Inspection on 08/11/05 for Brook House

This inspection was carried out on 8th November 2005.

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

Other inspections for this house

Brook House 01/12/08

Brook House 04/02/08

Brook House 08/05/07

Brook House 03/05/06

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

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

CARE HOME ADULTS 18-65 Brook House and 58 Ash Grove Brook House and 58 Ash Grove Four Pools Evesham Worcs WR11 6XN Lead Inspector P Wells Announced Inspection 8th November 2005 11:00 Brook House and 58 Ash Grove DS0000065900.V271081.R01.S.doc Version 5.0 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 Brook House and 58 Ash Grove DS0000065900.V271081.R01.S.doc Version 5.0 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. Brook House and 58 Ash Grove DS0000065900.V271081.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Brook House and 58 Ash Grove Address Brook House and 58 Ash Grove Four Pools Evesham Worcs WR11 6XN 01386 41769 01386 41769 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) www.macintyrecharity.org MacIntyre Care Care Home 10 Category(ies) of Learning disability (8), Learning disability over registration, with number 65 years of age (2) of places Brook House and 58 Ash Grove DS0000065900.V271081.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The care home is primarily for people with a learning disability but may also accommodate people with an additional physical disability. No more than eight residents will be accommodated at Brook House and no more than two at 58 Ashgrove. An electrical installation report in respect of 58 Ashgrove will be obtained from an accredited electrical contractor and any recommended remedial work undertaken within one month of registration. Remedial work to the electrical installations at Brook House, as recommended in the electrical contractor`s report of 17 August 2005, will be undertaken within one month of registration. Fire risk assessments of both properties will be available for inspection by 8 November 2005. Any remedial work recommended by the Fire Safety Officer in his report of 2 June 2004, that is identified as outstanding during the inspection on 8 November 2005, will be undertaken within a timescale agreed with CSCI and the Fire Authority. The current Statement of Purpose, Service User Guide and Service User Agreement for the home will be reviewed and produced in the MacIntyre Care format within three months of registration. The lease in respect of Brook House and the Service Level Agreement in respect of 58 Ashgrove (both between Evesham and Pershore Housing Association and MacIntyre Care) will be amended as advised by the CSCI within one month of registration. 16/05/05 4. 5. 6. 7. 8. Date of last inspection Brook House and 58 Ash Grove DS0000065900.V271081.R01.S.doc Version 5.0 Page 5 Brief Description of the Service: Brook House and 58 Ash Grove provide residential care for up to ten adults with learning disabilities. There is accommodation for up to eight service users in Brook House and for two service users at 58 Ash Grove (next door) where service users are able to live more independently. Brook House and 58 Ash Grove are now operated by MacIntyre Care who were registered on 1st November 2005 in respect of this service. Evesham, Pershore and District Mencap Society continue to own Brook House and 58 Ash Grove is owned by Evesham and Pershore Housing Association. The stated purpose of the organisation is, ‘to be recommended and respected as the best provider of services for people with learning disabilities throughout the United Kingdom.’ The Responsible Individual is Mrs Margaret Jukes and the acting manager is Mrs Julie O’Connor, who has applied for registration. Brook House and 58 Ash Grove DS0000065900.V271081.R01.S.doc Version 5.0 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine, announced inspection that took place during the day of 7th November 2005. The focus of the inspection was to follow up on the previous requirements and to view the houses with the Fire Safety Officer to ascertain whether the fire precaution work recommended had been completed. Hence the majority of time was spent with the acting manager, Mrs Julie O’Connor. To prepare for this inspection the inspector read the completed pre inspection questionnaire, referred to the last report and information submitted for registration by MacIntyre Care. Six hours were spent at the home, which included meeting with some of the service users and staff. Mrs Margaret Jukes, area manager and responsible individual for MacIntyre was present and Mrs Wendy Maloney, development manager was present for part of the inspection. The inspector appreciated the co-operation and time of the service users, staff and managers. What the service does well: What has improved since the last inspection? Brook House and 58 Ash Grove DS0000065900.V271081.R01.S.doc Version 5.0 Page 7 All aspects of the service have improved and this is most reassuring. The joint efforts of the outgoing and incoming providers, as well as the manager and staff, to maintain and develop the service during the last six months have been commendable. Macintyre Care have been registered as the provider and appointed a manager. The atmosphere in the home is more relaxed with service users chatting with staff. The service users have been enabled to have more say about their own individual lifestyles and the running of the home. Service users are being supported with their personal development. New staff have been appointed. Most of the previous list of action has been met. The records have improved. Health action plans have been introduced. Four relatives replied and felt that the service had had too many changes but were hopeful that the situation would improve with the new provider and manager. 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. Brook House and 58 Ash Grove DS0000065900.V271081.R01.S.doc Version 5.0 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 Brook House and 58 Ash Grove DS0000065900.V271081.