Inspection on 14/11/06 for Cambria House

This inspection was carried out on 14th November 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 14 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Cambria House 10/07/07

Cambria House 25/10/05

Cambria House 07/06/05

Cambria House 07/01/05

Cambria House 15/06/04

Cambria House 17/02/04

Similar services:

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

Pinta

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

CARE HOME ADULTS 18-65 Cambria House 24 St Peter`s Street Winchester Hampshire SO23 8BP Lead Inspector Sue Kinch Key Unannounced Inspection 14th November 2006 09:30 Cambria House DS0000047346.V320296.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 Cambria House DS0000047346.V320296.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. Cambria House DS0000047346.V320296.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cambria House Address 24 St Peter`s Street Winchester Hampshire SO23 8BP 01962 865226 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Choice Limited Mr Robert Anscomb Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Cambria House DS0000047346.V320296.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25th October 2005 Brief Description of the Service: Cambria House provides a service to eight younger adults with a learning disability. The home has been developed to work with service users with complex needs including service users who challenge the services provided for them. The home is owned and managed by C.H.O.I.C.E Ltd. Links are established with the community team, specialist services and the support of their own psychologist services. Accommodation is provided on three floors in a large house that has been refurbished and redeveloped to provide this service. The house is situated in the heart of Winchester and is close to all local services. Fees range from £1700-£2400 per week. This includes use of the homes transport. Cambria House DS0000047346.V320296.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first key inspection of the home this year and all key standards were assessed. It was unannounced and was completed by one inspector over 10.5 hours. Four residents, five staff members and the manager were spoken with. Residents were busy during the inspection and conversations with them were held mostly on the first day. Care practices were observed. A partial tour of the home was made with some of the residents. The shared areas were seen and some bedrooms. Some of the homes records and policies and procedures were also viewed. The organisation was sent an urgent action letter detailing some of the action required following the inspection. These items had a short timescale for completion as detailed at the end of this report. What the service does well: What has improved since the last inspection? What they could do better: More work is needed to ensure that goals and aspirations of residents are included in the activities that take place and are reviewed. Further work is needed to risk assess adequately and to ensure that there is evidence of why some restrictions are placed on residents. Action is needed to ensure that any planned physical intervention is fully documented. One was not. Training of staff in medication must be increased and some medication procedures improved in line with current national guidance. The homes procedures for assessing the competence of staff with medication must be used. Cambria House DS0000047346.V320296.R01.S.doc Version 5.2 Page 6 More staff need to be trained in adult protection and fire safety and all should be trained in elements of bi-polar disorder. The local adult protection policy needs to be used to ensure that any investigation into an allegation is co-ordinated by the local social services. Attention is needed to ensure that all elements of fire safety are addressed sufficiently. A plan to support and train the manager, appointed in August 2006, is needed to provide adequate induction and support into the role. 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. Cambria House DS0000047346.V320296.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Cambria House DS0000047346.V320296.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home can demonstrate that service users needs are assessed and residents can visit the service before they move in. EVIDENCE: A new resident had recently been admitted to the home and written information giving details of the initial care needs to be met was at the home. A substantial amount of information had been received from the previous carers. The organisations assistant psychologist had been involved in the preparation for admission and was at the home during the inspection reviewing progress so far. The resident had been able to visit the home before moving in and the manager and some staff had visited the resident. Two staff members spoken with about the admission were aware of the records available and had started to read the information relevant to the support needed. Both were able to highlight some of the specific needs of the resident. Consideration could be given to involving existing residents in decision – making about admissions. A member of staff confirmed that visits are made before someone moved in but was not aware of existing residents being consulted. One resident asked confirmed this. Cambria House DS0000047346.V320296.