Inspection on 22/11/07 for Cassini House

This inspection was carried out on 22nd November 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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 19 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Cassini House 25/05/06

Cassini House 03/11/05

Cassini House 02/12/04

Cassini House 12/07/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 Cassini House 13 Duckett Road London N4 1BJ Lead Inspector Jackie Izzard Key Unannounced Inspection 22nd November 2007 10:00 Cassini House DS0000010730.V352683.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 Cassini House DS0000010730.V352683.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. Cassini House DS0000010730.V352683.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cassini House Address 13 Duckett Road London N4 1BJ 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) 020 8340 1633 020 8340 1633 Precious Homes Limited ** Post Vacant *** Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Cassini House DS0000010730.V352683.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25th May 2006 Brief Description of the Service: Cassini House is owned by Precious Homes Ltd and is registered to provide residential care for six younger adults with a learning disability. The home specialises in supporting service users with autism and also service users with complex needs. Cassini House is a three-storey terrace house situated off Green Lanes, Haringey in North London. The home has six bedrooms and two bathrooms. The communal areas consist of a large lounge, a separate dining room and a kitchen. The garden area is of medium size with a paved area and access to the garden is via the dining room. The home is within easy access to local shops, restaurants, pubs, and public transport and near to Wood Green shopping city, Finsbury Park and Alexandra Park. Cassini House was registered in June 1998. The home’s stated mission is to be dedicated to creating a safe enabling environment in which individuals can experience respect, dignity and positive valuing and thereby sustain meaningful and fulfilled lives. The home also states that it seeks to provide high quality support in a residential care setting to adults with learning difficulties and challenging behaviour. This support reflects the individual service users unique needs and aspirations and cultural values, promotes autonomy and self-determination and enables the service users to lead their preferred way of life. The registered manager stated that the home charges from £990 to £2,300 per week depending on the service user’s assessed needs. The registered manager also stated that that CSCI inspection reports are made available, including to prospective service users and their representatives on request. Cassini House DS0000010730.V352683.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A questionnaire was received from each of the six people who use this service. The responses gave an overall good impression of the care and support that is provided by the home. Two comments were made that indicated that activities and consultation were less positive, one saying that activities were not good and the other that consultation only occurred sometimes. It would be timely, therefore, for the registered persons to explore those views further. Members of the staff team also returned four questionnaires. These gave mostly positive views about the service although improvements to staff support and training, as well as repairs, attracted particular suggestions for improvement. This inspection involved a visit to the service (by both a regulation inspector and inspecting pharmacist), discussions with staff, observation of interactions with the people who use the service and examination of specific records. The previous key standards report and information obtained from other sources were also taken into consideration. Due to unforeseen circumstances the draft report of this inspection was delayed beyond the usual Commission timescale for publication. It should be noted that this was not in any way due to any situation involving the registered persons. As a result, any subsequent communications that have been held with the registered person’s have, where relevant, also been referred to in this report. What the service does well: What has improved since the last inspection? The registered persons now ensure that the labelling on prescribed medication is correct when it is received in the home. Cassini House DS0000010730.V352683.R01.S.doc Version 5.2 Page 6 The home’s kitchen has been decorated and the kitchen floor has been replaced. Hand drying facilities are also now provided in the laundry and the two bathrooms. 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. Cassini House DS0000010730.V352683.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 Cassini House DS0000010730.V352683.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): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Standard 2 was assessed at this inspection visit. The needs of prospective users of this service have been seen to be assessed in significant detail to ensure that the home can meet these. EVIDENCE: As there have been no new admissions to the home this key standard does not necessitate any detailed comment at this stage. However, it should be noted that the three people who were admitted prior to the key inspection in May 2006 had all subsequently had updates to their assessments. These updates were designed to assess the continued suitability of their individual continued placement at the home. Cassini House DS0000010730.V352683.