Inspection on 21/10/05 for Cossham Gardens

This inspection was carried out on 21st October 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Cossham Gardens 05/02/08

Cossham Gardens 16/05/06

Cossham Gardens 20/05/05

Cossham Gardens 12/11/04

Cossham Gardens 17/05/04

Similar services:

The Vicarage

7 Hyde Road

5 Seafield Road

Trevaylor Manor

12 Orchard Mews

Stallcombe House

Stepping Stones

Cornerstones

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

CARE HOME ADULTS 18-65 Cossham Gardens Lodge Road Kingswood South Glos BS15 1LE Lead Inspector Andrew Pollard Unannounced Inspection 21st October 2005 09:45 Cossham Gardens DS0000020230.V257285.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 Cossham Gardens DS0000020230.V257285.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. Cossham Gardens DS0000020230.V257285.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Cossham Gardens Address Lodge Road Kingswood South Glos BS15 1LE 0117 9673667 0117 9670849 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) Leonard Cheshire Juliette Nicola Marsden Care Home 16 Category(ies) of Physical disability (16) registration, with number of places Cossham Gardens DS0000020230.V257285.R01.S.doc Version 5.0 Page 4 Cossham Gardens DS0000020230.V257285.R01.S.doc Version 5.0 Page 5 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Staffing Notice dated 29/03/2000 applies Manager must be a RN on parts 1 or 12 of the NMC register May accommodate persons aged 19 years and over only. Date of last inspection 20th May 2005 Brief Description of the Service: Cossham Gardens is registered as a Care Home with nursing for a maximum of 16 residents with profound disability, all of who require nursing care. The Home is situated in Kingswood, behind Cossham Hospital and is set in its own grounds. The home is a purpose built property providing accommodation in 16 single en-suite rooms designed for people with physical disabilities. There is communal and activity space in 5 areas. It has easy access to local community facilities and is less than 1 mile from local shops and services and 4 miles to Bristol city centre. It can be accessed by car, or by bus with a short walk. There are also pleasant gardens to the rear and side of the property. All parts of the home are accessible to wheelchair users as well as the able-bodied. Cossham Gardens DS0000020230.V257285.R01.S.doc Version 5.0 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The following methods of evidence gathering have been used in the production of this report; observation, discussion with residents, staff and relatives a tour of the home and sampling policies, records and care plans. The house was purpose built for disabled people and is generally well designed for the function. It is well furnished and equipped to a high standard. The house is considered a home for life and all physical health care needs would be met including terminal care. The home is an open, well-managed and friendly establishment and has a pleasant relaxed atmosphere. There are a small number of requirements and recommendations set out in this report, which were discussed during the inspection but the standards overall are high. The inspector was only able to verbally communicate with a few residents and spoke with some members of staff. Residents appeared content and well cared for. One relative spoken with was full of praise for the staff and their caring attitude. What the service does well: What has improved since the last inspection? The medication policy has been updated to relate to the new dispensing arrangements. Work is progressing well on carrying out minor repairs and redecoration since the appointment of a maintenance man. Cossham Gardens DS0000020230.V257285.R01.S.doc Version 5.0 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. Cossham Gardens DS0000020230.V257285.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection Cossham Gardens DS0000020230.V257285.R01.S.doc Version 5.0 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 the following standard(s): 1,2,4 Prospective residents or their families have all relevant information to make a decision about the nature of the home. A thorough assessment of prospective residents needs is carried out. Trial visits give prospective residents an opportunity to assess the nature of the home. EVIDENCE: The statement of purpose, inspection report and service user guide are available in the foyer. Residents have been issued with an individual copy of the service user guide. The certificate was in order and on display in the foyer. Some activities, holidays, hairdressing and some toiletries are charged as extra Cossham Gardens DS0000020230.V257285.R01.S.doc Version 5.0 Page 10 according to need. A number of residents pay for private therapists to visit. There are 8 residents and 2 respite care beds funded by and under the care of the local PCT. The remainder are placed by Social Services. Both authorities supply assessment materials prior to any admission. There have been no new admissions since the last inspection other than residents who were formerly on the respite care rota. A full assessment has been completed for a proposed admission in the near future. The manager or other senior first level nursing staff carry out any pre admission assessment, using a comprehensive and holistic pre admission assessment document. Room choice is generally limited to one when a vacancy arises, however the rooms are similar in layout and size. Potential residents are invited to visit the home where possible and are invited for a meal and to meet other residents leading to an overnight stay where practical. Viewings are normally undertaken in the company of a relative or social worker. These visits are arranged for the home to assess if needs can be met and if the home is suitable for the prospective resident and whether they wish to move in. The outcomes of the NHS and Social Services care reviews demonstrate