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The lack of sufficient improvement in residents risk assessments and care plans means that the home cannot demonstrate how service user’s needs are fully supported and met. EVIDENCE: Residents spoken with were positive about the support received from the staff and no negative comments were made about their approaches. Residents said that they did things that they liked doing. However, inadequate work has taken place at the home to demonstrate that the resident’s goals and aspirations are regularly reviewed and updated. Clear strategies for achieving these are not documented and in additional day-to-day support plans sampled, insufficient details of action required by staff, was recorded. For example, for one person to whom money is important, there was no plan of how to support their purchasing or budgeting. For another person a specific goal documented in the records was no longer relevant. The need for clear strategies for supporting residents was required at the last inspection and previously in September Cambria House DS0000047346.V320296.R01.S.doc Version 5.2 Page 10 2005. The issues raised here were discussed in more detail with the manager who was aware of the need to update records. Risk assessments were also sampled and further work is needed. It was noted that these have been identified for a number of issues in and out of the home. Some of those sampled had been reviewed. However for one person the action for staff included the possible use of restraint although the specific technique was not recorded. Ensuring that physical intervention strategies were supported by clear guidelines was required following the last inspection. More work is needed to meet this requirement. For another person the restraint used was recorded but was due for review in April 2006. For another person a risk assessment had been reviewed in September 2006 but not all of the staff had signed to say that they had read it. Gaps in signatures were noted on other risks assessments. There is restricted access to the sensory room, to the day care room and one person’s ensuite facility. There are no risk assessments to demonstrate that this is needed. Cambria House DS0000047346.V320296.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from a range of regular, community based activities that they want to do with respectful support from staff. But ensuring that their personal wishes are included could further enhance this. Attention to residents rights and responsibilities would be enhanced by ensuring that restricted access to areas of the home has been fully risk assessed. Staff positively support residents with relationships and friendships. Residents enjoy the food, which is based on a health eating approach. EVIDENCE: Staff and residents confirmed that residents are asked about the things that they like to do on daily basis and are supported to be occupied in a range of activities including domestic tasks, hobbies, craft, participating in or watching sport, shopping and going to college and day services. An activity plan is Cambria House DS0000047346.V320296.R01.S.doc Version 5.2 Page 12 available for each person. Although plans are made residents still have a choice on a daily basis. One staff member is employed specifically to arrange activities although all of the care staff members are involved in supporting people to take part. Some creative work is displayed in the home and some residents were involved in pottery during the inspection. Another had been for a long early morning walk and several took part in playing tennis at the local sports centre in the afternoon. Another person spoke very positively about the day service that had been attended during the afternoon. However, as referred to in the section above on care planning, plans need to be in place to ensure that more specific goals and aspirations are included in daily routines. The home is very close to the city centre making access very easy and staff are able to support people to attend the library and other facilities regularly. One resident talked about support from staff to have regular contact with family members. Another resident talked to the inspectors about their experiences in the home and confirmed that they are supported to make friends and invite friends to the house. Rights and responsibilities are encouraged. Residents are encouraged to say what they want to do, to have keys, to answer the phone and the door and to be involved in household routines. The manager said that some of the residents like a structure to the day this has been provided. Two residents were asked about this and said that they liked it. Those asked also said that they felt listened to and respected. Restrictions to specific spaces in the home have been referred to in the section on individual needs and choices. This distracts from the promotion of rights and responsibilities. Cambria House DS0000047346.V320296.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents are supported to maintain good health and receive personal care. Insufficient numbers of staff are trained in medication to ensure that procedures adequately promote the safety of residents. EVIDENCE: Health needs of residents are monitored and evidence of support given is recorded for each individual. Records showed that a range of support is obtained from professionals based on individual needs. There was no record of one person visiting the dentist or of another visiting the optician and this needs to be followed up. Personal care support is also documented in the care plans. Medication is reported by staff to be administered by the senior staff in the home. Staff confirmed this. The training record states that only three staff in addition to the manager have received medication training. However those staff need to be assessed and deemed competent in line with the agencies procedures. Staff who are witnessing the administration of controlled drugs need also to have relevant training. As all staff are monitoring the health and Cambria House DS0000047346.V320296.R01.S.doc Version 5.2 Page 14 welfare of residents it is advisable that all have some training in the nature and affects of medication. Medication is stored securely and arrangements are in place for appropriate storage of controlled drugs. However, the policy in the home is not very detailed for controlled drugs and elements of practices are incorrect. The drug register needs to be in a bound book with numbered pages and current recording does not include the size of tablet, dosage or name of witness. Action is needed to ensure that procedures are in line with current best practice and the manager was advised to obtain details of the Royal Pharmaceutical Society guidelines. A requirement following the last inspection included the need to hold homely remedy agreements. There was sufficient written evidence at this inspection to demonstrate that this had been obtained for each resident involving the doctor. Guidance for ‘ as required ‘ medication was raised in the last inspection report as the procedures were not specified in the records viewed or detailed in the care plan. In the sampled viewed this time the record was in place but did not include the same level of detail as provided verbally by one of the staff. Therefore this record needs to be revised. Cambria House DS0000047346.V320296.