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): Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Standards 6, 7 & 9 were assessed at this inspection visit. The people who use this cannot feel entirely confident that the staff know what they need by way of updated care plans or risk assessments. There is a risk that changing needs may not be identified if the necessary review and updating does not occur. EVIDENCE: Three care plans were looked at in detail during this inspection visit. The home is introducing a revised personal care planning system, using booklets that outline the areas to be considered. Of the three care plans that were looked at, one had a completed pcp booklet, one had been started and the other had not yet commenced. In general care plans are overdue for review, even given the fact that a new system is being introduced it is important that the necessary reviews still take place and not be unnecessarily delayed because of any delay Cassini House DS0000010730.V352683.R01.S.doc Version 5.2 Page 10 in implementing the system. One of the people whose care plan was looked at clearly has a sensory impairment, although this is not reflected in their current care plan. The registered person must ensure that the home includes all relevant care and support information. The care plans must at all times properly outline each person’s needs and the most appropriate way in which the home will meet the needs of each of the people who use the service. The care plans also include risk assessments that tell staff and other people about anything that may harm anyone who lives here. Copies of risk assessments are kept in each person’s individual file and cover a variety of situations from accessing community activities to learning skills and activities within the home. However, risk assessments are not being reviewed consistently for everyone who uses this service, which must occur. Cassini House DS0000010730.V352683.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Standards 12, 13, 15, 16 & 17 were assessed at this inspection visit. The people who use this service can continue to feel confident that the staff of the home will provide opportunities for everyone to develop their personal and social skills. This includes active support for each person to participate in the community both in terms of the activities of daily life and leisure interests. The opportunity for each person to develop and maintain personal and family relations is also offered and is actively supported by the staff team. EVIDENCE: The people who use this service continue to be supported to make use of a wide range of community based facilities. These can be anything from regular shopping trips, whether for food for the home or personal shopping, to attending at day activities. The staff team are able to demonstrate a clear Cassini House DS0000010730.V352683.R01.S.doc Version 5.2 Page 12 understanding of the cultural and religious practise preference that each person who uses this service chooses to adhere to. Staff were observed interacting meaningfully and respectfully with the people who use this service at the inspection. The service users all have access to keys to their rooms, and are able to spend time in their rooms or in the communal areas of the home as they chose. The home has designated itself a non-smoking environment and this is included in the service users guide. The daily routines of the home continue to be flexible within reason. The home has the appropriate policies and practices about maintaining people’s dignity and rights. Individual preferences for the food that people like to eat are given due consideration. The menus show that appropriately varied and nutritious meals are available which take account of individual preferences and cultural and religious heritage. Cassini House DS0000010730.V352683.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): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Standards 18, 19 & 20 were assessed at this inspection visit. The people who use this service can remain confident that they will get the right support to take care of their day to day personal care and any arising healthcare needs. However, there are some risks that have been identified if aspects of medication recording, policy and audit do not improve. EVIDENCE: All of the people who live at the home require at least some support from the staff team to attend to their personal care needs. The methods of supporting each person that focuses on the unique preferences and personality of each are written down in their care plan. The people who use this service continue to make use of the range of community health services whenever necessary. A specialist pharmacist inspector also visited the home as a part of this key standards inspection. The report of their findings was supplied to the Cassini House DS0000010730.V352683.R01.S.doc Version 5.2 Page 14 registered person separately, but will be copied into this report, below, for ease of reference. The home had a medication policy, which had been written in March 2007 and described procedures for managing medicines safely in the home. Because several of the residents were going to day centres and to their families for the weekend there should also be clear written procedures so that staff know exactly how to ensure continuity of their medication during these times. In order to maintain an audit trail the home should also have a list of specimen signatures and initials of staff that are trained to handle medicines safely. Recording of medication was inspected and there was evidence of generally accurate recording of receipts, administration and disposal. Three gaps were noted on the administration records but although in two cases the tablets were not in the Monitored Dosage System, for an antibiotic, it was not possible to know whether it had been administered as prescribed. There was evidence for a tablet used to help the bladder and also an antibiotic, that one dose had been signed for but not given. Two tablets of chlorpromazine 100mg could not be accounted for another resident. There was good practice in the home of keeping medication profiles. However these were not always up-to-date. One resident had two entries for carbamazepine on the Medication Administration Record (MAR)-the same dose but different formulations. The change was not documented on the profile and there was no evidence found for a