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Inspection on 07/11/05 for Coachmans Drive (21)

Also see our care home review for Coachmans Drive (21) for more information

This inspection was carried out on 7th November 2005.

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 5 statutory requirements (actions the home must comply with) as a result of this inspection.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Observations during the visit show that staff are respectful and supportive of the service users. A comfortable, clean and homely environment is provided. Information is available to enable a representative of a service user to make a decision about whether the home is suitable. Service users would be fully assessed before moving to the home. Service users are assisted to make choices about their day-to-day lives. Service users are supported to maintain their relationships with family members. The food provided offers variety and caters for service users tastes and any special dietary needs. The personal support and health needs of service users are met. Service users are supported by the recruitment practices at the home and by the training opportunities provided to staff.

What has improved since the last inspection?

There has been an improvement to the record keeping in accordance with requirements made at the last inspection. Training has been provided to staff to ensure that they have up to date knowledge on health and safety matters.

What the care home could do better:

There are several areas in which improvements need to be made for the benefit of the service users. All care planning documentation relating to the health and safety of service users must be fully documented and subject to a regular review. On reviewing risk assessments each aspect of the assessment that details how a service user is to be safeguarded must be reviewed. Steps need to be taken to ensure that arrangements are made for service users to undertake activities outside of the home on a consistent basis. At present the opportunities for service users to undertake these activities is sometimes being restricted by the staffing levels available. The registered person has not met the requirement made at the last inspection to ensure that an application is made to the Commission for Social Care Inspection with regard to the registering of a manager for the service. This is not satisfactory, as theCommission for Social Care Inspection has not therefore had the opportunity to assess the competence of the acting manager for the position. The way in which the contracts/statement of terms and conditions and financial agreements are drawn up do not fully support service users as relatives/advocates are not always consulted. Service users would benefit from comprehensive information about their communication needs being made available.

