Inspection on 11/10/05 for Barleycombe Residential Home

This inspection was carried out on 11th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 9 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Barleycombe Residential Home 14/01/08

Barleycombe Residential Home 29/08/07

Barleycombe Residential Home 27/06/05

Barleycombe Residential Home 23/05/05

Barleycombe Residential Home 04/11/04

Barleycombe Residential Home 19/05/04

Barleycombe Residential Home 13/02/04

Barleycombe Residential Home 14/08/03

Barleycombe Residential Home 28/11/02

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 Barleycombe Residential Home Sudbury Road Long Melford Sudbury Suffolk CO10 9HE Lead Inspector Claire Hutton Announced Inspection 11th October 2005 & 3rd November 2005 10:00 Barleycombe Residential Home DS0000024331.V256452.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 Barleycombe Residential Home DS0000024331.V256452.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. Barleycombe Residential Home DS0000024331.V256452.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Barleycombe Residential Home Address Sudbury Road Long Melford Sudbury Suffolk CO10 9HE 01787 880203 01787 310809 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) West Regent Limited Ms Sandra Bishop Care Home 14 Category(ies) of Learning disability (14) registration, with number of places Barleycombe Residential Home DS0000024331.V256452.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 23rd May 2005 Brief Description of the Service: Barleycombe is a care home for adults with a learning disability and currently only has male residents. In December 2000 the home became registered under Exceler Healthcare Services (trading as West Regent Healthcare Ltd.) The home consists of a two storey building situated in extensive grounds, which had been cultivated to produce vegetables and maintain livestock. The home was set back from the main road running between Sudbury and Long Melford. Both towns were accessible via public transport, with Long Melford within reasonable walking distance. The owners of the home had produced plans to extend the service by providing a five bedroom “moving on” facility. Copies of the plans were submitted to the National Care Standards Commission in 2003, these have since been revised. Barleycombe Residential Home DS0000024331.V256452.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place over 2 days at the end of October and beginning of November 2005. The main reason was that Barleycombe is currently under going change. Two most significant changes are: the appointment of a new manager, Mrs Joanne Woodhead and the extension/ refurbishment of the home. The latter is still in the planning stage. Over the two days most of the residents were met and spoken with. Five staff, including the new manager, were seen individually. A full tour of the premises was undertaken. Care plans and associated records for three residents were examined. Staff recruitment and training records were also examined. Medication systems in place were scrutinised and activities on offered were looked at. A questionnaire from eleven relatives and thirteen residents seeking views of the home was collated and fed back to the managers. What the service does well: What has improved since the last inspection? There have been significant changes at the home since the last inspection. Primarily the appointment of a competent, qualified and experienced manager. Mrs Joanne Woodhead’s application for registration as manager was in the process of being assessed by CSCI. At the previous inspection there were concerns around the locking of the entrance gates to the home that infringed the liberty of all residents and the kitchen door being locked preventing residents from entering. In addition there was a concern around understanding of the risk assessment process. Upon this visit there was a change as the gates were unlocked but with a sign on them to keep closed. The kitchen was seen to be more accessible to residents. All individuals had access at some point during the week. Risk assessments were Barleycombe Residential Home DS0000024331.V256452.R01.S.doc Version 5.0 Page 6 in place for supervision and the extent of the activities within the kitchen. Some residents had more supervision that others in their use of the kitchen. A baseline policy on relationships and sexuality had been developed for the home. A number of staff had obtained a place on a training course for relationships and sexuality. Care plans had been developed further and there were plans to modernise these to enable then to be more accessible to the residents. Evidence of supervision of staff in the past showed that this was not consistently available, but the new manager had introduced a system of cascade monthly formal supervision. 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. Barleycombe Residential Home DS0000024331.V256452.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Barleycombe Residential Home DS0000024331.V256452.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 and 5 People who use this service cannot be guaranteed their needs will be assessed and known by the home or have written terms and conditions in place. EVIDENCE: Information relating to three residents was examined. One resident was quite new to the home and two residents had been at the home for some time. The new manager believed that an assessment had been carried out on the newer resident, but was unable to provide any evidence of assessment either from a social worker or from Barleycombe. On the second day of inspection the assessment from the social worker had been sent to the home. This was several weeks into his residency. There was no evidence of a contract or a signed terms and conditions. The new manager agreed to ensure both key pieces of information would be in place. Assessments for the two residents who had been at the home for some time were also not available for inspection. These were thought to have been out of date and archived. Due to the time lapse since initial assessment and the nature of disability, it was agreed that the manager request a re assessment of needs for these two individuals that include information on behavioural management plans. Barleycombe Residential Home DS0000024331.V256452.R01.S.doc Version 5.0 Page 9 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, 7 and 9 Residents