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Inspection on 09/10/06 for Bath Road, 85

Also see our care home review for Bath Road, 85 for more information

This inspection was carried out on 9th October 2006.

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 9 statutory requirements (actions the home must comply with) as a result of this inspection.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home checks it can meet people`s needs before they move into the home. The home keeps records of service users` needs, and of how they reduce any risks to service users. Service users have busy lives in and out of the home. They are able to keep in touch with family and friends. Service users choose the food and like it. Personal care is given in ways which suit the service users. Medication is kept safely in the home. Staff are able to tell if service users are unhappy, and try to help. The building is clean, homely and well kept. Staff get on well with service users, and have most training they need to help them give the care service users need. The home checks staff before they work in the home, to make it less likely that unsuitable people can work in the home. The registered manager is experienced and trained to manage a care home well.

What has improved since the last inspection?

Staff have improved how they look after service users` medication, so it is safer for service users. The registered manager has completed her Registered Manager`s Award training.

What the care home could do better:

The home should make sure records of what care is needed are all easy for staff to find when they need them. Staff should keep all notes about health care in the same place. If staff help a service user for their own safety, e.g. if someone is not allowed to go out alone, then staff should record the reasons why. The home needs to make sure all staff know the proper ways to protect service users from possible harm. The home should make sure service users always have clean hand towels. Staff should have some more training to make sure everyone knows the best ways to care for service users. The home needs to check what it is doing regularly, and ask service users and their relatives for their opinions. This way they can keep improving the service in the home. Some things in the home could be kept safer for service users.

