Inspection on 31/10/07 for Bartlett Close 1

This inspection was carried out on 31st October 2007.

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 no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Bartlett Close 1 23/02/09

Bartlett Close 1 09/01/07

Bartlett Close 1 25/07/06

Bartlett Close 1 06/10/05

Bartlett Close 1 21/07/05

Bartlett Close 1 21/02/05

Bartlett Close 1 13/05/04

Bartlett Close 1 09/03/04

Similar services:

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

Pinta

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

CARE HOME ADULTS 18-65 Bartlett Close 1 Witney Oxfordshire OX28 6FD Lead Inspector Andrea Leverett Unannounced Inspection 31st October 2007 02:30 Bartlett Close 1 DS0000013063.V346591.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 Bartlett Close 1 DS0000013063.V346591.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. Bartlett Close 1 DS0000013063.V346591.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Bartlett Close 1 Address Witney Oxfordshire OX28 6FD 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) 01993 709646 01993 709659 donnamfp@yahoo.com www.macintyrecharity.org MacIntyre Care Pauline Buckingham Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Bartlett Close 1 DS0000013063.V346591.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9th January 2007 Brief Description of the Service: 1 Bartlett Close is home to four adults with learning and some physical disabilities close to the centre of Witney, a market town in West Oxfordshire. The home is managed by MacIntyre Care. The building is modern and purpose built to meet the needs of people with physical disabilities. Care is provided by a staff team, which aims to enable the service users to lead active lives and pursue their own interests in and out of the home. Fees range from £49,371 per annum to £54,542 per annum. Bartlett Close 1 DS0000013063.V346591.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection took place on the 31st of October 2007. The inspector met and observed people who use the service during the site visit and 4 staff and the manager were spoken with. Due to the nature of the service, it is difficult to reliably incorporate accurate reflections of people who use the service in the report. Some judgements about quality of life and choices were taken from direct observation on the day followed by discussion with support staff and evidencing records held at the home. The inspector concluded that people who live at Bartlett Close receive an adequate quality of service. Observation showed that staff work hard to meet peoples needs in terms of day-to-day living and community access but poor staffing levels are undermining this. Several requirements have been made in regards to poor staffing levels and ensuring systems are in place to properly monitor them. What the service does well: Records showed that people who live at the Home have their care and support regularly reviewed and every effort is made to ensure that the Home is run in their best interests. However, poor staffing levels are undermining this. Staff were observed supporting people in a sensitive and respectful manner and worked hard to try and ensure that peoples choices were respected and acted upon in regards to day to day living. Staff practice created a welcoming and homely atmosphere and people felt able to approach staff for support. The Home is proactive in accessing specialist health services on behalf of people and staff work closely with them to develop appropriate health care plans. Risk assessments covered all key areas such as moving and handling, eating and drinking, medication and behaviour. The documents gave good detailed information in order to support people safely and in keeping with their needs. The Home supports people with a range of communication systems to promote choice and interaction. Communication systems included makaton and signs and symbols and it was also clear that this work was undertaken with the support of speech therapists. It was evident that relationships with families were supported and staff worked hard to try and ensure that people had access to their local community and appropriate therapeutic activities in keeping with their needs. Bartlett Close 1 DS0000013063.V346591.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. Bartlett Close 1 DS0000013063.V346591.R01.S.doc Version 5.2 Page 7 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. Bartlett Close 1 DS0000013063.V346591.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 Bartlett Close 1 DS0000013063.V346591.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): 2, People who use this service receive good quality outcomes in this area. People who use this service can be confident that their needs and aspirations will be fully assessed before they move in to Bartlett Close. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The assessment records of two people who use the service were inspected as part of the case tracking process. Records showed that no one moves into the Home without having their needs properly assessed. Assessments included detailed pen pictures, communication passports, Health and Social care needs and likes and dislikes. Risk assessments covered all key areas such as moving and handling, eating and drinking, medication and behaviour. The documents gave good detailed information in order to support people safely and in keeping with their needs. Records also showed that the Home worked with specialist health professionals such as speech therapists to assess needs, particularly around communication and eating and drinking assessments. Bartlett Close 1 DS0000013063.V346591.