Inspection on 11/08/05 for Dramsdon

This inspection was carried out on 11th August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Dramsdon 28/06/07

Dramsdon 13/03/06

Dramsdon 22/02/05

Dramsdon 27/08/04

Dramsdon 18/03/04

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 08/07/2008.

CARE HOME ADULTS 18-65 Dramsdon Rivar Road Shalbourne Marlborough Wiltshire SN8 3QE Lead Inspector Stuart Barnes Unannounced 11 August 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. Dramsdon D51 D01 s28600 Dramsdon v240313 110805 Stage4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Dramsdon Address Rivar Road Shalbourne Marlborough Wiltshire SN8 3QE 01672 870565 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) White Horse Care Trust Mrs Elizabeth Lavis Care Home 5 Category(ies) of LD Learning Disability (5) registration, with number of places Dramsdon D51 D01 s28600 Dramsdon v240313 110805 Stage4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. No more than five service users with a learning disability at any one time. Date of last inspection 22nd February 2005 Brief Description of the Service: Dramsdon is managed by the White Horse Care Trust, which has several care homes throughout Wiltshire and beyond. The home is located on the outreaches of Pewsey, Malborough and Devizes in a small rural village where there is a pub and one shop. The service replicates ordinary living principles. It is a spacious bungalow with an extensive and safe garden. The service provides care and accommodation for five service users under the age of 65 that have a learning disability. Some of the peolple who live at Dramsdon have complex needs. Typically the home is staffed with a minimum of 3 staff on duty during the day. At night there is no awake staff presence. Instead the support staff take it in turns to sleep in the home on a rotational basis. This person is expected to respond to any night-time emergencies as they arise. The home does not employ any cooks or a cleaner. Instead support staff undertake these tasks. The home provides a ‘people carrier’ to transport service users out and about. Dramsdon D51 D01 s28600 Dramsdon v240313 110805 Stage4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and involved 2 inspectors. The inspectors spent time with the manager. They spoke to other staff that were on duty and also observed staff interact with certain service users. Time was also spent progressing the response to the requirements and recommendations made at the previous inspection, examining a variety of case documentation some of which was randomly selected and viewing the accommodation. The inspectors were not able to obtain the opinions of the people who live at the home due to their lack of expressive communication or their understanding of questions put to them. The emphasis was to inspect life style outcomes, access to health care, and arrangements for personal care and to check the premises and facilities. In total 35 NMS were inspected out of a total of 43. What the service does well: 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. Dramsdon D51 D01 s28600 Dramsdon v240313 110805 Stage4.doc Version 1.40 Page 6 The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Dramsdon D51 D01 s28600 Dramsdon v240313 110805 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 Dramsdon D51 D01 s28600 Dramsdon v240313 110805 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) 1, 2, 3 and 5, This continues to be a service that provides good standards of documentation including good assessments and good care/support plans. The needs of service users are being well met and there is good attention to ensuring there is a consistent approach. EVIDENCE: The service provides a detailed statement of purpose and service user guide, which has been updated. Terms and conditions are in pictorial format as well as text. People who support service users are informed about how to make a complaint, if they want to. Service users are provided with a comment card to voice any concerns. Staff are aware that in practice current service users are unlikely to be able to use the comment card without assistance. The management of the home shows a clear commitment to act in the service users best interest and to consult widely with family and/or paid workers on key decisions. This is especially so in relation to health needs. Support staff impress as knowing the service users needs well. They understand the importance of ensuring a consistent approach in the way care is delivered. The inspectors examined 2 case files, which were selected at random. They briefly scanned two other files. The files seen were well presented, orderly and structured. They provide comprehensive details, including any associated holistic and health care needs of the person. Good attention is given to recording any needs arising from difficulties associated with communication Dramsdon D51 D01 s28600 Dramsdon v240313 110805 Stage4.doc Version 1.40 Page 9 and understanding. Personal preferences are recorded e.g. favourite foods, enjoyable activities and favoured pastimes. Difficult concepts are covered such as informed consent, understanding of death and expressions of sexuality, along with details about personal care, personal safety and day services. Support staff are encouraged to train. The take up of training courses is good. All files seen provide written terms and conditions of residency that broadly meets the standard. Inspectors observed one support worker to be very gentle, respectful and patient with a service user that is blind. In doing so they allowed the person a lot of time to make a choice and decide his options. They used gentle tones, gave clear instruction in an uncomplicated manner and they told the person what they were doing (or were intending to do) so the service user could know and understand. However the inspectors