CARE HOME ADULTS 18-65 Coachmans Drive (21) 21 Coachmans Drive Croxteth Park Liverpool Merseyside L12 0NX Lead Inspector Beate Roth Unannounced Inspection 7th November 2005 10:30 Coachmans Drive (21) DS0000025240.V265105.R01.S.doc Version 5.0 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 Coachmans Drive (21) DS0000025240.V265105.R01.S.doc Version 5.0 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. Coachmans Drive (21) DS0000025240.V265105.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Coachmans Drive (21) Address 21 Coachmans Drive Croxteth Park Liverpool Merseyside L12 0NX 0151 220 9729 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) Community Integrated Care Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Coachmans Drive (21) DS0000025240.V265105.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 6th June 2005 Brief Description of the Service: 21 Coachmans Drive is registered to provide care for three adults with a learning disability, at present there are only two service users living at the home. Service users have single bedrooms, there is a large lounge that contains a dining area, a bathroom with bathing aids, kitchen and an office. There is a private, enclosed garden to the rear of the home and an open plan front garden and driveway. There is wheelchair access to the property. The home is situated in a quiet residential area in Croxteth Park. The home has a mini bus, there is also a local bus service within walking distance. There are shops, parks, pubs and restaurants in the area. Coachmans Drive (21) DS0000025240.V265105.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over 4 hours. During the inspection time was spent in the office examining records and policies and procedures. A tour of the home was undertaken. Staff were observed delivering care to service users. Staff were spoken with. Following the inspection the acting manager was spoken with. What the service does well: What has improved since the last inspection? What they could do better: There are several areas in which improvements need to be made for the benefit of the service users. All care planning documentation relating to the health and safety of service users must be fully documented and subject to a regular review. On reviewing risk assessments each aspect of the assessment that details how a service user is to be safeguarded must be reviewed. Steps need to be taken to ensure that arrangements are made for service users to undertake activities outside of the home on a consistent basis. At present the opportunities for service users to undertake these activities is sometimes being restricted by the staffing levels available. The registered person has not met the requirement made at the last inspection to ensure that an application is made to the Commission for Social Care Inspection with regard to the registering of a manager for the service. This is not satisfactory, as the Coachmans Drive (21) DS0000025240.V265105.R01.S.doc Version 5.0 Page 6 Commission for Social Care Inspection has not therefore had the opportunity to assess the competence of the acting manager for the position. The way in which the contracts/statement of terms and conditions and financial agreements are drawn up do not fully support service users as relatives/advocates are not always consulted. Service users would benefit from comprehensive information about their communication needs being made available. 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. Coachmans Drive (21) DS0000025240.V265105.R01.S.doc Version 5.0 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 Coachmans Drive (21) DS0000025240.V265105.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3 and 5 Information is available to enable a representative of a service user to make a decision about whether the home is suitable. Service users would be fully assessed before moving to the home and their assessed needs would be met. The way in which the contracts/statement of terms and conditions and financial agreements are drawn up do not fully support service users. EVIDENCE: A service users guide is available. This contains the required information. Consideration could be given to making the guide more suitable to the needs of the service users living at the home. It is acknowledged that the current service users may not benefit from this. No new service users have come to live at the home since the last inspection. Records indicated that prospective service users would have a full assessment, which includes obtaining the views of the service user, relatives and health and social care professionals as appropriate. Prospective service users would be able to visit the home to meet the existing service user and staff and view the home. The records for the existing service users provided little background information on their lives before they came to live at the home. A member of staff reported that this information is recorded but could not locate it. Staff were aware of relevant information about the service users before they came to live at the home. Coachmans Drive (21) DS0000025240.V265105.R01.S.doc Version 5.0 Page 9 The records indicated that consultation with relevant agencies such as community nurses, dieticians, G.P’s and chiropodists takes place. Service users have access to hoists and wheelchairs and specialist equipment. There is information around the communication needs of service user in their care plans. However, it continues to be recommended that this be expanded upon. Work has taken place to address this since the last inspection as communication dictionaries are in the process of being developed. Steps are being taken to ensure that the staff have a qualification in caring for adults with a learning disability. 2 members of staff have an NVQ Level 2 and 2 of the staff are currently undertaking this qualification. At the last inspection it was reported that the service users have a tenancy agreement with Maritime Housing and a contract with Community Integrated Care. The whereabouts of the tenancy agreements/contracts could not be located at this inspection. At the last inspection it was reported that a relative had completed the contract for a service user. Senior staff from Community Integrated Care had signed the contract for the other service user. It was recommended that an advocate be approached regarding the completion of this contract with this service user given that they are not directly linked to the organisation providing the service and can view the contract objectively. It was also reported at the last inspection that the contract asks service users if they agree to paying a contribution towards the cost of the mini bus. The agreement of service users or their representatives was not indicated, although they are both paying a contribution. At this inspection a Consumer Hire Agreement was available. This indicates that the service users agree to pay a weekly cost towards the cost of the mini bus. This is signed by representatives of CIC. A relative or an advocate should be involved in the completion of any agreement relating to the service users contributing to the cost of the home’s minibus, to ensure this is the best use of service users’ money. Coachmans Drive (21) DS0000025240.V265105.R01.S.doc Version 5.0 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 the following standard(s): 6, 7 and 9 In general, care planning reflects the assessed and changing needs of service users. Improvements need to be made to the recording of risk assessments in order to ensure these fully support service users. EVIDENCE: The care plans and essential lifestyle plans were inspected for the two service users living in the home. The information they contained was useful and relevant to their