Inspection on 12/02/07 for Boxgrove

This inspection was carried out on 12th 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 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 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Boxgrove 06/06/07

Boxgrove 07/07/06

Boxgrove 17/10/05

Boxgrove 03/05/05

Boxgrove 26/01/05

Boxgrove 11/11/04

Similar services:

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Pinta

Kestrel House, St Anne`s Opportunity Centre,

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

CARE HOME ADULTS 18-65 Boxgrove Little Heath Road Tilehurst Reading Berkshire RG31 5TY Lead Inspector Catherine Kane Unannounced Inspection 12th February 2007 12:30 DS0000011190.V328559.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 DS0000011190.V328559.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. DS0000011190.V328559.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Boxgrove Address Little Heath Road Tilehurst Reading Berkshire RG31 5TY 0118 943 1019 0118 945 4669 boxgrove@choiceltd.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) Choice Limited Ms Judith Ann Robertson Care Home 10 Category(ies) of Learning disability (10) registration, with number of places DS0000011190.V328559.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7th July 2006 Brief Description of the Service: Boxgrove House is a purpose built care home for 10 adult men with severe learning difficulties. The home is situated on the outskirts of Tilehurst in Reading and is surrounded by open countryside. The home has an extensive garden which service users are encouraged to use and provides opportunities for horticultural activities. A separate day care building is situated on the site and provides a range of day care activities for service users. The staffing ratio is high to meet the complex needs of the service users. Staff have access to a range of training and the provider organisation have facilitated access to NVQ training for staff. The current scale of charges as at February 2007 is between £1741.00 and £2069.12 per week. There are additional charges for toiletries, chiropody, meals out and holidays. DS0000011190.V328559.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Commission has, since the 1st April 2006, developed the way it undertakes its inspection of care services. This inspection of the service was an unannounced ‘Key Inspection’. The inspector arrived at the service at 12.30pm on Monday, 12 February 2007. The inspector was in the service for a total of five and a half hours. It was a thorough look at how well the service is doing. It took into account detailed information provided by the service’s owner or manager, and any information that CSCI has received about the service since the last inspection. The inspector asked the views of the people who use the service and other people seen during the inspection. The inspector looked at how well the service was meeting the standards set by the government and has in this report made judgements about the standard of the service. The assistant manager was on duty at the time of the inspection visit. A total of eight members staff and one agency staff were on duty, four on the early shift until 3pm then five staff for the late shift. The inspector met all ten residents. The inpsector saw staff and residents prepare for their midday meal and saw how staff help residents look after their medicines. She also looked at residents care plans and other records kept in the home and made a tour of the part of premesis. The registered manager was not available on the day of the inspection visit. The operations manager informed the inspector that the registered manager may be absent for some time and was making temporary arrangements for the day to day management and running of the home. The inspector would like to thank the assistant manager and the staff team for their assistance with the inspection. She also thanks residents who shared their experience of this home. What the service does well: The home would be able to meet the needs of individuals of various religious, racial or cultural backgrounds. Residents have good opportunities to take part in a variety of activities at the home and out and about in their local community. The home has a core of well-established staff that understand residents needs and they relate well to. DS0000011190.V328559.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. DS0000011190.V328559.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 DS0000011190.V328559.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): Standards 1 and 2. Quality in this outcome area is good. The admission procedure is good although not tested, as there have been no new admissions to the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Since the last inspection the Statement of Purpose document and information provided to residents as a Service User Guide have been updated. These documents would provide information on what a new resident could expect if they moved into this home. There have been no new admissions to this home since the last inspection. At the time of this inspection the home had no vacancies. Generally, admissions would not made to the home until a full needs assessment has been undertaken. The home would then be able to confirm that they can meet the needs of the individual through the service they deliver. DS0000011190.V328559.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6, 7 and 9. Quality in this outcome area is adequate. The care planning system in place to provide staff with the information they need and for assessing risk has improved but needs to be developed further. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During the inspection the inspector viewed four residents’ care plans selected at random. Care plans seen were written in plain language and considered areas of the individual’s life that include health, personal and social care needs. The care plans seen included up dated risk assessments. Since the last inspection each resident has an allocated key worker. Considerable work had been done since the last inspection to develop care plans for each resident. However, to be fully person centred these care plans need to be developed further to show how the resident was involved in the process, how their views, hopes and aspirations were included and how, and by whom, they are supported to make choices and decisions. DS0000011190.V328559.R01.S.doc Version 5.2 Page 10 The inspector observed that the home was using listening monitors to alert staff should one resident require assistance. Bedsides were used to prevent one resident falling out of bed. There were no clear guidelines included in either resident’s care plan. The decision to start using this equipment, which could compromise residents’ privacy, dignity or restrict their freedom, had been made by the home. While the inspector understands the decision taken to put limitations may be in the best interest of the resident this must be done only though a full care planning process if the resident is not able to give their consent. This would involve the individuals who would be able to act on the resident’s behalf, for example, their relatives or advocate and other social care or healthcare professionals. From the evidence seen by the inspector and comments received, the inspector considers that this service would be able to provide a service to meet the needs of individuals of various religious, racial or cultural needs. DS0000011190.V328559.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 15, 16 and 17 Quality in this outcome area is good. Opportunities for residents to take part in a variety of interesting activities are good. Since the last inspection the menu planning and recording of meals has improved. This judgement has been made using available evidence including a visit to this service. EVIDENCE: On the day of the inspection the inspector was in the home during the afternoon and early evening. She spent some time with the residents and the staff on duty. Nine service users, helped by staff, returned questionnaires to the inspector. Only one resident was able to provide a response; they indicated that staff always treat them well. Two residents had good communication skills, were confident and able to tell the inspector about their experiences of the home. DS0000011190.V328559.R01.S.doc Version 5.2 Page 12 One resident told the inspector “I like cooking and baking”. Another resident shared their understanding about interviewing staff and what jobs staff do in the home. Other residents were not able to communicate with the inspector but from notes kept and discussions with staff the inspector got an idea about what they like to do. Minutes of residents meetings were seen facilitated by the day service co-ordinator; since the last inspection these meetings have been regularly taking place. The home has a dedicated day service within the grounds of the home and residents have opportunities to take part in a variety of activities including using the art room, sensory area, cooking and music. Many activities provided in house were based on what residents prefer to do in their leisure time. Residents have a programme of regular activities outside the home including organised clubs, ice-skating, cinema, going to the shops and the pub, horticultural centre and local church. The home kept notes where details were seen how staff support residents to maintain their relationships with their families. For some there was regular contact and involvement. However, for many residents contact with family or friends outside the home is rare. The assistant manager was not aware of any resident having involvement with an independent advocate. Since the last inspection the cook has left. Care staff are currently preparing and cooking all meals until a new cook is appointed. On the day of the inspection the midday meal consisted of a choice of shepherds pie, pasta bake or nut cutlet with mash potatoes and vegetables, all freshly cooked. The home keeps a note of what each resident has eaten at each mealtime. From information available to the inspector a varied menu is provided that includes fresh produce and residents special dietary needs are catered for. DS0000011190.V328559.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18, 19 and 20. Quality in this outcome area is poor. The personal and healthcare needs of residents are generally well met but how staff help residents to look after and take their medicines could put residents at risk. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Essential information needed by staff to be able to provide personal and health care support was included in residents’ files. Staff help residents to look after their own medication and see they get to see their local GP and other community healthcare services when needed. A comment card was returned from a resident’s GP where they indicated that they were satisfied with the overall care provided in this home. They commented that the home has always worked well and in partnership with them. DS0000011190.V328559.R01.S.doc Version 5.2 Page 14 During the inspection visit two staff demonstrated how residents are helped to look after and take their medicines. Medicines were securely kept in a locked medicines cabinets. The home uses a pharmacist produced medicines administration record (MAR) sheet. The inspector recommends that all handwritten entries to the MAR sheet are checked and countersigned by a person assessed as competent to administer medicines. The supplying pharmacist provides most residents’ medicines in a monitored dose system and there is a system for