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: MacIntyre have agreed to introduce their statement of purpose, service user guide and agreement within three months of registration (condition of registration). This will include discussions with the service users. Standards 2-4 were not inspected on this occasion, as there had been no new admissions since December 2003. Brook House and 58 Ash Grove DS0000065900.V271081.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 The plans introduced needed to be completed with a person centred approach and a record kept of the reviews. The service users were being enabled to take decisions about their daily routines and lifestyles with support. EVIDENCE: Since the last inspection the service user plans and risk assessments had been developed and person centred planning was being introduced. It was apparent that considerable time had been spent by staff on gathering information for the plans, which had been necessary because the previous records had been retained by the police. A sample service user plan and risk assessments were viewed. Also health actions plans had been completed for each person. The records were clear to read, and with the health action plan, indicated the individual’s needs and how these needs would be met. Reviews need to be recorded and the person centred plans completed with each service user. Speech and language assessments were being undertaken for all the service users by a speech therapist. Through observations and discussions it was apparent that the service user were being encouraged to be more involved in choosing their daily routines, Brook House and 58 Ash Grove DS0000065900.V271081.R01.S.doc Version 5.0 Page 11 holidays and managing their own finances (see page 17). Residents meetings had been introduced. Brook House and 58 Ash Grove DS0000065900.V271081.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,14,17 Personal development was being encouraged and the service users supported in making decisions about their own lifestyles. A variety of activities were available both in and out of the home. A record of the food provided for each service user should be kept. EVIDENCE: It was evident from observation and speaking with service users, staff on duty and the manager that the service users were having more opportunities to lead active and individual lifestyles with personal development being promoted. For example the service users had been on holiday, out often in the summer and were looking forward to going on holiday again this year. The atmosphere in the home was more relaxed and service users were observed chatting with staff and pursuing their own interests. One service user made his own favourite sandwich for lunch, some service users were out at day placements and others had been bowling. Menus were in place and service users consulted about the meals they liked. Service users. who were able, were being encouraged to make drinks and Brook House and 58 Ash Grove DS0000065900.V271081.R01.S.doc Version 5.0 Page 13 snacks. A record of food provided needed to be kept to indicate that the service users were having a varied and nutritious diet. A very large table had been installed in the dining room at Brook House so that service users and staff could sit down for a meal together. Brook House and 58 Ash Grove DS0000065900.V271081.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20 The service users were well supported by staff with their healthcare needs. The medication system was considered satisfactory by the pharmacists who had visited. EVIDENCE: Health action plans had been introduced and clearly indicated each person’s health care needs, how these were to be met and appointments. A service user who had a minor ailment spoke positively about the immediate support she had received from staff in the home and helping her see a doctor and obtain the medication recommended. It was apparent that any health problem is monitored and medical guidance sort at an early stage. The pharmacist inspector had visited on 21st June 2005 and sent a separate report to the manager with regard the matters discussed. There had been two medication errors and suitable preventative measures had been implemented to prevent this occurring again. The home have a monitored dosage system supplied by Boots and the Boots pharmacist had also visited and checked the in-house arrangements. The four recommendations had been discussed with staff. Brook House and 58 Ash Grove DS0000065900.V271081.R01.S.doc Version 5.0 Page 15 Some of the staff had attended a training session in the safe handling and administration of medicines on 6th July 2005. another training session was being attended by four staff on 8th November 2005. Brook House and 58 Ash Grove DS0000065900.V271081.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Service users were being listened to and encouraged to express their views. Any complaints were taken seriously and the home had a complaints procedure. MacIntyre’s policies and procedures for protecting vulnerable adults were about to be introduced to staff. The arrangements for the service users’ monies had improved. EVIDENCE: Macintyre’s complaints procedure will be introduced and given to the service users and their families. There had been two complaints to the home since the last inspection, which had been investigated within 28days, upheld and addressed. Macintyre’s complaints procedure will be introduced and given to the service users and their families. The home now has MacIntyre’s policies and procedures on protecting vulnerable adults and staff will be introduced to this guidance. Staff are aware of protecting vulnerable adults. The matters commented upon in respect of the service users’ personal monies, previously, were being pursued by the police and each service user had been reimbursed by the previous provider. The manager had made a concerted effort to enable the service users to have access to their personal monies and assisted them in opening building society accounts. Clear records were being kept of service users’ monies that were in safekeeping. Two signatures for transactions should be introduced. The new Brook House and 58 Ash Grove DS0000065900.V271081.R01.S.doc Version 5.0 Page 17 arrangements could be developed further so that service users, with support, look after their own monies. Brook House and 58 Ash Grove DS0000065900.V271081.