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Inspection on 05/05/05 for Corner House Nursing Home

Also see our care home review for Corner House Nursing Home for more information

This inspection was carried out on 5th May 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 but made no statutory requirements on the home.

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

The staff team are committed to the support and care of the service users. One service user was in hospital and staff were taking it in turns to spend time at the hospital to support him. Staff take care with service users` personal care and appearance. Service users all looked clean, had their hair styled and were wearing suitable clothes for their needs and the weather. Service users` health is monitored and care is taken to identify any areas of concern and take appropriate action to remedy.

What has improved since the last inspection?

The acting manager has delegated areas of responsibility to the two deputy managers and team leaders and this has improved staff accountability, motivation and the management of the home. One of the team leaders is responsible for organising training and has made considerable progress with ongoing staff training. The training matrix showed that training was being attended and statutory training was up to date or booked within the next few weeks.

What the care home could do better:

The home needs a registered manager who is committed to developing the home and provide some stability. There needs to be more focus on developing service users` communication. Service users are isolated as they rely so heavily on staff who get to know them and can interpret their behaviour. None of the systems, posters, pictures or notices are adapted for the level of communication needed to make them understood. Communication systems need to be developed that are universally understood, photos, objects, pictures, some signs need to use all methods in combination and routinely in the home. Risk assessments need to be developed in all areas, particularly where individuals are affected by incidents in the home or other service users` behaviour. The range and frequency of activities needs to increase. At present more able service users attend more activities. What needs to happen is that less able service users need to be offered more activities that will probably be different to the ones offered to more able service users. Environment could be more stimulating with interesting things to look at and touch. Parts of the home need redecorating and some of the furniture needs replacing. There needs to be somewhere outside that is safe and has appropriate and interesting space and seating.

