Inspection on 11/01/07 for Cedar House

This inspection was carried out on 11th January 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 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Cedar House 23/02/10

Cedar House 27/11/09

Cedar House 14/05/09

Cedar House 29/05/08

Cedar House 09/05/06

Cedar House 14/09/05

Cedar House 24/05/05

Cedar House 04/11/04

Cedar House 06/04/04

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

CARE HOME ADULTS 18-65 Cedar House, 47 Smethurst Street, Middleton, M/cr M24 2BA Cedar House 47 Smethurst Street Middleton Manchester M24 2BA Lead Inspector Bernard Tracey Unannounced Inspection 11th January 2007 09:30 Cedar House, 47 Smethurst Street, Middleton, M/cr M24 2BA DS0000041209.V298185.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 Cedar House, 47 Smethurst Street, Middleton, M/cr M24 2BA DS0000041209.V298185.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. Cedar House, 47 Smethurst Street, Middleton, M/cr M24 2BA DS0000041209.V298185.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cedar House, 47 Smethurst Street, Middleton, M/cr M24 2BA Cedar House 47 Smethurst Street Middleton Manchester M24 2BA 0161 6553553 Address 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) Mrs Ann Merabi Ms Valerie Hewitt Care Home 16 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (16), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (3) Cedar House, 47 Smethurst Street, Middleton, M/cr M24 2BA DS0000041209.V298185.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum number of 16 service users to include 16 service users in the category of MD (Mental disorder) and up to 3 service users in the category of MD(E) (Mental disorder excluding learning disability or dementia over 65 years of age) within the total number of 16. The service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 9th May 2006 2. Date of last inspection Brief Description of the Service: Cedar House is a care home providing personal care for 16 adults, who have been diagnosed with a mental disorder. Three places are registered for residents over the age of 65 years, although no one of this age was living at Cedar House at the time of the inspection. The home provides 16 single bedrooms, a lounge, conservatory, dining room, communal toilets and bathing facilities. Cedar House is located at the end of a residential street, approximately 2 miles from the town centre of Middleton. A number of small local shops, post office, and pubs are near by. The home has a car park for residents and visitors. A grassed area is provided to the rear of the house and small garden areas to the front. The most recent Commission for Social Care Inspection (CSCI) report is available in the office. The home makes charges over and above the weekly care and accommodation fees that are listed after this section: Chiropody Hairdressing Magazines and Newspapers toiletries, activities, clothing and transport. Fees charged by the home provided in January 2007 are as follows: £253.00 to £373.54 per week Cedar House, 47 Smethurst Street, Middleton, M/cr M24 2BA DS0000041209.V298185.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The home was not made aware that this site visit was going to take place. Several weeks before the inspection questionnaires were sent out to doctors, social workers and district nurses, as well as to the residents of the home and their relatives. The questionnaires asked what people thought of the care and services provided by the home. The home was also asked to fill in a questionnaire. The Inspector spent 8 hours at the home, over two days. During this time he looked at care and medicine records to ensure that health and care needs were met and also studied how information was given to people before they decided to move into the home. A tour of the building was undertaken and time was spent looking at records regarding safety in the home. He also examined files that contained information about how the staff were recruited for their jobs, as well as records about staff training. The Inspector spent time speaking to 7 residents as well as speaking to 2 relatives, 3 staff, the manager and the joint owners. What the service does well: This is a care home where residents are well looked after. One resident said “The home as part of my life, and this home is very acceptable”. Feedback from relatives and other professionals confirm that the residents are well looked after. The staff team work well together and show a good understanding of the needs of the people living at the home. The home was good at visiting people before they moved in, to make sure the home could provide the care they needed. The home has an experienced and enthusiastic team of staff who work well together and enjoy taking part in training and development sessions. The staff are motivated and keen to ensure that residents receive high standards of care. Meals and mealtimes were considered to be an important part of the residents’ day. The dining rooms are nice places to sit, eat and meet with other residents. The residents said that they really enjoyed their meals. They were satisfied with the choice of meals and the way they were cooked and served. Cedar House, 47 Smethurst Street, Middleton, M/cr M24 2BA DS0000041209.V298185.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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. Cedar House, 47 Smethurst Street, Middleton, M/cr M24 2BA DS0000041209.V298185.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 Cedar House, 47 Smethurst Street, Middleton, M/cr M24 2BA DS0000041209.V298185.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. Residents have their needs assessed, prior to admission. