Inspection on 17/04/07 for Carlton Specialist Care Centre

This inspection was carried out on 17th April 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Carlton Specialist Care Centre 08/04/08

Carlton Specialist Care Centre 23/05/06

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

The Cornerstone

John Street Nursing Home

Pennine Camphill

Muston Road (70)

Grayling

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

CARE HOME ADULTS 18-65 Carlton Specialist Care Centre 18 Greenway Milnsbridge Huddersfield HD3 4RZ Lead Inspector Cathy Howarth Key Unannounced Inspection 17th April 2007 09:30 Carlton Specialist Care Centre DS0000064511.V331228.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 Carlton Specialist Care Centre DS0000064511.V331228.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. Carlton Specialist Care Centre DS0000064511.V331228.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Carlton Specialist Care Centre Address 18 Greenway Milnsbridge Huddersfield HD3 4RZ 01484 649899 01484 649899 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) Carlton Nursing Homes Ltd Mr Gary Anthony Simpkins Care Home 10 Category(ies) of Learning disability (10) registration, with number of places Carlton Specialist Care Centre DS0000064511.V331228.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home shall be registered for ten places but, immediately following registration, numbers will be limited to four. When further staff have been recruited, and in agreement with CSCI, registered places shall increase up to the maximum number. Can provide accommodation and care for one named service user under 18 years of age. 23 May 2006 2. Date of last inspection Brief Description of the Service: Carlton Specialist Care Service is a new service designed to provide support to individuals who may present severe challenges to a service. The service aims to provide an individualised service tailored to service users’ needs. The building is a converted club which has a large open living space with numerous other rooms geared towards specific activities such as a TV room, gym, wet room with hot tub and Jacuzzi, arts and crafts room and a sensory room. Each service user has their own bedroom with ensuite bathroom. There is a dining room with another seating area and a kitchen. The outside space is mainly used for car parking and the whole unit is surrounded by a metal fence for security. Prospective service users and contractors are given the Service User Guide and Statement of Purpose which gives them information about the home. Fees range from around £2,000 per week but are dependent on individual assessments and care packages. Carlton Specialist Care Centre DS0000064511.V331228.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report relates to a key inspection of the service. In assessing the service, information provided by the home was used. Responses from service users, families and social workers, both from surveys sent out before the visit and from telephone calls with two relatives and one social worker, were used also. The inspector visited the site and spoke with people living there, staff and managers. What the service does well: What has improved since the last inspection? The environment has improved but still needs more attention in some areas, especially outside and in making sure that repairs are done in a reasonable time. Staff recruitment systems have improved. Certain areas of the home are much more homely. Carlton Specialist Care Centre DS0000064511.V331228.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Carlton Specialist Care Centre DS0000064511.V331228.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 Carlton Specialist Care Centre DS0000064511.V331228.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 People who use the service experience good quality outcomes in this area. The pre-admission assessment process is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The service has only admitted two new people to the home since the last key inspection. One person has left the home. The inspector spoke with both of these people who said that they had been fully involved in the planning and admission process. They had received information about the home and were supported to make a choice about whether they wanted to come or not. There was evidence on file that detailed assessment information about service users was sought before deciding if the home can meet individual needs. Carlton Specialist Care Centre DS0000064511.V331228.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 and 9 People who use the service experience adequate quality outcomes in this area. People living at Carlton SCC have their individual needs and choices taken into account but are only involved in planning in a limited way. The home’s approach to risk management could be more imaginative. This judgement has been made using available evidence including a visit to this service. EVIDENCE: From discussions with service users and staff, there was evidence that there is a commitment by staff to ensure that individual needs of people living at the home are carefully considered and planned for. Each person has an individual plan and the needs and issues that are particularly relevant to them are detailed on it. For example, as well as health issues, there are sections for some people on managing their finances or on leisure activities they particularly want to be involved in. One area for improvement could be in the way that service users’ involvement is documented in the paperwork, for Carlton Specialist Care Centre DS0000064511.V331228.R01.S.doc Version 5.2 Page 10 example one young man agreed that the elements in the plan had been discussed with him and he agreed with the strategies and approaches but very little of his view was reflected in the plan itself. Similarly, with risk assessments and review reports, it would be better to have the person’s view reflected more clearly and any areas of disagreement or conflict to be highlighted. Reviews of the plan are carried out approximately monthly but, again, there was little evidence of user