CARE HOME ADULTS 18-65
David Lewis Centre - Bryce House 3/4 Consort Close Bollington Macclesfield Cheshire SK10 5FB Lead Inspector
Sue Dolley and Judith Morton Announced Inspection 6th March 2006 09:30 David Lewis Centre - Bryce House DS0000006673.V277730.R01.S.doc Version 5.1 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 David Lewis Centre - Bryce House DS0000006673.V277730.R01.S.doc Version 5.1 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. David Lewis Centre - Bryce House DS0000006673.V277730.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service David Lewis Centre - Bryce House Address 3/4 Consort Close Bollington Macclesfield Cheshire SK10 5FB 01565 640000 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) David Lewis Organisation Mrs Rachel Elizabeth Clare Care Home 11 Category(ies) of Physical disability (11) registration, with number of places David Lewis Centre - Bryce House DS0000006673.V277730.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: The care home is registered for a maximum of 11 adults in the category of PD (physical disability). Date of last inspection 14th July and 11th August 2005 Brief Description of the Service: Bryce House is a community-based home run by the David Lewis Centre. Accommodation is provided for male and female service users between the ages of 18 and 65 years, who require support due to epilepsy, neurological problems, learning disabilities and other associated difficulties. Service users and staff members work towards addressing personal care needs, and independent living within the local community. The home is in the village of Bollington, approximately two miles from Macclesfield, within easy reach of local facilities such as shops, churches and public houses. There are adequate car parking facilities, and a garden with walkways and sitting areas is available for service users. Bryce House comprises two interlinked bungalows owned by a housing association. Service users accommodation consists of 11 single bedrooms; all of which have wash hand basins fitted. Communal space consists of two lounges and two kitchen/dining rooms. There is a utility room containing a washing machine and tumble drier, and an adequate number of bathing/shower/toilet facilities are available for service users. David Lewis Centre - Bryce House DS0000006673.V277730.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This home was inspected as part of an announced co-ordinated inspection of all the DLC services registered with CSCI. The purpose of this approach was to evaluate the effectiveness of the Centre in supporting each unit to improve outcomes for the people who live there. The co-ordinated inspection took place over five days and involved a team of eight inspection personnel from CSCI, including a service inspector, a regulation manager, a pharmacist and regulatory inspectors. The inspection also focused on how national minimum standards were being met across the registered services and what progress had been made to meet requirements from the last round of inspections carried out in the period from April to August 2005. During the period of the inspection, Bryce House was visited by one member of the inspection team. As part of the preparation for the inspection, the management staff at the David Lewis Centre produced self - assessment reports which summarised practice in the individual registered units and for the whole of the service. Before the start of the inspection, the inspection team carried out a number of surveys with placing agencies, parents, carers, service users and staff. During the inspection, the service inspector and regulation manager carried out a schedule of interviews with representatives of the Trustees, senior staff, operational managers and staff responsible for clinical, administrative and technical support to the centre. The inspection process included: tours of the premises; discussions with service users and their carers; meetings with senior centre managers and staff; visits to the centre laundry, transport and the central kitchen; meetings with clinical staff; and included an evening visit. The process enabled the inspection team to obtain a clear understanding of the factors influencing development and from the evidence gathered the team were able to form judgements on the quality and effectiveness of the services provided and the outcomes for those receiving services at the David Lewis Centre. What the service does well:
The trustee board and centre directors are actively engaged in developing a clear vision for the David Lewis Centre services and are prioritising developmental areas and projects. Service users have access to the multi-disciplinary team to ensure needs are addressed and met. The needs of service users at Bryce House are thoroughly assessed. The routine, close contact with expert medical care provides a degree of security for carers and staff from placing agencies. David Lewis Centre - Bryce House DS0000006673.V277730.R01.S.doc Version 5.1 Page 6 Care staff members provide attentive, friendly care and support. Health care needs are closely monitored and addressed. Staff members encourage service users to take responsibility for their own lives, helping them to reach their potential and to live as independently as possible within the local community. The induction and training of staff is well co-ordinated by the training centre. Bryce House has a small, well-trained and flexible staff team who provide continuity of care to service users. There is an established key worker system in place, which helps to co-ordinate the care packages for service users and staff members know service users well. The premises are kept clean and well maintained. Service users are involved in the day to day running of the home and are consulted about any possible changes to their care and the environment in which they live. There is a positive programme of work and life skills experience for adults. Bryce House has access to a mini bus to organise transport for service users who do not travel independently. What has improved since the last inspection?
