Inspection on 22/05/08 for Dean View

This inspection was carried out on 22nd May 2008.

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 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

Extracts from inspection reports are licensed from CQC, this page was updated on 27/09/2008.

CARE HOME ADULTS 18-65 Dean View Dean Street Crediton Devon EX17 3EN Lead Inspector Louise Delacroix Unannounced Inspection 22nd May 2008 10:25 Dean View DS0000071074.V358589.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 Dean View DS0000071074.V358589.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. Dean View DS0000071074.V358589.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Dean View Address Dean Street Crediton Devon EX17 3EN 01363 775333 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) Guinness Care and Support Ltd ****Post Vacant**** Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Dean View DS0000071074.V358589.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: 2. Learning disability (Code LD) The maximum number of service users who can be accommodated is 5. Date of last inspection 27th February 2007 Brief Description of the Service: Dean View is a large detached house situated in the town of Crediton, close to the town centre. It provides accommodation and personal care for five people with learning disabilities. Bedrooms are on the ground and first floor. Doorways are wide and some adaptations are in place for people who use wheelchairs. There is a garden and parking to the rear of the property. The current fee level is £697.00 per week. This does not include items such as toiletries and personal items. Information about this home, including reports, is available direct from the home. Dean View DS0000071074.V358589.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people using this service experience good quality outcomes. The inspection took place over two days. The first day was unannounced and lasted four and half hours. The second day was announced so that we could meet the manager, and this part of the inspection lasted two and quarter hours. We spent some time talking to people living at the home, although because people have complex communication needs, we also spent time in communal areas to gain an impression of what it is like to live at Dean View. We also spoke to staff about how they are supported to do their job and their understanding of the individual needs of people living a the home. Everyone living at the home completed a survey about the service they received with the help of their keyworker. Four staff members also completed surveys for us. Information from surveys have been included in the report. The manager also completed an Annual Quality Assurance Assessment (AQAA), which helped us measure the quality of the service. What the service does well: People who are thinking about coming to live at Dean View will be assessed so that staff know what their needs are and that they can meet them. Each person who lives here has a plan of care, which details how their needs are to be met. Staff get to know the people well so that they can recognise and call a doctor if there are signs of pain or illness. They also ensure that specialist referrals are made so that the people who live here remain healthy. People are supported to access the local community, including social and life skill groups. People who need help with managing their money are supported on a day to day level. The home is furnished in a homely way and it is kept clean. The staff at Dean View are committed to their work to ensure continuity of care. They receive training to support their role. We could not look at recruitment as there have been no new staff since the last inspection. The home is well managed and good systems are in place to keep it this way. The home and service users are kept safe through good maintenance and by training staff in health and safety, first aid, moving and handling, fire and food Dean View DS0000071074.V358589.R01.S.doc Version 5.2 Page 6 hygiene. Quality assurance procedures ensure that people can influence the service. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Dean View DS0000071074.V358589.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 Dean View DS0000071074.V358589.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. JUDGEMENT – we looked at outcomes for the following standard(s): We looked at standard 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People’s needs are assessed before they move into the home to help ensure that the service can meet their identified needs. EVIDENCE: Since our last inspection, one person has moved into the home. We could see from their plan of care that steps were taken to gather information from different sources about their social history and their care needs. We were told that the person had initially moved in after a period of respite at the home. However, the information on file did not show how their stay had been planned for on an individual basis, or how they had been supported with this lifechanging decision. We could not see from records how they had been supported to understand the home’s statement of purpose and the service user guide. The home does have a guide about the home in ‘widget’, which uses symbols to support written information. The person’s move to the home took place before the manager began working at the home. Four of the five people living at the home told us that they had chosen to move there and had received enough information to help them make a decision, one other person said that they were not asked if they wanted to move there and had not received enough information. Dean View DS0000071074.V358589.