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home considers the needs assessment for each prospective resident before agreeing admission to the home. One recently admitted resident said he had the opportunity to visit and spend time in the home prior to agreeing to admission. All comment cards received from the residents confirmed that they felt they were asked if they wanted to move to this home, one resident commented that it was closer to his family. All confirmed that they received enough information about this home before moving in so they could decide if it was the right place for them The home has recently reviewed a statement of purpose so that it sets out the objectives and philosophy of the service, and provides good clear information about the home. The guide describes what the prospective resident can expect and gives an account of the quality of the accommodation, qualifications and experience of staff, and how to make a complaint. Clear information about contracts/terms and conditions, is available in a format appropriate to the individual resident, and their family. Residents and relatives said that the staff had spent time with prospective residents to ensure they understand the terms and conditions of the placement. They are regularly reviewed and kept up to date, involving residents, their families and other professionals. Cedar House, 47 Smethurst Street, Middleton, M/cr M24 2BA DS0000041209.V298185.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 adequate Care plans do not always ensure that each person receives the support they need to be healthy, safe and promote good levels of independence and selfworth. Positive and supportive relationships between staff and residents lead to a caring, friendly atmosphere. This judgement has been made using available evidence including a visit to this service. EVIDENCE: At the last inspection an initial improvement was seen in the introduction of a new care plan format and staff had been given guidance on how to write them. The format included a personal profile, assessment of social, leisure, physical and mental health needs and related risk assessments. Staff had not completed the plans sufficiently well to clearly describe residents’ needs and how the home planned to meet them. Preferred daily routines and how much support the individual needed in these areas were not clearly identified. There was no evidence of individual goal planning with residents or use of recognised assessment/management tools. There were no recorded goals and action relating to residents’ involvement in making decisions, going into and Cedar House, 47 Smethurst Street, Middleton, M/cr M24 2BA DS0000041209.V298185.R01.S.doc Version 5.2 Page 10 becoming part of the local community, their leisure needs and development of relationships. Further development of the care planning process is required and how this can be achieved was discussed with the manager and the responsible individuals. Discussion with residents and staff indicated that since the manager started work at the home there had been progress in each of these areas but care plans did not record or clearly monitor progress. These omissions indicated that staff did not have the training, knowledge or skills to assess and understand residents’ need. This also limited the care they could provide. Residents spoken with said that staff are respectful and they had no concerns regarding their privacy. Comments from relatives included “Thank you for all the care and attention you give my sister,” and “the kindness and patience is much appreciated.” Other comments from residents included “Feel comfortable coming out of my room to talk to staff and other residents” and “Always someone around to talk to” Cedar House, 47 Smethurst Street, Middleton, M/cr M24 2BA DS0000041209.V298185.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 adequate Opportunities for integration into community life and leisure activities need to be further expanded so that residents can develop their skills and live more independent and fulfilling lifestyles. The dietary needs of the residents are well catered for with a balanced and varied selection of food available that meets the residents’ preferences, tastes and choices. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staff are seen to support residents in the activities of daily living, which in the case of some individuals is presently fully meeting their needs, but arrangements must be put in place to enable residents to take up opportunities in relation to education and training activities. A programme of meaningful activities, agreed with the individual resident, implemented and supported by the care staff with records kept, is a requirement of this report. Care staff support residents in accessing local facilities for leisure and shopping, according to the assessed needs of the individual. Staff offer Cedar House, 47 Smethurst Street, Middleton, M/cr M24 2BA DS0000041209.V298185.R01.S.doc Version 5.2 Page 12 support to residents in ensuring access to public transport as well as the organised trips to places of interest and enjoyment, suggested by the residents. Residents are encouraged to participate in the political process through the opportunity to vote in local and general elections. Members of the care staff maintain residents’ right to privacy, dignity and respect. Staff members were observed to obtain permission prior to entering the individual’s personal accommodation and used the service users preferred form of address. Freedom of movement for an individual must be identified within the care plan and agreed with the individual following the assessment of risk. Residents informed the inspector that the food is always served in adequate portions. Special diets are catered for. Other residents with special dietary needs such as fat free or diabetic were also catered for. Staff helped residents who required assistance to eat and drink, in a sensitive and dignified way. Cedar House, 47 Smethurst Street, Middleton, M/cr M24 2BA DS0000041209.V298185.