The centre now includes the accredited model of physical intervention within their induction programme. The induction period has been developed into a two - week programme, which is comprehensive. The centre’s psychology department is developing a physical intervention programme for the David Lewis Centre, which is to be submitted to the British Institute for Learning Disabilities for accreditation. Work is being undertaken to complete a common care file for each service user. Essential lifestyle planning has continued with the involvement of service users and all service users are actively involved in deciding what personal care they receive. Self - determination in all aspects of decision-making and risk taking is promoted. The care and home records are well organised. The David Lewis Centre has developed and established an internal monitoring system to self evaluate and monitor developments within the service. The housing association has resolved problems related to damp by fitting two large extractor fans in the corridor ceilings. A new fire zone alarm system has been fitted. David Lewis Centre - Bryce House DS0000006673.V277730.R01.S.doc Version 5.1 Page 7 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. David Lewis Centre - Bryce House DS0000006673.V277730.R01.S.doc Version 5.1 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 David Lewis Centre - Bryce House DS0000006673.V277730.R01.S.doc Version 5.1 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, 3 and 4 Needs assessments are thorough and well written, ensuring that service users needs are accurately identified. The process of people moving into Bryce House is well managed to make sure individual needs are met and service users quickly settle into their new environment. EVIDENCE: Some of the common care files had been completed prior to the inspection. One case tracking exercise was completed at Bryce House during the inspection and the related common file information had been completed to a good standard. All of the information was included that was required. All care needs had been identified and addressed. Identifying information and photographs were included. A brief history or ‘pen picture’ would give a clearer and instant overview of the service user and would consolidate the information that was in the file, spread over a number of pages. See Recommendation 1. The service user had been involved in the person centred planning and had signed all the related documentation. Bryce House opened in 1994 offering new concepts of care to promote community integration for individuals with epilepsy and learning disabilities. Its David Lewis Centre - Bryce House DS0000006673.V277730.R01.S.doc Version 5.1 Page 10 ethos is to actively encourage and support self - management, independent daily living and a community presence. The statement of purpose mentions skill development programmes for individuals identified for resettlement or rehabilitation. Several of the service users have gained many independent living skills during their stay at Bryce House. Although some service users have expressed a wish to move to live in a more independent and less supported environment in the community, the possibilities for progression to resettlement are limited. There are no current plans to secure a more independent form of supported living for individuals in this service user group. See Recommendation 2. The majority of admissions to Bryce House are internal and received from the adult division of the David Lewis Centre. The assessments recorded within individual files are internal assessment documents. One external placement has recently been provided and a full assessment of needs had been undertaken. The transition arrangements for this service user were well planned and managed. David Lewis Centre - Bryce House DS0000006673.V277730.R01.S.doc Version 5.1 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 Service users are consulted about their care, are supported to make individual decisions and choices. Independence is encouraged and staff enable service users to take responsible risks, ensuring they have good information on which to base decisions. EVIDENCE: Bryce House aims to meet and respect the individual choice and rights of all service users, and to promote self-determination in all aspects of decision making and risk taking. Individual goals towards developing greater independence within the community were well documented and person centred planning ensures service users are involved in identifying their care needs and in planning the necessary support. David Lewis Centre - Bryce House DS0000006673.V277730.R01.S.doc Version 5.1 Page 12 One common care file checked provided evidence of necessary risk assessments regarding independent travel and the use of kitchen equipment. Recording risks separately makes it clearer to see when each has been reviewed and changes made. There was no indication as to how frequently risks were to be reviewed. In the older system of recording, risks would be classified high, medium and low and reviewed accordingly. There is a possibility here that all risks could now be reviewed only annually. See Recommendation 3. Staff members within the finance department of the David Lewis Centre ensure that payments are made to the Housing Association and act as appointees for services users in relation to benefits. The majority of service users handle their own medication, personal allowances and bank accounts with support as needed. The common care file checked by the inspector provided evidence that the service user had been involved in producing their person centred plan and had signed all the documentation to agree the plan. The service user had been encouraged to manage their allowances. As they had not been previously been used to being able to spend when they had wanted to, they would spend the allowances all in one go. Staff members were aware of the difficulties and had assisted with financial management by providing a labelled/sectioned box and divided the allowance into sections. This enabled the service user to save some money. Contact arrangements for the service user were clearly stated and in addition the service user had decided to keep contact with their family each evening and was supported to do this. Service users’ meetings provide service users with a forum to express their views and concerns and to ask questions. Minutes of the meetings were displayed on the service users’ notice board together with a copy of the last inspection report. David Lewis Centre - Bryce House DS0000006673.V277730.R01.S.doc Version 5.1 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): 11, 12 and 13 Staff members enable service users to have opportunities to maintain and develop skills, which will aid their personal development and independent living. Service users are engaged in various leisure and social activities, which, promote social interaction and individual interests. EVIDENCE: Care files and timetables provided evidence of service users being supported to attend local colleges for continuing education. The adult education and recreational courses attended help