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): We looked at standards 6,7 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are supported to reach their personal goals, make decisions about their lives and lead an independent lifestyle. EVIDENCE: Each person has a plan of care, which gives details of their physical, emotional and social needs. Needs and preferences are recorded so that staff give individual care and support, which staff confirmed in their discussions. For example, likes and dislikes with food. We read that one person liked to spend time outside and saw that staff supported this wish, and read that another person enjoyed riding their bike, which again we saw happening. This individual approach was also acknowledged in the home’s AQAA, the people at ‘Dean View are all very different in their personalities and their likes and dislikes, we ensure that that they all get the choices suited and requested by them’. The manager told us that work is due to start to make the plans more person centred. Dean View DS0000071074.V358589.R01.S.doc Version 5.2 Page 10 Care plans show that people living at the home are helped to set goals to enhance their lives. Such as going shopping or developing life skills. Care plans are reviewed regularly and formal reviews include health and social care professionals. Four staff members said that they are always given up to date information about the needs of the people they care for. Staff were overheard offering choices about items such as food, what to do and where to spend their time. A staff member said that ‘residents are always given choices and their decisions respected’. Some people need help with managing their monies. There is a system in place for recording this. Two accounts were checked and found to be in order and all monies are kept securely. The system is auditable and checked regularly. People living here have differing abilities and as a consequence are able to take different levels of risk. Care plans and discussions with staff show that people have different levels of risk. Written assessments are in place and are generally reviewed as needed. Three people told us that they always made decisions about what they did each day while two people said this was sometimes the case. However, everyone said that they could do what they wanted to do during the day and the evening, and at weekends. Dean View DS0000071074.V358589.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): We looked at standards 12,13,15,16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at the home do have access to social activities but further work is needed to ensure that people’s individual needs i.e. their faith are being met, and that they have the opportunity to benefit from increased privacy. EVIDENCE: People appeared relaxed in their surroundings, and although they were not able to discuss their feelings in detail, people generally seemed satisfied with their lives at Dean View. Several people’s plans of care suggested that they were reluctant to socialise outside of the home, and in discussion staff recognised the reasons behind these decisions, such as discomfort or wish for privacy. Other people living at the home told us or their care plans recorded their enjoyment in going out and socialising, and we saw that this was supported through visits to a social group, attending an educational course and going Dean View DS0000071074.V358589.R01.S.doc Version 5.2 Page 12 shopping, which are part of their personal goals. People also participate in music sessions at the home. One person told us in their survey that staff try and meet their needs but staffing levels can make this difficult. We spoke with staff and the manager about staffing levels and how this impacts on what activities people living at the home can participate in. Staff have mixed views, some felt it was managed successfully and others said that it was difficult to meet people’s individual social needs. One person who lives at the home has recorded in their care plan that they wish to attend church. Their weekly activity schedule shows this happens on a Sunday but daily records show that in May this had not happened. The manager explained how this was now being addressed and that verbally she has encouraged staff to ensure this person is supported to practice their faith. Another person has baking recorded as an activity on their weekly schedule but their care plan states they have chosen not to cook. It is also recorded that they go to church on a Sunday but we could not find evidence that this had happened. We saw from records that people have access to local community services, such as a social group, a life skills group and local shops. Some people are also supported to visit Exeter to go shopping. We were told that the home plans to share a minibus with other homes in the area, which staff told us would improve the opportunities for people to go on trips outside of Crediton. From discussions with staff and from records, we could see that where possible the home helps people maintain links with families or significant people in their lives. We looked at how people are supported to maintain their daily routines, including maintaining privacy. We were informed prior to the inspection of an incident between two people at the home over a privacy issue. Currently none of the bedrooms can be locked, one person told us that they did not want a lock but staff felt that other people might like this option. We saw that people chose where to spend their time around the home and chose whether to be alone or spend time in the company of others. Staff told us in surveys that ‘many staff are good cooks and good home cooked food is given’. Staff told us that people living at the home are encouraged to eat together, which we saw during the inspection, and to be involved in choosing new dishes to be added to the menu. Staff took a creative approach by looking at cookbooks with people so that they could make decisions based on photographs of meals. Staff told us this had been a successful approach and helped broaden people’s tastes. Staff knew about people’s like and dislikes and gave examples of how they people’s needs are cared for. Dean View DS0000071074.V358589.