Inspection on 20/09/05 for Dalwood Farm

This inspection was carried out on 20th September 2005.

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

The inspector 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

Dalwood Farm 22/01/08

Dalwood Farm 10/10/06

Dalwood Farm 21/02/06

Dalwood Farm 13/01/05

Dalwood Farm 27/05/04

Dalwood Farm 11/12/03

Dalwood Farm 17/04/03

Dalwood Farm 07/11/02

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

CARE HOME ADULTS 18-65 Dalwood Farm Dinton Salisbury Wiltshire Wiltshire SP3 5EY Lead Inspector Alison Duffy Announced 20 September 2005 th The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Dalwood Farm D51_D01_S28348_DALW00D_v240697_200905_Stage4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Dalwood Farm Address Dinton Salisbury Wiltshire SP3 5EY 01722 717922 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Ability Associates Limited Mr Andrew Nosko Care Home 3 Category(ies) of Learning Disability (2) registration, with number Physical Disability (1) of places Dalwood Farm D51_D01_S28348_DALW00D_v240697_200905_Stage4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. No more than 2 male service users with a Learning Disability at any one time. 2. No more than one male service user with a Learning Disability AND a Physical Disability at any one time. Date of last inspection 13th January 2005 Brief Description of the Service: Dalwood Farm is a residential care home registered to care for three adults with a learning disability, one of whom may also have a physical disability. The home is situated in the village of Dinton which is on the B3089 approximately half an hours drive from Salisbury. The Registered Provider is Ability Associates Ltd and the Registered Manager is Mr Andrew Nosko. Mr Nosko also manages another small care home within the organisation. Dalwood Farm is an old farmhouse providing single room accommodation on both the ground and first floor. There is a homely sitting room and a large spacious kitchen with a dining area. An additional room on the ground floor has been allocated to a games room with a pool table in situ. In addition to the farmhouse there are a number of outbuildings, large vegetable gardens, an orchard and adjoining fields. The farm also has a number of animals including shetland ponies, goats and chickens. The environment and animals are all maintained by service users and staff. Due to its rural, tranquil positioning, the home has two company cars for journeys as required. Staffing levels are maintained according to individual need and generally service users receive one-to-one support during the day. At night two members of staff provide sleeping in provision. There is also an on call management system in place. Dalwood Farm D51_D01_S28348_DALW00D_v240697_200905_Stage4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Dalwood Farm is one of two care homes managed by Ability Associates. As both homes are similar in nature it was agreed to undertake the announced inspections of both services over a period of two days. This inspection therefore took place between 10.15am and 2pm on the 20th September and 10am – 3.45pm on the 21st September 2005. During this time, key themes such as staffing matters, were addressed in relation to both homes. Over the course of the two-day period, the inspector was able to meet all service users and a number of staff members. Mr Andrew Nosko was available throughout and received feedback at the end of the inspection. A tour of the accommodation was made and the inspector joined the staff team for a morning handover. Care planning and daily information, personnel records and health and safety matters were viewed and the medication systems were examined. As part of the inspection process one comment card was received. This was positive, as was feedback received from service users. What the service does well: What has improved since the last inspection? Systems such as staff meetings and regular supervision have been developed. Documentation demonstrates the content of such and staff involvement. Training within the home has been reviewed and a summary of training undertaken is now in place. Future requirements are also evident. Dalwood Farm D51_D01_S28348_DALW00D_v240697_200905_Stage4.doc Version 1.40 Page 6 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. Dalwood Farm D51_D01_S28348_DALW00D_v240697_200905_Stage4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Dalwood Farm D51_D01_S28348_DALW00D_v240697_200905_Stage4.doc Version 1.40 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 standard(s) 2 and 4 The home has clear admission criteria and the assessment process is well managed. EVIDENCE: The most recent admission to the home took place approximately a year ago. It was apparent through documentation that a detailed assessment process had been followed. Community care assessments, discharge letters and details of previous placements were on file. Documentation also demonstrated that visits had been made to the home before admission. Discussion