involvement in this process. Risk assessments showed that, ordinarily, people living at the home have the appropriate risk assessments in place. In some areas, it would appear that the home errs on the side of caution, for example in whether they allow people to self medicate, and staff appear to have a tendency to implement sweeping restrictions which affect all the occupants rather than developing strategies to deal with specific concerns or needs of individuals, for example in locking the kitchen door to control access to food and to manage risk in the kitchen. Staffing levels are good enough for more imaginative individual approaches to be used. The home has a key worker system in place but parents that spoke with the inspector said they were not aware of who this person was for their relatives. Both relatives who spoke with the inspector felt that the home did a good job in addressing individual needs generally. Carlton Specialist Care Centre DS0000064511.V331228.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, 14, 15 16 and 17 People who use the service experience adequate quality outcomes in this area. People living at the home are generally able to make choices about their lifestyle, and are supported to develop their life skills but experience unnecessary restrictions in the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Within the home, there is a reasonable range of leisure opportunities available, with a small gym, wet room with Jacuzzi, sensory room, TV lounge and an arts and crafts room. The arts and craft room was not equipped at the last key inspection nor at the random inspection carried out in December 2006. On this visit, some equipment was available and is used by people living at the home but the room itself continues to lack a sense of purpose as it contained a Carlton Specialist Care Centre DS0000064511.V331228.R01.S.doc Version 5.2 Page 12 broken table and a defunct washing machine. People seem to prefer to do these projects in the computer room which used to be the main office. There was evidence that staff do try and encourage and support opportunities for personal development. Some service users have attended college courses to learn life skills and any particular interest, for example in using the gym, is promoted. One relative expressed some concern that their son had little activity during the day and was allowed to stay in bed too long, getting into a cycle of night time wakefulness and lack of motivation to get out of bed in the mornings. The person themselves confirmed that they have problems with this and there was evidence that staff do try and encourage and promote more day time activity. Ultimately, however, the person is an adult and responsible for their own choices, poor or otherwise. Staff do need to document carefully how they have encouraged and promoted the care plan, however, so that it is clear that the choices have been offered and supported. Imagination and incentives should be used to promote desirable outcomes for service users who may lack motivation themselves. People are encouraged and supported to maintain contacts with families and both parents who spoke with the inspector said they appreciate the efforts that staff make to enable this to happen, particularly when they live far away from the home. The inspector was concerned again, on this visit, that some people living there do not have opportunities to make friends and socialise with peers. Staff need to work harder to promote opportunities for this to happen. Daily routines within the home generally promote individual choices. Staffing levels are such that individuals can make choices and be supported to do their chosen activity without significant impact on other people. The inspector observed staff approaching people living there with respect and knocking before entering rooms. At the random inspection carried out in December, it was noted that there was an improvement in the way that meals were planned and the social aspects of mealtimes was being addressed through group meals. Menus for individuals are recorded on each file and, on the whole, appear to be balanced. One relative expressed some concern that there were a lot of takeaways offered. The records and conversation with people living at the home did not reflect this. The inspector did have some concerns about the fact that the kitchen is locked at certain points of the day. This does not seem to be an acceptable approach to allowing people freedom within their own home. The issue of unnecessary restrictions affecting every service user was raised at the last key inspection and again in December 2006. This is an area the home needs to address as a matter priority. A requirement has again been made in respect of this. Two service users explained that they are sometimes involved in cooking and shopping for food. However, this does not seem to be a routine. One person Carlton Specialist Care Centre DS0000064511.V331228.R01.S.doc Version 5.2 Page 13 said he had been shopping once or twice. His view was that staff do this and sometimes people living there might go with the staff. There was a similar view of cooking, that it’s a staff job and occasionally people might ‘help’. It would promote ownership if there was more emphasis on staff helping people living there to buy and cook their own food, and they could have access to this when they wished. Carlton Specialist Care Centre DS0000064511.V331228.