Inspection on 21/06/06 for Cressage House

This inspection was carried out on 21st June 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Cressage House 08/07/08

Cressage House 20/02/08

Cressage House 20/06/07

Cressage House 06/10/05

Cressage House 14/04/05

Similar services:

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

Pinta

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

CARE HOME ADULTS 18-65 Cressage House 30 St Edward`s Road Southsea Hampshire PO5 3DJ Lead Inspector Mr Richard Slimm Unannounced Inspection 21st June 2006 09:30 Cressage House DS0000062441.V301676.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 Cressage House DS0000062441.V301676.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. Cressage House DS0000062441.V301676.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cressage House Address 30 St Edward`s Road Southsea Hampshire PO5 3DJ 023 9282 1486 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) Mrs Susan Ann Walker Mrs Ann Grace Care Home 13 Category(ies) of Learning disability (13), Learning disability over registration, with number 65 years of age (13), Mental disorder, excluding of places learning disability or dementia (13), Mental Disorder, excluding learning disability or dementia - over 65 years of age (13) Cressage House DS0000062441.V301676.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. All service users in the category LD(E) and MD(E) only to be admitted with a dual diagnosis. Service users in the above categories not to be admitted under 40 years of age. 6th October 2005 Date of last inspection Brief Description of the Service: Cressage House is a small care home situated in a residential area of Southsea, Portsmouth. The home is registered for thirteen service users within the category of younger adults, however, the home also accommodates two service users within the older persons category as they have lived at the home for many years. The home is situated close to local amenities and a short distance from the town of Portsmouth. The home has a minibus and as such service users are able to access venues and activities outside of the home and local area. The home provides a range of accommodation in single and double bedrooms, with a high number of shared rooms currently. On the ground floor is a lounge, dining room and a smokers room. The home also has a domestic kitchen, accessible via a number of steps, and service users may access the kitchen to prepare snacks and drinks as they choose. The home has an enclosed rear enclosed garden that is accessible to service users. There is a large office to the front of the home on the ground floor. The current charge is £378.78 per week. Cressage House DS0000062441.V301676.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This site inspection was unannounced and was part of the inspection process since the last site visit and report; which took place on the 2nd February 2006. This visit took place between the hours of 9:30 am and 6 pm. The evidence used to inform judgements in this report included; documentation, records, service history, telephone interviews, and other contact with stakeholders from outside of the service, interviews with service users and the registered manager, including a case tracking exercise, observations during the visit and the last inspection report. The manager of the home, the owner, one staff member and 12 of the current service users assisted the inspector during the site visit, plus a visitor. The inspector interviewed the manager and owner, and the staff member privately. In addition the inspector spoke to the service users case tracked individually. A tour of the premises was made and a sample of policies and procedures, documentation and case records was inspected. The statement of purpose and service user guide was also used to inform the inspection process, as was the pre-inspection information provided by the home. What the service does well: What has improved since the last inspection? There has been a lot of much needed investment to the fabric of the home, improving the facilities, décor, maintenance and the general hygiene in the home. This has also included the upgrading of the fire alarm/detection system. Service users feel more included in the running of their home and more valued by the way they are treated. There had been some development in assessment, risk assessment and care planning systems and these developments are ongoing, and will be monitored during future site inspection visits. Residents felt more consulted and appreciated the regular group meetings. Residents explained that there were more freedoms at their home and they could make more choices about their day-to-day lives. Two residents who have had to share a bedroom historically are to be enabled to move into single rooms. The site of the laundry has been moved away from the food preparation area of the home. New facilities have been provided at the home, Cressage House DS0000062441.V301676.R01.S.doc Version 5.2 Page 6 and all of the communal toilet/shower/bathrooms have been upgraded to provide valuing clean bright facilities. The kitchen area has also been re-fitted and residents now have access to this area if they wish. One resident is being supported to learn to cook in his own kitchen, with support from external staff and his key worker. 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. Cressage House DS0000062441.V301676.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Cressage House DS0000062441.V301676.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 All service users are assessed prior to admission, in order to establish their needs and wishes. The home is improving the manner in which residents’ needs are met. Pre-admission information needs to be more user friendly. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. EVIDENCE: This service was taken over as a poor provision with many developmental and general improvement needs. The new owner has started the process of improvments and is prioritising well. The CSCI accept that bringing this service up to the necessary standards is going to take time and expenditure. Much needed to be done to improve the environment and organisation of the home, to bring the service up to standard, and these improvments are ongoing. The resident group have been fairly static and over the years practices at the home were historically very institutionalised and residents consequently very compliant to this and other forms of restriction. The home has developed a modern statement of purpose that states the intention for residents to be supported to learn new skills and enabled to unlearn many things that have been foisted upon them over the years. Most of the service user come from institutional settings prior to admission, some have lived at the home for decades, and came there from long stay hospitals. The previous inspector noted that over three visits the service was begining to improve, and there was Cressage House DS0000062441.V301676.R01.S.doc Version 5.2 Page 9 evidence of this continuing. All residents are publicly funded and were assessed by their funding agencies prior to admission. The home are developing updated forms of assessments, and have introduce improved risk assessments since the last inspection. There is a need to introduce user friendly formats to ensure that the contents of pre-admission information anf the service user guide is fully understood by potential residents, in order to enable them to make informed choices and decisions about moving into the home. Cressage House DS0000062441.V301676.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6-7-9 Service users healthcare, personal and social care needs are assessed and identified in a plan of care. Residents feel they are treated with dignity and respect, and that the service has begun to promote independence since taken over by the new owner. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users spoken to stated that the quality of care and support provided at the home had improved significantly. One resident stated that he now felt that he was treated as a human being. Each resident has a plan of care. Service user plans are currently fairly basic and do not include all identified needs and wishes. There has been a history of weakness in record keeping and care planning at the home, and the manager is in the process of introducing an imporved system of assessment, monitoring and review that will be person centred in line with current best practice. Plans did take account of personal and healthcare needs and wishes and action is taken to provide support where needed, and to arrange exteranl support. Cressage House DS0000062441.V301676.R01.S.doc Version 5.2 Page 11 Service users are consulted about their lives and the running of the home. Service users are able to take risks, and risk taking is now more supported by suitable assessments and documented risk assessments. Some residents have enduring mental health care needs and are supported by the local community mental health care team. Two residents have a dual diagnosis and they are supported to attend a local day service for people with learning difficulties. Residents interviewed said that they were treated well now, and that staff treat them with both dignity and respect. Cressage House DS0000062441.V301676.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12-13-15-16-17 Service users’ lifestyle experiences have improved and continue to improve at the home. Relationships and contact with friends and families is supported whenever possible. Service users are beginning to exercise increased choice and control over their daily lives. Service user rights are being promoted and protected. Service users are provided with a good balanced diet that they enjoy. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Residents said they are actively encouraged and enabled to gain educational opportunities and some residents attend local colleges. Two service users have jobs outside of the home. Another resident explained that he enjoys staying busy and occupied and gets involved in a variety of tasks around the home, but stressed that he decides what and when he does things these days. Other residents are supported to attend local day services and some of the day service sessions enable a resident to be supported to learn independence skills in his own home. Resident care plans and interviews confirmed that key Cressage House DS0000062441.V301676.R01.S.doc Version 5.2 Page 13 workers are enabling residents to pursue personal interests and to make choices in their daily lives. There was evidence that residents’ are encouraged and where needed supported to access the local community safely. This includes both the safety of service user concerned and the local community. Residents’ are encouaged and supported to maintain and develop functional relationships. Links with families, when available, are encouraged and freedom of choice and diversity is acknowledged at the home. The inspector met one visitor to the home at the time of the site visit. The inspector contacted external professionals and a number of comments were very possitive about the changes that had been noted at the home, since the new owner took over. Residents’ stated that the quality of food had imporved since the new owner took over. Residents’ now have access to their kitchen when they wish and KeyWorkers’ are supporting residents’ to get involved in developing skills in the kitchen area on a planned basis, as well as residents’ being supported in their own home by day service staff. There were a number of routines at the home that the owner explained had been inherited from the previous arrangements. The residents still choose to come down at 10.30 to the communal dining area for tea and coffee, even though they can now make their own drinks when they wish. At the lunch time meal the whole meal which included the main course and the dessert, as well as a drink was all served together, with little or no consultation with each individual resident being served. This in addition to the current manner medications are distributed from the office did give the impression of rather an institutionalised feel. However, it should be noted that residents were quite happy with these arrangements. Cressage House DS0000062441.V301676.