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 Health care needs, including medication, are monitored and residents and relatives are confident that the home can meet their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staff were observed encouraging residents to take responsibility for personal hygiene and assisting when necessary. Staff said they accompanied residents on health and social appointments, and encouraged them to participate in activities both in and outside the home. Residents were happy with the approach staff took and observation indicated they enjoyed good relationships with staff. The home has a procedure for managing residents’ prescribed medication and those assessed as fit to self-medicate are accommodated through provision of locked facilities. A member of staff who administers medication said she has attended a college course and holds a certificate in the “safe handling of medicines.” Medication is held in a locked trolley and the keys are held secure when not in use. Medication administration records were satisfactorily maintained other than when these had been handwritten. In instances where Cedar House, 47 Smethurst Street, Middleton, M/cr M24 2BA DS0000041209.V298185.R01.S.doc Version 5.2 Page 14 prescribed drugs are not pre-printed on the pharmacy MAR sheet, the writer should have a colleague check and sign the drug, time, dose and name of the resident for whom the medication is prescribed, to avoid error and risks to residents. Cedar House, 47 Smethurst Street, Middleton, M/cr M24 2BA DS0000041209.V298185.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good The home has a satisfactory complaints system with residents being able to express their views on the home, and these are acted upon. The policies and procedures for the protection of residents are in line with good practice. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The systems for resident consultation are good with a variety of evidence that indicates that residents’ views are sought and acted upon. The home has an adequate complaints procedure with a copy in each person’s Guide. The manager had identified the written complaints procedure and other written documents in the home as needing to be more user-friendly and was currently working with the owners to develop these. All residents comment cards stated that they knew how to make a complaint. The policies and procedures regarding protection of residents are regularly reviewed and updated. The service is clear when incidents need external input and who to refer the incident to. The outcomes from any referral are managed well and issues being resolved to the satisfaction of all involved. Some staff have received Adult Protection training and were able to demonstrate an awareness of the content of the policy and know the immediate action to take, and who to refer to. Feedback from relatives and others associated with the home state that they are satisfied with the service provision, and are confident that residents are safe and well supported by the home which has their protection and safety as a priority. Cedar House, 47 Smethurst Street, Middleton, M/cr M24 2BA DS0000041209.V298185.R01.S.doc Version 5.2 Page 16 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 adequate In the main, the home has made significant improvements to the standard of the environment in the communal areas to provide a more homely and comfortable setting for the residents; further refurbishment is required to be carried out with some redecoration and replacement furniture is still required This judgement has been made using available evidence including a visit to this service. EVIDENCE: Residents made positive comments about the environment. The inspectors were told: “it’s alright, I like it,” “it’s not a bad place to be,” and “I’m quite happy living here.” There had been improvements in consultation with residents regarding room changes. A programme of re-decoration of the personal and communal accommodation had begun in the past year and there was evidence that the home has continued with this. Some personal accommodation has been re decorated and provides residents with a homely and comfortable setting. The home should continue with this programme and provide the Commission for Social Care Inspection with a schedule for completion of the remaining rooms. Many Cedar House, 47 Smethurst Street, Middleton, M/cr M24 2BA DS0000041209.V298185.R01.S.doc Version 5.2 Page 17 bedrooms require replacement furniture. Details of room numbers and schedule of the work to be completed should be included in the action plan. Some replacement toilet seats were identified at the inspection, as was the need to remove paintbrushes and white spirit that was found stored in the laundry area. Cedar House, 47 Smethurst Street, Middleton, M/cr M24 2BA DS0000041209.V298185.R01.S.doc Version 5.2 Page 18 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 adequate Residents feel supported and that their needs are understood and met by the staff group. The home’s recruitment policy is generally robust to protect the residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The selection procedure includes obtaining two written references, a formal interview and an informal interview. All staff had enhanced CRB disclosure checks. Upon appointment staff are issued with a handbook, which includes job