needs. The care plans had been regularly reviewed and updated accordingly. The essential lifestyle plans are in the process of being reviewed, this will include the involvement of family and relevant professionals. The records and a discussion with staff indicated that service users are assisted to make decisions about their lives in accordance with their abilities. Records of service users likes and dislikes and preferences around daily living, such as what time they like to get up and the activities they enjoy ensures service users choices are respected. Further written information around how the service users communicate their needs would also assist in this process. Coachmans Drive (21) DS0000025240.V265105.R01.S.doc Version 5.0 Page 11 A night-time harness is available for a service user. The guidelines for the use of the harness have been drawn up by the occupational therapist, with involvement from the health and safety officer from Community Integrated Care, the service users family and staff. A risk assessment for the use of the harness has been devised and a weekly review of this assessment is being undertaken. The weekly review indicates the continuing need for the harness but does not indicate that the risk assessment is being followed by the acting manager and staff. It was evident from an examination of records that not all aspects of the risk assessment are being followed. Staff are not able to refer to a communication dictionary as it is not complete. A record of the two hourly checks at night-time had not been consistently completed. A record of staff training in the use of the harness and who had provided the training could not be located for all staff. This was discussed with the acting manager following the inspection who agreed to ensure that this is attended to without delay. Risk assessments are carried out for both personal and environmental risks. A sample were seen. It was unclear as to whether these were up to date as they were not dated. The risk assessments for manual handling had not been recently reviewed. A risk assessment for a bed rail that is in use was not available. Coachmans Drive (21) DS0000025240.V265105.R01.S.doc Version 5.0 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 the following standard(s): 11, 15 and 17 Service users do not always have enough opportunities to undertake activities outside of the home. Service users are supported to maintain their relationships with family members. The food provided offers variety and caters for service users tastes and any special dietary needs. EVIDENCE: Neither of the current service users take part in any employment nor do they attend college. However, they are both encouraged to pursue individual hobbies, for example one of the service users likes to go canoeing. Other activities are on offer such as visiting the local sensory room, going to the theatre and helping with household tasks such as shopping. At present the staffing levels are sometimes restricting the opportunities for service users to undertake activities outside the home. There are 3 staff vacancies, which are in general being covered by the existing staff team of 4. This is resulting in two staff being on duty at most times during the day and evening. The service users need two staff each to undertake some activities, which means there would need to be a minimum of three staff on duty for a service user to undertake an activity outside of the home. Coachmans Drive (21) DS0000025240.V265105.R01.S.doc Version 5.0 Page 13 The staff were observed to support service users in a respectful and friendly manner. The staff team were able to show they had a good knowledge and understanding of the service users needs. The records indicate the contact that service users have with family members. The staff interviewed provided information as to how this is facilitated. It was clear from the records and a discussion with staff that contact between the service users and family is actively promoted. The service user plans detail likes and dislikes and any dietary requirements. A record of food provided is maintained and indicated that a variety of different foods are provided. Coachmans Drive (21) DS0000025240.V265105.R01.S.doc Version 5.0 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 and 19 The physical and emotional health needs of service users are met. EVIDENCE: Records indicate how staff are to support the health care needs of service users and that medical interventions are sought as and when necessary. A care plan is available regarding the management of a service user’s epilepsy. This has been amended to include the arrangements at night time when there is only one waking member of staff on duty. Observations indicated that staff promote the dignity of service users. Staff interviewed were aware of the support needs of service users. Records show that service users are supported to attend healthcare appointments and have access to health care services when they are needed. Coachmans Drive (21) DS0000025240.V265105.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 The service users and their representatives could benefit from the home’s complaints procedure being more user friendly. Service users are protected by the adult protection procedures in place at the home. EVIDENCE: The home has a detailed complaints procedure with timescales for action and responses to concerns raised, however this documentation is lengthy and not user friendly. Consideration could be given to making the procedure more suitable to the needs of the service users living at the home. It is acknowledged that the current service users may not benefit from this. Staff spoken with were aware of the complaint procedure and what to do if they are approached with a complaint. No complaints have been made to the Commission for Social Care Inspection about the home since the last inspection. The home has an adult protection procedure and a copy of the Liverpool City Council’s adult protection procedures is also available. A whistle blowing policy is available. The staff interviewed had received training in the adult protection procedure. Coachmans Drive (21) DS0000025240.V265105.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25 and 30 The home is well presented and provides a comfortable and pleasant environment for service users. EVIDENCE: Coachmans Drive (21) DS0000025240.V265105.R01.S.doc Version 5.0 Page 17 A tour of the home indicated that the home is in general, well maintained. The home is comfortably furnished and has a homely, domestic appearance. The bedrooms provided for service users are single, these are adequately sized and enable the service users to be moved around the room in wheelchairs. There is a large lounge/dining room and a bathroom. The bathroom and toilet facilities are adequate, however the appearance of the bathroom was worn and dated and it continues to be recommended that it is refurbished. Bathing aids are provided. The kitchen is a good size and is fully fitted. The washing machine and dryer are housed in a utility room away from the main part of the home. It continues to be recommended that consideration is given to moving the fuse box inside the house to ensure that both service users and staff are safe. At present the staff have to go outside into the garage if the electricity fails to operate the trip switch. This leaves the service users vulnerable at night as there is only one member of staff on duty. All of the communal rooms used by service users are on the ground floor, access to and from the front and back of the house is satisfactory and service users have freedom of movement around the home. The home was clean, odour free and the standard of housekeeping on inspection was very high. Coachmans Drive (21) DS0000025240.V265105.