Inspection on 18/01/08 for Boscobel

This inspection was carried out on 18th January 2008.

CSCI found this care home to be providing an Adequate service.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Boscobel 26/02/07

Boscobel 17/01/06

Boscobel 11/10/05

Boscobel 09/03/05

Boscobel 09/12/04

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

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

CARE HOME ADULTS 18-65 Boscobel 1 Preston Road Southport Merseyside PR9 9EG Lead Inspector Ms Lorraine Farrar Unannounced Inspection 18 January 2008 12:45 th Boscobel DS0000005357.V345805.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 Boscobel DS0000005357.V345805.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. Boscobel DS0000005357.V345805.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Boscobel Address 1 Preston Road Southport Merseyside PR9 9EG 01704 537611 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 Derek Ellison Mrs M Ellison Mrs Marjorie Ismay Care Home 20 Category(ies) of Learning disability (20) registration, with number of places Boscobel DS0000005357.V345805.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Service users to include up to 20 LD One named out of category service user, Physical Disability (PD), as defined in letter dated 19/04/90. 26th February 2007 Date of last inspection Brief Description of the Service: Boscobel is owned by Mr and Mrs Ellison and is managed by Mrs Marjorie Ismay. It provides accommodation, personal care and support for up to 20 adults who have a learning disability. Staff are available 24 hours a day to support the people living there. Located in Southport, the home has easy access to public transport going to Southport & Liverpool, with Southport town centre approximately ten minutes bus journey from the home. There are local shops & facilities nearby, with a wider range available in the town centre. The property is a detached four-storey house in a wide, tree-lined street. There is plenty of parking available outside the home and some within its grounds. Accommodation is available on three floors. On the ground floor there are two shared lounges with the dining room in the basement. No passenger lift is available, however people can eat in the lounge if they choose and there are some bedrooms on the ground floor. There is a large, enclosed garden to the rear of the property. It costs between £372 and £410 each week to live at Boscobel. Boscobel DS0000005357.V345805.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is one star. This means the people who use this service experience adequate quality outcomes. Information for this inspection was gathered in a number of different ways. An unannounced site visit took place for five hours on 18th January 2008 and an announced site visit for four and a half hours on 23rd January 2008. This included reading records and looking at the building. ‘Case tracking’ was used as part of the visit, this involves looking at the support a person gets from the home including their care plans, medication, money and bedroom. Time is also spent talking with the person and with staff about how they meet the person’s needs. During the site visit, case tracking was used to look at life at Boscobel for three of the people living there. Discussion took place with three people living at Boscobel, we met with others and spoke to five members of staff. Any information the Commission for Social Care Inspection (CSCI) has received since the last inspection about the home is also taken into account in writing this report. This includes information provided by the Manager on a self assessment form and comment cards sent to the people living there and their relatives. A total of sixteen comment cards were returned to us from the people living at Boscobel. An easy to understand summary of this report is available. If you would like to see a copy please ask the staff at Boscobel. What the service does well: Before people decide whether to move into Boscobel or not they are provided with information about what the home is like, its polices and procedures and how it operates. Staff also meet with the person and they carry out an assessment of the persons needs and choices as well as obtaining a copy of the persons Social Services assessment. This exchange of information helps everyone to decide whether the home is a suitable place for the person to live and whether staff and the environment can meet their needs and choices. The people living at Boscobel are able to engage in hobbies and activities of they like both within and outside of the home. They told us that they can do the things they want to do, make their own decisions and that staff listen to them and act on what they say. Boscobel DS0000005357.V345805.R01.S.doc Version 5.2 Page 6 There are good practices within the home for encouraging people to air their views and learn about their rights. This includes regular residents meetings where people can discuss things they want to do, places they want to go, current affairs and issues such as dealing with fire and making choices. There is a stable staff team working in the home who have a good knowledge of the people living there and the support they require. People told us they get the support they need with their personal and health care as well as with their hobbies and lifestyle. 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. Boscobel DS0000005357.V345805.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 Boscobel DS0000005357.V345805.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): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Before anyone moves into Boscobel enough information is given to them and obtained about them to help everyone decide if it is the right place for them to live. EVIDENCE: The people living at Boscobel told us in their comment cards that before they moved in they were asked if they wanted to live there. They also told us that they were given enough information about the service to help them make a decision. One person explained, “I am very happy here”. Nobody new has moved into Boscobel since the last big inspection therefore it is not possible to practically assess the support they would be offered. However a member of staff was able to explain that before anyone moves in a full assessment of thier needs and choices would be carried out. She also explained the person would be invited to visit the home several times and given information about the services they provide. Assessment forms and procedures are in place to support guide staff with this. Boscobel DS0000005357.V345805.R01.S.doc Version 5.2 Page 9 This level of support and information will help everyone to decide if Boscobel is the right place for the person to live and if it would suit their lifestyle. Boscobel DS0000005357.V345805.