with Mr Nosko detailed clear admission criteria and an awareness of need, which would be conducive to the home’s environment. Dalwood Farm D51_D01_S28348_DALW00D_v240697_200905_Stage4.doc Version 1.40 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7 and 9 Information regarding service users is detailed yet key themes would benefit from greater focus in order to demonstrate that individual needs are fully met. Risk taking is promoted yet behavioural strategies, agreed with care managers and other interested parties, would ensure greater protection. Consultation and decision-making processes are fully promoted within the home. EVIDENCE: All service users have a file containing detailed information. The care plan format is portrayed within guidelines and a monthly key worker report gives clear monitoring and review. The guidelines are comprehensive and give a clear summary of need. However, matters of higher importance such as the management of specific conditions require greater emphasis. Mr Nosko was therefore advised to develop individual plans of care for key matters such as self-harming and leaving the building unattended. Discussion also took place regarding limitations or consequences of actions. It was agreed that such matters should be agreed with care managers and service users as appropriate. At the last inspection a requirement was made to ensure all service users are involved in the development of their plan and then sign Dalwood Farm D51_D01_S28348_DALW00D_v240697_200905_Stage4.doc Version 1.40 Page 10 accordingly. Mr Nosko reported that this practice is currently being developed. One service user confirmed this. Following the last inspection, photographs are now in place. Opportunity and quality of life are important factors and therefore staff give assistance on a one-to-one basis to develop skills, confidence and independence. Appropriate risk taking is promoted and careful consideration is given to levels of risk. A number of written personal risk assessments were in place although in some instances the risk may be too high and therefore not agreed. This was discussed with Mr Nosko and it was apparent that multiagency agreement is currently being sought regarding one matter. Mr Nosko was advised to ensure full written strategies form part of the agreement. Such agreements should also be signed with a monitoring and review system built in. In relation to risks, it was agreed that matters such as road safety should also be evidenced following a programme of assessment. Mr Nosko reported that such matters would be addressed following the assessments of health care professionals currently being undertaken. Service users reported being fully able to make decisions about their daily lives. Preferred routines such as getting up and going to bed are followed and service users are able to choose matters such as activities within their free time. All are able to contribute to choices of decoration, purchasing, furnishing private accommodation and menu planning. Dalwood Farm D51_D01_S28348_DALW00D_v240697_200905_Stage4.doc Version 1.40 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14, 15, 16 and 17 Service users undertake a range of activities that are linked to individual need and preference. Visitors are welcome and hospitality is evident. Healthy eating is promoted yet service users’ choice is fully respected. EVIDENCE: Service users have a varied weekly programme, which is linked to individual need and wishes. One service user reported enjoying college three days a week with the remainder of the week at the Farm undertaking housekeeping tasks or activities of personal choice. Other service users generally remain at the Farm and are able to undertake paid employment by undertaking tasks such cutting the grass, maintaining the vegetable gardens and burning the rubbish. Within the programme, activities such as swimming are also included. During evenings and weekends, service users are able to choose their activity. This may include a visit to the pub, attendance at certain clubs, a trip out to places of interest or in house entertainment. All activities are individual in relation to need and interest and are undertaken with staff support as Dalwood Farm D51_D01_S28348_DALW00D_v240697_200905_Stage4.doc Version 1.40 Page 12 required. Mr Nosko has a mobile home on the coast, which is regularly used for holidays. Service users can also suggest alternative destinations or undertake days out if a holiday is not wanted. Service users reported that they meet their friends at the local pub and may undertake activities such as darts. Staff confirmed that service users also attend village events and often visit the local shop/post office. Service users are therefore considered very much part of the local community. Service users reported they are able to have visitors when they wish and use communal areas or private accommodation as required. Regular contact with family members is encouraged and staff facilitate transport on a regular basis. During the inspection the home