CARE HOME ADULTS 18-65
Brimley 1 Read Close Pound Lane Exmouth Devon EX8 4NP Lead Inspector
Teresa Anderson Key Unannounced Inspection 13th December 2006 13:00 Brimley DS0000021893.V316941.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 Brimley DS0000021893.V316941.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. Brimley DS0000021893.V316941.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Brimley Address 1 Read Close Pound Lane Exmouth Devon EX8 4NP 01395 265775 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) linda@normanlea.co.uk Devon & Cornwall Housing Assn. Normanlea Society Limited Mrs Linda Williams Care Home 6 Category(ies) of Learning disability (6), Physical disability (6) registration, with number of places Brimley DS0000021893.V316941.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 26th October 2005 Brief Description of the Service: Brimley provides residential care for up to 6 people with learning disabilities who may have a physical disability. The property is a purpose-built detached bungalow located in a residential suburb of Exmouth, not far from the town centre. There is a bus stop close to the home and the town has a train service. The home has six single bedrooms for residents, a lounge/dining room and a conservatory. There is a pleasant garden with seating areas. Car parking is ample. The home has the use of a mini bus that it shares with its sister home that is also in Exmouth. Fees charged at this home range from £377.00 to £586.00 per week. Information about this home, including reports, is available from the home direct. Brimley DS0000021893.V316941.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place as part of the normal programme of inspection. The site visit started at 1.30pm and finished at 5.30 pm. An additional visit was made to the sister home to view some records unavailable on the day of the site visit. During the inspection the inspector spoke with 5 of the 6 people whose home this is. Some of whom have communication difficulties. She looked in depth at the care and services offered to 2 residents. This helps in understanding the experiences of people who live here. She spent time observing the interactions between staff and residents. She spoke with the deputy manager and with the other person on duty at the time. She also spoke with other staff at the sister home who also work at this home. Records in relation to care planning, residents’ monies, staff recruitment and fire safety were inspected. Before the site visit ‘comment cards’ were sent to all 6 people who live here and 5 were returned and to 6 staff and 2 were returned (although 8 were returned from staff at the sister home who also work here). No surveys were returned by health and social care professionals who have contact with the home. In addition to the above the project manager provided the commission with information in a ‘pre-inspection questionnaire’. What the service does well:
People who live at this home ‘love living here’ and say they are ‘happy’. Each person was assessed prior to moving in to ensure their needs could be met and to ensure that they would fit into the home and with the group of residents who live here. Staff know the residents needs well and work hard to ensure they are treated with respect. The people who live here are given lots of choices and support to make decisions about how they live their lives. Staff support residents to manage their finances to the best of their ability and ensure monies are kept safety and securely. People who live here, and who are able to communicate, told the inspector about the things they do. This includes art classes, exercise classes, skittles, going to discos and karaoke, going into town for lunch and out on the minibus. They have excellent links with the local community make use of the local facilities and amenities. One resident often walks from the home into town and
Brimley DS0000021893.V316941.R01.S.doc Version 5.2 Page 6 then to the sister home for coffee before getting a lift back. Visitors say they can come and go as they please and are always welcomed. One visitor was overheard being offered a lift to get home. The people who live here and are able and want to are involved in planning the meals and in shopping for them. During the site visit two residents went out with a member of staff to the local supermarket. When they returned there was a combined effort to put the groceries away and to ‘get the kettle on’. Comments about the food include ‘lovely’, ‘great’ and ‘really good’. Staff work hard to strike the balance between healthy eating and some residents preferences for less healthy foods. Fresh fruit is easily available. Residents who are able make tea and coffee when they feel like it and others are offered drinks and snacks frequently. People who live here have their healthcare needs met through proactive means. Residents regularly see the dentist and chiropodist for example and each is registered with their own GP and see specialist health and social care staff when needed. Medications are well managed and reviews take place as needed. The people who live here say that staff listen and act on what they say and that they know who to complain to if they need to. No complaints have been received by the home or by the commission. Staff receive training in safeguarding adults and demonstrate a good understanding of this. Residents are clearly relaxed and confident in the company of the staff. The home is clean and hygienic throughout and has good access for people with mobility problems. Each resident has their own room and there is a communal lounge with dining area. Residents told the inspector how much they like the staff and observations of interactions demonstrate healthy, relaxed, respectful and fun relationships. There is one member of staff on duty in the morning, evening and during the night (sleeping) and two in the afternoon when the majority of activities take place. Staff receive appropriate training and supervision. Recruitment practices ensure that prospective staff are vetted to promote the safety of residents. Some residents are involved in this process. This home is well managed and keeps the interests of the residents at the forefront of all practices and meets their needs. What has improved since the last inspection?
