Inspection on 22/02/06 for Broomfield

This inspection was carried out on 22nd February 2006.

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

Other inspections for this house

Broomfield 05/06/07

Broomfield 08/09/05

Broomfield 24/03/05

Broomfield 03/03/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Broomfield 40 Gladstone Rd Combe Down Bath Bath & N E Somerset BA2 2HL Lead Inspector Sarah Webb Unannounced Inspection 23rd February 2006 10:00 Broomfield DS0000008196.V270167.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 Broomfield DS0000008196.V270167.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. Broomfield DS0000008196.V270167.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Broomfield Address 40 Gladstone Rd Combe Down Bath Bath & N E Somerset BA2 2HL 01225 830047 01225 830047 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) New Era Housing Association Limited Mr Mark Ashley Pearson Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Broomfield DS0000008196.V270167.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. May accommodate up to 3 persons aged 22 - 50 years May accommodate up to 3 persons with Physical Disabilities Date of last inspection 8th September 2005 Brief Description of the Service: Broomfield is registered with the Commission of Social Care inspection to provide accommodation and personal care to 3 people with profound learning and physical disabilities with varying degrees of sensory impairment. Broomfield is a large bungalow situated in a quiet cul-de-sac in Combe Down, on the outskirts of Bath. It has access to local amenities such as shops, pubs, local surgery and a post office. The city centre of Bath is approximately 3 miles away. The home has three single bedrooms; two comply with the spatial standards for wheelchair users, as set out in the national minimum standards. The third bedroom is a smaller room. Two of the bedrooms share en suite bathroom facilities. The third has easy access to a specialist shower for wheelchair users. There is also a spacious lounge, kitchen, utility, two staff sleep in rooms and a conservatory. Broomfield DS0000008196.V270167.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over 5.5 hours and was carried out as an unannounced inspection. The inspection methods used included record checks, case tracking, and discussion with members of the staff team regarding how they supported individuals with their care. The manager was unavailable but was contacted the following day to clarify some information. Two tenants were at the home during the day. Due to the level of disability presented by the tenants, families and staff continue to advocate on their behalf. What the service does well: What has improved since the last inspection? Individuals care plans have been reviewed, with the involvement of staff, and updated in order to provide relevant information to meet the assessed needs of tenants. Two new staff are involved in supporting tenants through a specific communication programme. Fire training has been provided for staff in order to ensure the health and safety of service users and the maintenance of weekly testing of fire Broomfield DS0000008196.V270167.R01.S.doc Version 5.0 Page 6 equipment has improved in order to take adequate precautions against risk of fire. (This was an immediate requirement from the previous inspection) A fire risk assessment has been completed and discussion has taken place with fire officer regarding evacuation action for the tenants. Staff have been offered training in the related physical support needs of tenants. Improvements have been made to individuals’ bedrooms in that they have been decorated and personalised in order for the home to take on a more homely atmosphere. The home has implemented appropriate financial arrangements for a tenant’s monies. The home now has references in place for two staff. What they could do better: The home needs to review all risk assessments, including those associated with manual handling and to include risk quantification in order to determine level of risk. A risk assessment needs to be reviewed for individuals transported by lone working staff in order to set in place arrangements in the event of an emergency. A risk assessment need to be implemented in relation to financial procedures relating to the management of service users monies, including the current practice of withdrawing monies on their behalf. The home needs to obtain individualised supply of PRN medication for tenants and keep a running balance. The home needs to repair and decorate internal bare brickwork to the front entrance lobby. The home needs to improve in ensuring there are arrangements in place for sufficient numbers of staff to be on duty in order to meet the assessed needs of tenants. The manager needs to continue to investigate specific training opportunities for staff linked to individuals needs. The home needs to review manual handling training offered to staff in order that staff are trained appropriately to support the individual needs of the tenants. Broomfield DS0000008196.V270167.R01.S.doc Version 5.0 Page 7 The home needs to inform the Commission through regulation 37 of incidents that may affect tenants adversely. The home needs to keep a record of named staff involved in fire drills. 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. Broomfield DS0000008196.V270167.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 Broomfield DS0000008196.V270167.