Inspection on 23/05/06 for Carlton Specialist Care Centre

This inspection was carried out on 23rd May 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 no outstanding requirements from the previous inspection report, but made 8 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 17/04/07

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 Inspection 23rd May 2006 10:00 Carlton Specialist Care Centre DS0000064511.V294443.R01.S.doc Version 5.1 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.V294443.R01.S.doc Version 5.1 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.V294443.R01.S.doc Version 5.1 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.V294443.R01.S.doc Version 5.1 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. This is the first inspection of this service. 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. Each service user has their own bedroom with ensuite bathroom. There is a dining room with another seating area and a main kitchen and a snacks kitchen where service users can make snacks and cold drinks. 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 £2000 per week but are dependent on individual assessments and care packages. Carlton Specialist Care Centre DS0000064511.V294443.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out by collecting information about the service held on file, the return of information from the home, surveys of two service users, conversations with four parents of service users, survey returned by one social worker as well as a visit to the service. The visit to the service involved examination of the environment, relevant records, discussions with staff at various levels and direct discussions with service users and observations of the care provided to individuals. Carlton Specialist Care is a new service and is therefore is in the early stages of developing its identity and working culture within the staff team, which is a new team. Overall the signs are positive, staff have been given good induction training opportunities and there are sufficient staff recruited to meet the needs of the three people living at the home at present. There are areas where guidance is needed to encourage staff to be more imaginative and to develop practice. A clear lead is needed to ensure that the home’s aims will be met and this needs to be carefully monitored by the manager especially in the early stages while the ethos of the team is developing. What the service does well: What has improved since the last inspection? This is the first inspection of this service. Carlton Specialist Care Centre DS0000064511.V294443.R01.S.doc Version 5.1 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. Carlton Specialist Care Centre DS0000064511.V294443.R01.S.doc Version 5.1 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.V294443.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 The pre-admission assessment process is good. Quality in this outcome area is good. This judgement has been made from evidence gathered before, during and after the visit to this service. EVIDENCE: In assessing this area, the inspector used information known about the service, responses from service users and their families and social workers. One service user informed the inspector that they had received information about the home and had the opportunity to visit for a short stay before deciding to move in. There was evidence on file that detailed assessment information about service users is sought before deciding if the home can meet individual needs. Carlton Specialist Care Centre DS0000064511.V294443.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 Care planning and risk assessments, and the delivery of those plans, within the home needs to be better developed. Quality in this outcome area is adequate. This judgement has been made from evidence gathered before, during and after the visit to this service. EVIDENCE: Individual service users each have their own care plans, which are written in conjunction with them and their relatives or social workers. One service user commented that he had been involved in the plan but felt that staff were “not playing their part” as they weren’t allowing him the independence he wants as part of the plan. Risk assessments were found on file but there is no clear plan for how this person is to develop their skills or how they will be supported through a stepped process towards this. Clear risk assessments should be in place identifying why decisions have been made to make restrictions on individuals and what needs to happen to remove those restrictions. A relative of another service user felt that the plan for their daughter was basic and that it only meets basic needs, “she is not stimulated enough”. “The weekly activity plan is not fulfilled if she refuses”. This relative felt that the Carlton Specialist Care Centre DS0000064511.V294443.R01.S.doc Version 5.1 Page 10 staff “ lack imagination” in encouraging and trying different approaches to make the plan work. For one service user, who is unable to articulate their needs, the inspector found that the care plan did not give sufficient detail for staff to know how to care for her adequately. Information about diet, likes and dislikes, for example was missing as well as information about other aspects of personal care and activities. Given that many of the staff are fairly inexperienced and the service user is new to the service this information is essential in order to make sure that needs can be met safely. During the visit to the service, the inspector observed instances of staff spending time with service users on a one to one basis and trying to engage them in meaningful activities, with some success. However it was clear from the daily reports that this is difficult to sustain and may depend largely on the skills and inventiveness of individual staff members. The home has a key worker team system in operation. It is not clear how this system is working. One service user said he was aware of it but did not know what they do. Overall this is an area where staff need training and leadership in order to ensure that they are adopting an imaginative approach to meeting needs and developing skills in supporting service users to develop their skills and promote independence. Carlton Specialist Care Centre DS0000064511.V294443.