Since the last inspection the staff team have been working hard to develop the care planning and risk assessment documentation. The TV in the lounge has been replaced as has the freezer in the kitchen meaning that the home is better equipped.
Brimley DS0000021893.V316941.R01.S.doc Version 5.2 Page 7 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. Brimley DS0000021893.V316941.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Brimley DS0000021893.V316941.R01.S.doc Version 5.2 Page 9 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2. Quality in this outcome area is good. People who come to live here can be assured that the staff will have a good understanding of them and what their needs and desires are. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All but one person living at this home have lived here for a long time. One person moved in to the home more recently. This person had a comprehensive assessment undertaken by health and social care staff. The staff at the home also carried out an assessment and met with this resident over a period of time so that they could get to understand them, their needs and wishes before they moved in. This person was given opportunities to spend time at the home and meet with other residents and staff before deciding to live here permanently. Brimley DS0000021893.V316941.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 adequate. The systems in place to provide staff with the information they require to safely meet residents’ needs require further development. People are helped to make decisions about their lives and how they live them but the system in place for managing risks need improvement. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Each person living at Brimley has a plan of care. Staff report that they have recently been working on improving these. In addition the manager reports that five members of staff have or are to receive training in person centred care planning. Each person living here has a key worker and those residents spoken with knew who these are and what their role is.
Brimley DS0000021893.V316941.R01.S.doc Version 5.2 Page 11 The inspector looked at the care plans and associated risk assessments of two people who live at the home which have been written in the new format developed by the staff team. Each care plan is based on an assessment of the person and on the staff’s knowledge of that person, which is clearly comprehensive. Each gave the reader a pen picture of the resident, their history, abilities, likes and dislikes. One care plan gave staff very good detail in relation to how that resident likes to receive personal care. However, in general care plans lacked breadth and detail and are not all presented in a format that the service user would find easily accessible. The plans identify current needs but do not, on the whole, focus on the development of new skills or the future aspirations of that person. Risk assessments are not comprehensive and whilst identifying outcomes in relation to low, mid or high risk do not demonstrate how the decision in relation to that level of risk has come to be made. In addition, how risk is to be managed is not always identified and there is a lack of evidence in the care plans seen that risk is balanced against the aspirations for independence and choice of the resident. Examples of where care planning could be improved are that one person said they would like to use the local bus service. Staff identify that this person is at risk and told the inspector why. They suggested a way that this could be overcome. If this were part of the care planning process, it would be person centred, goal orientated, would manage risk and would help the resident to achieve their aspiration. At the second site visit the manager reports that some staff have attended person centred care planning (this had been arranged prior to the inspection) and the manager had made efforts to find examples of ‘good’ care planning. The staff are now further developing care plans along the lines of person centred care planning. Residents were seen to have freedom throughout the home and being encouraged to be independent and to use their skills. One resident answers the phone and one resident made cups of tea for herself and offers others tea. Throughout the inspection staff were heard offering choices to the residents for example around going shopping, whether or not to have their hair done and around what to eat and drink. Regular residents meetings are held and some residents talked to the inspector about what is discussed during these. Brimley DS0000021893.V316941.R01.S.doc Version 5.2 Page 12 The Administrator acts as appointee for handling resident’s finances. All monies are kept safely and securely. The home has an internal auditing system carried out by the Treasurer of the Normanlea Society. This had been carried out on the day of this site visit. All accounts are kept separate and two members of staff check monies at least once daily. Brimley DS0000021893.V316941.R01.S.doc Version 5.2 Page 13 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 good. People who live here experience a lifestyle that enhances their quality of life. The rights of people who have disabilities are protected and promoted by the staff and the ethos of the home. People who live here benefit from a diet that is varied, nutritious and which is much enjoyed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: In surveys three residents say that there are always activities arranged by the home that they can take part in, two residents said there usually are and one said there are sometimes. One resident said they like to go out as much as they can and one that they would like to go out more if there are enough staff.