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The residents are able to air their views and complaints are addressed, however, the protection of residents would be enhanced by appropriate use of local adult protection procedures. EVIDENCE: Residents say that they feel able to talk to the staff and that they know what to do if they are not happy about something. Records of complaints are held in the home and the last complaint recorded had also been reported to CSCI. There was evidence that this had been followed up by the management. There is an adult protection policy in the home and also a copy of the locally agreed procedures. However the manager was not fully aware of the role of social services when an allegation is made and was advised of this. One incident, which had been reported to CSCI, had been internally investigated and the action taken reported by the previous manager to CSCI did not match with the view of the current manager or with the care plans and risk records held in the home. Only two of the staff are recorded to have received training in the protection of vulnerable adults in the last two years although plans are in place for a further six staff to be trained in January 2007. It is advised that this is reviewed to ensure that all staff have received training and to ensure that reporting procedures and roles of other agencies are included in this. Cambria House DS0000047346.V320296.R01.S.doc Version 5.2 Page 16 Procedures are in place in the home for working with residents in a supportive way with money. The manager regularly checks the accounting of this to ensure that the money is managed satisfactorily. In the samples checked at the inspection findings were satisfactory. Cambria House DS0000047346.V320296.R01.S.doc Version 5.2 Page 17 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): 24,25,30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The residents will benefit from the plan of works to improve the fabric of the home, which is currently showing signs of wear and tear. They would also benefit from a review of cleaning schedules, which currently are inadequate to provide a clean environment. EVIDENCE: The shared areas and some of the bedrooms were viewed. Some of these areas need redecorating and this includes the ensuite facilities, which are stained and/or have some paint peeling on the walls or ceilings. Residents have previously been involved in painting but people have changed rooms and the generally marked paintwork is not necessarily the current occupant’s choice. The kitchen needs redecoration and has some damaged cupboards. The dining room and lounge are satisfactory although there are marks on the lounge wall. Cambria House DS0000047346.V320296.R01.S.doc Version 5.2 Page 18 The manager has audited the environment and spoke of work planned in several areas of the home, including bedrooms, ensuite facilities, the kitchen, laundry, and sensory room. There are written plans for these. A schedule from head office was seen and some improvement is planned to take place from October 2006-2007. Maintenance issues are recorded on a sheet in the office and this is sent to head office regularly. The manager and a staff member said that these issues were given adequate attention. Domestic staff are not currently employed in the home. This is reflected in the level of cleanliness. Staff encourage residents to be involved in cleaning responsibilities and residents are encouraged to be responsible for their rooms. However on close observation of the bedrooms (skirting boards and en suites, marked walls) communal areas (i.e. stairwells, carpets in basement, and day care room) were not adequately clean. The manager said that cleanliness was a challenge. Schedules need to be reviewed and consideration should be given to alternative ways of achieving a higher standard. . Cambria House DS0000047346.V320296.R01.S.doc Version 5.2 Page 19 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): 32,34,35 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Residents benefit from an established and caring staff team provided in sufficient numbers to meet their needs but more staff training would enhance this. The protection of residents would be improved by more evidence of robust recruitment procedures and evidence of how new staff are supervised. EVIDENCE: Residents spoke well of the staff team who have covered the three vacant posts between them in recent months. Positive, and supportive, calm approaches from the management and staff towards residents were noted during the inspection. Five staff are on duty on shift in the mornings and four in the afternoon including one to one care for one person. Two waking night staff are on duty at night. Recruitment procedures were inadequate in 2005 and an enforcement notice had been issued from CSCI. Compliance had been achieved by December 2005. Now C.H.O.I.C.E have agreed with CSCI to keep forms at the office and provide the manager with ‘annexe 4 forms’ the CSCI forms regarding staff Cambria House DS0000047346.V320296.R01.S.doc Version 5.2 Page 20 particulars. During the inspection, the manager demonstrated an awareness of the checks needed before employment. Two sets of staff records were examined but inadequate information was available to demonstrate: that POVA First checks were completed before two staff started work; that a CRB check had been completed for one person and that a supervisor had been nominated to each person working before a CRB check was completed and the arrangements of that supervision. Since the inspection the manager has submitted further information but this was also insufficient evidence to demonstrate that a POVA First check was completed before employment in the home. Staff are provided with a regular training programme and they confirmed that they had received training. A record of most training is held and was provided to CSCI before the inspection. Certificates are held in the home. The manager, following the inspection, gave information on progress towards staff achieving NVQ level 2 or above. Recent work has taken place to find another training provider. Checks are needed, however