Inspection on 06/09/05 for Chiswick Care Ltd

This inspection was carried out on 6th September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 but made no statutory requirements on the home.

Other inspections for this house

Chiswick Care Ltd 04/09/07

Chiswick Care Ltd 30/05/06

Chiswick Care Ltd 21/02/06

Chiswick Care Ltd 12/10/04

Chiswick Care Ltd 13/04/04

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 Chiswick Care Ltd 11-13 Chiswick Road London N9 7AN Lead Inspector Rebecca Bauers Unannounced 6 September 2005 @ 10.00 am 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 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 Stationary 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. Chiswick Care Ltd 20050906 Chiswick Care X00023 UN Stage 4 S10618 V212285 G59.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Chiswick Care Ltd Address 11-13 Chiswick Road, London N9 7AN Telephone number Fax number Email 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 8803 8002 Mr Bhooneswur K Luchman & Mrs Reeta Luchman Reeta Luchman PC Care Home only 6 beds Category(ies) of LD Learning Disability registration, with number of places Chiswick Care Ltd 20050906 Chiswick Care X00023 UN Stage 4 S10618 V212285 G59.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. One specified service user who is over 65 years of age may remain accommodated in the home. 2. This condition will remain until such time as the home can no longer meet his needs. Date of last inspection 12 October 2004 Brief Description of the Service: 11-13 Chiswick Road, London, N9 7AN is a care home owned and run by Chiswick Care Limited. The home is located in a residential area of North London with community resources and facilities within close proximity. The home has two bathrooms, a kitchen, a lounge and a large paved garden at the back of the building. Chiswick Care provides support and supervision for 6 Adults with a learning disability and associated mental health problems. Each service user has a single bedroom. The home has obtained a variation to its registration with respect to one service user over 65 years of age. Service users are supported to access community-based facilities such as libraries, swimming pools, cinemas and shops. There is a range of leisure activities provided at the home. In addition to support during the day, the home has one member of staff who is awake at night to respond to the needs of the service users at night. Mrs Reeta Luchman is the registered manager of the home. Chiswick Care Ltd 20050906 Chiswick Care X00023 UN Stage 4 S10618 V212285 G59.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place on the 6th of September 2005 as part of the annual inspection programme to identify progress with previous requirements. In addition, the standards of care were checked against the core standards. The inspection took four and a half hours to complete. A partial tour of the home took place; all six service users were spoken to both on an individual basis and in a group. Care records, quality assurance audits, staff records and health and safety records were examined. Three staff were spoken to. The registered manager was present throughout. Positive comments were given with regard to the care received and the caring, enthusiastic attitude of the staff team to meet the needs of the service users. What the service does well: Service users benefit from fulfilling activities to enhance their lives and meet their aspirations all within the guidelines of measured risk. Service users benefit from the experience of multidisciplinary working to ensure that their personal care, social and emotional health needs are met. The home ensures that service users, relatives and other professional’s views are listened to and addressed to improve service provision. Service users benefit from a well-established staff team who understand their needs and are provided with the support and information to work with service users in a consistent way. The home is well managed and all health and safety checks are carried out to ensure the health, welfare and safety of service users living in the home. Service users say that the staff are very helpful, caring and friendly. All service users said that they felt comfortable in the home and that enjoyed the food. Chiswick Care Ltd 20050906 Chiswick Care X00023 UN Stage 4 S10618 V212285 G59.doc Version 1.40 Page 6 What has improved since the last inspection? Twelve of the eighteen requirements made at the last inspection had been met. All three recommendations had been met. Service users are benefiting from risk assessments that promote their independence. Service users are benefiting from a clear policy and procedure for individual planning and review. Service users are protected by the homes medication policy and procedures. The service users can feel confident that their wishes in the event of terminal illness and death including observation of religious and cultural customs will be respected by staff. Service users can feel confident that the staff are able to identify signs of abuse and are clear with regard to the appropriate reporting procedures. All service users who wish to have a lockable storage space have one. The home now has an up-to-date recruitment policy and procedure in place which is in line with current legislative checks. Service users benefit from being supported by well supervised staff. All