CARE HOME ADULTS 18-65 Bath Road, 85 85 Bath Road Worcester Worcestershire WR5 3AE Lead Inspector D Lewis Unannounced Inspection 9th October 2006 2:15 Bath Road, 85 DS0000018626.V310928.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 Bath Road, 85 DS0000018626.V310928.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. Bath Road, 85 DS0000018626.V310928.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Bath Road, 85 Address 85 Bath Road Worcester Worcestershire WR5 3AE 01905 360439 01905 360447 home@bathroad85.fsnet.co.uk 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) Mr David George Broadbent Miss Josephine Mary Fowler Care Home 5 Category(ies) of Learning disability (5), Sensory impairment (5) registration, with number of places Bath Road, 85 DS0000018626.V310928.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The service is for people with a learning disability who also have a hearing impairment. 30th March 2006 Date of last inspection Brief Description of the Service: 85 Bath Road is a large terraced house in Worcester, within walking distance of local amenities and the facilities of the city. The home provides accommodation in five single rooms for five younger adults with learning disabilities and profound hearing loss. Communal lounge, dining facilities, bathroom and toilet facilities are provided. Residents need to have good mobility to negotiate stairs to their bedrooms. The service aims to enable them to lead a normal life and gain fulfilment through support to develop skills in communication, social and daily living activities and to participate in further learning opportunities. The registered provider is Mr David Broadbent, who maintains a regular link with and oversight of the home and supervises the registered manager, Ms Josephine Fowler. Information about the home is available in a service users’ guide. The fees for care in the home are in a range starting at £952, with additional fees for 1:1 care if needed. Bath Road, 85 DS0000018626.V310928.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the home’s first inspection of 2006-7. It was a Key Inspection. This means that the inspector checked all of the standards which have most impact on service users. Information came from a visit to the home, a pre-inspection questionnaire, and replies from relatives to a CSCI (Commission for Social Care Inspection) survey about the home. The inspector was in the home from just after 2pm until the evening. The inspector met and talked with 4 of the 5 service users; with several staff on duty; and with the registered manager. An independent sign language interpreter helped the inspector to communicate with the service users and with a deaf staff member. What the service does well: What has improved since the last inspection? Staff have improved how they look after service users’ medication, so it is safer for service users. The registered manager has completed her Registered Manager’s Award training. Bath Road, 85 DS0000018626.V310928.R01.S.doc Version 5.2 Page 6 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. Bath Road, 85 DS0000018626.V310928.R01.S.doc Version 5.2 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 Bath Road, 85 DS0000018626.V310928.R01.S.doc Version 5.2 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users’ needs are properly assessed so the home makes sure they get the care they need. EVIDENCE: Samples of service users’ files contained detailed, up to date assessments of service users’ needs, which were being regularly reviewed. Not all had been fully updated but this was in progress. There had been no new service users in the past 6 years, but the home was aware of the need to obtain a full assessment before admitting any new service user to the home. There was a CCA (community care assessment) in place for the last service user admitted to the home. Bath Road, 85 DS0000018626.V310928.R01.S.doc Version 5.2 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, 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users’ needs are recorded so staff know what care is needed. Service users make their own choices when they have the ability to do so. Staff support service users to undertake everyday activities and assess the risks associated with such activities. EVIDENCE: Service users’ files contained detailed assessments of their needs, as described above in “Choice of home”. There were daily records and monthly summaries. There were separate daily records of personal care provided. There were good details of individual communication skills and needs. The assessments had not been translated into separate care plans, which meant the information about the active care needed was to be found in a larger document with the full assessment. This meant it was not easily accessible. In addition the folders did not have an index so it was not easy to locate specific information. Bath Road, 85 DS0000018626.V310928.R01.S.doc Version 5.2 Page 10 Service users had varying levels of ability to understand and make choices. In most cases staff offer a range of options, as service users are unlikely to initiate changes. However there was evidence that, if the service user had the capability, they made their own decisions e.g. one service user described choosing when and where to go out. Most service users made their own choices about things like clothing, hairstyle, food, and bedroom furnishings (these were examples given by service users and by staff who supported them). The home had individual risk assessments for each service user, enabling them to undertake activities such as going out alone (following assessment and road safety training). Bath Road, 85 DS0000018626.V310928.R01.S.doc Version 5.2 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, 16, 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users take part in a range of activities and education in the home and in the community. Their relationships with relatives are supported. Daily routines in the home do not inappropriately restrict service users. Service users choose and like the food provided in the home. EVIDENCE: From talking with service users and from care records, there was evidence that service users took part in a range of activities in and out of the home. Service users described going to college, hairdresser, family visits, gardening, pottery, swimming, painting, and cooking. College courses included reading and money skills. Service users used community facilities such as pubs, restaurants, and sports centres. Service users had regular contact with their families, sometimes at the family home and sometimes at Bath Road. 3 relatives completed a CSCI (Commission for Social Care Inspection) comment card. All said they were welcome in the Bath Road, 85 DS0000018626.V310928.R01.S.doc Version 5.2 Page 12 home, they could see their relative in private and they were kept informed. All were satisfied with the overall care provided. There were some restrictions in daily routines. Some service users were unable to go out unless accompanied by staff, for their own safety. Not all service users held their own keys. (After the inspection the registered provider explained that all service users held keys, but