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16, 17 Service users’ lifestyle choices could be improved and the functioning of the home should promote more choice and freedom rather than restrict it. Quality in this outcome area is adequate. This judgement has been made from evidence gathered before, during and after the visit to this service. EVIDENCE: None of the service users at the home have employment or further education placements. Any opportunities for personal development or independence skills have to be provided by staff working at the home. Staff do support some of this personal development as it is identified in care plans, but as discussed previously this does not seem to be working effectively for the service users in residence at the time of this inspection. There was evidence from case records, that staff do support service users to use community facilities such as sports centres, shopping, restaurants and pubs. In the majority of cases this is through using public transport but the home does have access to a vehicle. Carlton Specialist Care Centre DS0000064511.V294443.R01.S.doc Version 5.1 Page 12 Within the home there is a reasonable range of leisure opportunities available, with a small gym, wet room with Jacuzzi, TV lounge and an arts and crafts room. The arts and craft room was not equipped however and one relative commented that they would like to see more games available, which is something their relative enjoys very much. Two parents expressed concern that their relatives were bored at the home and they did not have enough to occupy them or stimulate them. Service users are encouraged and supported to maintain contacts with families, although in the case of two service users this is limited by agreement because of specific circumstances and this is clearly documented and agreed on case files. This has led to a restriction on access to the pay phone for service users. One person complained that this meant that they had to ask for access to the phone or use the office phone, which limited privacy. The parent of this person confirmed that they also find this a problem as their relative becomes distressed and agitated when people come in the office while they are on the phone. A more imaginative solution to this problem needs to be found, as this situation is not acceptable as it is at present. The inspector was concerned, and two parents echoed this, that service users 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 promote individual choices. The inspector observed staff approaching service users with respect and knocking before entering rooms. Choices of service users were observed. Service users do not have unrestricted access throughout the home. In fact staff do not either as many doors are locked and there were insufficient keys to allow staff to have a set each. This means that staff have to search out keys to move from one room to another. This gives the home a rather institutional feeling. As far as service users are concerned these restrictions are blanket ones rather than individual, which means that access to areas such as the kitchen limits everyone regardless of individual ability and risks. This approach should be reviewed by the manager to see how this could be improved to better cater for individual needs. Individual service users buy their own food and meals are planned and cooked on an individual basis. This is positive in that individuals can receive food that they like. However, as the dining room is very large this tended to give the mealtimes a rather desolate feeling as one person just has a meal alone supported by staff who do not eat with service users, unless they choose to eat their own meals at the same time. This gave the meal a rather functional feel and ignores the social aspects of food and the opportunities for people to learn from other about appropriate behaviour at mealtimes. One parent commented that she felt that meals should be better and there should be a Sunday lunch Carlton Specialist Care Centre DS0000064511.V294443.R01.S.doc Version 5.1 Page 13 for example rather than just “snack type” meals. It is recommended that the manager look at ways of improving this aspect of the service. Service users’ dietary needs and preferences were not found to be very detailed on care plans, nor was there evidence of any monitoring of weight even though this is an issue for at least one service user. This needs to be improved. One service user told the inspector that he cooks his own food with staff supervision, although he doesn’t like being supervised at all times. Carlton Specialist Care Centre DS0000064511.V294443.R01.S.doc Version 5.1 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Personal choices of service users are generally respected at the home. Improvements are needed in how some aspects of health care are managed Quality in this outcome area is adequate. This judgement has been made from evidence gathered before, during and after the visit to this service. EVIDENCE: From observations and discussions with service users and families, the inspector noted that service users’ individual preferences are observed where possible in relation to personal care support. Assistance with these issues was offered discreetly and respectfully where this was necessary. Again it was clear from case files that the information surrounding health care for individuals was inadequate. One relative expressed disappointment that it had taken nearly six weeks for a service user to be registered with a local GP and this was holding up a referral to a specialist that is needed as a priority. Another parent expressed some concern that they had only been contacted about a visit to the