staff have received a copy of the General Social Care Councils Code of Conduct (GSCC). Staff rotas are clear and shift planning has enabled consistent planned work with the service users. Service users are protected by the homes workplace risk assessment and all notifiable incidences are reported to the Commission. All policies and procedures have been updated to include the Commissions contact details. Chiswick Care Ltd 20050906 Chiswick Care X00023 UN Stage 4 S10618 V212285 G59.doc Version 1.40 Page 7 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. Chiswick Care Ltd 20050906 Chiswick Care X00023 UN Stage 4 S10618 V212285 G59.doc Version 1.40 Page 8 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 Standards Statutory Requirements Identified During the Inspection Chiswick Care Ltd 20050906 Chiswick Care X00023 UN Stage 4 S10618 V212285 G59.doc Version 1.40 Page 9 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 standard(s) 2,5 Service users can feel confident that their individual needs are assessed prior to admission. Not all service users have an individual written contract or statement of the terms and conditions with the home. EVIDENCE: There has been one new admission since the last inspection. The service users file contained detailed information with regard to assessed needs, support required and aspirations. The service user can feel confident that staff have a good understanding of his needs. Progress had not been made following a requirement made at the last inspection for each service user to have an individual written contract or statement of terms and conditions with the home. Two of the four service users files examined did not contain contracts. This must be rectified to ensure service users have clarity with regard to the terms and conditions of their tenancy and the service that they can expect to receive. Chiswick Care Ltd 20050906 Chiswick Care X00023 UN Stage 4 S10618 V212285 G59.doc Version 1.40 Page 10 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 standard(s) 6,7,9 All service users do not have detailed individual plans that reflect their individual assessed, changing and personal goals, nor are these being reviewed as regularly as they should be. However person centred planning is in the process of being introduced to the service users to promote ownership and a holistic approach to individual planning. Appropriate risk assessments are in place. Decisions and support with regard to finances still need to be documented to protect service users. EVIDENCE: Requirements made for the new risk assessments to be implemented fully with specific actions identified to minimise risk had been progressed. All service users had basic risk assessments in place. More risk assessments were being developed to promote independence and safeguard service users. The requirement made for the financial arrangements, support and tuition provided by staff to individual service users to be documented in their individual plans had not been progressed. This must be prioritised to ensure that service users are protected and supported by staff consistently in the management of their finances. Chiswick Care Ltd 20050906 Chiswick Care X00023 UN Stage 4 S10618 V212285 G59.doc Version 1.40 Page 11 Four service user files were examined three contained individual plans, one did not, some individual plans had not been reviewed since 31/7/04. The evaluation sheets that are in place and state that individual plans will be reviewed three monthly had not in fact been utilised in the way they were intended. This must be rectified to ensure that service users changing needs are reflected in the individual plans. The senior carer advised that the home is in the process of introducing person centred planning to ensure that service users wishes, desires are communicated in a person centred way to promote ownership of the individual plan. This is an example of good practice. Service users confirmed their involvement in multidisciplinary reviews and felt positive about being enabled to express their wishes with regard to their lifestyles. Clear guidelines are in place for managing challenging behaviour, monitoring charts are being utilised to identify triggers and to inform the consultant psychiatrist during frequent meetings. Chiswick Care Ltd 20050906 Chiswick Care X00023 UN Stage 4 S10618 V212285 G59.doc Version 1.40 Page 12 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 standard(s) 11,12,15,16,17 Service users benefit from good access to the local community for college’s daycentres and work. Meaningful activities and holidays are offered and undertaken by service users. Service users benefit from regular contact with family and friends and personal relationships are promoted. There is a feeling of real equality within the home. Service users enjoy the food that they choose and cook. EVIDENCE: Service users have access to local colleges; daycentres and some have jobs within the local community. A recent summer holiday to Bournemouth was thoroughly enjoyed. Service users expressed with excitement the detail of the holiday and how much they would have liked to have stayed there. Service users see family and friends regularly and some have developed close personal relationships, support around these relationships had been documented in the individual plans. Chiswick Care Ltd 20050906 Chiswick Care X00023 UN Stage 4 S10618 V212285 G59.doc