CARE HOME ADULTS 18-65
Creative Support 43 Station Road Crumpsall Manchester M8 5EB Lead Inspector
Helen Dempster Key Unannounced Inspection 19th June 2006 2:20 Creative Support DS0000021608.V298834.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Creative Support DS0000021608.V298834.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Creative Support DS0000021608.V298834.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Creative Support Address 43 Station Road Crumpsall Manchester M8 5EB 0161 795 2477 0161 795 2477 sheila@cs-rehab.freeserve.co.uk 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) Creative Support Ltd Sheila Reynolds Newby Care Home 5 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (5) of places Creative Support DS0000021608.V298834.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 29th November 2005 Brief Description of the Service: Station Road is a care home providing 24-hour support and accommodation for up to five (5) people whose support needs relate to their mental health. The service forms part of the North Manchester Rehabilitation Scheme. Creative Support and the Manchester Mental Health and Social Care Trust (MMHSCT) jointly fund the service. The building is owned and maintained by St Vincents Housing Association. The home is situated in the Crumpsall area of North Manchester and is close to transport links, local shops and leisure facilities. The house is on a residential street and is similar in style to other houses in the immediate area. The homes philosophy focuses on empowering people and ensuring that they are proactively involved in the planning to meet their needs. Bedroom accommodation is provided on the first and second floors. All bedrooms are single and are fitted with wash hand basins. The home does not have a passenger lift and access to the first and second floors is via a central staircase. The home is therefore unable to offer a service to people with a high level of impaired mobility. Communal space is provided on the ground floor with two lounges and a large kitchen area. Laundry facilities and a games room are located in the basement. Creative Support DS0000021608.V298834.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was conducted by gathering lots of information about how well the home was meeting the National Minimum Standards. This included the manager filling in a questionnaire about the home, which gave information about the residents, the staff and the building. The inspection also included carrying out an unannounced visit to the home on 19th June 2006 from 2:20pm to 8:30pm. During this visit, lots of information about the way that the home was run was gathered and time was taken in talking with the residents and the staff team about the day-to-day care and what living at the home was like for the residents. Other information was also used to produce this report. This included reports about things and events affecting residents that the home had informed the Commission about. The main focus of the inspection process was to understand how the home was meeting the needs of the residents and how well the staff were themselves supported by the home to make sure that they had the skills, training and support to meet the needs of the residents. What the service does well:
New residents were fully involved in the assessment of their needs and were well informed about how the service could meet their needs. New residents are given a contact as soon as they are admitted to the home, which tells them about the terms and conditions of their stay at the home. Residents were involved in planning their care and were encouraged to make decisions and choices and any risks were assessed with them. The home used a key worker system where named staff would work with residents to plan their care. The residents were aware of who their keyworker was and one of the residents talked about the role of the keyworker and how this supported them. Meetings to review each resident’s needs were held every 3 months at the home. These meetings involved the resident and the health care professionals who supported them. Residents had access to advocates to help them, including professionals at the Zion Centre, who were particularly helpful to black residents. The home had a strong focus on residents being as independent as possible and to develop skills as part of their rehabilitation. One resident said that the staff “try to get people well and move you along”. Residents talked about their
Creative Support DS0000021608.V298834.R01.S.doc Version 5.2 Page 6 involvement in “Tenants Meetings” where they were able to give their views on the running of the home. One resident had recently chaired one of these meetings and found this to be good. Residents talked about having choices about when they got up, what they wore and the food they ate. Residents were encouraged to take part in leisure and community activities. One resident said that the best thing about the home was the “structured activities”. This resident added that the home was “a thousand times better than places I’ve been in before because the planned activities mean that you’re so much more occupied”. This is a strength of the service. Residents had cookery lessons from the occupational therapist based at the home and residents were encouraged and supported to go on holiday. Residents said that they had a key to their bedroom and the front door and could come and go as they pleased. Residents’ concerns and complaints are investigated and the home has the policies, procedures and systems in place to protect people from harm and abuse. Residents were happy with the staff. One resident said that staff are “straight with you” and that residents had “never heard staff falling out with each other”. Staff also described good teamwork and one member of staff said that it was “an incredibly good staff team”. Staff had good access to training and supervision. One member of staff said “I’ve done more training since I’ve been here than I’ve ever done in my life”. One member of staff said that the manager was “very open”, “very honest” and “very knowledgeable” and that the team were “exceptionally well supported”. The home had records of regular safety checks, including fire safety checks, which kept residents safe. What has improved since the last inspection?
