before carrying out their role. This will ensure residents are in safe hands at all times and that their needs are understood. Ashwood Avenue DS0000068816.V333825.R01.S.doc Version 5.2 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 YA6 Good Practice Recommendations Ensure care plans provide information on how to meet the needs of residents, while risk assessments provide information on minimising and managing certain risks associated with meeting those needs. Provide communication tools for meals and meal times to give residents more choice. Devise a homely remedies policy for the home so that over the counter paracetamol can continue being given to residents and any other over the counter medicines can be given when appropriate. This is in accordance with Pharmaceutical guidance. 2 3 YA17 YA20 Ashwood Avenue DS0000068816.V333825.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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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