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 The premises are suitable for their purpose. The location of the houses is convenient to local services and facilities. The houses are homely, warm, clean and suitably furnished. Each service user has their own bedroom and there is suitable communal space for ten service users. EVIDENCE: The houses are situated on a residential estate near a bus route and an out of town Retail Park. Brook House, a detached, extended family house for eight service users and 58 Ash Grove a semi detached house for two service users. Brook House (no 56) is owned by Evesham and Pershore District Mencap and 58 Ash Grove owned by Evesham and Pershore Housing Association. Draft leases were submitted for registration and the signed, finalized agreements are expected by 1st December 2005 (condition of registration). The houses were homely, clean, warm and well maintained. A maintenance book had been introduced. The following had been addressed since the last inspection: The paving slabs in the garden of 58 had been levelled. Wash hand basins had been fitted in the two bedrooms at 58. Brook House and 58 Ash Grove DS0000065900.V271081.R01.S.doc Version 5.0 Page 19 The back door at 58 had been fitted with safety glass. All fluids that could be a hazard to service user were being kept in locked cupboards. An audit had been carried out of the bedroom furniture and a few deficits identified. The pipes in the kitchen at Brook house had been boxed in. On this occasion the communal areas of the home were viewed with the managers, fire safety officer and support worker delegated to oversee the fire precautions. Time scales were agreed for the outstanding fire precaution work in both houses to be carried out (condition of registration). At the time of writing this report, the fire safety officer had written to the manager to confirm the work that needed to be completed within the agreed timescales. This work has commenced and is due to be completed by 31.12.05. A service user who had recently moved into the main house showed the inspector his bedroom. It was small in size but the person confirmed that this bedroom was okay and all his belongings had been moved and unpacked with him. He had chosen the colour of the walls, which had been painted prior to him moving in. The laundry was viewed with a member of staff who confirmed it was practical except for the low sink, which was the outlet for water from the washing machine. This sink was also used for hand washing and for soaking soiled items. This arrangement was unsatisfactory and there needed to be an outlet pipe for the washing machine installed by an approved plumber. The washing machine did not have sluicing cycle and this cycle is essential for the safe cleaning of soiled items. The manager agreed to carry out a risk assessment for the laundry until such time as the alterations could be made. The main kitchen in Brook House, where all the meals were prepared, was suitably equipped. For more information about heath and safety matters, see pages 24 of this report. Brook House and 58 Ash Grove DS0000065900.V271081.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33,34,35 There was a suitable staff group to support the service users. Staff would benefit from a training programme being introduced. The recruitment practices needed improving in line with the new provider’s recruitment process. EVIDENCE: The home was fully staffed with new staff having been appointed in the last six months. Unfortunately due to staff sickness, hours had to be regularly covered by relief and agency staff but the home book agency workers that know the service. Rotas were submitted and indicated that there was a suitable number of staff on duty during the days and at night a member of staff slept in at each house. The working hours of the manager (managerial or on shift) and the deputy should be included the rotas. The rotas need to be reviewed to ensure that there is senior cover in the home at all times and more staff on duty when all the service users are at home and less on the days that service users are out at day placements. In the absence of a senior, a designated senior on shift needs to be identified. Staff files had been set up and the recruitment process for the two new staff was discussed with the manager. One file for a new member of staff could not be located but two other files were viewed. Two references had not always been obtained. A POVA check and an enhanced CRB disclosure had not always been received before staff started working at the home. The area manager Brook House and 58 Ash Grove DS0000065900.V271081.R01.S.doc Version 5.0 Page 21 confirmed that it was MacIntyre’s policy to carry out both these checks prior to a new employee commencing work. Training details were available and indicated that many of the staff needed further training in safe working practices and courses related to working with people who have a learning disability. The manager had identified this and submitted a training programme request to MacIntyre. In the last six months some staff had attended training for medication, communication, moving and handling, person centred planning. It is known that MacIntyre offer a variety of training opportunities and it is anticipated that a training programme will be introduced for this staff group as well as a LDAF induction training for new workers and NVQ’s in care for staff. Currently 33 of the staff have an NVQ in care and it is recommended that a minimum of 50 of staff have an NVQ in care. The staff spoken with were enthusiastic about working with service users and committed to training. Brook House and 58 Ash Grove DS0000065900.V271081.