to promote personal development. Some service users attend the David Lewis Centre’s day services. Several of the service users are supported to participate in sport and social activities on and off site and have voluntary employment opportunities. Staff and service users have the use of a mini bus, which is part of the David Lewis Centre fleet of vehicles. David Lewis Centre - Bryce House DS0000006673.V277730.R01.S.doc Version 5.1 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 and 20 Service users are very well looked after in respect of their health and personal care needs and family carers are supported. Service users are closely monitored so that potential health problems are promptly addressed by the appropriate healthcare services. EVIDENCE: Service users are consulted about their care and support needs. They are actively involved in deciding what personal care they receive and all personal care is provided in private. Staff members provide sensitive and flexible support to promote service users’ privacy, dignity and independence. All service users have identified key workers who support them with personal hygiene and in their selection of personal clothing and toiletries. Health and care needs are closely monitored and promptly addressed. All service users at Bryce House receive specialist care for their epilepsy from a multi-disciplinary team based at the David Lewis Centre. They meet with each service user every eight weeks to oversee the service user’s medical and social needs. Service users retain, administer and control their own medication where appropriate and receive occasional assistance with medication when
David Lewis Centre - Bryce House DS0000006673.V277730.R01.S.doc Version 5.1 Page 15 necessary. Staff members closely monitor the condition of service users on medication. They call in the GP if they are concerned about any change in condition that may be a result of medication and prompt regular medication reviews. Records of administration of medicines are generally completed well. The David Lewis Centre Medicines Management Policy was approved and implemented on 6th September 2005. The CSCI pharmacist within the inspection team has recently studied the policy and a number of areas for change and improvement are currently under discussion. The policy includes a protocol for supporting service users to manage their own medication and those who do so have locked storage for it in their own rooms. David Lewis Centre - Bryce House DS0000006673.V277730.R01.S.doc Version 5.1 Page 16 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 Although there are arrangements in place for safeguarding service users, these were found to be unsystematic, and the arrangements for safeguarding service users’ personal finances needed to be developed further. The centre’s complaints policy and procedure need revising to ensure the systematic management and handling of complaints so that service users’ concerns are seen to be fully addressed. There is a lack of clarity in adult services about the use of an approved model of physical intervention to protect service users and staff. EVIDENCE: There is a written adult protection procedure for the home. A copy of the Department of Health guidance ‘No Secrets’ is available to staff for reference. All staff members except one had received training on the protection of vulnerable adults. There had not been any complaints made regarding Bryce House since the last inspection. However, the centre has a complaints policy but no clear procedure for staff to follow. As a consequence some complaints records held in the centre did not contain evidence of acknowledgement letters to the complainant providing details of how the complaint would be addressed. Some complaints records were unavailable for inspection, some were incomplete and so the outcomes were uncertain. Currently the policy does not refer to the complainant’s right of complain to their placing authority. Nor does the policy refer to the contact details for the Commission for Social Care inspection. See Requirement 1. David Lewis Centre - Bryce House DS0000006673.V277730.R01.S.doc Version 5.1 Page 17 The centre has a protection and social work team on site. The team are responsible for the oversight of internal protection practice and liaison with the relevant professional bodies. Following discussion with the manager of the protection and social work team, it was evident that there is a lack of clarity in differentiating between issues of protection and general concerns and an unsystematic approach by management staff regarding communication, liaison and management of concerns complaints and allegations. The internal adult protection records need a clearer indexing and reference system. Case recording must be thorough, all records must clearly identify all staff members involved and must include all the outcomes of adult protection cases. See Requirement 2. Discussions with the Senior Behavioural Support Advisor and the Clinical Psychologist provided evidence of a new behaviour management strategy to be introduced across the centre and which they plan to submit to B.I.L.D. for accreditation. Currently carers of adults receive training in different models of physical intervention. The staff members in some adult houses have received breakaway training in the past. There was no recent evidence of training in this area. In other adult care houses staff members are using control and restraint methods, which are not appropriate in social care settings. Some centre staff have received training in de-escalation techniques within a ‘Timian’ model of practice. This programme is accredited with the British Institute for Learning Disabilities (B.I.L.D.). Care staff receive this instruction within their induction programme and can later access refresher sessions. See Recommendation 4. Service users have access to their personal financial records and the finance department of the David Lewis Centre oversees the receipt of personal allowances. The finance department provides banking facilities for service users via a branch of a high street bank and they operate systems for access to money and for the receipt of interest on savings. Service users have access to the centre’s cash office and their own bank accounts to obtain their personal money. Lists are kept of service users’ personal furniture and items within Bryce House. The David Lewis Centre has an official and approved appointee for a large number of service users across the centre. There is a lack of clarity regarding the capacity of some individuals to receive and manage their own finances and no clear guidance from the centre to staff members regarding the need to refer service users for support via Power of Attorney, Guardianship and Court of Protection. See Recommendation 5. There is draft procedure for the management of money and valuables within the residential houses. The procedure provides staff with guidance on withdrawing money on service users’ behalf although the document does not clarify the maximum amount of service users money that can be held for safekeeping on each house. See Recommendation 6.