CARE HOME ADULTS 18-65 Corner House 116 Cheriton Road Folkestone Kent CT19 5HQ Lead Inspector Julie Sumner Unannounced 5 and 6 May 2005 10:00 th th 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. Corner House H56-H05 S26088 Corner House V223650 050505 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Corner House Address 116 Cheriton Road, Folkestone, Kent CT19 5HQ 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) 01303 258892 01303 258922 Mr William Puxley CRH 19 Category(ies) of LD/PD 19 registration, with number of places Corner House H56-H05 S26088 Corner House V223650 050505 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21/09/04 Brief Description of the Service: Corner House provides care and support to adults with physical and learning disabilities, some of whom also have some health conditions and sensory impairment. It is a large detached home situated in a residential area of Folkestone. The building is in keeping with the local area and is close to the town centre, the leisure centre and parks. Accommodation is on 3 floors, all of which can be reached by a passenger lift. There are 9 single bedrooms, 5 shared bedrooms and 2 with ensuite bathrooms. A conservatory has been built at the front of the building to provide more indoor space for service users. The home has no garden. There is spacious parking and 2 gateways. Corner House is part of a group of homes owned by Counticare that also provide a day service in Folkestone called the Martello. Corner House H56-H05 S26088 Corner House V223650 050505 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Corner House struggles to meet the national minimum standards for younger adults (NMS). This is mainly due to the size of the home restricting the provision of individualised care and inconsistent management. The home has had a turbulent management structure since the original registered manager went on long term sick in April 2002. There has been a succession of managers working in the home with varying degrees of success since and gaps with no manager. The current manager and the previous manager have made some significant improvements but unfortunately due to personal reasons neither have been able to stay in post and another manager needs to be recruited. This has had a detrimental effect on the management and care of service users and has contributed to the home’s lack of progress in meeting NMS. Staff are committed and many are prepared to work additional hours and work in their own time to give service users opportunities to go out. This is commendable but the company needs to ensure that there are enough staff and good arrangements to enable service users to go out more often. The manager explained that the company has recently approved an increase in the staff allocation to the home. Increasing staff per shift from 5 to 6 carers and a nurse team leader. The manager has started to advertise for new staff. Two additional staff are going to start working part time to help with activities during the weekend. Nearly all service users were in the home on the days of the inspection. One service user stayed at home for his review. Some indoor activities, including painting, were being carried out by staff. All service users have communication difficulties. No service users can speak. Most service users communicate their needs by various noises and behaviour. Staff have got to know the service users and can interpret most basic needs. Staff interact with service users and give lots of positive verbal attention. There need to be some systems and aids to develop expression and response to non-verbal communication in the home. The home intends to buy a digital camera and this could be very useful for communication aids. One service user is very noisy both during the day and night and also likes to sit in the doorways and refuses to move. Staff said they are finding this behaviour difficult to manage. The individual assessment indicates that this home has several factors that the service user does not like. However, staff have taken appropriate action and have sought advice from other professionals for support. Corner House H56-H05 S26088 Corner House V223650 050505 Stage 4.doc Version 1.20 Page 6 This unannounced inspection was carried out by Julie Sumner, regulatory inspector, over two days. The following methods of inspection and information gathering were used: discussion with acting manager, one-to-one discussion and group discussion with staff, spending time with service users, observing activity in the home and interaction with service users and reading and discussing: individual support plans, risk assessments, selected policies, statement of purpose, draft service user guide, medication charts, training matrix and tour of the home and grounds. What the service does well: What has improved since the last inspection? The acting manager has delegated areas of responsibility to the two deputy managers and team leaders and this has improved staff accountability, motivation and the management of the home. One of the team leaders is responsible for organising training and has made considerable progress with ongoing staff training. The training matrix showed that training was being attended and statutory training was up to date or booked within the next few weeks. Corner House H56-H05 S26088 Corner House V223650 050505 Stage 4.doc Version 1.20 Page 7 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Corner House H56-H05 S26088 Corner House V223650 050505 Stage 4.doc Version 1.20 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 Corner House H56-H05 S26088 Corner House V223650 050505 Stage 4.doc Version 1.20 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) 1 and 2. The statement of purpose does not reflect actual practice in the home. Assessments made for individuals when deciding to move into the home are not carried out effectively and placements are made without reference to them. EVIDENCE: The statement of purpose contains all elements required in regulation 4 and schedule 1 of the care homes regulations and indicated in standard 1 of the NMS for YA. To prevent unrealistic expectations from service users and their representatives, the description of care and support provided needs to be modified to