some did not choose to lock their bedroom doors. The inspector was referring also to house keys.) The inspector did not see written assessments of the evidence which had led to these restrictions (although after the inspection the registered provider explained that such assessments were present). Bedrooms had flashing light “doorbells” so service users knew when staff wished to enter their rooms. The inspector saw a service user unlock their own bedroom door. The home kept records of meals eaten by each individual service user. There was a choice of foods and the records confirmed that individual preferences were followed (e.g. 4 different types of sandwich provided at lunch). Service users usually ate the same main meal, but records showed that sometimes a service user had an alternative choice. Staff prepared menus, then service users made their choices from a range of pictures showing different foods. Service users were able to tell the inspector what foods they liked and said they chose, and liked, the food in the home. The records of food did not record snacks e.g. fruit, and suggested the home was not always providing the recommended 5 portions of fruit and vegetables per day to help maintain service users’ health. This was not discussed during the inspection visit. Bath Road, 85 DS0000018626.V310928.R01.S.doc Version 5.2 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): 18, 19, 20 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users are supported with their personal care needs in a suitable way. Health care is not always recorded in a clear and consistent way, which could potentially mean that service users’ healthcare needs are not properly met. Medication is properly managed in the home so service users get the medication they need. EVIDENCE: Records and discussions indicated that personal care, when needed, was given in a supportive and discreet manner. Full details were recorded in individual assessments, which would help to make sure care was given as it was needed. Health care was recorded in separate Health Action Plans. However these were not being used consistently e.g. the inspector found some health details recorded in service user plans, including a 2006 optician visit and details of audiometry and chiropody. All health information should be kept in the Health Action Plans. In addition the inspector looked for a record of a specific GP visit but could not find it in the Health Action Plan. This could lead to confusion about what was needed, or had been decided, to keep a service user healthy. Bath Road, 85 DS0000018626.V310928.R01.S.doc Version 5.2 Page 14 The inspector saw records of medication received, administered and returned. These were completed as required. Handwritten instructions on MAR charts (medication administration records) were signed by the registered manager. There were records of staff authorised to give out medication and their signatures; and of homely remedies authorised by the GP. Medication was stored appropriately and where needed, medication packs were marked with the date of opening. Requirements made at the last inspection had been met. Medication was being safety managed to ensure service users received the correct medication in a safe manner. Bath Road, 85 DS0000018626.V310928.R01.S.doc Version 5.2 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, 23 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staff responded to service users’ concerns by their knowledge of how individuals expressed anxiety or distress. The home needed to revise its systems for responding to potential concerns about abuse, to ensure that correct procedures were clear to all staff, so that service users could be protected. EVIDENCE: Service users were not able to understand the complaints procedure because of their limited communication skills and ability. However the detailed knowledge that the staff had of each service user enabled them to identify when they were unhappy or concerned and all efforts were made to identify and address the cause. There was a place to record complaints, though none had been received. It was acknowledged that even minor concerns were unlikely to be explicitly expressed by service users. Staff had received in-house training in adult protection. The home was hoping to access an external provider for further training and the inspector advised contacting the local adult protection coordinator for advice on this, to ensure that a suitable trainer could be identified. The inspector saw the home’s policy on adult protection, which needed to be changed as it referred to the home investigating adult protection concerns (all such concerns should be referred to the adult protection coordinator, who will make arrangements for suitable investigation to ensure all evidence is intact). The policy also referred to the possibility of not passing on information if the suspected victim was unwilling Bath Road, 85 DS0000018626.V310928.R01.S.doc Version 5.2 Page 16 to take the matter further. This would not protect them or other potential victims from possible further abuse. Bath Road, 85 DS0000018626.V310928.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 26, 27, 28, 29, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is clean, homely and well maintained. Service users have suitable bedrooms, bathrooms and shared facilities. Adaptations are provided as needed, e.g. flashing light doorbells. The home is clean and hygienic. EVIDENCE: The inspector was shown around the home and some service users showed their bedrooms to the inspector. The home was generally clean, homely and well maintained. Bedrooms were clearly personalised to reflect individuals’ tastes and interests, and were lockable - the inspector observed one service user unlock their own bedroom. There were sufficient toilets and bathrooms, and they were lockable. The inspector noted that there were no hand towels in one bathroom and one toilet. Disposable paper towels should be provided for hygiene reasons. Shared space was adequate, with a comfortable lounge and a dining area; there was a lack of private areas for seeing visitors, but this would be difficult Bath Road, 85 DS0000018626.V310928.R01.S.doc Version 5.2 Page 18 to resolve in the existing layout of the building. The lounge was used, or sometimes visitors took their relatives away from the home e.g. for a meal. Suitable equipment was in place for the service users, including doorbells (on the front door and bedroom doors) and fire alarm systems, all of which used flashing lights. Bath Road, 85 DS0000018626.V310928.