the home’s ability to meet needs. A formal three-month trial is followed by a full review. No emergency admissions are accepted. Cossham Gardens DS0000020230.V257285.R01.S.doc Version 5.0 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 the following standard(s): 6,7,10 The care plans identify needs and give clear directions to staff. Some evaluation dates are missed. Residents or their advocates are consulted with about care matters and decisions about the way the home operates. Risk assessments are clear and detailed. Confidentiality of information is maintained. EVIDENCE: The model of care is based on the activities of daily living and social model of disability. A named Registered Nurse and key worker are responsible for planning and reviewing care for residents. It was accepted that the named nurse system had not been fully effective due staff changes but has now been re-established. Where possible residents or relatives engage with this process and sign consents and care plans. Residents also sign to give consent for staff to discuss service provision and indicate gender preferences of staff giving personal care. Care planning documentation and evaluating of care plans were detailed although not always up to date. However the general standard remains good. Cossham Gardens DS0000020230.V257285.R01.S.doc Version 5.0 Page 12 Of the documents checked a number of review dates had been missed and there was no clear annual reassessment and re-writing process. There are individualised risk assessments in case files Waterlow and Sterling index assessments and risk assessments for moving and handling, falls risk and nutritional risk are carried out. The nature of many of the resident’s disabilities means that meaningful participation in the running of the home is limited by their ability to communicate; therefore relationship building with staff is vital. The involvement of residents in decision-making relies heavily on these relationships and non-verbal communication or recognition of behaviours. Many relatives take an advocacy role on behalf of residents. Formal advocacy services can be accessed if needed. The organisation has Data Protection registration and a copy of the certificate was seen. The home has a confidentiality policy. Case files and records are stored securely. Cossham Gardens DS0000020230.V257285.R01.S.doc Version 5.0 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 the following standard(s): 12,13,15,17 It was evident from the range of social and occupational activities taking place that the staff strive to enhance the quality of life for the residents. Resident’s families are involved and informed of issues related to their relatives. The menus are varied and offer choice and a healthy diet. Appropriate arrangements are in place to support residents with peg feeds. EVIDENCE: There are two adapted vehicles and two cars personally owned by residents. Residents require one to one or two to one support to go out of the home sometimes in the company of staff or relatives. Two residents attend dance voice and eight go to hydrotherapy. An activities organiser and volunteer’s co-ordinator works 35 hours per week, however at present there is only one volunteer. There are in addition two carers are engaged with activities for 23 hours a week jointly. Activities are targeted to individuals and require mostly one to one work. Some group activities are undertaken such as craftwork, cooking and use of computers trips out and holidays. Residents have been on caravan, chalet and foreign holidays. One resident is able to go into the local community independently using an Cossham Gardens DS0000020230.V257285.R01.S.doc Version 5.0 Page 14 electric wheelchair. The home has a well equipped activities and multi-sensory room. Many residents enjoy a foot massage from the aroma therapist. The majority of residents have strong family ties and their relatives are actively involved with the home. The resident’s forum was not operating at the time of inspection but the expectation is this will recommence in the near future. Local clergymen arrange services and attends to residents spiritual needs. There has been a recent Harvest festival service and there are plans for a carol concert at Christmas. There are no residents from other faith backgrounds. The cook has previously carried out a survey of resident likes and dislikes and plans a weekly menu. Daily choices of food are offered at each meal and alternatives are always available. The menu was varied and offered a balanced diet. None of the residents have special cultural dietary needs. Three people are able to feed themselves, the majority needing to be fed. Six residents have peg feeds. A dietician supports the staff and provides advice. All residents have feed programmes. One person requires a mainly vegetarian diet and one a diabetic diet. The home has previously won a good food commendation. The cook has completed the appropriate qualifications to teach basic food hygiene to the staff. Cossham Gardens DS0000020230.V257285.R01.S.doc Version 5.0 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 the following standard(s): 19,20, There are good arrangements in place to provide health care to the residents. Proper and safe procedures are in place to manage store and administer medication. Stock control and disposal arrangements need refining. EVIDENCE: Cossham Gardens DS0000020230.V257285.R01.S.doc Version 5.0 Page 16 Residents previously cared for via an NHS contract are now managed through the local PCT. The house is considered a home for life and all physical health care needs can be met including terminal care. The manager has training and experience in managing terminal care. The doctors at the neighbouring Lodge side practice provide primary care services on rotation. A doctor will visit the home every Tuesday or as required. Where practical some residents will be escorted to the surgery for appointments. All bar one of the