Version 1.40 Page 13 Staff were observed positively interacting with service users and engaging in meaningful conversations. There is a genuine feeling of fun in the home. Staff and service users were seen laughing and joking equally with each other. The home has clear and agreed rules on smoking in the home, which are adhered to and were observed on the day of the inspection. Service users have free access to the kitchen and take it in turns to cook for each other throughout the week. Menus are decided upon as a group and the shopping is done weekly by service users with some staff support. Culturally specific foods are purchased routinely. Chiswick Care Ltd 20050906 Chiswick Care X00023 UN Stage 4 S10618 V212285 G59.doc Version 1.40 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 standard(s) 18,19,20,21 Service users preferences for personal care are documented and adhered to by staff. Emotional health needs are being met although it is not clear that all physical health needs are being met as the outcomes are rarely being recorded or monitored. Service users are now being protected by the homes medication policies and procedures although specific PRN guidelines for managing challenging behaviour are not in place to safeguard service users. Information is now available to ensure that ageing, illness and death of a service user is handled with respect and in accordance with their wishes. EVIDENCE: Service users receive personal care in the way that they prefer and this had been documented in their individual plans. Service users emotional health needs are being met through multidisciplinary input from psychologists and psychiatrists. Regular health checks from GP’s, dentists and opticians are taking place and had been listed in the individual files however the requirement for these appointments and the outcomes to be documented in the service users files had not been fully progressed. In some cases only one appointment out of five appointments case tracked had documented outcomes in the service users files. Records were sporadic and need to be worked on to ensure all relevant information is held on file with regard to service users physical health needs. Chiswick Care Ltd 20050906 Chiswick Care X00023 UN Stage 4 S10618 V212285 G59.doc Version 1.40 Page 15 A requirement made for issues of sexuality to be detailed in the service user individual plans had not been progressed. This must be rectified, as it is essential if a holistic view of the individual is to be obtained using a person centred approach. A requirement made for the medication administration records to be signed immediately after administration of medication to each service user had been fully progressed. The medication records were examined for all six service users and found to be complete with no gaps. Staff are competent in following the homes medication policy and procedures to safeguard service users. Some service users have PRN rectal diazepam for which staff have been appropriately trained; there are clear agreed written guidelines in place. Other service users are prescribed PRN medication to help to manage challenging behaviour. There were no guidelines in place to state when this should be administered. This must be rectified to ensure there is no over administration of PRN to safeguard the service users. The details of service users wishes in the event of terminal illness and death including observation of religious and cultural customs have now been recorded in their individual plans of care. Chiswick Care Ltd 20050906 Chiswick Care X00023 UN Stage 4 S10618 V212285 G59.doc Version 1.40 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 standard(s) 22,23 Service users benefit from good accessible systems within the home to ensure that their views are listened to and acted upon. Staff are well equipped through recent training and the homes adult protection policies to safeguard service users from potential abuse. EVIDENCE: A requirement made for the homes adult protection procedures to include clear guidance and a reporting procedure for staff to follow in the event of an allegation of abuse being made had been fully progressed. Staff spoken to were knowledgeable with regard to who to report to and what information must be documented using the appropriate local authority alerter’s form. The senior support worker informed the inspector that during a recent staff meeting all staff had been given a copy of the homes adult protection policy and reporting procedures. Guidance with regard to POVA had also been disseminated to staff to ensure that staff are up-to-date with current legislation and that they feel confident in the identification of abuse and reporting to protect service users. Risk assessments are in place for those service users who are deemed at risk of self–harm. Service users spoken to do feel that their views are listened to and acted upon. Service users said that they have opportunities to discuss issues during resident meetings and on a daily basis with staff. Service users file also contained completed quality assurance forms which asked questions with Chiswick Care Ltd 20050906 Chiswick Care X00023 UN Stage 4 S10618 V212285 G59.doc Version 1.40 Page 17 regard to the service they receive from the care staff. There had been no complaints since the last inspection. Chiswick Care Ltd 20050906 Chiswick Care X00023 UN Stage 4 S10618 V212285 G59.doc