can expect to have plans developed around their individual needs, however residents may not be supported to make decisions and take risks as part of an independent lifestyle. EVIDENCE: Care plans for the same three individuals were examined. A newer format had been developed that covered thirteen elements of daily living, such as recreation and social, sleep and rest, eating and drinking. Since the new manager had started these plans had been reconsidered and one senior carer was in the process of developing a much more accessible care plan. The plan proposed would be more understood by the individual resident, who would help develop the plan, creating ownership and the format would be more pictorial. A discussion was held with the manager about the plans also retaining a formal function. This being, the formal instruction from the manager, to care staff on how to care for each individual. The manager was confident that a balance would be found. Feedback from the thirteen residents surveyed stated that nine of them would like to be more involved in decision-making. Barleycombe Residential Home DS0000024331.V256452.R01.S.doc Version 5.0 Page 10 There was evidence of information required to be held by regulation being present and there was also evidence of recent review of care plans. One objective of a plan was to develop independence around every day living tasks. The kitchen area was now more accessible to residents in order to develop this skill. Some residents capable of preparing lunch for the group of residents present had this planned into their timetable. Three other residents who were capable of preparing their own food had this timetabled in as a one to one cooking session. The last inspection report stated ‘One other care plan had been developed from an historical assessment when the person first came to the home. The instruction to staff to state “stay in your chair or I will take lunch away” must be reviewed’. It was stated that a multidisciplinary group must review this level of sanction. At this inspection the care plan had been reviewed by the home, but the above statement was still in the file and only removed during inspection when brought to the new manager’s attention. Therefore this request to review sanctions in relation to management of behaviour still stands. The document ‘Guidance on Restrictive Physical Interventions For People With Learning Disability And Autistic Spectrum Disorder’ produced by the Department of Health was discussed with the new manager and she agreed to access a copy to ensure all care staff are aware of the principles. There was a requirement from the last inspection to ensure that a risk assessment was put in place for the individual who had left the premises without notifying staff. A review with other professionals was said to have taken place, but no minutes or decision record was available. No risk assessment was available for inspection around the arrangements that the home have now put in place. Barleycombe Residential Home DS0000024331.V256452.R01.S.doc Version 5.0 Page 11 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): 12,13,14,15 and 17. People who use this service can expect a lifestyle that offers opportunities for personal development, leisure and community participation. EVIDENCE: There has been a recent change in the program of activities at Barleycombe. There is now more structure in place with designated individuals to tasks. The activities program has designated staff and individual resident names along side times. Activities include care of the animals, with one specific person employed who is appropriate to teach care of the animals, housekeeping, lunch preparation, shopping, cooking, fishing and horticulture. In addition some individuals attend day services fro people with a learning disability or college. The amount of appropriate activities on offer to participate in the local community was varied and based around resident’s preferences. Throughout the week there is are evening activities. These are trips to the local pub, the Legion, Gateway, shopping and swimming. Residents spoken to were pleased to have the opportunity to go shopping and buy their individual purchases. Other opportunities for leisure included shiatsu and a video night. Seven out of twelve residents surveyed felt that activities on offer were suitable. Barleycombe Residential Home DS0000024331.V256452.R01.S.doc Version 5.0 Page 12 The menu for residents has recently changed. Residents were said to be consulted on the changes. A copy of the two weekly menus was provided and these do ensure a wholesome balanced diet was on offer. A meal with the residents was taken on both occasions at the home. Each meal ended with fresh fruit and yogurt. One member of staff thought the changes were healthier and that residents had generally responded positively to the healthy options now presented. Ten out of thirteen residents surveyed liked the food offered at Barleycombe. At two previous inspections to the home a requirement was made to develop a policy around all aspects of relationships, as this was particularly relevant to a group of young men. A baseline policy was now in place. This was said to have been developed by the area manager. The previous request was to have staff and residents consulted on the development and to offer staff training. Five staff had obtained a place on a local training course run by Suffolk Social Services on relationships and sexuality. The manager agreed that the policy would be reviewed in light of the training these staff had under gone. Barleycombe Residential Home DS0000024331.V256452.R01.S.doc Version 5.0 Page 13 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): 20 People who use this service cannot be guaranteed that the current practices around medication will keep them safe. EVIDENCE: The medication systems in place were scrutinised. The system used at Barleycombe is the Nomad system. The storage of medicines was in a suitable secure cupboard and the duty person held the key. There was a medication fridge available to store medication. However there was no record of the temperatures. One resident had been prescribed medication to help him stop smoking. This prescribed medication was not locked away appropriately or recorded on the MAR (Medication Administration Record). The manager agreed to review the medication administration procedure, as aspects of this