residents require staff support to access primary care services. Respite care residents can be registered as temporary residents during their stay. A physiotherapist is employed 19 hours per week. Chiropody, speech therapy, dental and OT services are accessed when needed and domiciliary appointments can be made. Various other staff are working in the home such as private physiotherapists, aroma therapist and OT’s. The manager has previously has clarified lines of accountability and insurance arrangements for these staff all of whom have had CRB checks. Registered Nurses have responsibility for the management of medication. None of the residents are able to self medicate. The home has recently changed its medication system to a monitored dose system. The supplying pharmacist has provided staff training. Proper arrangements have been made for the disposal of unwanted medication, however it is important that disposals are logged and disposed of at the time they are removed from stock and not stored for later logging. There appeared to be excessive stock levels of some medication, which may be the result of the recent change of supplier. A medication policy and procedure and risk assessment systems are in place. The receipt and disposal records were in order. Controlled drugs records and storage arrangements were in order. Temperature recordings for the drug’s fridge are monitored and recorded daily. There are two suction machines, one of which is portable. There are ridged catheters available for these machines. Cossham Gardens DS0000020230.V257285.R01.S.doc Version 5.0 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 the following standard(s): 22,23 The complaint and POVA policies are clear and detailed. The staff are aware of the complaints and POVA policies and are trained in putting them into practice to protect residents from abuse. The record keeping related to petty cash and residents Money held in safekeeping are unsatisfactory. EVIDENCE: There have been no complaints since the last inspection. The complaint procedure is a comprehensive document. The policy makes reference to CSCI as is required. There are alternative simplified and tape formats available for resident use if needed. A detailed log of complaints and their outcomes is kept and full details of complaints, actions and outcomes are recorded. The home has written procedures for adult protection, whistle blowing, management of aggression, abuse and bullying. The staff on duty were unsure if a policy existed for the management, storage and record keeping of residents monies and valuables. One resident had £110 in the drug cupboard with no obvious record as when it was deposited there. Two other amounts of money £16.68 and £3.90 were also in the cupboard, one having no name attached. The main records held with the resident’s money in the safe showed sporadic balance checks three balances were checked, two were correct and one last checked in August was 20p short. There is no single ledger that records how money is transferred within the home. It appears that as the only key holders for the safe do not work at weekends various sums of money are held in the drug cupboard in case required. Some residents build up large balances of cash, which seem excessive. Cossham Gardens DS0000020230.V257285.R01.S.doc Version 5.0 Page 18 A small amount of petty cash was also in the drug cupboard and there was a £5.36 discrepancy between the records and the amount of money. In the main petty cash tin held in the safe there was £16.18 in an envelope with no date or obvious reason to not be accounted for. The home’s POVA statement gives a clear process to be followed. The DOH ‘No Secrets’ document was available and the Local Authority version of the same. All staff have completed POVA update training and it is part of staff induction programmes. The manager has recently completed and trainers course in POVA issues. All staff receive training related to the protection of vulnerable adults and managing difficult behaviour when appropriate. All staff have been issued with the GSCC code of practice. Cossham Gardens DS0000020230.V257285.R01.S.doc Version 5.0 Page 19 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): 24,25,27,28,29,30. The house is a clean, comfortable and safe environment for the current residents. The bedrooms and communal rooms and facilities are suitable for their purpose and meet the resident’s needs. Residents have any specialist equipment they presently require to maintain and promote their independence. EVIDENCE: The house was purpose built for disabled people and is generally well designed for the function. The home is suitably equipped to meet the resident care needs and has sufficient fixed and mobile hoists. A number of new beds and pressure relieving equipment have been acquired. The home is furnished to a high standard. The standard of décor is good and since the appointment of a new handyman the backlog of jobs has been cleared. All residents have single rooms with en-suite facilities. The bedrooms are furnished with good quality equipment that meets the resident’s needs and aids staff in the safe provision of physical care. All rooms have overhead tracking system to facilitate ease of movement between the room and bathroom. Some residents have an electronic door opening system Cossham Gardens DS0000020230.V257285.R01.S.doc Version 5.0 Page 20 and others can be fitted if residents are able to use them. Rooms evidence a great degree of personalisation. All four bathrooms and WC’s are large and suitable for disabled use and have a range of specialist baths and showers. All residents require staff support to use toilet and bathroom facilities. Two of the four separate communal areas are currently used as part dining rooms. There is one activity room and a sensory/multimedia room. The home was clean, tidy and in good order. The laundry facilities are good. The kitchen was clean and in good order. The food hazard analysis