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 People who use the service experience good quality outcomes in this area. People experience health and personal care based on their individual needs. Their wishes and concerns are listened to and acted upon. This judgement has been made using available evidence including a visit to this service. EVIDENCE: This is an area that has seen some improvements since the last key inspection. The plans for each individual now show more clearly how personal and health care needs are to be met within the service. Where there are ongoing health issues, these are clearly documented and there are systems in place to monitor these with systems such as monthly weight monitoring if this is an issue and monitoring of any other health conditions. Relatives now report that they are kept informed of any health issues or accidents. The care plans are written in such a way as to support people’s individual wishes and concerns about the way they are supported. One person living at the home did raise an issue with the inspector about how medication was managed. This related to him wanting to be more independent. The acting Carlton Specialist Care Centre DS0000064511.V331228.R01.S.doc Version 5.2 Page 15 manager agreed that this could be addressed through a risk assessment process, with phased steps towards independence and monitoring of outcomes. This was a positive response which the person was happy with. Appropriate referrals are made to other health care professionals when necessary. Medication administration systems were also improved. Storage was appropriate and safeguards were in place to ensure that stocks were well controlled. Where ‘as required’ medicines are needed, protocols for their use were in place. Staff who handle medication have been trained, and access to the medicines is restricted to one person on each shift. Carlton Specialist Care Centre DS0000064511.V331228.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 People who use the service experience adequate quality outcomes in this area. Individuals feel listened to and are generally protected from harm. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a complaints procedure which individuals are encouraged to use, either formally or informally. One person did say they had previously made complaints during a difficult time for the unit, because of problems with one individual. However, no complaints have been recorded in the log. The acting manager acknowledged that this may well have been the case but nothing was recorded. At the last key inspection, one person had expressed a lack of confidence in the system and this seems to have been confirmed. However, people did express the view on this visit that they are listened to now. None of them has recently made a complaint, however, so it is not clear whether the system has improved. There are clear systems for protecting individuals living at the home from abuse. The majority of staff have undergone training in recognising and responding to abuse. Their approach to individuals presenting with challenges is to talk and try and understand rather than to contain or restrain. One person said he was happy that he has only been restrained once whereas he had experienced this daily in a previous placement. He felt the difference was that staff listen and try and help him work through his difficulties. Carlton Specialist Care Centre DS0000064511.V331228.R01.S.doc Version 5.2 Page 17 One area for concern is that one person who has difficulties managing money, and has a propensity to buy items on credit, has sold some of these items to staff. Given that this person’s care plan details how he is to be supported to limit his spending, this is not acceptable. There must be a clear policy for staff prohibiting any financial transactions with people living at the home. Carlton Specialist Care Centre DS0000064511.V331228.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 28, 30 People who use the service experience adequate quality outcomes in this area. The environment has improved but still needs more attention in some areas. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Outside, the approach to the building was rather depressing. The perimeter metal fence has still not been entirely painted and the tubs at the entrance were overgrown with weeds. There is no garden furniture and the area does not give the impression of being well used by the occupants. At the last key inspection, it was noted that the home lacked a homely atmosphere and, at the inspection in December, it was noted that there was a great deal of clutter around the home and it had a feel of being neglected and uncared for. This has improved somewhat. The home was clean and tidy and some of the rooms have been made noticeably more welcoming and there was Carlton Specialist Care Centre DS0000064511.V331228.R01.S.doc Version 5.2 Page 19 a lot less clutter around on this visit. Individuals’ bedrooms reflected their interests and personality. The variety of rooms available for different activities is good, such as TV lounge, Jacuzzi, sensory room and a gym as well as the computer room. There is also a table tennis table and a pool table available. The main area is still lacking in atmosphere, however, and a hole in the ceiling noted in December is still awaiting attention. One person told the inspector that he was not happy with the fact that the washer was not working and hadn’t been for some months. Staff confirmed that this was the case. Laundry is being done at the sister home across the road and the owner is in the process of building a new laundry to serve all three homes in this vicinity. However, given the nature and stated purpose of this home, there must be a domestic type machine available for people to do their own laundry as part of their life skills development. Carlton Specialist Care Centre DS0000064511.V331228.