GP after it had occurred. They would have preferred to be informed beforehand so they could have any input required as they saw fit, particularly as this service user is still legally a child. Carlton Specialist Care Centre DS0000064511.V294443.R01.S.doc Version 5.1 Page 15 However it is clear that staff have responded in a timely way when service users have become unwell or needed medical attention. Medication is managed adequately. Only nominated persons can administer medication and these people are clearly identified. The keys are currently part of the main bunch however and these must be kept separately, by the person designated to handle medication, for safety of the system. Examination of the records showed that overall medication is handled appropriately. However one mistake had been made in booking in medication given by the hospital following an incident the previous day, which resulted in a service user not being given the medication as prescribed. Staff must be vigilant in making sure medication is booked in and given as prescribed. Carlton Specialist Care Centre DS0000064511.V294443.R01.S.doc Version 5.1 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Quality in this outcome area is adequate. This judgement has been made from evidence gathered before, during and after the visit to this service. EVIDENCE: The home has a complaints procedure and one service user indicated that they were aware of how to use this but felt ambivalent about doing so as they did not feel confident that it would be taken seriously; “he could just screw it up and put it in the bin” was their concern. This service user expressed the view that staff do not listen and they found this upsetting and frustrating. Relatives who spoke with the inspector indicated that they found the manager responsive when issues were raised and that this is helpful. It is recommended that work be done with service users to ensure they have confidence that any complaints will be taken seriously and acted upon. Staff training in this area may be helpful. There are systems in place to protect the welfare of service users. Staff receive training in preventing and responding to abuse as part of their induction. One new member of staff was able to demonstrate a good level of understanding of their role in responding to abuse. A senior member of staff was similarly able to talk through how they would respond. Recently there was an incident where a staff member had behaved inappropriately towards a service user. Staff on duty used the correct procedures to report this and the matter is being dealt with by the manager. Carlton Specialist Care Centre DS0000064511.V294443.R01.S.doc Version 5.1 Page 17 One service user demonstrates some challenging behaviour at times. Staff have been trained in control and restrain measures and there are guidelines on the care plan regarding this. Carlton Specialist Care Centre DS0000064511.V294443.R01.S.doc Version 5.1 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The home is clean but lacks atmosphere and appears institutional. Quality in this outcome area is adequate. This judgement has been made from evidence gathered before, during and after the visit to this service. EVIDENCE: The home is converted club and has a wide-open space at its centre surrounded by rooms for different activities and bedrooms. As the home was only accommodating three service users at the time of this inspection, the open space felt quite sparse. Relatives have commented, “it feels quite institutional”, one person said. Another said it “lacks atmosphere” and felt it would be improved if there were more people around. There was a noticeable lack of ornamentation such as pictures, vases and other things to make the areas more homely. The fact that many doors are locked and staff need to carry a large bunch of keys to move about the home, contributes to the institutional feel also. Outside, the building lacks a welcome feel also. One parent commented that something should be done to make a better impression such as tidying up the overgrown tubs of flowers. The inspector noted that the metal fence has only been half painted also, this needs to be finished off. The manager should review how the overall environment could be improved. Carlton Specialist Care Centre DS0000064511.V294443.R01.S.doc Version 5.1 Page 19 The inspector noted that the home was clean on the day of this visit. The dining room flooring, although new was already showing signs of lifting where the seams join. This needs attention without delay so that it does not become a health and safety hazard. The arrangements for the safe handling of laundry and for infection control were found to be satisfactory, although laundry baskets with lids would be preferable to the open baskets in use. Carlton Specialist Care Centre DS0000064511.V294443.R01.S.doc Version 5.1 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34 and 35 Induction training for staff is good. Further training is needed and more qualified and competent staff are needed within the service. The arrangements to ensure there are sufficient numbers of competent staff on duty need to improve. Quality in this outcome area is adequate. This judgement has been made from evidence gathered before, during and after the visit to this service. EVIDENCE: This is a new service and the team is still in the process of being established. Most of the staff have only been recruited in the last few months and a number of these have little qualification or experience in this type of work. The manager has implemented a good induction programme covering a wide range of topics relevant to the client group covering such areas as autism, epilepsy and control and restraint. However these are basic information courses mainly offered in house. The manager is a qualified learning disability nurse but the other senior staff do not have the same level of experience and many of the care staff do not have any experience in this area of work at all. Relatives who spoke with the