has been updated. Cossham Gardens DS0000020230.V257285.R01.S.doc Version 5.0 Page 21 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 The recruitment process is well organised. A small number of staff did not have evidence of a CRB disclosure in the home. The staff are experienced and trained to meet the individual and joint needs of the residents. The staff skill mix and staffing levels are conducive to maintaining and enhancing the resident’s quality of life. The home has a clear commitment to and focuses on training. EVIDENCE: At least eight care staff and one Registered Nurse (RN) works each morning, four plus one in the afternoon and two plus one waking staff at night. The manager is supernumerary. Other RN’s are also given supernumerary time for managing care records and development. These staffing levels are above the minimum levels set in the staffing notice but reflect the high dependency levels of the residents. One regular and one bank RN have recently been recruited which has reduced the demand for bank/ agency staff. All such staff have orientation and induction into the home and consistency of supply is sought. There are various therapists, activities staff and at times volunteers working at the home There is a full and part time cook and 28 hours domestic staff each week. A maintenance man /gardener has been recruited 21 hours per week. At present there are no laundry staff. Training staff and admin staff are also employed. Cossham Gardens DS0000020230.V257285.R01.S.doc Version 5.0 Page 22 Files for recently employed staff evidenced a robust recruitment process and contained all the required documentation. The process for carrying out CRB and POVA checks for staff is carried out by the organisation’s head office, which supplies a list of satisfactory checks received. However there were some files that did not contain such a statement. A number of other files contained photocopied disclosures some of which were from former employers. It was unclear what policy the organisation has for renewals of CRB’s. All new staff completes a detailed orientation and induction programme. The training co-ordinator has completed a training matrix and identified an annual training plan to ensure all staff attend required training. The identification of learning needs is addressed through the appraisal and supervision process. Detailed training records for RN’s clinical updating and NVQ are maintained. RN validations with the Nursing & Midwifery Council had been completed. Cossham Gardens DS0000020230.V257285.R01.S.doc Version 5.0 Page 23 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): 37,42 The staff are motivated to maitain and improve the residents quality of life. The staff seek to empower the residents and safeguard them from hazards. The home is a safe and well-maintained home. EVIDENCE: Cossham Gardens DS0000020230.V257285.R01.S.doc Version 5.0 Page 24 The organisation has a quality monitoring system linked to perfomance indicators A service review was recently conducted,good progress has been made on implimenting the action plan and a formal review was to take place late in October. All residents have contract reviews carried out by Social services, the NHS and multi disciplinary review. The organisation has Health and Safety policies and procedures and employs a Health and Safety Advisor. Ms Marsden has responsibility for health and safety within the home. There is a monthly H&S audit carried out and a quarterly H&S committee meets at the home. The boilers and hoist/bath equipment has been serviced. The fire log book was up to date and in order, training and drills have taken place. The kitchen has been upgraded and re-equipped and new fly screens fitted. A maintenance man works three days per week and the home is in good order. Hot water temperatures are monitored regularly. There is a system in place to manage the risk of legionella. PAT testing is regularly carried out. All staff receive mandatory training in load handling, first aid, fire safety, food hygiene and health and safety. The home has trained first aiders. Food hygiene training for staff is to be provided by the cook. Cossham Gardens DS0000020230.V257285.R01.S.doc Version 5.0 Page 25 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 X 3 X Standard No 22 23 Score 3 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 3 X X 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 X 3 3 3 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score X 3 3 2 3 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Cossham Gardens Score X 3 2 X Standard No 37 38 39 40 41 42 43 Score 3 X X X X 3 X DS0000020230.V257285.R01.S.doc Version 5.0 Page 26 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 23 Regulation 16.2 Schedule 4.9 Schedule 2.7 Requirement Timescale for action 01/11/05 2 34 Develop a procedure to manage and record accurately the safekeeping and use of resident’s money with a clear audit trail. That all staff have evidence of a 31/12/05 satisfactory CRB/POVA disclosure carried out by the employer. That old disclosures are confidentially destroyed. 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 6 Good Practice Recommendations Carry out annual reassessments of residents needs and revise or rewrite the care plan. Ensure all aspects of the plan are reviewed at least 6 monthly and changes recorded. That stock levels are monitored. That all drugs taken out of use are logged and disposed of at that time. Establish regular checking and recording of petty cash resident’s money held for safekeeping. Arrange for the regular audit of these accounts. DS0000020230.V257285.R01.S.doc Version 5.0 Page 27 2 3 20 23 Cossham Gardens 4 34 Determine a policy on renewals of CRB checks. Cossham Gardens DS0000020230.V257285.R01.S.doc Version 5.0 Page 28 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos BS32 4RG 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. 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