Brimley DS0000021893.V316941.R01.S.doc Version 5.2 Page 14 Residents at Brimley join in activities that include karaoke, discos, art classes, skittles, going out for lunch, going shopping and going into Exmouth. Unfortunately some residents are still feeling saddened by the closure of a local facility which provided extensive activities for people with a learning disability. They talked to the inspector about how they had campaigned to keep this open and how much they miss it. Staff work hard to find other activities locally which residents can join in with. One told the inspector that they attend music classes and another told the inspector about the walking group they had joined and the exercise classes they attend. One resident really enjoys music and has their own Karaoke machine and a large selection of CD’s. Another resident enjoys knitting and staff ensure this person has wool and needles. On the day of the site visit one resident had walked into town and joined the residents at the sister home for coffee, and two were out. Some residents went out shopping with a staff member and when another resident was picked up two residents went along for the ride. This is clearly something that happens all the time. Links with the local community are good and there are a number of local clubs that residents belong to. One visitor seen was warmly welcomed and offered refreshments. Residents are able to maintain relationships with family and friends and there is no restriction on visiting. Staff were seen to maintain residents’ privacy and dignity by giving help with personal care in private, knocking on bedroom doors before they enter and one member of staff talked of the importance of not talking about residents in front of others. All residents said how much they enjoy the food. One said ‘lovely’, another said they like salads and that they have these and another said ‘I love the food’. Those who could talked about the types of things they like and what they eat. Some residents would prefer a much less healthy diet and staff do a good job ensuring there is a balance between choice and nutrition. Residents are involved in shopping, menu planning and cooking depending on abilities. Two residents showed the inspector the Christmas cakes they had made. Bowls of fresh fruit are available. Brimley DS0000021893.V316941.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 good. The people who live here are helped to stay healthy and the management of medications ensures their safety. Personal support is offered to the people who live here in a way that offers choice and promotes independence. This judgement has been made using available evidence including a visit to this service. EVIDENCE: In surveys all residents say that they always receive the medical support that they need. Each resident is registered with a local GP and records indicate that regular visits are made to the dentist and opticians. Additional medical support is obtained as and when it is required. Staff report that a psychologist working with one resident has said how much that person has improved because of the efforts of the staff.
Brimley DS0000021893.V316941.R01.S.doc Version 5.2 Page 16 Another resident had been referred to the physiotherapist. This has resulted in this person having a mobility aid which has vastly aided their mobility and independence. Details in one care plan show that staff have a good understanding of the importance of offering personal support in a way that suits each resident. Staff demonstrate a good understanding of residents needs and signs or symptoms of distress or pain and deal with this appropriately. The home uses a monitored dosage system of medication issued by the local pharmacy. Staff manage the residents medication as they report that none of the current residents are able to or want to manage their own medication. Staff said that they had received training in managing medication. Records were seen and they indicate that medication is being administered appropriately and that records are kept up to date. Brimley DS0000021893.V316941.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): Quality in this outcome area is good. People who live here are protected from harm and can be sure any grievances will be listened to. This judgement has been made using available evidence including a visit to this service. EVIDENCE: No complaints have been received about this home. In surveys residents say that staff listen and act on what they say and that they always know who to speak with if they are not happy. During the site visit residents told the inspector that they have no complaints and ‘love’ living here. The complaints procedure is displayed in ‘easy read’ format. Staff receive training in safeguarding adults and demonstrate an excellent understanding of what abuse is and a zero tolerance to it. They watch a video produced by the Department of Health and some have attended training sessions organised by the local authority. Some training is directly related to supporting residents to know about their right to be protected and not to be harmed in any way. Residents told the inspector they feel safe and were observed to be relaxed and confident in the company of staff.
Brimley DS0000021893.V316941.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 and 30. Quality in this outcome area is good. The people who live here enjoy an attractive, clean, safe and homely environment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: In surveys residents say the home is usually or always clean and fresh. Some residents say they have responsibilities in relation to housework and enjoy this. Others say they help to keep their bedrooms clean and tidy. On the day of the site visit the home was clean and as tidy as a home with an active family living there is expected to be. And the home is accessible throughout for those who have mobility problems. There is a contract in place for the collection of clinical waste meaning that staff and residents are protected from cross infection.