accounting for other prescribed medicines. The inspector recommends that there is a system for accounting for all over the counter medicines or homely remedies kept in the home and administered to residents. Certificates were seen for some staff who have completed medication training provided by a local college delivered by individuals with a creditable knowledge of medicines. Some staff have also completed training about how to support people with epilepsy that includes the administration of rectal diazepam. However, no evidence was available that an appropriately qualified healthcare professional has assessed as competent individual staff members in this complex healthcare task for specific individuals who live in this home. There was no record kept of the homes process used to assess the competence of staff prior to their administering medication in line with the homes policy. The inspector recommends that a sample of the initials of all staff assessed as competent to administer medicines be kept. DS0000011190.V328559.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22 and 23. Quality in this outcome area is good. The home has a protection from abuse policy and the complaints procedure is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager declared that home has received one complaint in the last year. Details of this was made available to the inspector at the time of the visit. The Commission has received no information relating to complaints in the last year. Staff have attended specific training on protecting vulnerable people from abuse and about local adult protection procedures. Staff who spoke with the inspector were clear about their responsibilities and were aware of the homes ‘whistle blowing’ policy. The Commission has received no information relating to adult protection issues since the last inspection. DS0000011190.V328559.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 14 and 30. Quality in this outcome area is adequate. The home was tidy and generally clean at the time of the inspection visit but there continues to be unpleasant odours in areas of the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Since the last inspection new sofas and a new carpet have been fitted in the lounge. The home has a programme of maintenance and renewal; during the inspectors visit routine maintenance and redecoration in areas of the home was being carried out. Routine checks recorded of water temperatures taken in residents bathrooms indicate a temperature of between 34°c- 38°c. When one resident was asked he confirmed that his bath water was cold. The home must ensure that the water temperatures are regulated to ensure that residents’ baths or showers are not too cold or too hot. DS0000011190.V328559.R01.S.doc Version 5.2 Page 17 Since the last inspection a full time cleaner has been employed and a cleaning schedule put in place. Staff have commented that cleanliness in the home has greatly improved. However, there continues to be the unpleasant odour of stale urine in areas of the home. Over the last two weeks prior to the inspectors visit the cleaner had been redeployed for part of their time to other tasks within the home. Further efforts are necessary to ensure that the bad odours are eliminated completely and a pleasant living environment is maintained. DS0000011190.V328559.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 32, 33, 34, 35 and 36. Quality in this outcome area is adequate. This homes recruitment procedures and training for staff to do their jobs well is generally good but there needs to be sufficient staff on shift to meet the needs of residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During the inspection the inspector spoke with three members of staff on duty. The home has a core of well-established staff that understand residents needs and they relate well to; this was seen in the positive relationships that had been formed with residents. Staff commented that morale is generally good. From the shift rota seen there has been some moderate use of agency staff in this home over recent months. Two care staff have left and two new care staff have been recruited since the last inspection. Since the last inspection the cook has left. Until a new cook is appointed care staff have been undertaking the preparation and cooking of the main midday DS0000011190.V328559.R01.S.doc Version 5.2 Page 19 meal. At times in the two weeks prior to the inspection visit the cleaner has been redeployed to other duties to cover staff shortages due to sickness. The home must ensure there are sufficient staff on duty to ensure that the day to day running of the home is carried out effectively and efficiently without compromising the quality of care for residents. The recruitment process is thorough. The inspector viewed staff files for four staff sampled at random. These were well organised and contained the necessary documentation. The assistant manager confirmed that Choice intends to renew the Criminal Record Bureau (CRB) disclosures made on staff every three years. The home keeps a record of induction and training completed by staff; staff spoken with confirmed details of the training they have undertaken. However, a record of the induction programme completed by agency staff that come to work in the home has not been kept. The inspector strongly recommends that all staff working in learning disability services undertake foundation induction that is Learning Disability Award Framework (LDAF) accredited.13 staff members have completed a relevant National Vocational Qualification (NVQ) and five further staff are currently undertaking this qualification. Also see Standard 20. Staff confirmed that a formal supervision system has started and the first sessions had taken place in December 2006. However, this was made a requirement in July 2006 with no explanation for the delay in setting up the supervision programme. The inspector strongly recommends that regular staff supervision sessions continues to take place throughout the year. DS0000011190.V328559.