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): 3 The home has improved the involvement of staff in supporting tenants with their communication in order to meet their assessed needs. EVIDENCE: Standard 2 was assessed at the previous inspection and was met. A requirement to keep a record of the total fees paid by tenants is in the process of being met by the area manager through the review and update of the statement of purpose. As at the previous inspection there have been no new tenants admitted to the home since the last inspection. All tenants have lived at the home for many years. All the staff team, bar two newer staff, have worked with the 3 tenants for many years. Three staff were spoken with who had concerns from the last inspection report where it had been recorded that staff were only meeting care needs on a basic level. Discussion took place in relation to how staff supported the tenants at Broomfield and that staff were able to demonstrate their skills and experience in meeting individuals physical support needs, but that they also needed to Broomfield DS0000008196.V270167.R01.S.doc Version 5.0 Page 10 evidence an enthusiasm and commitment towards identified training in order that tenants benefit from a positive culture. Through observation of interaction between a member of staff and a tenant, it was evident that the staff member had a positive relationship with this individual and that the tenant was relaxed and happy with their attention. Families and staff continue to advocate on tenants behalf; a specialist service also continues to be involved in an intensive interaction communication programme with two tenants. Since the last inspection two newer staff have been involved in sessions with individuals. This is good practice to increase staff involvement and their understanding of tenants individual communication needs. It was evident that tenants continue to be supported locally by specific specialist services. Staff indicated that regular contact was had with physiotherapist, speech and language therapist, occupational therapist and hearing therapist. Broomfield DS0000008196.V270167.R01.S.doc Version 5.0 Page 11 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&9 The home has improved in ensuring care plans are reviewed to adequately provide staff with current information they need to satisfactorily meet tenants needs. The home needs to improve risk management procedures in place to ensure tenants are supported safely in taking risks. EVIDENCE: Broomfield DS0000008196.V270167.R01.S.doc Version 5.0 Page 12 A requirement has been met for the review and update of tenants care plans; a recommendation has also been met for staff to be involved with this process. Care plans now reflect current practices in place in supporting individuals. All three tenants need a very high level of support to engage with the activities of living. Individualised risk assessments have been carried out and are kept in case files. These were examined and covered areas such as the use of bed rails, individuals’ epilepsy, personal support needs and when a tenant is unwell at night taking into consideration that the home do not provide waking staff (this was a requirement from the last inspection). All risk assessments completed do not include risk quantification or the identification of whether the risk being assessed is high, medium or low; a requirement is made for risk assessments to be reviewed and updated to include level of risk. Broomfield DS0000008196.V270167.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 15 & 16 Service users are supported in maintaining family relationships. Service users rights are respected through ongoing daily routines and support systems in place. EVIDENCE: Standards 12, 13, 14, and 17 were assessed at the previous inspection and were met. The home has good relationships with families and ensures tenants are supported in both receiving visits, and organising transport to an individual’s family home. Through discussion with staff it was evident that there are occasions when individuals are transported by lone working staff. Due to the physical needs of all tenants, a requirement is made to review risk assessment in place when taking tenants out in the mini bus to in order to include arrangements in place in the event of an emergency. Broomfield DS0000008196.V270167.R01.S.doc Version 5.0 Page 14 The house is a non-smoking environment. Observation during the inspection and discussion with staff evidenced that tenants are treated with respect and dignity. Staff are aware of the needs and preferences of the individuals, and are often able to anticipate peoples needs based on experience of knowing them. Tenants are unable to use door locks. Staff open and read mail to the tenants. All staff and tenants are on first name terms. Broomfield DS0000008196.V270167.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 & 20 Staff are provided with appropriate information in supporting tenants with their personal support needs. The home has improved in the recording of the administration of medication but still needs to keep individual supplies of PRN medication. EVIDENCE: Standard 19 was assessed at the previous inspection and was met. All tenants have a high level of support with their personal care needs. These are recorded in detail in care plans. There was also clear written instruction in care plans on the use of specific equipment for the safe moving and handling of individuals. It was evident that tenants are supported well by specialist services based in the local community. This was evidenced through individuals’ documentation and discussion with staff regarding referrals for specialist equipment. Broomfield DS0000008196.V270167.R01.S.doc Version 5.0 Page 16 An individual is in receipt of a specialist chair through an assessment by a specialist service. However staff said that the chair is unable to access the bathroom; staff are following up this concern with the manufacturer. Staff described how tenants are supported with their physical support needs and procedures in place for the checking equipment. Reports have been received since this inspection evidencing that there are arrangements in place for all hoists to be inspected 6 monthly. The manager said he is in the process of changing the homes service contract. A requirement is forwarded through this inspection for a risk assessment to be reviewed in the instance when a tenant is unwell at night taking into consideration that the home do not provide waking staff. This is made again inline with all risk assessments to be reviewed to include risk quantification. The practice of recording the administration of PRN medication has improved; this is now recorded on the MAR sheet. However, a requirement is unmet to obtain individualised supply of this medication for tenants. The manager said that staff now bring in their own PRN medication as set out in the organisational homely remedies policy. Broomfield DS0000008196.V270167.