change in formulation. The home needs to work with both the pharmacist and the GP to ensure that prescriptions are accurate for both content and quantity and are not duplicated on the MAR. Many of the residents were having their medication changed quite frequently and it was difficult to track dosage changes in the various notes. The home needs to ensure that evidence of the current dosage is readily accessible to prevent the risk of error. The MAR was endorsed correctly when residents went away from the home and details were recorded of the quantity sent with the resident and returned. There must be signatures and witnesses in order to maintain the audit trail. Several residents were prescribed as required medicines in the home and there was evidence of either individual protocols or detailed instructions for when to give. The care plan for one resident was tracked and it was noted that there were frequent, regular documented reviews of medication. Risk assessments and mood charts were kept and care plans recorded improvements in behaviour and any changes in mood. The home had an audit tool but no evidence of regular audits was available for inspection. Cassini House DS0000010730.V352683.R01.S.doc Version 5.2 Page 15 The requirements that were made as a result of the pharmacist inspection will also appear in the requirements section of this report. Cassini House DS0000010730.V352683.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): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Standards 22 & 23 were assessed at this inspection visit. The people who use this service cannot feel entirely confident that the staff team at the home know fully what to do if there are complaints or concerns about abuse. The home has clear guidance for staff about the procedures to be followed in either of these circumstances, however, the awareness across the staff team about the complaints procedure open to question. EVIDENCE: The home does not have a complaints record on site, which must be established and any complaints must be recorded. The Commission received a concern about financial safeguards in the home prior to this inspection. As a result of this the registered provider wrote to the Commission outlining the measures that would immediately be established. It should be noted that the concern did not relate to the day to day management of service users finances on site, but organisationally. This issue has been dealt with separately by the Commission and will not result in further comment in this report. However, a requirement will be made to tighten financial procedures. Cassini House DS0000010730.V352683.R01.S.doc Version 5.2 Page 17 The home has a copy of the geographical authorities protection of vulnerable adults procedure. Aside from the concern referred to above, no complaints of suspected abuse have been made to the home, the Commission or local authority since the previous key standards inspection. Cassini House DS0000010730.V352683.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Standards 24 & 30 were assessed at this inspection. The people who use this service can usually feel confident that they are living in a well maintained home, although some small areas of attention have been identified. The home is kept clean and hygienic and is largely a pleasant environment for the people who live here. EVIDENCE: The home is a converted three story domestic premises that remains generally well decorated, well maintained and which continues to provide an overall pleasant environment to meet the current service users needs. There are a couple of areas in need of attention, namely the lounge floor needs replacing and the sofas need thorough cleaning. Cassini House DS0000010730.V352683.R01.S.doc Version 5.2 Page 19 The home has satisfactory laundry facilities and storage for chemical cleaning materials. The home was seen to be clean and tidy during the inspection. Cassini House DS0000010730.V352683.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): Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Standards 32, 33, 34 & 35 were assessed at this inspection. The people who use this service users cannot feel confident that the staff are recruited in a way that means that proper background checks are carried out. This is necessary in order to prove that these are safe people to support them. The quality of the support that is offered by the staff team could also be compromised if staff are not provided with proper induction. EVIDENCE: New staff should be required to undergo a proper induction as a part of their initial introduction and period of probation at the home. There were four newly recruited staff records viewed and of these three had no evidence that any induction programme had been completed. Additionally there was indication that some staff may be working excessively long hours. The European working time directive sets out specific requirements upon employers in regard to average working hours each week. This is designed to ensure that, unless staff specifically agree to work more than an average 48 hours per week, that an employer cannot make them do so. In a care environment it is always Cassini House DS0000010730.V352683.R01.S.doc Version 5.2 Page 21 necessary for staff to remain diligent at all times. Excessively long average weekly hours of work could overly tire staff and effect their competence at work. The registered person is required to confirm in writing with the Commission how the service complies with the working time directive. Additionally it is required that the registered provider outlines the current staffing situation at the home, including any vacancies that exist amongst the full time complement of the staff team. The registered person is required to carry out checks to make sure that those who work here are safe people to work with vulnerable adults. These include things like checking if a new member of staff has ever been found guilty of a crime (known as a CRB check), and asking people who used to employ them if their work was good and if they are the right sort of person to work with the people who live here. It was identified at this inspection that the registered person is not adhering to this legal obligation and as a result an immediate requirement was made that they do so. This registered person, in response, gave a written undertaking that they would ensure that these checks occur. The requirements that were made will appear in this report for reference purposes. The home keeps records that say what training courses staff have done, and when they did them. These records show that staff training is still sporadic and although a new training plan has been recently developed it is of concern that this has taken time to establish. Cassini House DS0000010730.V352683.