Inspection on 08/02/07 for Beech House

This inspection was carried out on 8th February 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 7 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Beech House 28/02/06

Beech House 30/06/05

Beech House 08/03/05

Beech House 10/05/04

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 Beech House 49 Crockhamwell Road Woodley Reading Berkshire RG5 3JY Lead Inspector Kerry Kingston Unannounced Inspection 8th February 2007 12:30 Beech House DS0000011350.V329620.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 Beech House DS0000011350.V329620.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. Beech House DS0000011350.V329620.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Beech House Address 49 Crockhamwell Road Woodley Reading Berkshire RG5 3JY 0118 969 8373 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) http/www.milburycare.com/home.html Milbury Care Services Limited Mrs Marina Diane May King Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Beech House DS0000011350.V329620.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28th February 2006 Brief Description of the Service: Milbury Care Services Ltd. is registered to provide personal care in Beech House for up to six adults aged between 18-65 who have learning difficulties and associated behavioural problems. Beech House is a large two storey modern house that is situated in Woodley in a residential area close to a local shopping centre and facilities. Accommodation is offered in single bedrooms. There is a car parking area at the front of the property and the residents have the use of a secluded garden at the rear. The fees are £945.69 to £1,328 per week. Beech House DS0000011350.V329620.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection visit took place on the 8th February 2007 between the hours of 12.30am and 6.30pm. The purpose of the visit was to collect information to inform the key inspection report. Information for this inspection was collected by means of questionnaires sent to families (two were returned), service user surveys which were returned completed with the help of staff, as service users were unable to complete them. A pre- inspection questionnaire was sent to the home but was not received by the Commission for Social Care Inspection prior to the visit. On the day of the visit the inspector toured the building, observed care practice, spoke with two staff members, the manager and met all five service users. Only one service user is able to verbally communicate, other service users are disturbed by the presence of ‘strangers’, observation was consequently very limited. Service user care plans and other records were looked at. The home has developed in some areas, since the last inspection, but there remain many areas for improvement. The home has five service users resident in the home and they have very complex and diverse needs, a well-trained and experienced staff team is therefore necessary to meet these needs. The home has staff retention problems and operates with a largely inexperienced staff team. What the service does well: The home do their best to make sure that they help residents to choose things for themselves. Residents are shown pictures of food so that they can choose what they would like to eat. There is plenty of nice food in the house so they can have nice meals. The home writes down how residents need and like to be helped to look after themselves, staff can read this to make sure they are doing it properly. Beech House DS0000011350.V329620.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. 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. Beech House DS0000011350.V329620.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 Beech House DS0000011350.V329620.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. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 2. Quality in this outcome area is good. Service users’ needs are properly assessed and they would be given enough information to help them to make a choice about where to live. The home would consider service user choice by adherence to the introductory programme and interpreting the behaviours of the individual whilst in the home, as detailed in the admission policy and described by the manager This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Statement of Purpose was updated in January 2007 and the Commission for Social Care Inspection have been provided with a copy. The last admission was approximately four years ago. The care manager completed a full assessment of care and residential staff developed a service user plan from this assessment. Service users have complex needs and consequently services that are able to meet their needs are limited, there is therefore limited choice about where they would like to live. The care manager, the residential home, family and/or advocates make decisions about placements. The admissions policy and procedure details how service users’ views may be ascertained during introductory visits, such as Beech House DS0000011350.V329620.R01.S.doc Version 5.2 Page 9 interactions with staff and existing residents and behaviours presented. The home is registered for six service users but due to the complexity and diversity of needs of the current resident group, one bed has remained empty for over four years. The home has ensured compatibility issues and the needs of existing service users have been a major part of the assessment process. Beech House DS0000011350.V329620.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 and 9. Quality in this outcome area is good. Service users’ needs are assessed, their care plans are, generally, reviewed on a regular basis and the staff help them to make as many choices and decisions for themselves as is possible. Service users’ behavioural difficulties and how they are helped with these are not included on the care plan. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Three care plans were looked at; they are regularly reviewed, monthly by the residential staff and annually by a multi-disciplinary team. One of the annual reviews is out of date, by over one year. Some parts of the care plans are presented pictorially with signs or simple text, whichever is relevant to the individual. Beech House DS0000011350.V329620.R01.S.doc Version 5.2 Page 11 Service users’ needs are well documented, except for challenging behaviours and guidelines to help staff to meet those specific needs. The way service users express their choices and decisions is noted on the care plans and the communication guidelines, where completed are of a very high standard. Staff were able to fully describe how they help service users to make their own choices and decisions, as far as they are able to. Menu choices are presented in pictorial form to ensure service users can make as informed a choice as possible. There are detailed risk assessments in place. These ensure service users are able to do as much as possible for themselves, as safely as possible. Service users have risk assessments for many areas of their life such as making tea, going out, travelling in the car, swimming and going walking. Risk assessments were seen to be up-to-date, having been reviewed in 2006. There was a discussion with the manager with regard to the difference between Health and Safety risk assessments to ensure safe working practices, and risk assessments for service users to ensure as much independence as possible. Beech House DS0000011350.V329620.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 and 17. Quality in this outcome area is poor. That the home provides a positive lifestyle in some areas, but overall participation in meaningful activities and opportunities for community presence are very limited. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The three activities programmes seen showed few regular or organised activities. Service users have five and a half hours per week, three and a half hours per week and two and a half hours per week organised and away from the home, the rest of the activities are ‘in-house’. One service user attended day services for five days a week all day until 2006 when he was excluded because of behavioural issues. The residential service has been given no additional staff or resources to provide activities, on a planned basis. Activity programmes did not match daily records or the special activity records. Beech House DS0000011350.V329620.R01.S.doc Version 5.2 Page 13 One service user’s records showed only five activities over a sixteen-day period. The manager advised that the service user was particularly difficult to motivate but there was no record of attempts made, or opportunities offered, and no record of access to the community. The service user said, ‘ I have plenty to do, I want to stay in bed all day’. Another service user had a walk and drive (same day) and playing games three times over a five-day period, no community activities were noted. The manager explained that this individual needed 2:1 staffing to access the community. The manager was confident that service users do access the community, more often than is recorded but said that there are difficulties because two of the service users need 2:1 support and present very challenging behaviours, this was not noted on care plans. Staff felt that the home could improve the variety and frequency of activities offered to service users, and also noted even those limited organised activities have to be cancelled on occasion because of a lack of staff able to drive the home’s vehicle. Staff members and the manager advised that there are more activities when the weather is better. An increase in activities was noted as a goal on one of the service user’s review notes, this has happened on a very limited scale. Service users do not visit the community to access hairdressers, the doctor, dentists, chiropodists or optical services (see Personal and Healthcare Support). Four service users have contact with families, two have limited contact, two have regular weekly contact and one has no contact. The reason for the lack of family contact has not been investigated for several years and it was discussed with the manager whether this would be an appropriate action, with the potential to greatly enhance the service user’s lifestyle. Staff clearly described service users’ rights and how they ensured they recognised those rights and respected individual service users. The Organisation has a service users’ ‘charter’, which is displayed in the home and fully details, simply, service users’ rights and responsibilities and how these will be recognised. The menus seen were well balanced, fresh ingredients were seen being prepared and service users were observed to be assisting with (or observing) food preparation, in the kitchen. Menu choices are presented in pictorial form, as are some recipes. Service users indicate by sign or physical actions their choices and who has chosen a particular meal is indicated on the daily menu. There was very limited observations of interactions between staff and service users as the individuals ‘do not like strangers’ and the presence of a stranger Beech House DS0000011350.V329620.R01.S.doc Version 5.2 Page 14 was having a negative impact on the resident group, one individual in particular. One service user said, ‘it’s nice here, I like the staff, I like living here’. Staff spoken to demonstrated a good understanding of individuals. Service users’ communication systems, describing the meaning of different behaviours (also included on communication passports), including sign and physical prompting, specific to the particular service users. Some staff were seen to communicate effectively with some service users. Beech House DS0000011350.V329620.