was relaxed and hospitality was evident. The home has a service user focus and individual rights are respected. One service user spoke of being able to remain in their own room and undertake activities of personal choice without disturbance. Staff respect such privacy although assist as required. Service users assist with meal preparation and the development of the menus. There are two set menus in place, which are linked to individual need although both are flexible accordingly to individual preferences on the day. Healthy eating is promoted yet this is balanced with individual choice. Service users are expected to eat in the kitchen/dining area in order for the meal to be a social occasion. Service users and staff always eat together. At this present time there are no specialised diets. Dalwood Farm D51_D01_S28348_DALW00D_v240697_200905_Stage4.doc Version 1.40 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19 and 20 Service users’ health and personal care are well managed. Medication, although generally satisfactory, would benefit from greater review to ensure all medication is current and recorded accordingly. EVIDENCE: Service users require limited amounts of assistance with personal care routines. General support, prompting and encouragement are more appropriate and this is clearly recorded within each individual file. During the inspection various appointments were being attended with staff support. Documentation also demonstrated regular intervention from health care professionals such as the GP, dentists and opticians. Hospital referrals had been made and specialised appointments with psychologists and psychiatrists had been undertaken. Staff members reported excellent support from services such as the GP. Daily records demonstrated service users’ general well being. The home uses a monitored dosage system for medication administration. Service users do not at this time self-medicate. The medication is supplied on a monthly basis and records demonstrate such receipt. A separate book is designated to the return of medication. Medication administration sheets were signed appropriately although Mr Nosko was advised to ensure a member of staff countersigns any written instructions to the MAR sheets. Within the storage of medication it was evident that a number of creams were not Dalwood Farm D51_D01_S28348_DALW00D_v240697_200905_Stage4.doc Version 1.40 Page 14 recorded. Mr Nosko believed these to be no longer used and therefore disposal is required. A homely remedy list signed by a GP is in place. Dalwood Farm D51_D01_S28348_DALW00D_v240697_200905_Stage4.doc Version 1.40 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 standard(s) 22 and 23 While a complaint procedure is in place, some service users rely on staff involvement to determine and address possible discontentment. Satisfactory systems are in place to minimise the risk of abuse to service users. EVIDENCE: There is a copy of the complaints procedure within each service users’ file. The procedure is in need of updating however, as the National Care Standards Commission is still stated. The procedure did not appear to be written in a user-friendly format and therefore would benefit from simpler wording and possible pictures. Mr Nosko reported however, that service users who would not understand the current format would need full staff assistance to recognise any discontentment. A more user friendlier format would therefore not be of benefit. One service user reported that they would tell ‘Andy’ in the event of any problem. The complaints procedure has been recently discussed within supervision sessions with staff being encouraged to contact CSCI in the event of a complaint about management. There have been no complaints reported to CSCI. A copy of the ‘No Secrets’ documentation is clearly displayed on the notice board in the office and the home also has a copy of the Wiltshire and Swindon Vulnerable Adults protocol. Referrals have been appropriately made in relation to service user incidents. Mr Nosko reported that experience of the procedure has enhanced learning and some staff have covered adult protection within their NVQ training. Additional adult protection training is however planned. A small amount of service users’ personal money is kept in the home for safekeeping. A number of cash amounts were checked and balance sheets Dalwood Farm D51_D01_S28348_DALW00D_v240697_200905_Stage4.doc Version 1.40 Page 16 were viewed. All were found to correspond, with receipts numbered accordingly. At the last inspection it was noted that service users were paying for staff meals when out and car parking. A requirement was made to stop this practice and reimburse money accordingly. Mr Nosko reported that this practice has since ceased and service users have been reimbursed. Balance sheets did not demonstrate any such expenditure. Dalwood Farm D51_D01_S28348_DALW00D_v240697_200905_Stage4.doc Version 1.40 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 26, 27 and 28 Dalwood Farm with its range of animals and external spaces