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 23 The home needs to improve in the arrangements in place for protecting individuals from possible risk of financial abuse. EVIDENCE: Standard 22 was assessed at the last inspection and was met. The complaints log was not examined at this inspection. The organisation has a policy and procedure for the protection of vulnerable adults. The Manager has completed Investigators training; staff have also attended training in relation to abuse. The log recording information from the Criminal Records Bureau was not seen. It was evident through observation of records, and discussion with both the manager and staff that, although there are arrangements in place for staff to support tenants with accessing their finances and for the safekeeping of individuals’ monies, there are no risk assessments or recorded instruction for staff to follow. Therefore a requirement is made for the home to risk assess financial procedures relating to the management of service users monies, including the current practice of withdrawing monies on their behalf. A recommendation has been met to set up a bank account in an individual’s name; the home is in the process of paying in appropriate monies. Two tenants finances were examined. Broomfield DS0000008196.V270167.R01.S.doc Version 5.0 Page 18 Financial records checked for these individual’s personal allowance was correct and consistent with balances kept. Broomfield DS0000008196.V270167.R01.S.doc Version 5.0 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 26, 29 & 30 The general appearance of the home has improved with the decoration of tenants’ bedrooms. The home provides suitable specialist equipment in order to support the assessed physical needs of individuals. The home benefits from being kept clean and hygienic. EVIDENCE: Individuals’ bedrooms had been decorated and personalised and it was evident that improvements have been made in order for the home to take on a homely atmosphere. The home is appropriately adapted to meet the needs of the current tenant group. Ceiling track hoists have been fitted to areas within the home and changing facilities are available in the home’s bathroom. The home also has one mobile hoist. Broomfield DS0000008196.V270167.R01.S.doc Version 5.0 Page 20 Staff sign a statement to indicate that they have been trained in their competency to use hoisting equipment. The home has a wheel in shower and a new bath has been installed recently both of which are suitable to meet the tenants needs. A recommendation is still in the process of being reviewed regarding the use of the conservatory and whether it will be used as an additional space for tenants. Staff spoken to indicated the space was limited in order that all tenants use it as a dining space. The identification of a new cooker identified through a health and safety audit has been purchased. The temperature of a tenants’ bedroom was taken, as it felt colder than other areas of the home. Although the temperature was below 21C staff indicated that this person only used their room to sleep in; also they had responded to their specific body temperature needs. Staff evidenced that they were able to turn the heating up on their radiator if there should be a change in the individual’s needs. A requirement is unmet to repair and decorate internal bare brickwork to front entrance lobby. The home was clean and tidy and free from malodours. Broomfield DS0000008196.V270167.R01.S.doc Version 5.0 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33 & 35 The home needs to improve in ensuring there are arrangements in place for sufficient numbers of staff to be on duty in order to meet the assessed needs of tenants. The home has ensured the staff team are up to date with statutory training in order that individuals’ health and safety is considered. The manager needs to continue to investigate specific training opportunities for staff linked to individuals needs and for committed participation by staff to attend training in order to meet individual and joint needs. EVIDENCE: Standards 34 & 35 were assessed at the previous inspection and were partially met. A requirement to keep a copy of each reference obtained in respect of newly employed staff is met. All the staff team bar two recently employed members have worked at the home for several years. Broomfield DS0000008196.V270167.R01.S.doc Version 5.0 Page 22 Two staff are rostered to be on duty at all times; this also covers sleep in shifts. It was evident through observation of the diary, rota and discussion with staff that on a recent occasion, there was only one staff on duty both day and night. An agency staff was booked to cover a shift when several staff were on leave, but failed to show. The staff member was advised by the manager to contact all the home’s staff to see cover was available. It was evident that this was not implemented fully leaving the staff member to work on their own. A requirement is made to review the arrangements in place in the event of staff unable to cover their shift in order to ensure the health, safety and welfare of both tenants and staff. The home has made a start in meeting a requirement for staff to receive training regarding related physical care issues or learning disability specific issues. Through discussion with staff and observation of records it was evident some staff had attended epilepsy training. A requirement is made again through this inspection to continue to follow up investigation for further training specific to tenants needs. The Commission was not informed of the above incident therefore a requirement is made to inform the Commission through regulation 37 of incidents that may affect tenants adversely. The training matrix examined evidenced that staff have completed training in food hygiene, health and safety, first aid, risk assessment and the protection of vulnerable adults. A newer staff member employed related they had attended anti discriminatory practice, epilepsy and communication training in addition to statutory training. They had also completed LDAF handbook. They said it would be useful to attend specific training in relation to those tenants at the home. Broomfield DS0000008196.V270167.R01.S.doc Version 5.0 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 