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): 6,7,9 People who use this service receive adequate quality outcomes in this area. People who use this service can be confident that they’re assessed and changing needs and personal goals are reflected in their individual plan and that these enable people to exercise choice and control over their lives. People who live at Bartlett Close know that they will be enabled to take risks as part of an independent lifestyle and will be consulted and encouraged to take part in all aspects of life at the Home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Two assessments and care plans of people who live at Bartlett Close were inspected. Care plans were detailed and reflected their assessed needs. Detailed risk assessments were also in place that promoted people’s safety and quality of life. These documents were reviewed regularly with input from health professionals such as speech therapists. Care plans fully reflect people’s wishes Bartlett Close 1 DS0000013063.V346591.R01.S.doc Version 5.2 Page 11 and needs in terms of social and recreational activities and the Home supports people with a range of communication systems to promote choice and interaction. Communication systems included makaton and signs and symbols and it was also clear that this work was undertaken with the support of speech therapists. Observation during the site visit and activity records seen showed that guidelines and care plans for people who use the service on the whole were followed but poor staffing levels are sometimes undermining this as reflected in the overall rating of this service. Bartlett Close 1 DS0000013063.V346591.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 People who use the service experience adequate quality outcomes in this area. People who use the service take part in a range of activities including community activities and their rights are respected and responsibilities recognised in their daily lives, however access to activities are not always consistent because of poor staffing levels. Time is taken to encourage and support people to maintain personal and family relationships. People are encouraged and supported to maintain a healthy diet and their needs and wishes are sort and respected in this regard, however more needs to be done to ensure that individuals eating and drinking guidelines are followed. This judgement has been made using available evidence including a visit to this service. Bartlett Close 1 DS0000013063.V346591.R01.S.doc Version 5.2 Page 13 EVIDENCE: People who live at Bartlett Close attend college course and a range of therapeutic activities both inside and outside the home. Staff at the Home worked hard to promote community access and there was evidence that outing to cafés, pubs and libraries were undertaken. In addition people get the opportunity to go on holidays. The manager informed the inspector that the Home has some access to its own transport and is in the process of purchasing a specially adapted vehicle for the use of people who live in the Home. As stated previously it was evident that planned activities including community activities were in line with people’s wishes, but more could be done to ensure that these are consistent. Records seen and discussions with staff showed that because of poor staffing levels people sometimes have to miss planned activities as reflected in the overall rating of this service. A requirement has been made regarding this (Seeing staffing Standards for more details) It was evident that relationships with families were supported by the service and feedback staff showed that the home works in partnership with families to make decisions in the best interest of people who live there. An inspection of the home’s kitchen, food storage areas and the home’s menus was undertaken which showed that a balanced diet was provided. Detailed eating and drinking programs were in place that had been developed with input from speech therapists. However more could be done to ensure that food prepared to particular consistencies is in keeping with speech therapy guidelines and good practice. Staff were observed offering choices around food and drinks and taking time to try and understand and be sensitive to peoples needs and wishes in this regard. Bartlett Close 1 DS0000013063.V346591.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 People who use the service experience adequate quality outcomes in this area. Staff work hard to try and ensure that People receive a good standard of support to maintain their personal care in the way they prefer and require but poor staffing levels are undermining their ability to meet peoples physical and emotional health needs fully. People are protected by the homes policies and procedures for dealing with medicines. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Records seen and observation during the site visit showed that information was available to ensure that staff were able to meet peoples personal needs and staff work hard to try and ensure they are acted upon. Information was also available regarding peoples preferred routines and observation on the day indicated that staff work hard to try and adhere to them. However poor Bartlett Close 1 DS0000013063.V346591.R01.S.doc Version 5.2 Page 15 staffing levels are undermining this as reflected in the overall rating of this service. For example one persons care plan states that two staff are needed for personal care and others need consistent support with challenging needs and epilepsy. It is not clear how this is achieved when only two staff is on duty most of the time and often one member of staff is out of the Home supporting people with activities. A requirement has been made regarding this. (See staffing Standards for more information.) Evidence seen on the day and feedback from staff and the manager suggests that the Home is proactive in accessing specialist health services on behalf of people and that staff work closely with them to develop appropriate health care plans. Records showed that people have access to a range of routine and specialist health services in keeping with their needs and that their health care is properly monitored. An inspection of the homes’ administration and medication procedures was undertaken. Records inspected indicated that appropriate record keeping was being maintained and that medication was being stored appropriately. Discussion with staff and records seen also evidenced that all staff that administer medication are appropriately trained to do so. Bartlett Close 1 DS0000013063.V346591.