to ensure that all staff, where necessary are trained in specific topics. As mentioned in other areas of this report insufficient numbers of staff are trained in fire matters or at the correct frequency. Inadequate numbers of staff are trained in medication and adult protection and staff need training in bi-polar disorder. Induction is taking place but records need improvement. Of the two records requested, one was not available and the other needed to be completed and signed. Cambria House DS0000047346.V320296.R01.S.doc Version 5.2 Page 21 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): 37,39,42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Support and guidance for the manager would enhance his leadership and ability to ensure that residents needs are met. Residents are consulted about the service at the home but would benefit from more regular monitoring of it. The health and safety of residents would be promoted further if adequate attention were given to fire matters. EVIDENCE: The current manager has been in post since August 2006 and has yet to be registered to complete NVQ4 in care or the RMA course. However during the inspection positive comments were received about the support and guidance provided from him. He was reported by staff to be approachable, aware of the residents needs and of activity in the home. There was no evidence of the manager receiving regular supervision, management induction or training since being in post. Cambria House DS0000047346.V320296.R01.S.doc Version 5.2 Page 22 The previous manager carried out a consultation process that included consultation with relatives, staff, service users, care managers. The results were analysed and an improvement plan was produced which includes a range of improvements and reflected the wishes of residents. There is also an improvement plan for the fabric of the home. However it was advised that consideration is given to auditing a wider range of practices regularly in the home for example in order to meet the standards reported on in this report. Attention is given to health and safety in the home and staff receive relevant training, but checks are needed to ensure that all training is received within the correct timescales. For example staff are not receiving fire training twice a year. Only six of all current staff were recorded as trained once in 2005-2006. Other fire matters were raised. The fire risk assessment was out of date and room use had been changed since it was completed. This should have been reviewed and any future review should take further planned changes into account and the fire officer consulted. There was no record of the last specialist check of the fire equipment. No obvious signs hazards posing risks to residents were noted during the tour of the home. The gas and boiler rooms were locked. Hazardous substances were locked away. Cambria House DS0000047346.V320296.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 x 2 3 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 2 25 x 26 x 27 x 28 x 29 x 30 2 STAFFING Standard No Score 31 x 32 2 33 x 34 2 35 2 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 2 x 2 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 2 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x 2 x 2 x x 2 x Cambria House DS0000047346.V320296.R01.S.doc Version 5.2 Page 24 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 15 Requirement Timescale for action 14/02/07 2. YA6 15 3. YA9 YA16 13(4) 4 YA20 13 The registered person must ensure all service users plans are reviewed and updated. This must include clear strategies for supporting service users to achieve goals and aspirations. This is a repeated requirement; previous timescale of 25/10/05 and 7/9/05 was not met. The registered person must 11/12/06 ensure that all physical intervention strategies are supported by clear guidelines. This is a repeated requirement; previous timescale of 25/10/05 was not met. The registered person must 11/12/06 ensure that all risks are assessed and action plans provided to meet residents needs. This includes restricted access within the home such as (ensuite facilities, the sensory room and the day care room). The manager must ensure that 11/12/06 clear guidelines are in place within the service user’s plan for ‘when required’ medication. DS0000047346.V320296.R01.S.doc Version 5.2 Cambria House Page 25 5. YA20 13 6. YA20 13 7. YA23 13 (6) 8. YA23 18(1) 9. YA34 19 schedule 2 10. YA34 19 This is an amended and repeated requirement, previous timescale of 25/10/06 and was not met. The registered person must ensure that any staff member administering medication has been appropriately trained and assessed as competent in line with the organisations procedures before administering medication. The registered person must ensure that an appropriate register for controlled medication is used and that recording is in line with current guidance. The registered person must ensure that local adult protection procedures are used when an allegation is made. The registered person must ensure that adequate numbers of staff are trained in adult protection. The registered person must ensure that any staff member starting work prior to the return of their CRB application has had a Pova first check. A statutory requirement notice has previously been issued in respect of this requirement in 2005. The registered person must ensure that a supervisor is nominated for those staff awaiting completion of a full CRB check and supervisory arrangements are in place. The registered person must make arrangements to ensure that staff trained in bi polar disorder. The registered person must ensure that the fire risk assessment is up to date, that DS0000047346.V320296.R01.S.doc 11/12/06 11/12/06 11/12/06 14/03/07 11/12/06 11/12/06 11. YA35 18(1) 11/12/06 12. YA42 13(4) 11/12/06 Cambria House Version 5.2 Page 26 13 YA37 10(3),18 (1) adequate numbers of staff are trained in fire matters and that checks of the equipment are completed and documented. The registered person must ensure that adequate training, support and supervision is provided to the manager. 14/02/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Cambria House DS0000047346.V320296.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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