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20. Quality in this outcome area is adequate. Overall the home offers good healthcare and personal support but the lack of detail about service users’ behavioural needs means that staff may be unable to offer a good standard of physical and emotional support to service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Personal support needs are well documented; good personal care support guidelines are included in care plans, as is how service users make choices and how they communicate their wishes, choices and opinions. The service users have complex needs, which include behavioural issues; these are not addressed in the care plans. There are no behavioural guidelines on many of the support plans; it is not clear how staff help the service users to try to present positive behaviours. There is evidence of referrals to psychologists/psychiatrists and the doctor but it is not clear why. Behavioural guidelines for one service user were seen but these were last dated 2004. One staff member felt that better behavioural guidelines and an experienced practitioner to model how to deal with difficult behaviours would enable the staff team to deal properly with challenging behaviours. Beech House DS0000011350.V329620.R01.S.doc Version 5.2 Page 16 Service users receive regular health checks, at least annually, these include, opticians, chiropodists and dentists. These health practitioners visit the home as the manager advised that the service users’ behaviours preclude surgery visits. Health records are accurate and clear. Medication records (seen) were accurate and medication is safely stored. There was a discussion about more detailed guidelines being produced for medication that is only given occasionally, especially those given to assist behavioural control. Staff are tested and judged competent to administer medication by a senior staff member from a different home. Beech House DS0000011350.V329620.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is adequate. The home generally listens and acts upon the views of the service users and generally protects them from abuse. The home lacks clear behaviour guidelines to help staff to support service users to safely control any difficult behaviour. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a complaints book that is filled in; there was discussion about the home providing more detail with regard to the outcome and satisfaction of the complainant. The Commission for Social Care Inspection has received information about one complaint, since the last inspection. This was referred back to the provider who verbally discussed how they had dealt with it. There was no written reference to the complaint within the home and no details of how it had been dealt with. The Protection of Vulnerable Adults Procedure is robust and staff receive training in this area. One staff member was absolutely clear about what action he would take in the event of a vulnerable adults concern and the other knew his duty of protection (legally and morally) but showed some lack of knowledge with regard to reporting outside of the organisation, he had completed the protection training. Beech House DS0000011350.V329620.R01.S.doc Version 5.2 Page 18 Behaviour guidelines are not in place, which makes it difficult for staff to help service users deal with any difficult behaviours, safely (see Personal and Healthcare support). The home does not use physical intervention but staff described how this had to be used on one occasion for a service user’s safety. Incident forms are used but they are more accurately behavioural charts and it is not clear what action is being taken with regard to the incident described. Two service users’ financial records were seen, cash records were accurate. Families act as appointees for two service users and Milbury’s financial officer is the appointee for two others, the local authority act on behalf of another service user. Benefit entitlements and contributions are included in the service user plan. Service users pay part of their Mobility allowance to the provider for transport costs, if the home’s vehicle is not available the home pay for taxi/public transport from the home’s petty cash allowance. Beech House DS0000011350.V329620.R01.S.doc Version 5.2 Page 19 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 and 30. Quality in this outcome area is good. The environment is clean and hygienic and meets the needs of the service users, it has been improved since the last inspection. It does not present as very ‘homely’ in some areas. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has recently been re-decorated and a new kitchen installed, there is new furniture in parts of the building and one service user’s room has had an en-suite shower installed. The paintwork is fresh and clean as is the flooring, the bathrooms have been refurbished. The home is well kept but some areas could do with ‘homely’ touches, for example bathrooms and hallways. Beech House DS0000011350.V329620.R01.S.doc Version 5.2 Page 20 Four bedrooms were seen, two were homely and comfortable reflecting the individuals’ personalities and tastes, in one, furniture and other decoration were very sparse because of challenging behaviour and one was ‘Spartan’ in appearance, the manager advised that this was a matter of choice by the service user. There was a discussion with the manager about using imagination and thinking of ways of helping the service user with challenging behaviours to maintain a more comfortable living environment. The home smelt fresh and looked clean and hygienic, it has good quality laundry machines and disposes of waste in the recommended manner. Beech House DS0000011350.V329620.R01.S.doc Version 5.2 Page 21 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 AND 36. Quality in this outcome area is poor. The staff team are not as effective as they could be, they need training and support to ensure that they are able to meet all the complex needs of the service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is a minimum of four staff on duty at any one time (daytime hours). There is a total staff team of twelve, including one permanent bank staff member. Agency staff are very rarely used, any shortages are covered by existing permanent staff and the bank staff member. Seven of the twelve staff have little experience in care work and only three staff have been working in the home for more than one year. This was the situation as at the last inspection. Beech House DS0000011350.V329620.R01.S.doc Version 5.2 Page 22 Three staff have an N.V.Q.2 (or above) qualification. The staff have an ‘ongoing’ training process, which begins with the induction, but training courses completed are not recorded and the home or individuals do not have a ‘training plan’. New staff do some of the Health and Safety training courses and some other basic care courses prior to commencing work, but these are not clearly recorded. The manager advised that the company’s training officer is going to complete a training audit, of the home, imminently. Records seen for two new staff showed that they had not had supervision for six months, both staff are inexperienced, new to care work and working with adults with complex and specialised care needs. Two staff members spoken to confirmed that they received supervision two or three times a year. One staff member commented that the ‘team is improving as people now staying longer.’ Recruitment records were seen and all necessary paperwork was included in the staff file. Two staff confirmed that they have completed the Health and Safety courses and that these are up-dated as necessary, records did not reflect this information. Staff commented that staff meetings are not regular and rarely include the whole staff team. There were some issues of some staff not feeling valued. ‘It sometimes feels like there’s two separate staff teams, formed around our ethnicity’. The home has historically had a large turnover of staff and there are only three staff who have been working in the home for more than a year (see above). A relative noted that ‘staff appear not to have a real understanding of the needs of those with Learning Disabilities’. Beech House DS0000011350.V329620.R01.S.doc Version 5.2 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 and 42. Quality in this outcome area is adequate. The practical aspects of the management of the home are of a good standard but the management and support of the staff team needs to be developed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager has been in post for over three years and is suitably qualified and experienced. Some development work has been undertaken and completed but formal support for staff needs to be of a much better standard (see Staffing). A staff member felt that some staff did not feel valued and there was little opportunity for them to discuss these views (see Staffing). Beech House DS0000011350.V329620.R01.S.doc Version 5.2 Page 24 The home has an annual service review; there is no paperwork in the house. With regard to what form the review takes, the manager described that the company send surveys/questionnaires to service users, families, advocates (if any) and other professionals. The responses to these surveys are analysed by head office and form the basis for the annual review report and the annual development plan. The annual development plan notes feedback received from the different parties. Regulation 26 visits take place monthly and service users’ care plans are reviewed by the home monthly. The home has a health and safety check list, which is completed monthly and a weekly fire audit. All Health and Safety maintenance and servicing are upto-date (the five year Electrical safety certificate could not be located but the manager is aware and will check when it is due.). Staff confirmed that they had received Health and Safety Training although there are no reliable records to this effect. Accident and incident forms cross-reference but it is not clear what action is taken as a result of the reports, to minimise the likelihood of recurrences, (behavioural charts are currently used as incident reports, see Complaints and Protection). There have been fourteen incidents since the last inspection in February 06. Beech House DS0000011350.V329620.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 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 2 23 2 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 2 33 X 34 3 35 2 36 1 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 1 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 3 X 2 2 3 X X 3 X Beech House DS0000011350.V329620.R01.S.doc Version 5.2 Page 26 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 YA12 Regulation 16.2(n) Requirement To review the activities programmes to ensure individuals are positively occupied according to their needs. To ensure service users are able to access and be involved in the local community. To develop behavioural guidelines to assist service users to display more positive and rewarding behaviours. To develop specific behavioural guidelines for those who may display physically challenging behaviours, to ensure the safety of the service users and the staff. To ensure that staff are supported to be as competent as possible, in the care of the service users. To develop training plans/programmes for all staff and keep a record of completed and necessary training. To ensure staff are regularly supervised and supported to carry out their tasks. Timescale for action 01/05/07 2. 3. YA13 YA19 16.2(m) 12.1(a) 01/06/07 01/05/07 4. YA23 13.6 & 7 01/04/07 5. YA32 18.1(a) 01/04/07 6. YA35 18.1(c) 01/05/07 7. YA36 18.2 01/04/07 Beech House DS0000011350.V329620.R01.S.doc Version 5.2 Page 27 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. 3. 4. Refer to Standard YA20 YA22 YA24 YA38 Good Practice Recommendations To develop more detailed guidelines for the administration of ‘when necessary’ medication, particularly if used as an aid to behaviour control. To include further detail with regard to the outcome of a complaint and the satisfaction (or not) of the complainant. To add ‘homely’ touches to the house, with particular regard to the bedroom of one service user who has some behavioural issues. For the manager to review the dynamics of the staff team and her interactions with them, with particular regard to people of different cultural and ethnic backgrounds working together as a team. Beech House DS0000011350.V329620.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Oxford Office Burgner House 4630 Kingsgate 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 Beech House DS0000011350.V329620.R01.S.doc Version 5.2 Page 29 - 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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