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): 22,23 People who use the service experience good quality outcomes in this area. People know that their concerns will be listened to and acted upon and they will be protected from abuse, neglect and self-harm. However more could be done to ensure that there is a more transparent system in place for managing peoples personal money that is looked after by the local authority. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Discussion with staff and records seen on the day of the site visit showed that the Home had an appropriate complaints system and communication systems to promote their right to raise concerns and make complaints. Staff were seen being sensitive and responsive to peoples needs and observation of the staff hand over meeting showed that information was passed over and responded to appropriately. The commission has received no complaints about this service in the last 12 months. Discussion with staff and training records seen also showed that staff had the skills and training to protect people from abuse and the Home now has a rolling programme for adult protection training in place. A sample of people’s financial records and money was inspected. Records are kept of all money held in the homes safe and receipts are in place to evidence Bartlett Close 1 DS0000013063.V346591.R01.S.doc Version 5.2 Page 17 how money is spent. However the manager informed the inspector that people also have money, which is looked after by Oxfordshire County Councils Money management services. Information regarding the amount of money people have with Oxfordshire Council is not made available to people who use the service or advocates or key workers acting on their behalf. The inspector is concerned that the lack of transparency about people’s finances does not allow staff or advocates supporting people to use their finances in their best interests. A recommended that more needs to be done to ensure that people who live at Bartlett Close have up to date information and appropriate access to money that is held on their behalf by the local authority. . Bartlett Close 1 DS0000013063.V346591.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24,27,30 People who use the service experience good quality outcomes in this area. People live in a clean, comfortable and safe environment, which is maintained appropriately and is in keeping with people’s needs and wishes. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A tour of the premises was undertaken. The Home provides a spacious environment to accommodate people who use wheelchairs and mobility aids. The Home is furnished and decorated to a good standard and was clean and free from offensive odours. The Home has hoists and a range of mobility aids that are appropriate to meet peoples needs and records seen showed that these are well maintained. Bartlett Close 1 DS0000013063.V346591.R01.S.doc Version 5.2 Page 19 The homes fire risk assessment has now been updated and fire records showed that fire alarms and evacuation procedures are regularly tested. Facilities and equipment are serviced regularly and some carpets have been replaced since the last inspection. The manager also informed the inspector that the Home is putting plans are in place to refurbish the homes laundry area and develop additional spaces that can be used for therapeutic activities. A sample of peoples bedrooms were seen and these were spacious, nicely decorated and furnished to people’s individual preferences and needs. Bartlett Close 1 DS0000013063.V346591.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35 People who use the service experience adequate quality outcomes in this area. People who live at Bartlett Close are not supported by a sufficient number of staff to meet their needs but staff is competent and qualified and are supervised appropriately. On the whole People can be confident that they will be protected by the homes recruitment practices but more needs to be done to ensure that recruitment checks can always be evidenced. This judgement has been made using available evidence including a visit to this service. EVIDENCE: On the day of the site visit the inspector arrived at the Home to find one member of staff supporting three people who use the service. Observation of this situation showed that people could not be supported safely and their individual needs were compromised. People who use this service have very complex needs, including profound Learning Disability, Epilepsy, challenging behaviour and physical disability and need a high level of support, which the Bartlett Close 1 DS0000013063.V346591.R01.S.doc Version 5.2 Page 21 staff member was struggling to provide on their own. Another staff member was out supporting a resident to access a community activity. Discussions with staff, the manager and records seen evidenced that two staff per shift support people who live at Barlett Close most of the time and consequently their individual needs are not being met and their safety is being put at risk. Staff complete near miss incident reports and the inspector was informed that these average about ten a month. A requirement has been made that the organisation ensures that sufficient staff are provided to meet peoples needs. Bartlett Close does not currently have waking night staff, one member of staff sleeps in and an on call system is in place for emergencies. However records seen and discussions with staff evidenced that people who use this service frequently need support during the night. A requirement has been made that the organisation review and risk assess the nighttime staffing arrangements and ensure that these are in keeping