describe what is actually available to service users in the home and an idea of their likely lifestyle. Placements are usually made by care managers and a company representative with some input by the home manager. A recent placement arranged was causing difficulty to both the individual and other service users in the home. The assessment and information contained in the service user plan indicates that this home may not suitable for the individual. The behaviour displayed also indicates that the service user is not settled. A trial placement is ongoing. The identified needs and what the home can offer do not match. The staff are working to accommodate the individual and other service users with great difficulties. Corner House H56-H05 S26088 Corner House V223650 050505 Stage 4.doc Version 1.20 Page 10 Corner House H56-H05 S26088 Corner House V223650 050505 Stage 4.doc Version 1.20 Page 11 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 and 9 Service user plans do give a clear picture of how a person needs to be supported. Service user plans are not updated quickly enough to reflect changes. Service users’ choice depends on other people having the time to give it to them. EVIDENCE: Service user plans contain some useful information about how individuals need to be supported to maintain their health and wellbeing. Care staff do not usually refer to these to gain information because they are not well organised and some of the information is out of date. Care staff get to know the individual and rely on verbal communication between the team. The nursing staff update the care plan and they will pass information during hand over. This is not a very satisfactory way of communicating individual needs and providing consistent care. Service user plans need to be organised and contain clear information that is easily accessible so that staff are able to refer to them for updated information. Corner House H56-H05 S26088 Corner House V223650 050505 Stage 4.doc Version 1.20 Page 12 Routines like mealtimes and times for getting up and going to bed have been made more changeable and the staff have found out what each person usually prefers. The number of people who live at Corner House and the different difficulties that occur with individual’s health and behaviour makes it difficult to have the time to find out what each person wants everyday. Reports of incidents have been completed with advice and agreement obtained from relevant professionals including the GP. Risk assessments need to be developed to include the effect of individual behaviour and how it is being managed and also its effect on other service users. Corner House H56-H05 S26088 Corner House V223650 050505 Stage 4.doc Version 1.20 Page 13 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) 11,12,13,14 and 16 Service users lead a limited lifestyle overall with little more than basic care being offered. EVIDENCE: Time constraints, staffing levels, number of people living in the home requiring high levels of support with personal care mean that there is little time left for any meaningful activity beyond good quality basic care. Staff spoken to felt very frustrated that they were so limited in what they were able to provide. A day service, The Martello, is offered by the company. One service user attends 5 days a week. Others attend on a rotational basis enabling the majority to attend once a week. The company employs one full time and one part time physiotherapist who support individuals with various exercise and mobility programmes, some of which are carried out in the day centre. Service users are currently offered a short break holiday once a year. The acting manager had had to rearrange the planned holiday this year but 3 Corner House H56-H05 S26088 Corner House V223650 050505 Stage 4.doc Version 1.20 Page 14 service users had been able to go on holiday last month and staff said they had all had an enjoyable time. Staff also explained their observations regarding changes in service users’ behaviour whilst away, commenting on increased skills with eating and more expressive communication. Alternative communication aids like using photos and objects need to be designed and used. For example photos of what is for dinner could be used on the menu. Methods to support speech like “Makaton” signing also need to be developed further. Some service users’ written plan indicated that they could use or responded to some key signs but no signs were observed being used routinely whilst supporting service users. If staff use key signs routinely it has a chance to become meaningful. All visitors would also be able to use the pictorial and signing methods in the home to expand communication to other people who are not staff if these communication systems are set up. Service users are currently not able to freely and safely go outside or access the conservatory. Additional keypad/locks need to be fitted to the front door, so that it can be used, the conservatory door so that can be used by service users and any other door that would be used for access in and out of the home. Corner House H56-H05 S26088 Corner House V223650 050505 Stage 4.doc Version 1.20 Page 15 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 and 21 The home cares for service users’ physical health well. EVIDENCE: Personal support is given in private and staff have got to know service users’ preferences in how they are supported with getting up, washing and getting dressed. All service users looked clean and well dressed. Preferred routines need to be included in the service user plan. One key worker spoke about the care and investigations ongoing and being planned for one individual. The home has a good systematic approach to eliminating possible causes for pain or discomfort that may be being communicated by displays of behaviour not usual in an individual. The community nurse from the Primary Care Trust (PCT) has visited the home recently and has said they can be contacted for support and advice regarding health and medical treatment. Service users see specialists for diabetes, epilepsy, speech and language therapists if there are swallowing difficulties and podiatrist and specialist for adapted foot wear. There are robust medication procedures in place. Staff responded