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): We looked at standards 18,19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at the home are generally supported to maintain their health, well-being and sense of individuality. However, changes to the management of medication will help improve people’s safety. EVIDENCE: We looked at how people receive support in the way they prefer and require. We could see from records and talking to staff that people have differing times to get up and go to bed, and that there is recognition about maintaining people’s feelings of self worth through massages, hair care, maintaining their personal appearance and selection of clothes. Everyone living at the home said that staff always treated them well and four said that staff always listened and one person said they sometimes did. Staff told us that people living at the home ‘are happy and content and encouraged to maintain as much independence as possible’. In discussion, staff showed their commitment to the well-being of people living at the home. However, some staff interaction with people living at the home could have a negative effect on their well-being. Examples include, talking about people in front of Dean View DS0000071074.V358589.R01.S.doc Version 5.2 Page 14 them, using the lounge for staff conversations when people are watching a film, and discussing other people’s care needs in front of other people living at the home. (See standard 35) Care plans show that there is timely and appropriate involvement of health and social care professionals. This includes dentist, chiropodist, district nurse and psychiatrist. Generally, these records also detail the health and personal care needs of each person and how these are to be met and during discussion staff showed a good knowledge of people’s health needs and how this might affect their behaviour. However, one person’s medical condition is noted as unstable, which can require medical intervention. However, there is no clear guidance in place as to when this should happen i.e. triggers to help staff decide whether to intervene. One person has complex healthcare needs. Advice has been sought from appropriate sources and there is evidence that this has been put into practice. The home has equipment to support people’s moving and handling and pressure care needs. None of the people living at the home manage their own medication. The home uses a monitored dosage system and we saw from training records that staff receive training in how to manage this. The medication administration records (MARS) show generally good record keeping. However, on the day of the inspection, staff said that anti- biotics were being stored in a kitchen cupboard, which is not safe practice, and a broken part of a diazepam tablet was found in a bottle in the medication cupboard. Staff and the manager told us that they were unclear why this had happened. Medication had also been given on 20th May, which had not been recorded on the MARS sheet for this person although the reason for giving it had been recorded in the daily notes. Dean View DS0000071074.V358589.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. JUDGEMENT – we looked at outcomes for the following standard(s): We looked at standards 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff are clear about their responsibilities to protect people living at the home. But more work is needed to ensure that people living at the home know how to make a complaint and that the use of their finances for expensive items have been appropriately agreed. EVIDENCE: Neither the home nor CSCI have received any complaints about Dean View. Everyone living at the home told us they know who to speak to if they are not happy. People were mixed in their response about making a complaint; two felt they always knew how to do this, one said sometimes and two said never. Staff told us that they knew what to do if people had concerns about the home and care records showed that staff were sensitive to people’s changes of moods. The manager showed us how she was currently updating the complaints procedure to ensure that it was to update about the provider details and CSCI’s new contact details. Staff were clear about their responsibilities to report poor practice and their records showed that they have received appropriate training. A past safeguarding issue has been identified regarding one person and although staff were clear about the background to this concern and their role to provide protection, there was no guidance on the person’s file to support their practice or to formally confirm that the concern appeared to have been Dean View DS0000071074.V358589.R01.S.doc Version 5.2 Page 16 resolved. The manager was clear that while there was a role for monitoring, there was no longer a safeguarding concern, and agreed to ensure that records reflected this outcome. We also spoke about ensuring that people are consulted about money spent on their behalf supported by a multi-disciplinary approach for issues such as buying expensive items i.e. transport and seizure alert alarm systems. Files do not currently show that these consultations have taken place. The manager told us that they have difficulties contacting some of the agencies involved. Dean View DS0000071074.V358589.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): We looked at standards 24 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people who live here enjoy an attractive, clean and homely environment. EVIDENCE: The home is well decorated and well maintained. Aids and adaptations are provided where needed. All bedrooms are single occupancy. Everyone living at the home said that it was always clean and fresh, and this was the case on the day of the inspection. Staff told us in their surveys that bedrooms are well kept and we saw that this was the case. A person living at the home told us how they chosen the colour for their bedroom, and appeared proud of their room and possessions. We saw that the garden is generally well maintained; the manager said that work is due to start on repairing a wall and that there is a budget for this. We were told that staff manage the upkeep of the garden, whilst spending time with some of the people living at the home, who we were told enjoyed keeping Dean View DS0000071074.V358589.R01.S.doc Version 5.2 Page 18 them company. The manager plans to encourage people living at the home to be involved in choosing plants for the garden. Dean View DS0000071074.V358589.