David Lewis Centre - Bryce House DS0000006673.V277730.R01.S.doc Version 5.1 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 The premises provide a homely, comfortable and clean environment for service users. EVIDENCE: The landlord of Bryce House is Northern Counties Housing Association and the individual service users have tenancy agreements. The Housing Association is responsible for the maintenance of the building. Records are available in the home that identify any remedial action reported and dates of completion remedial work. The premises are purpose built and suitable for the service user group. The two bungalows share a communal laundry. Other communal areas include a lounge, kitchen/dining rooms in each bungalow and there are shared gardens. The premises are in keeping with other housing in the community. Bedrooms are of various sizes and shapes and provide at least 10sq. m. of useable space. There is sufficient communal space to meet the needs of service users. Throughout the premises there are sufficient toilets and bathing facilities. There is a specialist shower facility in each bungalow and service users have hand wash-basins in their bedrooms.
David Lewis Centre - Bryce House DS0000006673.V277730.R01.S.doc Version 5.1 Page 19 To resolve the problem of mould on several ceiling areas, the housing association has fitted two large extractor fans in the corridor ceiling. The ceilings await repainting and the housing association has agreed to do this as soon as possible. David Lewis Centre - Bryce House DS0000006673.V277730.R01.S.doc Version 5.1 Page 20 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 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): 33 Staff members are approachable, flexible and motivated and have the necessary skills to provide appropriate care for service users. EVIDENCE: A lot of interaction takes place between staff and service users and staff members are able to meet needs in a highly supportive and flexible way, whilst encouraging independence. Currently the registered manager and other staff members are expected to provide assistance for the sole member of staff on waking duty should any emergencies arise during the night. There are safety issues in relation to staff working alone. Should an emergency arise during the night the staffing situation could prove problematic. See Recommendation 7. David Lewis Centre - Bryce House DS0000006673.V277730.R01.S.doc Version 5.1 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 The processes of managing Bryce House are open and transparent and service users can approach the staff and management to discuss any issues. As a consequence service users interests are promoted and service users and their relatives feel supported. EVIDENCE: Lines of accountability are clear within Bryce House and with the management and various departments of The David Lewis Centre. Service users confirmed that they feel supported within their environment by an attentive staff team. The registered manager receives advice and support in the field of health and safety from centre personnel. There was evidence of fire training being provided for all service users and a new fire zone alarm system had been fitted. David Lewis Centre - Bryce House DS0000006673.V277730.R01.S.doc Version 5.1 Page 22 Several of the centre wide policies and procedures used within Bryce House need to be reviewed to address areas mentioned earlier in the report and to ensure further safeguards are in place for service users. David Lewis Centre - Bryce House DS0000006673.V277730.R01.S.doc Version 5.1 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 2 3 2 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 1 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 X 33 2 34 X 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 2 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 X 15 X 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 X X X 3 X X X X X X David Lewis Centre - Bryce House DS0000006673.V277730.R01.S.doc Version 5.1 Page 24 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 YA23 Regulation 22 Requirement The complaints policy and procedure must be appropriate to the needs of the service user. They must refer to the service users right to contact their placing authority and must include the name, address and telephone number of the Commission for Social Care Inspection. A satisfactory system to monitor and record safeguarding arrangements must be in place to ensure that service users are protected from harm or abuse. Timescale for action 01/06/06 2. YA23 13 01/06/06 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 YA2 Good Practice Recommendations A brief history or ‘pen picture’ of the service user could be included in their common care file to give a clearer and instant overview of the service user and to consolidate the
DS0000006673.V277730.R01.S.doc Version 5.1 Page 25 David Lewis Centre - Bryce House 2 3 4 YA3 YA9 YA23 5 YA23 6 7 YA23 YA33 information spread over a number of pages. To meet the aspirations of some service users, pursue the possibility of resettlement, to a more independent environment within the community. Ensure the information in the common care files gives a clear indication as to how frequently risks are to be reviewed. A target date should be set for the introduction of a single method for managing challenging behaviour in adult services at the centre, supported by operational guidance and training for managers and staff. Ensure there is clarity regarding the capacity of individuals to receive and manage their own finances and provide clear guidance to staff members regarding the need to refer service users for support via Power of Attorney, Guardianship and Court of Protection. Provide clear guidance to staff regarding the maximum amount of service users money that can be held for safekeeping on each house. The night time staffing level should be reviewed regularly and the night time on call rota should be reconsidered, to ensure service users needs can be met at all times and by a staff team that reflects the gender composition of the service users. (Similar recommendations were made at inspections commencing on 8th November 2004 and 14th July 2005). David Lewis Centre - Bryce House DS0000006673.V277730.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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