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Peoples individual needs, choices and views are identified and met within the service. EVIDENCE: A care plan is in place for everyone living at Boscobel and people told us that they knew about their plan and who their keyworker is. This was further confirmed by a section in plans, which covers the person’s views of the support they receive. Plans also evidenced that people are involved in their care planning meetings. This ensures that they are clear about the support they should receive and also that their views are taken into account and listened to. Care plans contained clear guidance about how to support people with their personal care and with the way they relate to others. However other parts of the plans were brief with assessments in place that had been completed in 2004. This could lead to a person’s current support needs not being recognised. Boscobel DS0000005357.V345805.R01.S.doc Version 5.2 Page 11 One plan was confusing around the support offered to the person around their sexuality. Although a member of staff was clearly able to explain the support that has and is offered this was not clear within the care plan. Again this could be misleading for staff and could lead to the person not being supported in the way they prefer. Individual risk assessments are in place within everyone’s care plan. These help people to identify any areas of risk in their life and take steps to minimise it. The people living at Boscobel told us in their comment cards that they are able to make decisions about the things they do each day. One person explained, “I make my own decisions”. Regular meetings are held at Boscobel for the people living there. These cover a large variety of subjects, ranging from health and safety to outings and making choices. Staff use a series of booklets written by and for people with a learning disability to help people understand the subjects discussed. One of the people living there explained to us that, ““we talk about going out, about current affairs”. These meetings help people to gain a good understanding and influence how the home operates. They also help people to understand rights and responsibilities in their everyday life. Boscobel DS0000005357.V345805.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, 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. The people living at Boscobel are supported to live a lifestyle of their choosing. This could be further enhanced with support for everyday living skills. EVIDENCE: During our site visits people were engaged in a number of different activities. Some were at work, others going out swimming or to a club whilst those at home were chatting with staff or playing board games. The people living there told us in their comment cards that they are able to do the things they want to do at all times. During the site visit this was confirmed with people telling us they chose what to do and when to go to bed as well as discussing outings and holidays they want to take part in. They explained that they go out on their own or with staff as needed. Boscobel DS0000005357.V345805.R01.S.doc Version 5.2 Page 13 They also told us that they can go to church or attend an in house religious service weekly, as they prefer. One person explained that staff help her to keep in touch with her family when she wants. A social worker who completed a comment cards told us that, “they always informs family members or next of kin to any changes to needs / invites to meetings. Has family days, always welcoming when visiting”. They also said that staff support people to live a lifestyle of their choosing. The in housie meetings have included discussion about appropriate relationships and discrimination. This provides people with a safe environment in which to ask questions or discuss any issues they have around building relationships with others. People told us that they always get a choice of meals and the cook explained that everyone is asked daily what they would like. Records show that several different meals are prepared to meet people’s choices. The cook was able to explain the different diet needs people have and how these are catered for. Meals are served in the downstairs dining room. This is located in the basement and does not have a lift for access. However people with limited mobility are able to eat their meals with staff support in the lounge. There is limited opportunity for people to be involved in the shopping and preparation of meal times as the main kitchen is used by the cook and many of the supplies are delivered to the home. There is a small kitchen and dining area/ lounge in the basement of the house. During our site visit this kitchen contained only a box of cereal and box of tea bags. Staff spoken with said that there is sufficient time within the day for them to support some people to make a simple meal or drink. The lack of access to support with everyday living skills means peoples do not have the opportunity to increase their everyday living skills and become as independent as possible. Boscobel DS0000005357.V345805.