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): Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Standards 37, 39 & 42 were assessed at this inspection. The people who use this service cannot feel confident that they are living in a home that has been consistently managed, either internally or externally. EVIDENCE: The home has had six managers in the last year, the current manager having resigned shortly after the date of this inspection. The consistency of management arrangements is therefore of serious concern to the Commission. This will result in a requirement in this report. No information could be provided at the time of this inspection about the quality assurance procedures of the registered person. A requirement will be Cassini House DS0000010730.V352683.R01.S.doc Version 5.2 Page 23 made in this report that the registered person must ensure that they implement proper quality assurance systems. This must be with a particular emphasis on improving the performance of the service and the quality of care for those who live here. All standard safety inspections for the home were seen to be within date, however, the home has been experiencing ongoing problems with the boiler. Three maintenance visits in recent months have not resolved these problems, which must achieve a permanent resolution. Cassini House DS0000010730.V352683.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 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 1 33 2 34 1 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 1 3 X 1 X LIFESTYLES Standard No Score 11 x 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 1 x 1 X 1 X X 2 x Cassini House DS0000010730.V352683.R01.S.doc Version 5.2 Page 25 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA6 YA9 Regulation 13(4), 15(2) Requirement The registered persons must ensure that all care plan and risk assessment reviews are signed and dated by the person undertaking the reviews. (The previous timescale of 30/06/06 was not complied with) The registered persons must ensure that all care plan and risk assessment reviews are carried out within appropriate timescales. The registered persons must ensure that a record of complaints is maintained at the home and is recorded upon whenever necessary. The registered persons must ensure that financial procedures are sufficiently robust in order to protect the people who use this service from financial abuse. The accurate recording of administration of medication must be improved in the home so that all medication can be accounted for. Medication profiles must be kept up to date and evidence of the current prescribed medication DS0000010730.V352683.R01.S.doc Timescale for action 07/03/08 2. YA6 YA9 13(4), 15(2) 07/03/08 3. YA22 22 (3) & (8) 07/03/08 4. YA23 13 (6) 07/03/08 5. YA20 13(2) 01/01/08 6. YA20 13(2) 01/01/08 Cassini House Version 5.2 Page 26 7. YA20 13(2) 8. 9. YA20 YA24 13(2) 23 (2) (b) 10. YA32 18 (1) (a) & (b) 11. YA33 18 (1) (a) 12. YA34 19 (1) (b) (i) Schedule 2 19 (1) (b) (i) Schedule 2 19 (1) (b) (i) Schedule 2 8&9 13. YA34 14. YA34 15. YA37 kept readily accessible so that there is no risk of the residents receiving the wrong medicine That the home has clear written procedures for managing medication when the resident is away from the home. That there are regular audits of medication carried out to ensure that it is being handled safely. The registered persons must ensure that the lounge floor is replaced and the sofas are thoroughly cleaned. The registered person must clarify, in writing with the Commission, the current staffing position. This must also include the action that will be taken to ensure that the staffing situation does not result in any unnecessary risks to the consistency of service user’s care. The registered persons are required to confirm in writing with the Commission how the service complies with the working time directive. The registered person must cease employing people before the checks listed in schedule 2 of the Care Homes Regulations 2001 are received. The registered persons must provide evidence of POVA first checks on staff employed in 2007. The registered persons must investigate and report to the Commission about the failures in recruitment of named staff. The registered persons shall ensure that an application to register a manager for the home is made to the Commission without delay. DS0000010730.V352683.R01.S.doc 01/02/08 01/02/08 01/04/08 07/03/08 07/03/08 23/11/07 30/11/07 30/11/07 01/04/08 Cassini House Version 5.2 Page 27 16. YA39 24 (1) (a) & (b) 17. YA42 23 (2) (b) The registered persons shall establish and maintain a system for reviewing at appropriate intervals and improving the quality of care at the home. The registered persons shall ensue that a permanent resolution is achieved to the ongoing problems with the boiler at the home. 07/03/08 07/03/08 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 Cassini House DS0000010730.V352683.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Harrow Area office Fourth Floor Aspect Gate 166 College Road Harrow HA1 1BH 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 Cassini House DS0000010730.V352683.R01.S.doc Version 5.2 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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