promptly and efficiently when a mistake was made and procedures have been checked Corner House H56-H05 S26088 Corner House V223650 050505 Stage 4.doc Version 1.20 Page 16 and revised. Medication is reviewed regularly with the GP. If medication is needed as a form of restraint this is well documented and all required consent obtained. If individuals become ill advice is obtained from the GP and sometimes this results in service users being admitted into hospital. Staff take it in turns to go to the hospital and help look after service users. An assessment is carried out prior to returning to the home in case additional equipment or different staff skills are needed. The manager knows the limitations of what can be provided by the home and is willing to obtain further training and equipment prior to a service user returning home from hospital. Two staff have attended bereavement training and there are plans for other staff to attend. Service users needs are changing as they are getting older and some service users are developing symptoms of dementia. It is planned for all staff to attend dementia awareness training. Staff spoken to who had already attended said they had found this particularly useful. Corner House H56-H05 S26088 Corner House V223650 050505 Stage 4.doc Version 1.20 Page 17 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) 23 Staff have good knowledge and understanding of adult protection issues which protects service users from abuse. EVIDENCE: The acting manager and staff have a good understanding of the adult protection procedure and whistle blowing policy in the home. Some staff had experienced some involvement with an adult protection investigation and had a positive attitude to the support it had offered as well as resolving issues. The acting manager was comfortable with asking the adult protection coordinator for advice and working together on current difficulties being experienced with regard to one service user. The acting manager recognised what constituted restraint and had sought appropriate advice and consent with regard to one individual who needed to take medication to constrain behaviour. The acting manager and staff demonstrated that they would uphold individual rights if they were being compromised by events. One individual was displaying behaviour that was causing difficulty with other service users and different ways to manage this was being considered with advice from other relevant professionals including the GP. Corner House H56-H05 S26088 Corner House V223650 050505 Stage 4.doc Version 1.20 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, 26, and 28. Not all service users live in an airy, homely and comfortable environment. EVIDENCE: Some redecoration to the home has been carried out. Three bedrooms have been redecorated but one remains unfinished and the builders had been moved to work in another home. The builders need to come back to finish the room. Some new bedroom furniture had been purchased. The redecorated bedrooms need to be personalised. Some of the pictures around the home looked faded and old. The conservatory is not in proper use yet and was being used as wheelchair store. The door into the conservatory needs to be made secure. It was a warm day and there was a lack of ventilation in parts of the home particularly in one bedroom as the only window goes out to the conservatory. It felt very warm in the home. There is no outside area suitable for service users although staff said they have used the front area in the past for activities like ball games. The back and the Corner House H56-H05 S26088 Corner House V223650 050505 Stage 4.doc Version 1.20 Page 19 side of the home is taken up with the fire escape stairway. The main access side of the building is used as a drive and car park for the three vehicles used by the home. The acting manager was very keen to provide a garden area outside and various ideas were discussed. One of the gates needs to be repaired. There was a discussion about moving the clinical waste bins to be more discrete. Specialist equipment has been provided to meet individual needs. After reassessment further and alternative lifting and bathing equipment is needed and the necessary refurbishment and purchases are part of the home’s maintenance and refurbishment plan. The washing machine had broken and the home were using a domestic washing machine whilst waiting for this to be repaired. The home was clean and odour free. Corner House H56-H05 S26088 Corner House V223650 050505 Stage 4.doc Version 1.20 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) 31, 33, and 35. Staff are committed and many are prepared to work additional hours to provide support to service users. Additional competent staff are needed with increased input from other professionals to improve the quality of service users’ lives. EVIDENCE: Staff were clear in their roles. The acting manager had delegated areas of responsibility to each member of staff depending on their role in the home. Staff talked about the key worker role and what they did. The induction training programme has been redesigned to incorporate skills for care (formally TOPSS) guidelines. Two team leaders were attending the training to provide future induction training. Staff were very positive about the training they were attending. They said that service users’ needs were changing as they were getting older and they needed different skills. They said that service users needed more care and support than they had when they first came to live at Corner House. Corner House H56-H05 S26088 Corner House V223650 050505 Stage 4.doc Version 1.20 Page 21 Staff said that there did need to be more staff on shift but that it was difficult to recruit staff that stayed so they did not know how long it would take before there was a real difference in workload. Some staff were very frustrated by the lack of time to carry out meaningful educational/leisure activities. One member of staff said that she had worked in the home several years ago and remembered being able to go out with individuals more often. Staff were aware of makaton and different communication methods and some staff had attended recent training but they needed more support to use it routinely. Other professionals