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 37, 39, 41 and 42 Quality in this outcome area is poor. This home needs strong leadership and stability and ensure the smooth running of the home to provide a quality service for residents who live in this home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager was not available at the time of the inspection. The inspector was informed by the operations manager that the registered manager may be absent for some time. The responsible individual must provide CSCI with details of the management arrangements in the absence of a registered manager. DS0000011190.V328559.R01.S.doc Version 5.2 Page 21 The home, generally, has sound policies and procedures in line with current thinking and practice. Efficient systems are in place to monitor staff adherence to policies and procedures during their practice. However during the inspection it was clear that elements of the homes medicines policy had not been fully adhered to. The home works to a clear health and safety policy and checks take place to ensure the home meets relevant health and safety requirements and legislation. Records kept were generally adequate and are routinely completed. Residents and staff hold regular meetings and notes kept were seen during the visit. Proprietors’ representatives monthly visit reports have been regularly received. The Commission no longer requires that a copy of this report be sent to CSCI but a copy must be kept in the home and made available for inspection. Choice Limited undertakes audits of this home. The operations manager informed the inspector of the current quality assurance campaign with questionnaires sent to residents, their relatives and staff. The outcome will inform the future development plan for the home. Choice Limited, who run this service, has financial and accounting systems subject to internal and external audits. DS0000011190.V328559.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME 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 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 3 33 2 34 3 35 2 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 2 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 1 X 1 X 3 X 2 3 X DS0000011190.V328559.R01.S.doc Version 5.2 Page 23 Yes 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 YA7 Regulation 12 Schedule 3 Requirement The responsible person must ensure that a record is kept of decisions that have been made for residents and the reasons why these decisions have been made. The responsible person must advise the CSCI of what action has been taken to meet this standard. (Requirement only partially met from the previous inspection). The responsible person must provide CSCI with details of how, and by whom, staff are assessed as competent to undertake the administration of rectal diazepam. The responsible person must provide CSCI with details of how, and by whom, designated officers are assessed as competent to train other staff to administer residents’ medicines. The responsible person must ensure that the water temperatures are regulated to ensure that residents’ baths or showers are not too cold or too hot. The responsible person must DS0000011190.V328559.R01.S.doc Timescale for action 30/04/07 2. YA20 18(1) 30/04/07 3. YA20 18(1) 30/04/07 4. YA24 23(2)(j) 30/04/07 5. YA30 23 30/04/07 Page 24 Version 5.2 6. YA33 18(1) 7. YA37 38 ensure that further work is undertaken to eliminate unpleasant odours in areas of the home. The responsible person must advise CSCI of what action has been taken to ensure that the home is clean and hygienic. (Requirement only partially met from the previous inspection). The responsible person must 30/04/07 provide details of what action is to be taken ensure that there are sufficient staff on duty at all times to ensure the efficient running of the home. The responsible person must 28/02/07 provide details for the management and running of home in the absence of the registered manager. The responsible person ensures that all staff are familiar with the home’s policies and procedures. (Requirement only partially met from the previous inspection). 28/02/07 8. YA41 12 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 The inspector recommends that residents care plans should be developed further to be fully person centred to show how the resident, their family or advocate was involved in the process. The inspector recommends that handwritten entries to the MAR sheet should be checked and countersigned by a person assessed as competent to administer medicines. The inspector recommends that there should be a system for accounting for all over the counter medicines or homely remedies kept in the home and administered to residents. DS0000011190.V328559.R01.S.doc Version 5.2 Page 25 2. 3. YA20 YA20 4. 5. 6. YA20 YA35 YA35 7. YA36 The inspector recommends that a sample of the initials of all staff assessed as competent to administer medicines should be kept. The inspector strongly recommends that a record should be kept of the homes induction programme undertaken by agency staff that work in this home. The inspector strongly recommends that all staff working in learning disability services should undertake foundation induction that is Learning Disability Award Framework (LDAF) accredited. The inspector strongly recommends that regular staff supervision sessions should continue to take place. DS0000011190.V328559.R01.S.doc Version 5.2 Page 26 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 DS0000011190.V328559.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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