41 & 42 The home needs to improve in the keeping of records in order to safeguard tenants best interests. The home needs to improve in the risk assessing of all manual handling operations in order to safeguard and protect tenants whilst being supported with their personal support needs. The home has improved in its arrangements for the monitoring of fire safety and in providing fire training for staff in order to protect tenants. EVIDENCE: Staff record tasks carried out, visits made by and to tenants by specialist services and family, through a daily diary. This is also used to communicate information to staff. Broomfield DS0000008196.V270167.R01.S.doc Version 5.0 Page 24 Individual activity books record activities participated in by tenants. Weekly water temperature testing indicated that temperatures are recorded if outside of the recommendation of 43C. Safety Data sheets in relation to the control of substances hazardous to health were in place and had been reviewed. A requirement to complete a fire risk assessment has been met; the manager said a fire officer has visited the house and has made two recommendations regarding two bathroom doors. The manager said the issue of personal evacuation action for the tenants was discussed; he is awaiting the report from the fire officer in order to implement recommended action. An immediate requirement has been met to provide training for staff as has a requirement to maintain and carry out weekly tests of fire equipment. The fire log indicated that fire equipment is now maintained regularly, and recent fire drills have taken place. However a requirement is made for a record to be kept of named staff involved in fire drills. Manual handling risk assessments were also examined and covered certain aspects of the hazards identified and control methods in place; discussion was had with the manager regarding the need to include further appropriate information and identified risk qualification. A requirement is made for the review of all manual handling risk assessments involving individuals personal support needs. The manager should involve a specialist service involved with the care of the tenants at Broomfield. These need to include detailed information including number of staff involved in carrying out tasks and training received by staff. Individual tenant information also needs to be included such as aspects of communication, co operation, behaviour and any physical or medical conditions; the environment and named equipment to be used needs to be recorded in the risk assessments as the method and controls in carrying out tasks. Staff sign to indicate that they have read individual risk assessments in place. Through discussion with staff it was evident that they have received manual handling training but that this was on a generic basis and not involving the equipment used at Broomfield or the individuals support needs. Staff agreed that training offered would be more suitable and appropriate if it was specific to individuals needs. A recommendation is made to review manual handling training offered to staff in order that staff are trained appropriately to support the individual needs of the tenants. Broomfield DS0000008196.V270167.R01.S.doc Version 5.0 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x 3 x x Standard No 22 23 Score x 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 x x 2 x Standard No 24 25 26 27 28 29 30 STAFFING Score x x 3 x x 3 3 LIFESTYLES Standard No Score 11 x 12 x 13 x 14 x 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score x x 2 x 2 x CONDUCT AND MANAGEMENT OF THE HOME x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Broomfield Score 3 x 2 x Standard No 37 38 39 40 41 42 43 Score x x x x 2 2 x DS0000008196.V270167.R01.S.doc Version 5.0 Page 26 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 YA9 Regulation 12(1) Timescale for action Review risk assessments in order 31/05/06 to include risk quantification, or the identification of whether the risk being assessed are high, medium or low. Review risk assessment in place 23/02/06 when taking tenants out in the mini bus to in order to include arrangements in place in the event of an emergency. Obtain individualised supply of 30/04/06 paratecamol for tenants and keep a running balance. (This is brought forward from last inspection) Risk assess in the instance when 23/02/06 a tenant is unwell at night taking into consideration that the home do not provide waking staff. Risk assess financial procedures 23/02/06 relating to the management of service users monies, including the current practice of withdrawing monies on their behalf. Repair and decorate bare 31/07/06 brickwork to internal front entrance lobby and replace curtaining Review the arrangements in 23/02/06 DS0000008196.V270167.R01.S.doc Version 5.0 Page 27 Requirement 2. YA9 12(1) 3. YA20 13(2) 4. YA19 18(1) 5. YA9 12(1) 5. YA24 23(2) 6. YA33 18(1) Broomfield 7. 8. 9. YA41 YA41 YA35 37 23(4) 18(1) place in the event of staff unable to cover their shift in order to ensure the health, safety and welfare of both tenants and staff. Inform the Commission through 23/02/06 regulation 37 of all incidents that may affect tenants adversely. Keep a record of named staff 23/02/06 involved in fire drills. Ensure staff receive training appropriate to the work they carry out in:1) related physical care issues 2) learning disability specific issues Review of all manual handling risk assessments involving individuals personal support needs as set out in Standard 42. 31/08/06 10. YA9 12(1) 31/05/06 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. 3. Refer to Standard YA42 YA35 Good Practice Recommendations Review manual handling training offered to staff in order that staff are trained appropriately to support the individual needs of the tenants. Provide bereavement training for staff Broomfield DS0000008196.V270167.R01.S.doc Version 5.0 Page 28 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos BS32 4RG 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 Broomfield DS0000008196.V270167.R01.S.doc Version 5.0 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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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