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 and 36 People who use the service experience good quality outcomes in this area. People living at the home benefit from a staff team that is consistent and adequate to meet their needs on a daily basis. Staff training and support opportunities are good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is well staffed and the staff appear to have ‘bedded down’ into a cohesive unit. Staff handovers and communications within the home are good. Staff have individual responsibilities on each shift and this seems to help people be clear about expectations. Staff training is good. Most staff have completed basic induction training including moving and handling, epilepsy and breakaway techniques. Most staff are registered NVQ 3 candidates or have completed this. The others are just completing their induction before being registered candidates. Approximately 30 of staff have achieved the qualification. The acting manager has a training matrix which aids tracking where staff are up to with training. This list Carlton Specialist Care Centre DS0000064511.V331228.R01.S.doc Version 5.2 Page 21 does highlight some gaps, however, that need to be addressed. In particular, there should be at least one member of staff trained in First Aid on each shift. At present, there is one staff on days and one on nights with this training. Staff recruitment practices have improved since the last key inspection. Two files were examined as part of this inspection. These were satisfactory generally but vigilance is needed to ensure that paperwork is collected and filed so that it can be found easily. Certificates relating to qualifications should be copied and kept on file for any new staff. Staff supervision systems and appraisals are up to date now, although there was a period during 2006 of several months when supervision systems lapsed. Regular staff meetings are held. People living at the home, and relatives, expressed positive views about the staff, such as from one person living there: “the staff are friendly and very professional” and one relative: “they try and cater to his needs and desires, they support him extremely well.” Carlton Specialist Care Centre DS0000064511.V331228.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 People who use the service experience adequate quality outcomes in this area. The home is adequately managed but needs to address how to improve quality in the future and have a clear vision of the purpose of the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has not had a registered manager for the last six months. In the interim period, the Operations Manager has been acting manager of the home, supported by two Deputies. The home has seen some improvements in this time but a vision for the future has been lacking. There is no development plan at this stage as there is a plan to re-evaluate the home and rethink its Carlton Specialist Care Centre DS0000064511.V331228.R01.S.doc Version 5.2 Page 23 purpose in the light of the fact that there are still only four people living there. A new manager had started just before this visit with this remit. As the home has had no permanent manager, quality assurance has been lacking in order to concentrate on the day to day improvements that were needed. However, it may be this overall lack of attention to the quality of the service, and how it may present to prospective users, that has affected referrals to the service. Health and safety within the home is adequate but there is still a propensity for unsafe equipment to be simply left in rooms where they can still present a hazard, for example a table left in the craft room, the top of which was not fixed to its base. Fire safety within the building is generally satisfactory, however recently there has been a lapse in the testing routine due to a member of staff being on sick leave. Fire test therefore need to be back on a regular weekly routine as a matter of priority and drills need to be carried out on a frequency that ensures that all staff participate at least twice a year. The systems to ensure that food and water temperatures are adequate was found to be good. Staff receive training in health and safety. One area of concern for the inspector was that service users may use the gym without proper supervision by a qualified person. On previous visits, it was explained that a sessional worker was to be visiting. However, this system does not appear to be working as one person living there, who uses the gym, said that they had not seen this person. The new manager explained that there was a plan to train a member of staff. This should be done as a matter of priority. Carlton Specialist Care Centre DS0000064511.V331228.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 2 ENVIRONMENT Standard No Score 24 1 25 X 26 X 27 X 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 2 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 2 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 2 X X 2 X Carlton Specialist Care Centre DS0000064511.V331228.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? YES 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 YA16 Regulation 16(2) Requirement Restrictions around the home due to lack of keys or unsuitable locking arrangements should be reviewed and steps taken to ensure that individual freedoms are not unnecessarily restricted. (From inspection in May 2006 original timescale 16/06/06) 2 YA22 22 The complaints system must be effective and records must be kept of complaints made along with their outcome and actions taken in respect of them. There must be washing facilities for people who wish to do their own laundry. Staff must receive training in emergency first aid. The service should develop a quality assurance system and a development plan for the service. (From May 2006 original timescale was 30/7/06 ) The environment must be maintained, safe and clutterfree. (from December 2006 DS0000064511.V331228.R01.S.doc Timescale for action 31/12/07 17/05/07 3 4 5 YA24 16(f) 13(4) 24(1) 17/05/07 30/06/07 YA32 YA39 30/06/07 6 YA24 13 (4) 30/06/07 Carlton Specialist Care Centre Version 5.2 Page 26 timescale was 31/12/06) 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 2 3 Refer to Standard YA23 YA42 YA42 Good Practice Recommendations There must be clear policies and procedures to restrict financial transactions between staff and people living at the home. Fire tests should be done weekly and drills often enough to ensure that staff participate a minimum of twice a year. A member of staff should be trained to ensure that people use the gym equipment safely. Carlton Specialist Care Centre DS0000064511.V331228.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Brighouse Area Team First Floor St Pauls House 23 Park Square Leeds LS1 2ND National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Carlton Specialist Care Centre DS0000064511.V331228.R01.S.doc Version 5.2 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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