gives varying opportunities to service users. All areas are homely, comfortable and well maintained. Private accommodation is furnished and personalised to varying degrees, based on individual choices and preferences. EVIDENCE: Dalwood Farm is a listed building that is homely and comfortable and contains many original features. Communal areas consist of a small sitting room on the ground floor and dining area within the kitchen. Mr Nosko reported that additional lounge space is also allocated on the first floor although service users choose not to make use of this. Service users have a single room either on the ground or first floor. All are personalised to varying degrees based on individual wishes. One service user has a lock on their door, while others have declined this offer. Two rooms have recently been redecorated and one service user reported choosing the decoration of such. Dalwood Farm D51_D01_S28348_DALW00D_v240697_200905_Stage4.doc Version 1.40 Page 18 The home has a bathroom with bath, hand washbasin and toilet on the first floor and there is an additional toilet on the ground floor. One service user reported a preference for a shower although the home does not have this facility in place. Mr Nosko reported, that due to the low ceiling and difficulty of maintaining fixings to the wall, the fitment of a shower has not been possible. Within a tour of the accommodation Mr Nosko raised the current position of an area on the landing ceiling needing attention following a leak. Mr Nosko reported that the matter is being addressed although the area needs to dry out before final completion. As stated earlier in this report, the home is located within a rural area with various outbuildings, vegetable gardens and fields as part of the property. All areas are well maintained and give various opportunities to service users. Dalwood Farm D51_D01_S28348_DALW00D_v240697_200905_Stage4.doc Version 1.40 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 34, 35 and 36 Staffing levels are maintained as agreed by the previous Registration Authority. Robust recruitment procedures are in place minimising the risk of inappropriate selection. Training and supervision systems have been developed and appear to be working well. EVIDENCE: Staffing rosters were viewed and explained by the deputy manager on duty. It was evident that staff are deployed in accordance to service users needs and general activities of the day. Service users generally receive one-to-one support. At night there are two members of staff who provide sleeping in provision. An on call management system is also available. When devising staffing rosters, additional matters such as gender are taken into account. The home benefits from an established staff team. Since the last inspection there has been one new member of staff. This recruitment process and a number of personnel files were viewed and all contained the required information. Dalwood Farm D51_D01_S28348_DALW00D_v240697_200905_Stage4.doc Version 1.40 Page 20 Since the last inspection training and supervision systems have been considerably developed. A record of all training staff have undertaken is in place and courses required are identified. At the last inspection a requirement was made to ensure all staff have training regarding physical intervention. Mr Nosko reported that one training session had been undertaken and another is planned. Additional training has also included medication administration, first aid and infection control. The NVQ programme is progressing well and six staff including Mr Nosko have NVQ level 3. One member of staff has NVQ level 2 and four are undertaking the qualification. One member is planning NVQ level 2 and another is planning level 3. The deputy manager is also undertaking the Registered Managers Award. Mr Nosko has diabetes, epilepsy and autism training planned for all staff. Supervision systems have recently been developed with Mr Nosko, the deputy manager and the senior support worker formally supervising. Sessions have taken place on a two monthly basis, are recorded and signed by both the supervisor and supervisee. Since the last inspection staff meetings have also been developed. These are recorded and demonstrate service user issues and the general running of the home. It was recommended that all staff sign the staff meeting minutes. All staff appeared enthusiastic regarding their role and productive interactions were viewed. External activity and opportunity appeared paramount and staff spoke clearly of developing service users’ skills, confidence and achieving individual goals. Dalwood Farm D51_D01_S28348_DALW00D_v240697_200905_Stage4.doc Version 1.40 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 39 and 42 The home is well managed with a service user focus. A system to monitor the quality of the home is in the process of being established. Health and safety systems minimise risks to service users yet monitoring of hot water temperatures is required to ensure protection. EVIDENCE: Mr Nosko has previous experience of working