appeared to be out of date practice, e.g the PRN procedure instructions. (as and when required medication) Other medication administration records were examined. These were adequately completed. And a photograph of each resident was in place for identification. However the process of two staff administering medication and there only being space for one to sign was questioned. Along with the training that is expected to ensure any one individual is adequately trained to administer medication. The manager explained that she hoped to get staff on Barleycombe Residential Home DS0000024331.V256452.R01.S.doc Version 5.0 Page 14 a more in-depth medication-training course soon, as well as completing the local pharmacy course. One member of staff said they did not have medication training but were put in a position that they did administer medication. A list of sample signatures and initials to identify those administering medication was not available for inspection. Barleycombe Residential Home DS0000024331.V256452.R01.S.doc Version 5.0 Page 15 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 and 23 People who use this service can expect to have access to complaint system if they need it and to be protected from abuse as far a possible. EVIDENCE: The home had a Complaints Procedure, which was contained within the comprehensive Service User Guide and also displayed within the home, accessible to all residents, staff and visitors. The log of complaints held at the home was examined and found to be appropriate. No complaints have been received by the CSCI since the last inspection to the home. Feedback from the residents surveyed stated that ten out of thirteen residents knew who is speak to if they were unhappy. Two residents did not know who to speak to. The manager was aware of the local procedure for the Protection of Vulnerable Adults (POVA). She had recently referred a matter through that is now being dealt with. One member of staff spoken with confirmed they had received training in protection matters. This was also covered in the induction training seen on staff files. Staff files also show that staff are either POVA 1st checked or have a full CRB (criminal records bureau check) Barleycombe Residential Home DS0000024331.V256452.R01.S.doc Version 5.0 Page 16 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 and 30 The accommodation provided was generally clean and satisfactory, however some repairs are needed to maintain a minimum level of comfort and hygiene. EVIDENCE: A tour of the premises was undertaken. This included individual bedrooms and the more independent flat. On the whole the home is clean, presentable and meets the needs of the residents who live there. A discussion was held with the manager around the new extension and the refurbishment of the home. The refurbishment will make it possible for each bedroom to have an en-suite. This will be a very positive step as some of the bedrooms are rather cramped with all the possessions some individuals choose to have. One individual’s room was rather sparse. The en-suites will make a difference in the quality of accommodation offered. The discussion centred around the need to ensure that the home is maintained adequately in the interim. Therefore, matters such as the cleaning/replacement of carpet in room 5 must take place now. The seal on the fridge was broken and must be replaced. Door handles that were loose and unable to be used comfortably must be repaired/replaced and finally in the laundry room there was no wash hand basin, liquid soap and paper towels. Barleycombe Residential Home DS0000024331.V256452.R01.S.doc Version 5.0 Page 17 This is a high-risk area of infection and must therefore facilities must be provided. Barleycombe Residential Home DS0000024331.V256452.R01.S.doc Version 5.0 Page 18 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 and 36 Recruitment of staff is robust and offers protection to residents. Training plans show promise, but currently there gaps in the skill mix that can be achieved. EVIDENCE: Four care staff were spoken to privately. Records for three staff were examined. These included the recruitment and training achievements. The training plan and supervision plan was seen. The recruitment records were generally in good order. The manager was aware of the checks required prior to taking up employment. These were generally in place. However, there was not always photographic identification on file, but these may have been provided to obtain a CRB (criminal records bureau) clearance that was on file. A discussion was held around the home’s decision to employ individuals that had matters arising from either references or CRB checks. The manager understood her responsibility to risk assess the factors presented and document these on individuals files and agreed to do this. A training plan for 2006 was in place. This showed updates in first aid, manual handling, fire, health and safety and control and restraint. A discussion was held around staff who are employed who have appropriate training in control and restraint. The home chooses to use NAPPI (none abusive psychological and physical intervention) control and restraint training Barleycombe Residential Home DS0000024331.V256452.R01.S.doc Version 5.0 Page 19 for staff. There was evidence that this is accredited with BILD as recommended by the Department of Health. There were a number of staff identified who required this training. The manager sated that 3 staff employed were not fit enough to under go the training, however a further nine people were fit and needed to attend training. There are plans to have eight staff start National Vocational Qualification (NVQ) 2 and two other people start NVQ 3. As well as have two people train to be assessors. The home currently employs four staff who hold NVQ three. The manager recognised that in the past staff had not received frequent supervision. She was in the process of introducing a monthly cascade formal supervision process within the home. In order to do this some staff required training on how to supervise. This was set up for 16th November 2005. Barleycombe Residential Home DS0000024331.V256452.R01.S.doc Version 5.0 Page 20 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, 38, 39, and 42 Barleycombe now has the benefit of a competent manager, who is likely to improve the management of the service, however systems around health and safety are