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18-19-20 Residents’ personal and health care needs are met. Residents were happy with the arrangements for meeting their needs and the administration of their personal medications at the home, and these arrangements were safe. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Residents confirmed that their health care needs are met. Where residents need support with personal care they are consulted. Residents said the home felt more relaxed, and there was an incresed amount of freedom now. Each resident has a key worker and residents were aware of who their key worker was and all residents said they were happy with their key workers. Residents confirmed that they felt more valued and the staff work hard to meet their physical and emotional needs. Arrangements for the storage, administration and recording/disposal of medication were found to be satisfactory. Residents said they were happy with arrangements for their medications. Some residents receive their medications exteranlly to the home due to their specialist needs. Cressage House DS0000062441.V301676.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22-23 New and existing residents, and/or their relatives/advocates are given written information about the services complaints procedure. Some residents may not fully understand this information. Residents feel safe and confident enough to share their concerns with staff/management. The home adopts strategies that promote the protection of vulnerable adults. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There had been no complaints since the last inspection. Residents spoken to confirmed that they felt confident enough to speak to the new owner, the manager or their key worker if they had any concerns. The statement of purpose and the service user guide contains a written copy of the complaints procedure. The service may need to provide additional media in order to ensure residents with poor literacy skills are aware of how to make a formal complaint. The home has copies of the local authority adult protection procedures. The staff member interviewed was able to demonstrate an understanding of adult protection procedures. The home’s management had dealt with an adult protection matter in 2005, and there was evidence they had acted appropriately and put the welfare of service users first. Cressage House DS0000062441.V301676.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24-25-30 There have been many improvements to the physical environment since the new owner took over the ownership of the home. Much of the focus on improvements has been around safety and hygiene. The homeliness and comfort of the home has improved. Many communal areas have benefited from redecoration, and there are plans now to replace worn and damaged carpets. The home provides a high proportion of shared bedrooms. The home was cleaned to a good standard at the time of the unannounced site visit. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Since taking over the home the new owner has completely refurbished the kitchen area. The laundry area has been re-sited away from the food preparation area to reduce the risk of cross infection. All communal toilet, showers and bathrooms have benefited from refurbishment, providing valuing facilities for residents. Residents spoken to stated they felt prouder of their home now and that the environment was improving. The owner has replaced the fire alarm system with an up to date type as recommended by the chief fire officer. Cressage House DS0000062441.V301676.R01.S.doc Version 5.2 Page 17 Residents spoken to said they felt safe living at the home, and confirmed that they had been consulted about recent decorations and new carpets being provided at their home. The home provides a high proportion of shared bedrooms, and some residents sharing rooms stated that they would prefer a single bedroom. Other residents sharing bedrooms were found to be quite happy with these arrangements. Two residents were looking forward to being moved to single rooms, and one of these residents had never had a single bedroom before and was looking forward to the increased privacy this would afford him. Some areas of the home may, following alterations, potentially provide increased numbers of single bedrooms. The new owner said she would be looking into the feasibility of making structural changes to the home, and how rooms are currently configured. The home was cleaned to a good standard, and residents said the home was much cleaner these days. There was evidence of a commitment from the owner and manager to the steady improvement to the maintenance and upkeep of the environment, and a clear understanding that there is still more to do. Cressage House DS0000062441.V301676.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32-34-35 Fifty percent of staff members are not trained to the appropriate benchmark of NVQ 2. All Staff members have not been supported to train in specialist courses to support them in meeting service users needs. Service users stated they feel confident in the staff. Management carry out all necessary checks on new staff. Staff recruitment and selection procedures are robust and promote the protection of service users. Staff members are not always deployed to fully benefit service users across the time when residents are at the home. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. EVIDENCE: On entering the home there were 2 staff on duty to meet the needs of 10 service users, provide domestic services including cleaning and laundry, as well as catering duties. These staffing levels were not adequate to ensure the needs of service users were being fully met. The owner who was one of the staff on duty called in the manager to assist with the inspection site visit. The owner confided that a representative of a local trade association had recently visited the home and has advised the service was over staffed. This advice had apparently been offered with no reference to the assessed needs of the resident group, and consequently the advice was both flawed and potentially hazardous. The inspector established that the owner understands Cressage House DS0000062441.V301676.R01.S.doc Version 5.2 Page 19 her responsibilities to provide adequate staffing to meet the needs of residents as described in Regulation 18 of the Care Standards Act 2000. Less than 50 of the staff team are trained to the necessary standard. Currently the manager has NVQ 4 / Registered Manager Award, and one care staff member had NVQ 3. The inspector was advised that 2 staff will be starting the NVQ 3 course and a further three staff will be starting the NVQ 2 course at a local college in September 2006. The inspector asked if these courses will include electives from the Learning Disability Award Framework. The owner and manager agreed to find out this information and forward confirmation of the courses in writing to the CSCI. During this site visit there appeared to be a commitment to the training of staff to the standards. Staff selection and recruitment procedures had improved, and there was evidence that service users are protected by practices in this area. A staff member spoken to stated that she felt well supported and valued in her work at the home. Cressage House DS0000062441.V301676.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37-39-42 Service users are beginning to see the benefits of a service that is improving in the way it is run. Service users are consulted more often and more effectively about how their home is run and organised. Managers are improving the safety of the service in a planned and efficient manner. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There was evidence that there had been a number of improvements since the last visit, and these plus other improvements are ongoing, as is the commitment to developing the service. Developments have now been noted over the past four inspections. Management have identified and acted on a number of areas of risk at the home and taken the appropriate actions, as identified above. Other areas in Cressage House DS0000062441.V301676.R01.S.doc Version 5.2 Page 21 need of further development and improvement have also been identified and plans put in place to address these matters. Management plan to ensure staff begin to receive appropriate training in September 2006, in order to meet the standards and the needs of residents. In addition staff recruitment has improved, as has consultation with residents. The management have replaced the outdated fire detection system with an up to date model. Staff members get regular fire training. Residents stated that they felt safer living at the home. Improvements to the fabric of the home are ongoing, and are having a beneficial effect on the quality of life outcomes for residents. Cressage House DS0000062441.V301676.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 x 2 2 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 2 25 2 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 2 33 X 34 3 35 2 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 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 3 x x 3 x Cressage House DS0000062441.V301676.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No 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 YA32 YA35 Regulation 18 Requirement The registered persons must ensure staff members are trained to the national minimum standards. This training should link to NVQ and other specialist training needs in line with the assessed needs of service users. The registered persons must forward confirmation of course for staff by 31/08/06 The registered persons must ensure that broken windows are repaired. The registered persons must forward an action plan stating how they intend to maintain the premises. Timescale for action 31/08/06 2 YA24 12/13 31/08/06 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 YA33 YA13 Good Practice Recommendations The registered persons should keep staffing levels under review at all times, and consideration given to how staff are deployed at the home in line with the assessed needs DS0000062441.V301676.R01.S.doc Version 5.2 Page 24 Cressage House 2 YA35 3 YA1 4 5 YA14 YA25 6 YA16 and wishes of the residents, and when residents need support at the home. This will mean that staff will need to be provided at times when service users are not attending day services and/or colleges during the day. Evening support and weekend support should be increased. The home should avoid using calculations that do not address the assessed needs of service users when planning the levels of staff needed to meet their needs. It is recommended that staff members are provided with specialist training in mental health and learning disability, in line with the registration of the service and the needs of residents. Staff members may benefit from training input around managing behaviours that challenge the service, that will enable the appropriate management and develop strategies with service users. It is recommended that pre-admission information is developed in formats that can be readily understood and/or explained to service users who may not have reading/literacy skills due to their special needs. Such formats could also be provided to the care planning, assessment and monitoring systems developing at the home. Service users should be provided with a 7 day annual holiday outside of the home that they are involved in choosing and planning. It is recommended that the registered persons carry out a feasibility study of the home to see if it is possible to provide an increased number of single bedrooms in consultation with residents. It is recommended that routines at the home are kept under review in consultation with residents with a view to promoting routines that are flexible and individualised, that promote greater independence and the avoidance of routines that may be institutional. Cressage House DS0000062441.V301676.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Cressage House DS0000062441.V301676.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!