Brimley DS0000021893.V316941.R01.S.doc Version 5.2 Page 19 Since the last inspection the manager reports that a TV and a freezer have been replaced ensuring that equipment is upgraded. Brimley DS0000021893.V316941.R01.S.doc Version 5.2 Page 20 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35. Quality in this outcome area is good. Recruitment, training of staff and staffing levels ensure that the people who live here are well supported and are safe. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Normal staffing levels at Brimley are one member of staff in the morning, two in the afternoon, one in the evening and one member of staff sleeping at night. During this inspection there were two members of staff at the home. The home has it’s own bank of relief staff who work to help cover sickness and holidays and who work flexibly and with the permanent staff group to help the home respond to residents needs. For example, ‘coming in early on a nice day so that the residents can go out for lunch’. Residents say that staff respond to their needs, are ‘lovely’, ‘smashing’ and ‘great’. Some say they would like to go out more if there were more staff on duty.
Brimley DS0000021893.V316941.R01.S.doc Version 5.2 Page 21 In surveys staff say they know who to contact in an emergency and that they get the support they need. During discussions with the inspector staff demonstrated an excellent understanding of the client group, their right to equality and a real commitment to best practice and care. The project manager reports in the preinspection questionnaire that staff receive a variety of training including care planning, safeguarding adults, introduction to autism, age discrimination and supervision skills for line managers. The deputy manager says that 33 of staff hold NVQ Level 2 (care) certificates and two are currently undertaking NVQ level 3 with two more having just signed up to commence this. The deputy manager is soon to commence the Registered Managers Award. Two staff recruitment files were inspected and contained all the checks necessary to ensure the protection of residents. This includes police checks and two references. As part of the recruitment processes staff are interviewed by two members of staff and are asked some questions by a resident. One resident talked about how they were involved in meeting with prospective staff members and giving their opinion on them. Brimley DS0000021893.V316941.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42. Quality in this outcome area is good. People live in a home that is well managed, is safe and is run in their best interests. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A ‘Project Manager’ manages this and its sister home (29 Albion Hill). She has successfully completed the Registered Managers Award and has many years experience working in social care with people with a learning disability. The home also has a deputy manager who holds a degree in Health and Social Care and who is planning to undertake the Registered Manager’s Award. Brimley DS0000021893.V316941.R01.S.doc Version 5.2 Page 23 In the pre-inspection questionnaire the manager reports that appropriate maintenance checks and contracts are in place for systems such as heating and electrics. Appropriate fire checks take place and staff demonstrate a good understanding of this. They also demonstrate a good understanding of the residents’ lack of understanding around fire drills and they know what to do to compensate for this. Fire drills take place and residents who could told the inspector they would leave the home if the fire alarm sounded but that some residents need help. The fire log book is up to date. All staff receive mandatory training including 1st Aid, food hygiene and health and safety. The manager reports that formal questionnaires are not sent out to supporters, relatives or allied professionals who visit the home. She feels that the staff create an atmosphere which encourages visitors to make suggestions or to air their views. However, the use of more formal methods would ensure this is happening. Frequent meetings, open days and events are organised, which families are encouraged to attend. Brimley DS0000021893.V316941.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 x 2 3 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 4 33 x 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 x 2 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 3 x 3 x 2 x x 3 x Brimley DS0000021893.V316941.R01.S.doc Version 5.2 Page 25 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA6 Regulation 15 (3) Requirement You must, after consultation with the service user, prepare a written plan as to how the service user’s needs in respect of their health and welfare are to be met. (This needs to specify the needs of the resident and how these are to be met). Timescale for action 30/04/07 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 OP6 Good Practice Recommendations You should ensure that each service user’s plan of care describes how services will meet the service user’s current and changing needs and aspirations and how identified goals will be achieved. You should ensure that each plan sets out how current and anticipated specialist needs will be met (for example through positive planned interventions; development of language and communication; structured environments; one-to-one communication support). You should ensure that the plan is drawn up with the involvement of the service user and/or family/advocate as
DS0000021893.V316941.R01.S.doc Version 5.2 Page 26 2. OP6 3. OP6 Brimley 5. YA9 6. YA9 7. YA39 appropriate and is in a format that the service user can understand. You should ensure that staff enable service users to take responsible risks, ensuring they have good information on which to base decisions, within the context of the service users individual care plan and of the home’s risk assessment and risk management strategies. You should ensure that action is taken to minimise risks and hazards, and service user are given training about their personal safety to avoid limiting the service user’s preferred activity or choice. You should ensure that effective quality monitoring systems are in place. These should include obtaining the views of family, friends, advocates and of stakeholders in the community (e.g. GP’s, nurses, learning disability team, care managers). Brimley DS0000021893.V316941.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Exeter Suites 1 & 7 Renslade House Bonhay Road Exeter EX4 3AY 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
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