not completely comprehensive to ensure protection. EVIDENCE: Barleycombe has benefited from the appointment of a competent, qualified and experienced manager. Mrs Joanne Woodhead has recently been appointed and has begun to make changes at the home that have been positively received. All staff spoken to were pleased with the appointment and one person felt that she had a vision for the future of the home and had begun to challenge some practices within the home. The organisation that owns the home have a quality audit system in place. A visiting regional manager regularly completes this. The monthly regulation 26 visits, where the organisation inspects itself are completed and a copy sent to the CSCI. The manager spoke of her plans to introduce a more local auditing system around medication, care plans and health and safety. A discussion was held around the desire expressed by nine residents in the questionnaire to be Barleycombe Residential Home DS0000024331.V256452.R01.S.doc Version 5.0 Page 21 more involved in decisions with in the home. Residents meetings were advertised on the notice board and minutes kept. The manager agreed to look at involving advocacy particularly with the major changes planned. Records relating to health and safety checks and fire were examined. New contractors were required to be set up as previous agreements had stopped due to the organisation changing hands. The gas engineer was due to visit the next day to issue a landlords certificate. The five-year electrical hard wiring certificate was out of date. In one residents bedroom there was concern about the number of socket needing to be used and the use of extension leads. Yearly appliance checks were up to date and a pest control contract was in the process of being set up. There was evidence of regular checks on hot water temperatures to prevent scalding. In some cases this was a little low at 35°c. There was a fire risk assessment in place. The book used by the maintenance man to record checks he had done was difficult to follow and needed to be revised. One member of staff spoken with was not totally confident in their role in fire evacuation and assembly. The manager agreed to review the processes they had in place. Barleycombe Residential Home DS0000024331.V256452.R01.S.doc Version 5.0 Page 22 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 2 X X 2 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 2 x 2 x Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x x 2 LIFESTYLES Standard No Score 11 x 12 3 13 3 14 3 15 3 16 x 17 Standard No 31 32 33 34 35 36 Score X X X 3 2 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Barleycombe Residential Home Score X X 2 x Standard No 37 38 39 40 41 42 43 Score 3 3 3 X X 2 x DS0000024331.V256452.R01.S.doc Version 5.0 Page 23 Are there any outstanding requirements from the last inspection? Yes 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 YA2 Regulation 14 (1) Requirement Timescale for action 10/11/05 2 YA5 5 (1) 3 YA7 15 and 17 4 YA9 14 15 17(1) New residents must only be admitted on the basis of a full assessment undertaken by people competent to do so, involving the prospective service user, using an appropriate communication method and with an independent advocate as appropriate. The registered manager must 10/11/05 develop and agree with each prospective resident a written and costed contract/statement of terms and conditions between the home and the service user. The care plan must describe any 10/11/05 restriction or sanction on choice and freedom and must be made in agreement with the resident. Residents rights to make decisions are only restricted through assessment and must be recorded in their individual care plan. (This is repeat requirement from 10/02/05 and 23/05/05) Staff enable residents to take 10/11/05 responsible risks, ensuring they have good information on which to base decisions, within the context of the residents DS0000024331.V256452.R01.S.doc Version 5.0 Barleycombe Residential Home Page 24 5 YA20 13 (2) individual Plan and of the home’s risk assessment and risk management strategies. (This is repeat requirement from 23/05/05) The home must ensure that the storage, handling and administration of medication as detailed in this report are actioned. All staff that administers medication must be appropriately trained before they administer medication. The home must be kept in an acceptable state of repair as agreed and detailed in this report. The laundry room must have a wash hand basin, liquid soap and paper towels in place. Staff must be trained to meet the needs of individuals. Therefore more training is requires around the challenging behaviour presented by residents. The manager must ensure so far as is reasonably practicable the health, safety and welfare of residents and staff. See text for details on electrics and gas. 20/12/05 6 YA24 23 (2)(b) 20/12/05 7 8 YA30 YA35 16 (2)(j) 18 (1)(c)(i) 20/12/05 20/12/05 9 YA42 13 (4) 23 20/12/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard YA15 YA20 Good Practice Recommendations The policy on relationships and sexuality should be reviewed in light of staff receiving appropriate training to ensure the training and instruction from policy match. The current procedure in place for medication DS0000024331.V256452.R01.S.doc Version 5.0 Page 25 Barleycombe Residential Home administration should be reviewed and should be based upon the training given to staff. A sample list of staff signatures and initials should be available to identify those who have administered medication. Risk assessments should be carried out where the home chooses to employ an individual when matters have arisen on references or CRB. Residents should be more involved in developments at the home. An advocacy service should be used where appropriate. Bath temperatures should be hot enough for comfort around 43°c. The content of the maintenance mans book should be revised. The fire evacuation process and knowledge of staff should be reviewed. 3 4 5 YA34 YA39 YA42 Barleycombe Residential Home DS0000024331.V256452.R01.S.doc Version 5.0 Page 26 Commission for Social Care Inspection Suffolk Area Office St Vincent House Cutler Street Ipswich Suffolk IP1 1UQ 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 Barleycombe Residential Home DS0000024331.V256452.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. 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