are referred to for advice but it would be beneficial for their input to increase, particularly when staffing levels increase to ensure that the service users’ quality of life is improved. Corner House H56-H05 S26088 Corner House V223650 050505 Stage 4.doc Version 1.20 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) 37,38 and 42 Several changes of manager has affected the service users’ quality of life and has contributed to the lack of progress towards meeting national minimum standards. There is a good training plan resulting in nearly all staff having attended statutory training within required timescales. EVIDENCE: Progress to improve the service users’ quality of life and improve standards has been slow and inconsistent due to changes of manager and gaps with no manager over the last three years. Over this time, the home was managed on a day to day basis with little long term planning for overall improvement. The current acting manager is a nurse who has worked in Corner House for around three years and is familiar to staff and service users. The home has benefited from her management and the previous manager’s input over the last 9 months. Both have had ideas that have been put into practice to improve the quality of life for service users with regard to the care they Corner House H56-H05 S26088 Corner House V223650 050505 Stage 4.doc Version 1.20 Page 23 receive, flexibility of routines, enabling some choice and some improvements to the environment. More recently the current acting manager made a case for increasing the number of care staff each shift and this was approved. Unfortunately the acting manager is unable to stay in this post. The company have put plans for cover into place whilst a new manager is being recruited. The home has provided regulation 37 notices when incidents have occurred and have been open and honest about them. The format and content of the written notifications needs to be improved in line with CSCI guidance. Regulation 26 visits occur monthly by the same person, who is known to the staff team and has had previous experience working in the home. There is a cycle of planned statutory and essential training. The company provides training and some of the courses arranged have been from external training agencies. The training matrix showed that all statutory training is up to date or booked within the next few weeks. This is a great improvement from previous inspections. All new staff have received induction training. The physiotherapist visits the home each week and provides the home with further guidance on moving and handling. Staff wore protective clothing and aprons and head covers in the kitchen. SCORING OF OUTCOMES Corner House H56-H05 S26088 Corner House V223650 050505 Stage 4.doc Version 1.20 Page 24 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. Where there is no score against a standard it has not been looked at during this inspection. 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 2 2 x x x Standard No 22 23 ENVIRONMENT Score x 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 x x x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x 2 x 1 x x Standard No 11 12 13 14 15 16 17 2 2 2 2 x 2 x Standard No 31 32 33 34 35 36 Score 3 x 2 x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 3 3 3 Standard No 37 38 39 40 41 42 43 Score 1 2 x x x 2 x Corner House H56-H05 S26088 Corner House V223650 050505 Stage 4.doc Version 1.20 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 1 Regulation 4(1)(a) 5(1-3) Requirement a) Amend statement of purpose to refect actual practice. b) Complete service user guide and a modified version suitable for service users in the home with communication difficulties. (b) Previous timescale of 30th November 2004 not met) Service user plans need to be organised so that information is accessible and appropriate to maintain continuity of care and support. Remove outdated and irrelevant information and plan reviews to complete updated care plans and risk assessments by timescale. Create risk assessments for disruption caused by one individual to manage and support theirs and other service users welfare. Design risk assessment for arrangements whilst decorating bedrooms. Ensure and make provision for sufficient ventilation and control of temperature in the home to promote a healthy environment. Temporary measures to be in place by first timescale and Timescale for action 30th June 2005 2. 6 15 (1), (2) (b) 30th June 2005 3. 9 12 (1) 10th June 2005 4. 5. 9 24.6, 26.2vii 23 (2)(a)(b) 23(2)(p) 10th June 2005 10th and 30th June 2005 Corner House H56-H05 S26088 Corner House V223650 050505 Stage 4.doc Version 1.20 Page 26 6. 37 10 (1) action plan to be given to CSCI by 2nd timescale. Make appropriate management arrangements to cover the home until a registered manager is recruited. 9th May 2005 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. 3. 4. 5. 6. 7. Refer to Standard 6,7,8 11, 23 11, 27 16, 24 24 32 39 Good Practice Recommendations Design systems and aids to support effective communication between service users and staff, that will also be universally understood. To continue to revise the financial procedures to enable individually accountable expenditure and appropriate participation by more able service users. To continue to ensure service users privacy when bathrooms/toilets are in use. To make the conservatory door secure/lockable. To consider how the home can be organised into clusters of up to ten people. To be implemented by 2007. To continue to work towards 50 of the staff team achieving NVQ level 2 or above (2005). To strengthen the quality assurance process and development plan utilising feedback and information gathered to monitor the effectiveness and care standards in the home. A company business and development plan to be available in the home. 8. 43 Corner House H56-H05 S26088 Corner House V223650 050505 Stage 4.doc Version 1.20 Page 27 Commission for Social Care Inspection 11th Floor, International House Dover Place Ashford Kent TN23 1HU 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 Corner House H56-H05 S26088 Corner House V223650 050505 Stage 4.doc Version 1.20 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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