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 and 36 The staffing levels at the home are not fully supporting service users. The recruitment practices and opportunities for staff training support and protect service users. EVIDENCE: The rota for the week of the inspection and for the previous two months were examined. There are 3 staff vacancies, which are in general being covered by the existing staff team of 4. This is resulting in some staff working over 50 hours per week on some occasions. At this inspection there is a record of staff having completed an agreement with their employer to indicate their willingness to work such hours. However, the responsible person needs to ensure that staff working extra hours is not having a negative impact on their ability to undertake their duties effectively. The staff shortage at present is resulting in a minimum staffing level being in operation. Two staff are on duty at most times during the day and evening. A member of staff and the acting manager confirmed that having two staff on duty sometimes restricts the opportunities for service users to undertake activities outside the home. The service users need two staff each to undertake some activities, which means there would need to be a minimum of three staff on duty. The acting manager reported that advertisements have been placed to recruit further staff. Coachmans Drive (21) DS0000025240.V265105.R01.S.doc Version 5.0 Page 19 No new staff have been employed since the last inspection. At the last inspection a requirement was made that all records of recruitment be held at the home and that the records of recruitment must contain all the information detailed in Schedule 4 of The Care Homes Regulations 2001. At this inspection, the recruitment records for the existing staff were examined and indicated that these requirements have been met. Community Integrated care has its own training department which offers a variety of training to staff. Since the last inspection, the records of training have improved. Records indicate that all staff have received health and safety training relevant to their work. Steps are being taken to ensure that the staff have a qualification in caring for adults with a learning disability. Two members of staff have an NVQ Level 2 and 2 of the staff are currently undertaking this qualification. An induction and foundation training is provided to new staff. No staff were undertaking this training at the time of the inspection. The records of supervision and a discussion with the acting manager and staff indicated that supervision has taken place since the last inspection. This is in general occurring every two months. The acting manager has since the last inspection received training around providing supervision. Coachmans Drive (21) DS0000025240.V265105.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 The health and safety procedures and quality assurance systems support service users. EVIDENCE: The acting manager has been in post for 5 months. An application to register the acting manager has not been made to CSCI. The acting manager worked at the home for 16 months as a support worker before taking on the responsibility of the acting manager and prior to this was a senior carer at another residential service. The acting manager has completed an NVQ Level 3. Records show that the acting manager has undertaken training to keep her skills and knowledge up to date. The Service Manager carries out an audit of service users’ health and welfare, accidents, risk assessments both personal and environmental, and staffing levels. A financial audit is conducted once a year by the parent company. There is an annual survey sent out to relatives of service users asking for their views of the home from Head Office. Coachmans Drive (21) DS0000025240.V265105.R01.S.doc Version 5.0 Page 21 The records of fire safety checks were in order and all staff have received up to date training in fire safety. Records of gas and electrical safety were also seen and were in order. There is written information for staff on how to make sure they protect the health, safety and welfare of service users. Certificates of training were available on staff files and indicated that staff have received training in first aid, manual handling and food hygiene. Staff are provided with information around infection control as part of the induction. Coachmans Drive (21) DS0000025240.V265105.R01.S.doc Version 5.0 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 X 2 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 X 1 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 X X X X 3 LIFESTYLES Standard No Score 11 2 12 X 13 X 14 X 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score X 3 2 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Coachmans Drive (21) Score 3 3 X X Standard No 37 38 39 40 41 42 43 Score 1 X 3 X X 3 X DS0000025240.V265105.R01.S.doc Version 5.0 Page 23 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 YA9 Regulation 13 Requirement The registered person must ensure that risk assessments are regularly reviewed. A risk assessment for the use of a bed rail must be documented. The risk assessment around the use of the harness designed specifically for a service user must be followed in order to ensure the safety of the service user concerned. The review of this risk assessment must take into account every aspect in order to protect the safety of the service user. Arrangements must be in place to enable service users to benefit from local, social and community activities in accordance with their interests and wishes. The registered person is required to ensure that sufficient staffing levels are maintained at the home at all times. The registered persons must ensure an application form is forwarded to CSCI with regard to the registering of a manager within the stated timescale. (Previous timescale of 06/07/05 DS0000025240.V265105.R01.S.doc Timescale for action 07/11/05 2 YA9 13 07/11/05 3 YA11 16 07/11/05 4 YA33 18 07/11/05 5 YA37 8 07/12/05 Coachmans Drive (21) Version 5.0 Page 24 not met). 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 YA1 YA3 Good Practice Recommendations The service user guide could be made more suitable to the needs of prospective service users. Further written information around how service users communicate their needs should be made available for staff to ensure that they and future staff can as far as possible communicate effectively with each service user. The registered person should consider the introduction of an independent advocate for the service user who does not have family members to act on their behalf. A relative or an advocate should be involved in the completion of any agreement relating to the service users contributing to the cost of the home’s minibus, to ensure this is the best use of service users’ money. The service users and their representatives could benefit from the homes complaints procedure being more user friendly. It is recommended that consideration is given to moving the fuse box inside the house to ensure that both service users and staff are safe during the night shift. The appearance of the bathroom was worn and dated and it is recommended that it is refurbished in keeping with the rest of the décor at the home. 3. 4 YA5 YA5 5 6 7 YA22 YA24 YA24 Coachmans Drive (21) DS0000025240.V265105.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection Liverpool Satellite Office 3rd Floor Campbell Square 10 Duke Street Liverpool L1 5AS 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 Coachmans Drive (21) DS0000025240.V265105.R01.S.doc Version 5.0 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. 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