Version 1.40 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 standard(s) 24,30 Service users live in a generally homely, comfortable and safe environment. Decorating the communal areas will make the home more homely for service users. The home was clean and hygienic. EVIDENCE: A requirement made at the last inspection for service users to be consulted in respect of their wishes to have lockable storage space in their bedrooms had been fully progressed. Service users had either chosen a lockable tin or a lockable cabinet for their possessions. Service users bedrooms seen were decorated satisfactorily except for one service users bedroom who explained that his bed and chair were broken and needed replacing. The bedroom also needs redecorating. This must be rectified to ensure the comfort of the service user. It was recognised that redecoration is an ongoing issue for the service user. Communal areas also require decorating for example the hallway, lounge and stairway. The tiles in the upstairs toilet are cracked and need replacing. Another service users bedroom door was propped open because the service user prefers to keep the bedroom door open. For health and safety reasons a Chiswick Care Ltd 20050906 Chiswick Care X00023 UN Stage 4 S10618 V212285 G59.doc Version 1.40 Page 19 self -closing door device must be fitted to ensure that if there was a fire the door would close automatically. The home is clean and hygienic. Chiswick Care Ltd 20050906 Chiswick Care X00023 UN Stage 4 S10618 V212285 G59.doc Version 1.40 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 34,35,36 Service users are supported by an effective and competent staff team although statutory training needs updating. Service users benefit from a well supervised staff team who work consistently to support the service users. Service users are not protected by the homes recruitment procedures. EVIDENCE: A requirement made at the last inspection for the personnel records to contain proof of identity including a recent photograph, two written references and a statement by the person with regard to his/her mental health had been partially complied with. Four staff files were examined, two files did not contain references and three files did not contain current I.D. Some files did not contain completed induction and foundation nor contracts of employment. All these documents must be held on file to ensure the safety of service users. Training records did not demonstrate that staff had received all statutory training this must be rectified to ensure that the service users needs and welfare are being met by competent staff. Four staff have completed NVQ level 3 and three staff are currently undertaking NVQ level 3. The senior support worker is currently undertaking NVQ level 4. The requirement made for the homes recruitment policy and procedure to include a statement that clearly states than an enhanced CRB and POVA check Chiswick Care Ltd 20050906 Chiswick Care X00023 UN Stage 4 S10618 V212285 G59.doc Version 1.40 Page 21 must be undertaken prior to employment in the home had been fully progressed. The homes recruitment policy and procedure was satisfactory for the protection of service users although this must be adhered to in the recruitment of staff. Staff files contained evidence of regular supervision to ensure continuity in care practice for service users. All staff have been given a copy of the general social care council’s code of conduct as per the recommendation made at the last inspection. The staff rota was seen and reflected the current staff on duty at the time of inspection. The rota had been revised to ensure clarity of staff on duty and the responsible person on duty. The home now has a shift plan in place. Staff stated that the shifts were more organised and tasks are delegated equally. Staff personnel files were a little disorganised, it would be beneficial if these could be organised to ease access to information. Chiswick Care Ltd 20050906 Chiswick Care X00023 UN Stage 4 S10618 V212285 G59.doc Version 1.40 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 38,39,40,42 Service users benefit from an open management style. Service users are confident that their views underpin all self-monitoring and the health and safety of service users is generally well protected. Fire risk assessments and emergency plans are not in place. To safeguard service users and staff. EVIDENCE: The registered manager has completed the registered managers award and assessors course and is near to completing NVQ level 4 in care. Staff stated that the registered manager is approachable and supportive. A requirement made for the results from a quality assurance survey to be summarised had not been progressed. This must be rectified. The homes workplace risk assessment is now complete and includes clear actions to minimise risk. Some of the recommendations to minimise risk must be acted upon to safeguard service users and staff. A fire risk assessment and emergency plan must be developed. Chiswick Care Ltd 20050906 Chiswick Care X00023 UN Stage 4 S10618 V212285 G59.doc Version 1.40 Page 23 A requirement made for staff to receive fire training and first aid had not been progressed. This must be rectified as a priority to ensure the safety of service users in the event of a fire and if first aid needed to be carried out. The registered person is now notifying the Commission of all notifiable