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 & 20 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The people living at Boscobel receive support to meet their health and personal care needs. Practices around management of medication do not always ensure people are as safe as possible. EVIDENCE: The people living at Boscobel told us during our site visit that they get support from staff with their personal care when needed. They also explained staff will make and accompany them on health appointments, one person explained, “they come in with me” to help talk to the GP. Care plans contain information about the support people need with their health and personal care and records showed that this support is provided. They also showed that people are supported to attend regular healthcare checks such as the optician and chiropodist as well as more specialist appointments they may need. People told us that staff look after their medication and that they always get this on time. Boscobel DS0000005357.V345805.R01.S.doc Version 5.2 Page 15 Medication is stored safely in a locked cabinet and is only given out by senior Staff. Records showed that senior staff have received training in dealing with medication so that they are aware of the correct procedures to follow. Medication record sheets had not always been correctly completed. For example creams prescribed for two people had not been signed for nor had a note been made of any reasons why they may have been admitted. All prescribed medication should be recorded as given or the reason why it is not should be recorded. This will help establish a clear audit trail as to its usefulness. Records of tablets and liquids prescribed had been completed correctly. Two staff sign any handwritten entries. This helps to lessen the risk of mistakes in recording occurring. One person was prescribed ‘as required’ medication. There were no clear guidelines in pace for staff to follow when giving this. The medication sheet showed it had been given for two days in January; however daily records only recorded it as given once. Clear records should be maintained of the times this medication is given in order to establish whether there are any causes or patterns to the person’s behaviour that may be managed differently. Several of the people living at Boscobel have diabetes and staff test and record their blood sugars regularly. Although staff were able to explain the acceptable blood sugar levels no clear plan or guidance was in place for this. This could lead to unfamiliar staff not taking appropriate action to ensure the person is safe and well. All three people share a blood monitor machine, staff could explain how they clean this to prevent cross infection, however individual machines would lessen this risk again. An oxygen tank is kept in the lounge for one of the people living there. This is not secured to the wall and could present a fire risk of knocked over. Boscobel DS0000005357.V345805.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 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The people living at Boscobel feel their views are listened to and acted upon. However financial practices do not always ensure they are fully protected. EVIDENCE: The people living at Boscobel told us in their comment cards that they know who to talk to if they are unhappy about something and how to make a complaint. This was confirmed during our site visit. One person explained, they would talk to their keyworker or senior staff as, “they would help me with it”. Polices ands procedures are in place for dealing with complaints and adult protection issues that arise. One of the people living there explained that the complaints procedure is on the wall so everyone can see it. Staff receive training in dealing with adult protection to help them identify and deal with any issues that may arise. Staff spoken with were able to explain the actions they would take if this occurred. No complaints or concerns have been raised at Boscobel since the last inspection of the service. However a concern was raised with the CSCI regarding the management of peoples’ monies. Boscobel DS0000005357.V345805.R01.S.doc Version 5.2 Page 17 The owners of Boscobel act as appointee for everyone’s benefit money. Clear records are available in the home of the amount of money everyone receives and how much of this they pay towards their fees. However the money is held in a company account. An in house computer system is in place to record how much money each person has. However this had not been updated for several months. Therefore it was not possible to establish if the money in the company account was sufficient to cover that belonging to the people living there. Nor was it possible to establish whether this money had ever been used as part of the homes trading costs. A referral was made by us to the local Social Services department to investigate this under their adult protection procedures. Once they have decided upon their actions then we will look at this practice in terms of the home breaching care standards regulations. Boscobel DS0000005357.V345805.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 & 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Boscobel provides a safe place for people to live, some areas of the house would benefit from decoration and upgrading. EVIDENCE: The people living at Boscobel told us in their comment cards that the house is always fresh and clean and this was observed during our site visit. One person explained they liked their bedroom as, “I picked the colour, I can switch the heater on and off”. Boscobel is a large detached house in a residential area of Southport. It fits in well with other, domestic houses in the area and does not stand out as a care home. To the front there is a garden with parking and a ramp and steps leading to the front door. There is additional parking available on the road outside. At the back of the house is a large enclosed garden with seating available. Boscobel DS0000005357.V345805.R01.S.doc Version 5.2 Page 19 Shared areas of the home include, two lounges and a dining room in addition to which there is a ‘flat’, which provides a small kitchen and lounge. There are bedrooms on the ground and first floor, of which, four are twin rooms, with the others providing single accommodation. Bedrooms are not ensuite but do provide washbasins. There are toilets and bathrooms throughout the house including two showers that are easily accessible for people with mobility problems. In addition grab rails and painted steps help people to get around more easily. A separate laundry room is provided, this was well organised with systems in place to prevent the spread of infection. Several areas of the house appear shabby and outdated. For example the main lounge has single high-backed armchairs arranged around the walls. This gives it an institutional appearance. The dining room appears cold and uninviting and would also benefit from refurbishment and decoration. In the flat the kitchen and lounge are used as storage and would benefit from care and decoration. This would provide the people living there with a third living space that they could also use to learn lifestyle skills. Boscobel DS0000005357.V345805.