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff have suitable qualities and competencies to relate well to service users. Staff recruitment is done using appropriate checks on staff to reduce the risk of employing unsuitable people in the home. Staff are mostly well trained, although some aspects of training could be improved to ensure care is given in the best possible way. EVIDENCE: Staff on duty demonstrated that they were knowledgeable about and interested in the service users’ lives and needs. All had completed training in British Sign Language, at level 1, and all but one had also completed it at level 2. Half the care staff had a NVQ (national vocational qualification) level 2 in Health and Social Care, and others were working towards this. Two staff had significant hearing impairments. The inspector spoke with one deaf staff member, who said her communication needs were understood and met, e.g. the home used an interpreter for training sessions, and she carried a vibrating alert for contact by other staff. The presence of deaf staff is good practice as their experiences can add to the team’s understanding of service users. Bath Road, 85 DS0000018626.V310928.R01.S.doc Version 5.2 Page 20 The home had obtained CRB (Criminal Records Bureau) disclosures for all existing staff and was aware of the need to obtain a full disclosure before any new staff began working in the home. The inspector saw application forms, interview notes and 2 written references in staff files sampled, indicating that the home took care to reduce the risk of recruiting unsuitable staff. The staff team was generally well trained. In addition to NVQs (national vocational qualifications) and BSL training mentioned above, they undertook a range of suitable training with the aim being for all staff to undertake all relevant training. Training was recorded and planned in a systematic way. Not all staff had been trained in Protection of Vulnerable Adults procedures, Disability Equality and Total Communication. These should be prioritised. In addition, moving and handling training was needed by most staff, and the home was trying to source further Autism training to ensure staff were better equipped to meet the needs of service users with varying disabilities. Bath Road, 85 DS0000018626.V310928.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The registered manager is experienced and has the training needed to be an effective manager of the home. The home does not yet have a complete quality assurance system in order to regularly monitor their practices in the home and ensure ongoing development of good practice. The home is generally kept safe for service users, but some improvements could be made to further reduce risks to service users. EVIDENCE: The registered manager had worked at the home for 12 years, for 2 years as the deputy and then for the past 5 years the registered manager. She held the Advanced Management for Care certificate and had completed the Registered Bath Road, 85 DS0000018626.V310928.R01.S.doc Version 5.2 Page 22 Manager’s Award in the summer of 2006. She was awaiting final confirmation of her results. The home was not yet fully implementing a quality assurance (QA) procedure. They had used a range of tools which could contribute to this e.g. checking the home’s progress against the NMS (national minimum standards), surveys of service users and their relatives 2 years ago. The inspector advised that the evidence needed to be collated and a development plan drawn up for the home; the QA procedure needed to be implemented fully. The home was carrying out required fire safety checks and tests and maintenance and staff training in fire safety. The home’s risk assessments were generally in place as required and mostly up to date, although those covering specific areas of the premises had not been reviewed since 2000. (After the inspection, the registered provider explained that these had been “renewed or reviewed in August 2006 in consultation with the Health and Safety Executive”. This had not been noted on all risk assessments at the time of inspection.) The risk assessment covering water temperatures indicated that some service users needed supervision with bathing to ensure water was not too hot. Staff said water temperatures were measured by touch. They should be measured by thermometers and recorded, to ensure consistency and that clear records are kept. Bath Road, 85 DS0000018626.V310928.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 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 2 ENVIRONMENT Standard No Score 24 3 25 X 26 3 27 3 28 3 29 3 30 2 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 2 36 3 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 3 15 3 16 2 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 3 X 3 X 2 X X 2 X Bath Road, 85 DS0000018626.V310928.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 YA6 Regulation 15, 17 Requirement The home must develop service user plans of care which are separate from the assessments of their needs, to ensure that up to date and clear information about required actions is easily accessible. Timescale for action 31/12/06 2 YA16 17 When there are any restrictions 31/12/06 on service users’ choice or freedom, these must be recorded in their service user plan. All healthcare needs, and action taken to meet them, must be recorded consistently. The home’s policy and procedures for Adult Protection must be revised to ensure they are consistent with the Worcestershire Vulnerable Adults procedure. Hand towels, preferably of disposable paper, must be provided in all bathrooms and toilets to ensure hygiene is maintained. 31/12/06 3 YA19 15, 17 4 YA23 13 31/12/06 5 YA30 13 31/12/06 Bath Road, 85 DS0000018626.V310928.R01.S.doc Version 5.2 Page 25 6 YA35 18 Staff must receive training needed for their work, including Protection of Vulnerable adults; Disability Equality; Moving and handling; and Total Communication. A quality assurance system must be fully implemented. All risk assessments must be regularly reviewed and updated. If service users are in need of staff assistance with bathing, evidence must be kept to demonstrate that staff have checked that the water temperature is within a safe range. 31/03/07 7 8 9 YA39 YA42 YA42 24 13 13 31/12/06 31/12/06 30/11/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA6 Good Practice Recommendations Service user files should be reviewed to ensure consistency; ideally an index to each file would make them more accessible. Accounts of service users’ finances, where the registered provider is their appointee, should be independently audited. It would be good practice to train all staff in risk assessment and risk management. (Repeated from 2005) 4 YA17 The home should check if they are providing a healthy amount of fruit and vegetables (and record this provision). DS0000018626.V310928.R01.S.doc Version 5.2 Page 26 2 YA7 3 YA9 Bath Road, 85 5 YA20 Suitable storage and a register should be available for controlled drugs when prescribed. (Repeated from March 2006) 6 YA23 The home should contact the local Adult Protection coordinator for advice on sources of suitable training for staff in Adult Protection procedures. A copy of the report on the outcome of service users’ surveys, carried out as part of the quality assurance programme, should be provided to the Commission when completed. (Repeated from 2005) 7 YA39 Bath Road, 85 DS0000018626.V310928.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Worcester Local Office Commission for Social Care Inspection The Coach House John Comyn Drive Perdiswell Park, Droitwich Road Worcester WR3 7NW 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 Bath Road, 85 DS0000018626.V310928.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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