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,42 The management of the home has improved and will be developed by MacIntyre to ensure that the service users best interests and safety are paramount. EVIDENCE: The manager had initially started on a temporary basis but has now decided to stay, been appointed as manager, and applied for registration. Her application is being processed by CSCI. She has considerable experience in working with service users who have a learning disability and had completed NVQ level 4 in care and management. Her positive input since May 2005 was evident at this inspection, in particular with regard empowering the service users and developing the records required to be kept in a care home. It is her intention to commence the Registered Manager’s Award soon and to update her training in safe practices. MacIntyre’s quality assurance system, policies and procedures will be introduced to the service and the staff would benefit from the latter being introduced to them as soon as possible. Brook House and 58 Ash Grove DS0000065900.V271081.R01.S.doc Version 5.0 Page 23 The records required to be kept in a care home had been reviewed and developed which assured that service users were safeguarded. The standard on Safe Working Practices is wide ranging and was discussed in detail with the manager who was able to demonstrate she was knowledgeable about these matters and that appropriate records were being kept. Staff need training in safe working practices, as already identified (see page 22). The Macintyre health and safety manual and policy were available and being introduced. The houses had certificates of electrical safety and the remedial work was to be carried out by 1st December 2005 (condition of registration). The portable appliances had had an annual test this year. The gas services and appliances were being checked. The manager agreed to develop the risk assessments for safe working to cover security, equipment and legionella using the comprehensive MacIntyre risk assessment process. The fire risk assessments for the houses were discussed with the fire safety officer. The fire precaution records were viewed and suitable. A monthly check of the fire equipment needed to be included and quarterly in-house fire training for staff. The managers at the last inspection agreed an in-house fire training session would take place on 08.06.05 but there was no record to indicate that this had occurred. There was a record that some staff had received fire awareness training in July and August 2005. The support worker delegated to oversee the fire precautions could perhaps assist with this training in-house and the six monthly fire drills for staff and service users. There was fire signage in a suitable format for service users but both houses also needed additional, approved fire signage. Brook House and 58 Ash Grove DS0000065900.V271081.R01.S.doc Version 5.0 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X X X X X Standard No 22 23 Score X 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 3 X 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 X X X X X X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X X 2 2 2 X CONDUCT AND MANAGEMENT OF THE HOME 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Brook House and 58 Ash Grove Score X 3 X X Standard No 37 38 39 40 41 42 43 Score 2 X X X X 2 X DS0000065900.V271081.R01.S.doc Version 5.0 Page 25 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 YA6 Regulation 12,15 Requirement The service user plans must be completed with the service users and cover all aspects outlined in NMS 2.3, 6-21 (timescale of 30/06/05 nearly met) The service must arrange for the fire precaution work to be carried out within the agreed timescales and be completed by 31/12/05. Confirmation to be sent to CSCI. & Fire Authority, The service must arrange for the electrical remedial work to be carried out by an accredited electrical engineer within the agreed timescale of 01/12/05 Confirmation to be sent to CSCI. The current arrangements for the laundry must be risk assessed A washing machine with outlet pipe and sluicing cycle must be installed. The low sink must be replace with a wash hand basin. The rotas must be reviewed as outlined in this report. Staff must have POVA and enhanced CRB disclosure checks prior to commencing work in the houses. DS0000065900.V271081.R01.S.doc Timescale for action 28/02/06 2 YA24 23,13 31/12/05 3 YA24 23,13 01/12/05 4 5 YA30 YA30 13 23,13 30/11/05 31/03/06 6 7 YA33 YA34 18 19 31/12/05 30/11/05 Brook House and 58 Ash Grove Version 5.0 Page 26 8 YA35 18,13 9 10 11 12 YA35 YA42 YA42 YA42 18,13 13 13,18 23,13 The MacIntyre recruitment procedure must be followed. A training programme for staff must be introduced which includes training in safe working practices, LDAF induction and NVQ qualifications. 50 of the staff must obtain an NVQ level 2in care (timescale not yet met) Risk assessments for the houses and safe working practices must be in place. Arrange, and record, that staff receive quarterly fire awareness training. Approved fire signage to be in place in both houses. 01/01/06 31/12/05 31/01/06 31/01/06 30/11/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 4 Refer to Standard YA17 YA23 YA23 YA40 Good Practice Recommendations A record of food provided for the service users should be kept. Two signatures should be sought for financial transactions of service users money. Promote service users looking after their own monies, with support. Macintyre policies and procedures should be introduced to the staff at the earliest opportunity. Brook House and 58 Ash Grove DS0000065900.V271081.R01.S.doc Version 5.0 Page 27 Commission for Social Care Inspection Worcester Local Office Commission for Social Care Inspection The Coach House John Comyn Drive Perdiswell Park, Droitwich Road Worcester WR3 7NW National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Brook House and 58 Ash Grove DS0000065900.V271081.R01.S.doc Version 5.0 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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