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): We looked at standards 32,33,34 and 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff are well supported to carry out their work through access to training but it would benefit people living at the home if staff members’ training is updated to promote best and current practice. EVIDENCE: Staff were all positive about the quality of their induction when they started the job and told us that their training was relevant to their role, kept them up to date with new ways of working and helped them understand the individual needs of people. We saw evidence that they were kept up to date with mandatory training and had access to more specialist training, such as understanding dementia but records showed that people had not attended training specifically about working with people with a learning disability. (See standard 18). On the first day of inspection, there were two care staff on duty, and the second day there was one care staff and the manager on duty. Staff and the manager told us that the manager often acts as the second person on duty. Dean View DS0000071074.V358589.R01.S.doc Version 5.2 Page 20 We were told that bank staff could be used for trips out but that there are no set hours put aside for this. Staff gave us mixed responses about if there were enough staff to meet the individual needs of all the people who use the service. One felt there was always enough, two said usually and one said sometimes. Two people expressed concern that staffing levels have been reduced and they told us that this could be a restriction when meeting people’s individual needs to participate in activities outside of the home. (See standard 12). The manager said that while the home had run without a manager bank staff had been used to a greater degree. All four staff members that responded to our survey said that their employer had carried out appropriate checks before they started work. The manager told us that no new staff had started working at the home since the last inspection. One person had left but had been retained as bank staff before returning as a permanent member of staff. Dean View DS0000071074.V358589.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): We looked at standards 37,39 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People live in a home that is well managed, is safe and is run in their best interests with a committed staff team but would benefit from the manager being registered with CSCI. EVIDENCE: All five staff members told us that there was always good communication between staff. One person felt that the staff team had really pulled together between July and November 2007 when a manager from another home oversaw the home. Staff told us that the manager met regularly with them to provide support and discuss how they are working. One person said that they had requested supervision and received it when the manager came into post. A new manager has been appointed since November 2007 but no application has Dean View DS0000071074.V358589.R01.S.doc Version 5.2 Page 22 been made to register them with CSCI. Since the inspection, CSCI has received an application to register the manager. The manager told us about the quality assurance systems in the home, which include surveys to relatives, residents meeting and staff meetings, plus regulation 26 visits. We saw minutes for one residents’ meeting in February 2008 and the manager told us how bingo sessions have been organised as an outcome of this. We saw from people’s activity records that they were able to participate in bingo sessions. In the home’s AQAA, the manager told us that appropriate maintenance checks and contracts are in place for systems, such as hoist maintenance and the heating system. She said that portable electrical equipment is in hand. Staff receive appropriate training in manual handling, first aid, food hygiene and infection control and demonstrate a good understanding of the principles involved. Dean View DS0000071074.V358589.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 x 2 3 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 3 ENVIRONMENT Standard No Score 24 3 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 2 33 3 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x LIFESTYLES Standard No Score 11 x 12 2 13 3 14 x 15 3 16 2 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x 2 x 3 x x 3 x Dean View DS0000071074.V358589.R01.S.doc Version 5.2 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 YA20 Regulation 13 (2) Requirement Timescale for action 11/07/08 2. YA32 Medication must be administered, handled and stored safely to help keep people at the home safe. This relates to the unsafe storage of antibiotics, keeping broken tablets and a gap in recording medication administration. 18 (1) ( c) Staff must receive training to (i) help up date their practice in working with people with a learning disability to ensure that people’s dignity and well-being is maintained. 03/01/09 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 YA12 Good Practice Recommendations Staffing levels should be monitored to ensure that they do not prevent people accessing the community either in a group or individually. This monitoring should be included as part of people’s monthly reviews. People should by offered the option of having an DS0000071074.V358589.R01.S.doc Version 5.2 Page 25 2. YA16 Dean View 3. 4. 5. 6. YA20 YA22 YA23 YA37 appropriate lock on their room and, if possible, shown the lock and how the lock would work. Staff should have clear guidance about when medication should be given for an unstable medical condition. People living at the home should be supported to understand what to do or who they can go to if they are unhappy and want to make a complaint. People should be consulted about money spent on their behalf supported by multi-disciplinary consultation for buying expensive items. The manager should be registered with CSCI to confirm their suitability for this role. Dean View DS0000071074.V358589.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Dean View DS0000071074.V358589.R01.S.doc Version 5.2 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. 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. 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