The form which the staff use when they are assessing the needs of new residents had been improved since the last inspection to provide more information and to make it easier to use. Since the last inspection, the home had started to use a form called the “Healthy Living Schedule”. This recorded residents’ weight, health care needs and nutritional needs. Creative Support DS0000021608.V298834.R01.S.doc Version 5.2 Page 7 The refurbishment of the bathrooms at the home had almost finished. The need to do this was discussed at the last inspection. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Creative Support DS0000021608.V298834.R01.S.doc Version 5.2 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 Creative Support DS0000021608.V298834.R01.S.doc Version 5.2 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): 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. New residents were fully involved in the detailed assessment of their needs and were well informed about how the service could meet their needs. EVIDENCE: The home had an admissions policy and procedure, which described the process for referrals, assessments and how prospective residents are introduced to the home. The team manager explained that referrals are made by a variety of professionals, including Social Workers and Community Psychiatric Nurses (CPN’s). When the referral is received, a joint assessment is made by the Unit’s NHS Nurses and the Creative Support staff. The format of the “Initial Assessment” had been improved since the last inspection to provide more detailed information and to make it more user friendly. Other assessment documents are also used to provide detailed information about the new resident. These include the Care Programme Approach Assessments (CPA). The assessments covered personal, social, emotional, mental health and general health needs. Creative Support DS0000021608.V298834.R01.S.doc Version 5.2 Page 10 On the day of the inspection site visit, a new resident was admitted. The file for this resident was case tracked. A range of detailed assessments were on the file. The resident had been involved in the assessment and had signed some documents, including a “Licence Agreement” which detailed the terms and conditions of the stay at the home. Being fully involved in the preassessment process, and being well informed of the terms and conditions of stay, ensured that the resident was clear about how the service was able to meet their needs. It was evident that the organisation had encouraged the prospective resident to visit the home prior to making a decision about admission. Staff were seen to support the new resident to settle in at the home. Creative Support DS0000021608.V298834.R01.S.doc Version 5.2 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 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents were involved in planning their care and were encouraged to make decisions and choices within a risk assessment framework. EVIDENCE: Three residents files were case tracked. This involved looking at all the records made about these residents. Two of the 3 residents also spoke at length to the inspector about their experience of living at the home. The home used a key worker system where named staff would work in partnership with residents to develop and review the ongoing Care Plan. The residents were aware of who their keyworker was and one of the residents described in detail the role of the keyworker and how this supported them. Assessments and support and care plans provided details of the residents’ identified goals for personal and healthcare support and for their future housing and occupational goals. Assessments and care plans also included planned interventions and support and what the desired outcome from the
Creative Support DS0000021608.V298834.R01.S.doc Version 5.2 Page 12 support offered was for the resident. Care Plans were being reviewed on an ongoing basis. This included formal reviews of each resident’s needs in the Care Program Approach Clinics held every 3 months at the home, which involved the resident and the health care professionals who supported them. Residents had access to advocates to assist them with aspects of their support. One member of staff said that the home used advocates accessed through the NHS and had found professionals at the Zion Centre to be particularly helpful to black residents. Residents said that the home encouraged them to obtain help and advice by introducing them to relevant agencies, but also encouraged them to talk to people at these agencies independently. Both the residents spoken to said that they had not looked at their files but knew that they could if they wanted to. The home had a strong focus on residents being as independent as possible and to develop skills as part of their rehabilitation. One resident said that the staff “try to get people well and move you along”. Residents talked about their involvement in “Tenants’ Meetings” where they were able to give their views on the running of the home. One resident had recently chaired one of these meeting and found this to be good for personal confidence. Any restrictions on choice were identified through the risk assessment process in partnership with the resident. Residents talked about having choices about when they got up, what they wore and the food they ate. Creative Support DS0000021608.V298834.R01.S.doc Version 5.2 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, 14,15, 16 and 17. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents were encouraged to participate in leisure and community activities and to develop relationships with friends and family. This is a strength of the service. EVIDENCE: Residents living at the home clearly made decisions about the in-house and community based social and leisure activities they wanted to participate in. Residents talked about a wide range of activities that they took part in. This included going to the gym, swimming, playing badminton and going to a cyber café in Manchester City Centre. The level of activities was documented in each individual’s personal files and it was obvious that residents’ choices were respected e.g. when a resident “declined” to go swimming. Residents were also attending courses in pottery, glass painting, gardening and computing.