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): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The people living at Boscobel have confidence in the staff team who support them. Further training would enhance staff skills in supporting people and meeting their needs and choices. EVIDENCE: The people living at Boscobel told us in their comment cards that staff treat them well and listen and act on what they say. During our site visits staff were seen to spend time talking with people and engaging in activities with them. One of the people living there confirmed there are always enough staff to help then and that “they have time to listen”. This was further seen during our visit when a member of staff spent time quietly with one of the people living there reassuring her and talking through her concerns. Over half of the staff team have gained a national qualification in care (NVQ) and records showed that they undertake regular training. Training is arranged in basic areas of care such as infection control and fire. This training helps to ensure Staff have the skills and knowledge to identify and meet peoples’ individual needs and choices. Boscobel DS0000005357.V345805.R01.S.doc Version 5.2 Page 21 No training for staff around more specialist areas such as the Mental Capacity Act has been arranged and some staff have not had training in diabetes. As these areas directly affect some of the people they support, training would help to ensure staff are as up to date as possible in their knowledge and practise. Staff files contained evidence that before a new member of staff works in the home appropriate checks are carried out, this includes a full interview, obtaining references and CRB checks. These checks help to ensure that they are suitable to work with people who may be vulnerable. Boscobel DS0000005357.V345805.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): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Boscobel provides a safe place for people to live. The service seeks the views of others to plan improvements however these are not always fully implemented. EVIDENCE: Mrs Marjorie Ismay is the Registered Manager of the home. She is an experienced Manager who holds qualifications in both care and management. There are several systems in place within the home for checking that they are offering a good service. A recent quality audit of the service by an external company awarded them a 5 star rating, this included seeking the views of the people living there and their representatives. Boscobel DS0000005357.V345805.R01.S.doc Version 5.2 Page 23 Samples of surveys sent out by the home were seen by us. The responses were largely positive. The results of the surveys had not been collated, although staff were able to explain individual issues that arose and how these were handled, an overall report on the results of the surveys along with an action plan would help the service to audit itself and show planned improvements. In addition a requirement and a recommendation given at the last CSCI inspection to improve the safety and lifestyle of the people living at Boscobel had not been met. Health and safety records are up to date and satisfactory, showing that the building and equipment is safe for people living, working and visiting the home. Boscobel DS0000005357.V345805.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 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 3 33 X 34 3 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 4 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 2 X X 3 X Boscobel DS0000005357.V345805.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action 1. YA23 20 Money belonging to Residents 29/02/08 must not be held in a company account. This will ensure that Residents monies are safe from potential misuse. This is a previous requirement. inspection 2. YA6 15(2)(b) Care plans must be reviewed to 15/03/08 ensure they are up to date and contain clear guidance in all areas people require support. This will ensure people receive the support they require at all times. 3. YA20 13(2) Medication sheets must be fully 15/03/08 completed including the reasons why any medication is omitted. Risk assessments must be completed and implemented for the storage of oxygen and sharing of blood monitors. Boscobel DS0000005357.V345805.R01.S.doc Version 5.2 Page 26 This will help to ensure people’s medication is managed as safely as possible. 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 YA17 Good Practice Recommendations The service should look at ways to support people to become more involved in planning and preparing meals. This will increase the input people have into the running of their day-to-day lives. 2. YA20 Clear guidance should be recorded for anyone who takes ‘as required ‘ medication. Full records must be maintained of the times people need and receive ‘as required’ medication. This will help to ensure people receive their medication appropriately and safely. 3. YA24 An action plan for improving the décor and furnishings of the house should be drawn up and implemented. This will help to ensure the house is comfortable and provides a nice environment for people to live in. 4. YA35 A training plan should be compiled and implemented for staff around more specialist areas of support for the people living there. This should include training in diabetes and the mental Capacity Act. This would help ensure staff are as aware as possible of current good practice in supporting people. Boscobel DS0000005357.V345805.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection North West Regional Contact Team Unit 1, 3rd Floor Tustin Court Port Way Preston PR2 2YQ 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. 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