descriptions and terms and conditions. Appointments are subject to a sixmonth probationary period. Staff are also issued with the General Social Skills Council’s code of conduct handbook. The manager had introduced an in-house induction. The most recent employee had not completed the programme despite being employed at the home more than 6 weeks The manager was actively trying to recruit but had little response to adverts. Applicants generally did not have training or experience in mental health issues. No new permanent staff have been appointed since the last inspection and Cedar House, 47 Smethurst Street, Middleton, M/cr M24 2BA DS0000041209.V298185.R01.S.doc Version 5.2 Page 19 outstanding shifts are filled by existing or bank staff. Staff were complimentary regarding the support they receive from the manager. Residents interviewed described the staff as “Caring”, “Helpful” “Good company”, “Polite” and “All the members of staff support us and each other in every way”. The majority of staff had attended a basic mental health awareness course, other relevant courses had been identified but places had not been confirmed. Staff said they found the mental health awareness training relevant and helpful. Inspection of records, and discussion with the manager and staff provided evidence that staff received regular, formal supervision which was recorded, agreed and signed. Staff said the manager was supportive and understanding in these sessions but didn’t hesitate to identify poor practice and offer guidance for improvement. Supervision from an experienced mental health worker is available to the manager. Cedar House, 47 Smethurst Street, Middleton, M/cr M24 2BA DS0000041209.V298185.R01.S.doc Version 5.2 Page 20 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 adequate The manager continues to make positive changes but needs further support to ensure the home is well-run. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager was registered with CSCI in April 2006. She has a BTEC in Care Management and had attended NVQ level 2 and level 3 courses. She was undertaking NVQ level 4 and the Registered Manager’s Award at the time of the inspection. Information provided on comment cards and through talking to residents, relatives and staff was very positive as to the changes she had made since her appointment. One relative said “she is a really caring person and has done good things at the home since she became manager”, staff commented that residents got out a lot more and one care manager said that the cleanliness, furnishings, staffing levels and opportunities for client activities had improved. Cedar House, 47 Smethurst Street, Middleton, M/cr M24 2BA DS0000041209.V298185.R01.S.doc Version 5.2 Page 21 The Providers are giving support to the home but must re double their efforts to appoint a deputy to support the manager. Although the Provider visits on a regular basis they must provide a written report to be sent to the Commission for Social Care Inspection (Regulation 26) on a monthly basis. From these reports areas for improvement will be highlighted and the actions taken can be checked at inspection. Cedar House, 47 Smethurst Street, Middleton, M/cr M24 2BA DS0000041209.V298185.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 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 2 33 X 34 3 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 DS0000041209.V298185.R01.S.doc 2 2 X 2 X LIFESTYLES Standard No Score 11 X 12 2 13 2 14 X 15 3 16 3 17 3 Score PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 2 3 X 2 X 2 X X 2 X Version 5.2 Page 23 Cedar House, 47 Smethurst Street, Middleton, M/cr M24 2BA YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA6 Regulation 15 Requirement Care plans must clearly address residents’ needs, goals and action required to achieve them. Any agreed lifestyle restrictions must also be recorded. Following consultation with residents, a programme of activities must be arranged, to include person-centred activities All staff must have Protection of Vulnerable Adult training Timescale for action 30/03/07 2. YA14 16 30/03/07 3. 4. YA23 YA24 18 23 30/03/07 The maintenance and renewal 30/03/07 plan must be amended to include all items identified in the last inspection report, along with projected timescales for each area. A copy must be forwarded to CSCI. Additional ongoing mental health training must be provided for all staff including the manager. Evidence that this training has been booked must be provided to CSCI 30/03/07 5. YA32 18 Cedar House, 47 Smethurst Street, Middleton, M/cr M24 2BA DS0000041209.V298185.R01.S.doc Version 5.2 Page 24 8. YA35 18 Skills for Care common induction training must be completed for every new member of staff within recommended timescales. Provision must be made to support the manager in raising standards at the home, this to include recruitment of a competent deputy. 30/03/07 9. YA37 18 30/03/07 11. YA39 26 The registered provider must undertake monthly visits to Cedar House and send a copy of the visit report to the manager and CSCI. ( 30/03/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard YA20 YA39 Good Practice Recommendations All hand transcribed medications should be witnessed to avoid errors An annual development plan should be written. Cedar House, 47 Smethurst Street, Middleton, M/cr M24 2BA DS0000041209.V298185.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Bolton, Bury, Rochdale and Wigan Office Turton Suite Paragon Business Park Chorley New Road Horwich, Bolton BL6 6HG 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 Cedar House, 47 Smethurst Street, Middleton, M/cr M24 2BA DS0000041209.V298185.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!