Creative Support DS0000021608.V298834.R01.S.doc Version 5.2 Page 14 One resident said that the best thing about the home was the “structured activities”. This resident added that the home was “a thousand times better than places I’ve been in before because the planned activities mean that you’re so much more occupied” This resident explained that the benefit of the activities was that it meant that you weren’t thinking about your mental health but were staying busy. A resident described how their “physical health had improved dramatically through going to the gym”. This is clearly very good for the residents and the level of support to attend activities exceeds this standard. One resident talked about having cookery lessons from the occupational therapist based at the home, which included making pastry and sauces. This resident talked about a recent outwood bound holiday in the Lake District, which this resident said was the “best holiday I’ve ever had”. The resident described an initial reluctance to go, but said that staff encouraged but didn’t “force me to go”. The resident said that without this gentle persuasion and support the excellent holiday wouldn’t have happened. There is a games room in the basement at the home and resident’s said that they played pool there. Residents were encouraged and supported to maintain regular contact with their families and friends. Residents said that visitors were welcome to the home but that residents were expected to respect the needs and privacy of the other residents. The daily routines of the home were flexible and based on each individual resident’s needs. There were no set mealtimes as each resident budgeted, shopped for food and cooked their meals when they wanted them. Since the last inspection, the home had started to use the “Healthy Living Schedule”. This documented residents’ weight, physical health care needs and nutritional needs. These had not been completed for all the residents and it was recommended that residents’ nutritional needs are documented in the care plan. Residents said that they had a key to their bedroom and the front door and could come and go as they pleased. They also had lockable cupboards in the kitchen to store their food. Creative Support DS0000021608.V298834.R01.S.doc Version 5.2 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): 18, 19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefited from staff support to maximise independence in day to day living skills. EVIDENCE: The residents at the home did not need personal care. The main aim of the home was to support residents to be as independent as possible. This included cleaning their own room, doing their laundry and cooking their own meals. There was evidence on the residents’ files tracked to show that they had regular access to both specialist and general healthcare services based on their individual needs. Residents confirmed that they were encouraged and supported to take responsibility for their own health needs. Creative Support DS0000021608.V298834.R01.S.doc Version 5.2 Page 16 From looking at care plans and through talking to residents it was seen that the service offered the support and therapeutic input needed to help people to address their mental health needs. Residents benefited from swift access to hospital based services if their mental health deteriorated, because the NHS staff working at the home were able to make direct referrals. All the residents at the home were self-medicating. This had been achieved by a process of the resident managing medication for periods of 2 days with support, then for longer periods, until the resident eventually progressed to collecting their own prescription and self medicating independently. Residents said that they liked being independent with their medication. Records of medication prescribed were held and residents stored their medication in a locked cabinet in their lockable bedrooms. When looking at the medication records for one resident, it was noted that a when required (PRN) medication was in use to counteract the effects of other prescribed medication. Creative Support DS0000021608.V298834.R01.S.doc Version 5.2 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 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ concerns and complaints are investigated and the home has the policies, procedures and systems in place to protect people from harm and abuse. EVIDENCE: Residents said that they could make complaints at the home. The home kept a record of all complaints that included detail of the complaint, the investigation and outcomes. These records were held a hard backed book. This would not allow a complainant to see the record of their complaint without breeching data protection and the confidentiality of others. It also meant that statements, letters etc could not be stored with the record of the complaint. It was recommended that this record be reviewed so that complainants can see all the information about their complaint. The Local Authority’s Protection Of Vulnerable Adults (POVA) procedure was readily available at the home. Staff had received training in the protection of adults from abuse, which was covered in the induction procedure. Creative Support DS0000021608.V298834.R01.S.doc Version 5.2 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 the following standard(s): 24, 27 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ benefited from premises, which was well maintained and clean. EVIDENCE: The premises were clean, well maintained and decorated. At the time of inspection, the bathrooms were being refurbished in response to a requirement made at the last inspection. Residents’ rooms had been personalised. One resident said that this was encouraged, but residents could choose not to display personal effects if they didn’t want to. Residents said that they were encouraged and supported to do their own laundry. There was a domestic washing machine and tumble dryer located in the laundry. Creative Support DS0000021608.V298834.R01.S.doc Version 5.2 Page 19 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, 34 and 35 and 36. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefited from the support of NHS and Creative Support staff that were well trained and supervised and had a good skill mix. EVIDENCE: Creative Support provides a team of staff that includes the registered manager, a senior support worker and 3 support workers. Their role is to provide support to the people who use the service with social, leisure, occupational and current and future housing needs. The Manchester Mental Health and Social care Trust (MMHSCT) provides a team of registered mental health (RMN) nurses and support workers. Their role is to meet the mental health care and day-to-day support needs of the residents. It was seen that the 2 teams work well together to meet residents’ needs. One resident said that staff are “straight with you” and that residents had “never heard staff falling out with each other”. Staff also described good teamwork and one member of staff said that it was “an incredibly good staff team”. Creative Support DS0000021608.V298834.R01.S.doc Version 5.2 Page 20 There was a list of training for individual staff in the files seen, which showed that the staff had access to a range of ‘core’ and specialist training based on the needs of residents. One member of staff said “I’ve done more training since I’ve been here than I’ve ever done in my life”. On the 3 staff files seen, it was evident that staff received regular and frequent supervision from their line manager, which is good for the residents. Although there were details of training on individual files, having an overall audit of training would enable the manager to plan and prioritise training for the team. It was recommended that an audit of training for all the staff at the home was done to aid planning of training at the home and to ensure that all the staff regularly updated training, including mandatory training. The files of 3 members of staff, who had been recruited most recently, were seen. One file did not note the dates of the most recent previous job and did not contain references. Another file contained a reference from a neighbour. The need to check employment histories carefully and ensure that apporopriate references are taken was discussed and a requirement was made. Creative Support DS0000021608.V298834.R01.S.doc Version 5.2 Page 21 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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home had systems and procedures in place, which safeguard and protect residents. EVIDENCE: The manager was not on duty at the time of inspection. Staff spoke highly of the manager and one member of staff said that the manager was “very open”, “very honest” and “very knowledgeable” and that the team were “exceptionally well supported”. There were regular staff meetings held at the home and minutes were taken. Residents’ meetings were also held regularly and minutes of the meetings were taken. These meetings were used as an opportunity to discuss important issues which affect residents and, as noted earlier, residents were encouraged to chair the meetings. Creative Support DS0000021608.V298834.R01.S.doc Version 5.2 Page 22 The home had a quality assurance monitoring system. However, this was corporate and did not include finding out the views of residents at the home and their relatives/friends. The need for the home to develop a quality assurance system, which involved residents and professionals, to audit the service was discussed. This is important, as it would allow the home to take account of the views of residents and their relatives/friends about how the home is run, what is good and what could be improved. A requirement was made about this. The home had records of the regular maintenance and testing of the home’s equipment, including the gas boiler, emergency lighting, the fire alarm and portable electrical appliances. A fire risk assessment was in place and the fire alarm was tested at prescribed intervals. People living at the home and the staff were aware of the procedure to be followed in the event of the fire alarms being activated. Creative Support DS0000021608.V298834.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 x 2 3 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 x 26 x 27 3 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 x 34 2 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 4 15 3 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x 3 x 2 x x 3 x Creative Support DS0000021608.V298834.R01.S.doc Version 5.2 Page 24 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 YA20 Regulation 13 Requirement The home must make sure that the care plan for the administration of “when required” medication, including Propanolol, confirms why the medication is prescribed and in what circumstances this medication is given. Staff files must be audited to ensure that they consistently contain 2 appropriate references and all employment histories must be carefully checked. The home must review and develop their quality assurance system to provide a verifiable method, which involves residents, to audit the service and report on the findings. Timescale for action 24/07/06 2. YA34 18 24/07/06 3. YA39 24 24/08/06 Creative Support DS0000021608.V298834.R01.S.doc Version 5.2 Page 25 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 YA17 YA22 Good Practice Recommendations It is strongly recommended that residents’ nutritional needs are documented in the care plan. It is strongly recommended that the record of complaints is reviewed so that complainants can see all the information about their complaint without breeching the confidentiality of others. It is recommended that an audit of training is done to aid planning of training at the home. 3. YA35 Creative Support DS0000021608.V298834.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection CSCI, Local office 9th Floor Oakland House Talbot Road Manchester M16 0PQ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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