incidents. The water risk assessment had been completed and all checks to safeguard service users had been completed and recorded. Chiswick Care Ltd 20050906 Chiswick Care X00023 UN Stage 4 S10618 V212285 G59.doc Version 1.40 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x x 2 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 2 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x x 3 Standard No 11 12 13 14 15 16 17 3 3 x x 3 3 3 Standard No 31 32 33 34 35 36 Score x x x 2 2 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Chiswick Care Ltd Score 3 2 2 3 Standard No 37 38 39 40 41 42 43 Score x 3 3 3 x 2 x 20050906 Chiswick Care X00023 UN Stage 4 S10618 V212285 G59.doc Version 1.40 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 5 Regulation 5(1)(b) Requirement Timescale for action 31/10/05 2. 7 17(1)(a) Schedule 3 (3)(q) 3. 19 13(1)(b) 17(1)(a) The registered person must ensure that the contract or terms and conditions between the home and the service users are fully completed to include the weekly fees charged and the room to be occupied. This requirement is restated from the last inspection. The timescale for action was 1/12/04. The registered person must 31/10/05 ensure that the financial arrangements, support and tuition provided by staff to individual service users are documented in their care plan and reviewed six monthly. This requirement is restated from the last inspection. The timescale for action was 1/12/04. The registered person must 1/10/05 ensure that all service users have as a minimum, annual health checks with their GP, optician and dentist. An up-todate record of all health care appointments must be held in the service users file, which includes outcomes and actions of appointments. This requirement is restated from the last Version 1.40 Chiswick Care Ltd 20050906 Chiswick Care X00023 UN Stage 4 S10618 V212285 G59.doc Page 26 4. 19 12 (1)(a) 5. 34 7,9,19 6. 36 24(2) 7. 42 23(4)(d) 13(4)(c ) inspection. Timescale for action was 1/12/04 The registered person must ensure that issues of sexuality are detailed and completed in the relevant section of service user files. This must include specific risks related to the individual. This requirement is restated from the last inspection. Timescale for action was 1/12/04. The registered person must ensure that staff personnel files contain the following documents as stipulated in schedule 2 of the Care Homes Regulations 2001 (amended 9/7/04):· Proof of identity including a recent photograph.· Two written references, with at least one relating to the persons last period of employment, which involved working with vulnerable adults, of not less than 3 months. Terms and conditions of emplolyment. This requirement is amended and restated from the last inspection. Timescale for action was 1/12/04 The registered person must ensure that the results from quality assurance surveys involving service users and family members are summarised and made available to interested parties including prospective service users, CSCI, placing authorities. This requirement is restated from the last inspection. Timescale for action was 1/2/05. The registered person must ensure that all staff receive annual fire training and first aid training. Copies of certificates must be available for inspection. This requirement is restated from the last inspection. 31/10/05 1/10/05 30/11/05 1/12/05 Chiswick Care Ltd 20050906 Chiswick Care X00023 UN Stage 4 S10618 V212285 G59.doc Version 1.40 Page 27 Timescale for action was 1/3/05. 8. 6 15(1)(2)( b) The registered person must ensure that all service users have a detailed individual plan in place based on their assessed needs. These must be reviewed at least every six months. The registered person must ensure that guidelines are in place for the administration of PRN medication for specific individuals. The guidelines should be agreed by the consultant psychiatrist. The registered person must ensure that the maintenance issues listed under this standard are rectifIed. The registered person must ensure that all staff receive all statutory training on an annual basis. This includes infection control, manual handling and lifting and food hygiene. The registered person must ensure that records of induction and foundation training are held on staff files. The registered person must ensure that the identified actions to minimise risks highlighted in the work place risk assessment are addressed. The home must also have in place a fire risk assessment and emergency plan. 31/10/05 9. 20 13(2) 31/10/05 10. 24 23(2)(d) 31/1/06 11. 35 18(1) 31/1/06 12. 35 18(1) 31/1/06 13. 42 23(4) 13(4)(c ) 31/12/05 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 34 Good Practice Recommendations It is recommended that the registered person organise the personnel files so that information is more easily accessible. 20050906 Chiswick Care X00023 UN Stage 4 S10618 V212285 G59.doc Version 1.40 Page 28 Chiswick Care Ltd Chiswick Care Ltd 20050906 Chiswick Care X00023 UN Stage 4 S10618 V212285 G59.doc Version 1.40 Page 29 Commission for Social Care Inspection Solar House 1st Floor, 282 Chase Road Southgate London N14 6HA 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 Chiswick Care Ltd 20050906 Chiswick Care X00023 UN Stage 4 S10618 V212285 G59.doc Version 1.40 Page 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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