with peoples needs. Considerable improvements have been made in the area of staff training since the last inspection. A range of training is provided including Direct Care Induction, Moving and Handling, Fire Safety, Protection of Vulnerable Adults, Food Hygiene, First Aid, Medication Administration, Infection Control and specialist training in Epilepsy, Challenging Behaviour, Makaton and Intensive Interaction. In addition the Home offers staff NVQ training including level 3. Although some staff had gaps in their training, records seen and discussion with the manager showed that the Home now has a rolling programme of training in place, which all staff will benefit from. Staff were observed supporting people in a sensitive and respectful manner and it was clear that they worked hard to try and ensure that peoples choices were respected and acted upon in regards to day to day living. Staff practice created a welcoming and homely atmosphere and people felt able to approach staff for support. Bartlett Close 1 DS0000013063.V346591.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 People who use the service experience adequate quality outcomes in this area. The staff team is led by a competent and experienced manager, who ensures on the whole that the home is run well, however more needs to be done to ensure staffing levels are adequate to meet peoples needs. More needs to be done to ensure that people can be confident that their views underpin all self-monitoring, review and development by the Home and their health, safety and welfare are promoted and protected. This judgement has been made using available evidence including a visit to this service. Bartlett Close 1 DS0000013063.V346591.R01.S.doc Version 5.2 Page 23 EVIDENCE: The manager has had several years experience of working with this client group and is a qualified nurse. In addition they have a management degree in Social and Health care settings and have undertaken the Registered managers Award. Records seen and discussions with staff evidenced that considerable improvements have been made in the running of the Home since they came into post, particularly in the area of staff training. As well as ensuring that an appropriate rolling programme of training is in place staff have also under taken specialist and innovative training in Intensive Interaction and communication and the Home is working closely with speech therapist to implement this way of working with people who live at Bartlett Close. Records and discussions with staff showed that they receive regular supervision and attend staff and shift handover meetings and staff spoken to felt supported by the manager. Records showed that people who live at the Home have their care and support regularly reviewed and every effort is made to ensure that the Home is run in their best interests. However, as stated previously, poor staffing levels are undermining this. The organisation undertakes regular unannounced visits to the Home to monitor the care and quality of the service. Although in the main these reports are comprehensive the inspector was concerned to note that none of the reports sampled reflected the difficulties poor staffing levels are having on the Home. A requirement has been made that the organisation ensures that these reports reflect more fully what is going on in the Home and any implications for people living there. The manager explained that they are in the process improving the homes quality monitoring systems and developing ways of seeking the views of people who use the service and people who act in their interests. Records seen and a tour of the premises showed that the Home and its equipment and facilities are maintained appropriately. Bartlett Close 1 DS0000013063.V346591.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 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 3 25 X 26 X 27 3 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 1 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 2 13 2 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 2 3 X 2 X 2 X X 2 X Bartlett Close 1 DS0000013063.V346591.R01.S.doc Version 5.2 Page 25 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 YA33 Regulation 18.1(a) Requirement Timescale for action 26/01/08 1 YA33 18.1(a) 2 YA39 12 & 26 The registered person is required to review and risk assess staffing levels including at night and ensure these are in keeping with peoples needs. The registered person is required 26/11/07 to ensure that the Home has sufficient staff to meet peoples needs at all times: In that 2 staff are in the Home at all times during waking hours. The Registered Provider is 10/01/08 required to ensure that an effective quality assurance and quality monitoring system, based on seeking the views of service users and their relative/representative, are implemented. Previous timescale 30/06/07 was not met. In addition the registered person must also ensure that regulation 26 monitoring visits include the monitoring of staffing levels and the consistency of activities. Bartlett Close 1 DS0000013063.V346591.R01.S.doc Version 5.2 Page 26 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 YA23 Good Practice Recommendations It is strongly recommended that the organisation work closely with Oxfordshire Council Money Management Scheme to ensure people in their care or advocates acting on their behalf have up to date information regarding how much money the Scheme is holding on their behalf and that they have appropriate access to it. Bartlett Close 1 DS0000013063.V346591.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Oxford Area Office Burgner House 4630 Kingsgate, Cascade Way Oxford Business Park South Cowley Oxford OX4 2SU 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 © 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 Bartlett Close 1 DS0000013063.V346591.R01.S.doc Version 5.2 Page 28 - 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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