with people with a learning disability and within discussion demonstrated a clear understanding of service user needs. Mr Nosko has NVQ level 3 and has recently submitted all work for the completion of the Registered Manager’s Award. Service users appeared relaxed around Mr Nosko and positive relationships were evident. At the last and previous inspections a requirement was made to develop and maintain a Quality Assurance system. Mr Nosko reported that in order to develop knowledge of the topic and introduce a system effective for the home, Dalwood Farm D51_D01_S28348_DALW00D_v240697_200905_Stage4.doc Version 1.40 Page 22 a manual with strategies has been purchased. The implementation of the manual is in its initial stages although questionnaires have been developed and given to service users’ family members and care managers. The questionnaires give good feedback including a score of 10 out of 10 in one instance, for service provision. As further work is planned and some progress had been made in the area of Quality Assurance, a requirement was not set on this occasion. Further progress however, is expected to occur and will be viewed at the next inspection. The property is well maintained and attention is given to health and safety matters as required. Mr Nosko reported that maintenance work is generally undertaken efficiently following request. Covers have been fitted to all radiators accessible to service users other than in one service user’s room whereby the heating is never on. Due to the promotion of independence, hot water is currently unregulated although risk assessments are in place. It was noted however that the water from the hand washbasin in the bathroom was very hot to the touch. Mr Nosko was informed of the need to monitor and record such temperatures and undertake any action as a result. Mr Nosko reported that this practice had occurred in the past although needs to recommence. At present visual checks of the electrical appliances are undertaken although Mr Nosko reported that he is planning to formally train a member of staff to undertake PAT testing. Fire safety documentation was satisfactory with fire drills listing participants and the outcome of such. Documentation demonstrated vehicle checks although Mr Nosko was advised to make sure staff record when faults are rectified. A declaration notifying management of any driving offences was also recommended. Dalwood Farm D51_D01_S28348_DALW00D_v240697_200905_Stage4.doc Version 1.40 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x 3 x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x 3 3 3 x x Standard No 11 12 13 14 15 16 17 x 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score x 3 x 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Dalwood Farm Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score 3 x 2 x x 2 x D51_D01_S28348_DALW00D_v240697_200905_Stage4.doc Version 1.40 Page 24 No 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 6 Regulation 15 Requirement The Registered Person must ensure that care plans give clear information regarding the management of prominent matters. Behavioural strategies must be agreed with relevant professionals, confirmed in writing and be regularly monitored and reviewed. The Registered Person must ensure that the medication administration sheet is an accurate record of all medication taken. Any medication which is no longer used must be disposed of appropriately. The Registered Person must ensure that hot water temperatures are monitored and recorded on a regular basis. Exceptionally high temperatures must be addressed accordingly. Timescale for action 16th December 2005 2. 20 13(2) From 20th September 2005 3. 42 13(4)(c) From 20th September 2005 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Good Practice Recommendations D51_D01_S28348_DALW00D_v240697_200905_Stage4.doc Version 1.40 Page 25 Dalwood Farm 1. 2. 3. 4. 5. 6. Standard 6 20 22 36 42 42 The Registered Person should ensure that limitations or consequences of actions are recorded, agreed with service users and their care managers and regularly reviewed. The Registered Person should ensure that a member of staff countersigns any written instruction to the medication administration sheets. The Registered Person should ensure that the Complaint Procedure is updated to include the CSCI. The Registered Person should ensure that all staff sign the staff meeting minutes. The Registered Person should ensure that all faults highlighted within vehicle checks are recorded when rectified. The Registered Person should ensure that staff sign a declaration notifying management of any driving offences. Dalwood Farm D51_D01_S28348_DALW00D_v240697_200905_Stage4.doc Version 1.40 Page 26 Commission for Social Care Inspection Avonbridge House Bath Road Chippenham Wiltshire SN15 2BB 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 Dalwood Farm D51_D01_S28348_DALW00D_v240697_200905_Stage4.doc Version 1.40 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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