inspector expressed some reservations about the competence of the team. Whilst acknowledging that the team is new one parent commented, “they are pleasant enough but don’t seem to have the understanding”. Another said they felt that staff did not know what to say Carlton Specialist Care Centre DS0000064511.V294443.R01.S.doc Version 5.1 Page 21 when asked for feedback about their relative’s progress, just saying “yes or no” in response to questions. In general staffing levels are good, with staff providing one to one support for service users. On most shifts there is a senior member of staff on duty, who takes charge of the shift and plans how it is to be run. However the home has had a recent spate of sickness amongst the staff team, which resulted in one occasion with a new staff being one of only two staff on duty on their first day at the home. This is not acceptable and better systems need to be in place to ensure that such risks to the health and welfare of service users and staff do not recur. The system for the recruitment and selection of staff was found to be satisfactory overall. However one file sampled showed that one referee for one person was an inappropriate one and the employment history was incomplete. This had not been checked adequately at the time of recruitment. The manager must ensure that such checks are properly completed to protect the safety and welfare of service users. The home has a clear training plan for all staff to ensure they receive a good foundation in relevant aspects of the work. The manager informed the inspector that NVQ training would be made available to staff once they have completed their foundation training. Some basic courses have still to be provided to some staff such as Basic Food Hygiene, First Aid and LDAF. Carlton Specialist Care Centre DS0000064511.V294443.R01.S.doc Version 5.1 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 The manager is suitably qualified. The home needs to have a quality assurance system and a development plan. Health and safety is managed well. Quality in this outcome area is adequate. This judgement has been made from evidence gathered before, during and after the visit to this service. EVIDENCE: The registered manager is a qualified learning disability nurse and has the necessary experience to provide a service to this client group. One relative mentioned that they found him “professional” and “helpful”. The service has not yet developed a Quality Assurance system, although the manager was aware of the need for this and has sought some advice from the manager of the sister service opposite to inform how this can be implemented at the home. Carlton Specialist Care Centre DS0000064511.V294443.R01.S.doc Version 5.1 Page 23 Health and safety issues were found to be managed well. Certificates were up to date and COSHH substances locked away from service users. Staff receive training in relevant aspects of health and safety. Carlton Specialist Care Centre DS0000064511.V294443.R01.S.doc Version 5.1 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 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 2 34 2 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 2 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 2 15 2 16 1 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 2 X 3 X 2 X X X 3 Carlton Specialist Care Centre DS0000064511.V294443.R01.S.doc Version 5.1 Page 25 Are there any outstanding requirements from the last inspection? N/A 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 YA6YA17 15 Regulation Requirement Service user plans need to be more detailed to offer staff information on how goals can be achieved Nutritional and dietary issues should be clearly identified on care plans and weight should be monitored where this is an issue for individuals. The provider must make suitable arrangements for service users to have privacy for telephone calls. 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. 3 4 YA20 YA33 13(2) 18(1) The management of medication must be improved for the safety and welfare of service users. The provider must ensure there are adequate arrangements in place to ensure that there are sufficient suitably qualified and competent staff on duty at all DS0000064511.V294443.R01.S.doc Timescale for action 30/06/06 16(2) 2 YA16 16/06/06 23/05/06 23/05/06 Carlton Specialist Care Centre Version 5.1 Page 26 times. 5 YA34 33 The provider must ensure that the staff recruitment system is robust and suitable references and work histories are obtained for every member of staff. Staff should have the full range of basic training courses in order to ensure they can effectively met the needs of service users. The service should develop a quality assurance system and a development plan for the service. 23/05/06 6 YA35 18(1) 31/07/06 7 YA39 24(1) 31/07/06 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 Refer to Standard YA9 Good Practice Recommendations Clear risk assessments should be in place identifying why decisions have been made to make restrictions on individuals and what needs to happen to remove those restrictions. The home needs more equipment within the home for entertainment and stimulation of service users. Service users should be supported to make friends within the community. The manager should look at ways of improving the way the service deals with mealtimes. Staff should receive training in handling complaints and service users should be actively encouraged to use the system. The manager should look at ways to make the environment appear more homely. 2 3 4 5 6 YA14 YA15 YA17 YA22 YA24 Carlton Specialist Care Centre DS0000064511.V294443.R01.S.doc Version 5.1 Page 27 Commission for Social Care Inspection Brighouse Area Office Park View House Woodvale Office Park Woodvale Road Brighouse HD6 4AB 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 Carlton Specialist Care Centre DS0000064511.V294443.R01.S.doc Version 5.1 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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