also observed on 2 occasions two support staff sitting in a roomful of service users talking about matters personal to them and without engaging any of the service users. Dramsdon D51 D01 s28600 Dramsdon v240313 110805 Stage4.doc Version 1.40 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7, 8 and 9 Assessment and care planning is of a consistently good standard and the service is very good at engaging service users to share in decision making. Two minor deficits undermine what is generally good risk management in other areas. EVIDENCE: Each service user has their own support plan, which is routinely updated. This documentation includes attention to daily needs, specialist needs and any required actions by support staff (or others) to ensure outcomes or goals are met. Where any decision is recorded to restrict freedom or choice, such as not going out unescorted or restricting access to certain areas such a bedroom or kitchen these are supported by assessment documentation and appear appropriate to the circumstances. Plans and placements are being regularly reviewed by relevant staff. This documentation illustrates how service users are involved in the care planning and/or review process. The level of involvement depends on each person circumstances and understanding. In one recent case review a care manager concluded that the, “persons needs were being met to a high standard.” In another review there was evidence of progress in many areas. Dramsdon D51 D01 s28600 Dramsdon v240313 110805 Stage4.doc Version 1.40 Page 11 The support staff appear to work hard at supporting service users to be as involved as much as they can in key decisions. This is mostly done through an effective key worker system. It includes taking a ‘best interest’ approach or by offering limited options from which a person can choose. The inspectors observed this when someone was being supported to choose a leisure activity. It can be seen that day activity programmes vary, that rooms reflect individual preferences; times of going to bed/getting up are not the same for everyone and food likes and dislikes are recorded as part of on going assessment of need. The Trust provides options for service users to contribute to a wider quality assurance initiative. Staff impress as being protective and supportive and from discussion will not knowingly take undue risks. The Trust has a good, tried and tested system of assessing risk. However the leaving open of the garden gate and the faulty door alarm are reminders to be vigilant at all times in all places to be certain of ensuring safety. Dramsdon D51 D01 s28600 Dramsdon v240313 110805 Stage4.doc Version 1.40 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11, 12, 13, 14, 15, 16, and 17 Service Users are given the opportunity to make decisions about the way that they live their lives. People are encouraged to access the local community. A varied and nutritional menu is in place and fresh fruit is available as a snack when required. EVIDENCE: Each person has their own activities programme within their personal file. There is evidence of trips to the cinema, trampolining, walking, visits to pub and trips out in the homes vehicle. In-house activities include music, grooming and use of the garden swing. Staff will sometimes offer gentle hand massage to service users. One person had attended a distance-learning course, through Swindon College. Resident’s access a local resource centre, where they use the snoozlem or Jacuzzi. There is information on the local Tree Tops club including an Dramsdon D51 D01 s28600 Dramsdon v240313 110805 Stage4.doc Version 1.40 Page 13 entertainment programme for the year. Evening events include discos, Karaoke, treasure hunts and carol services at Christmas time. Staff members support people to integrate with the local community by attending local events; one example was a jazz festival. Guidelines and risk assessments are in place for accessing the community. Staff members reported that people can make choices by body language, gestures and facial expression. Staff stated that they have a sound knowledge of each person’s likes and dislikes and these are listed on each person’s assessments Friends and families are welcome at the house and this is stated in a pictorial format within the service user’s contract. The inspector observed staff interacting with individuals, whilst respecting their choice if they wished to be alone. Information leaflets were around the house and one person’s life book showed information about a recent activity holiday centre. This is a specialist centre, where the needs of service users could be supported. Meals are offered three times a day and the menus were varied and nutritional. Meals are generally taken together, however, people do have the option to eat alone if they wish. A bowl of fresh fruit was available for people when required. If service user’s need support from staff, when opening their mail, this is provided. Mail is opened in front of them and celebration cards are shown to them and then put on display. There is evidence that the service users spiritual needs and preferences are recorded in their file. Dramsdon D51 D01 s28600 Dramsdon v240313 110805 Stage4.doc Version 1.40 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 standard(s) 18, 18 and 21 Service users are being provided with good personal care and support. EVIDENCE: Policies in the home emphasise the importance of ensuring that all care is provided in a respectful and dignified manner and that there is a right to privacy. Each person having their own bedrooms and having 3 toilets/bath areas helps achieve this. Case documentation outlines clearly each person needs. These documents are supplemented by having a record of likes and dislikes and strengths and needs. Bedtimes and getting up times offer choice and a degree of flexibility. They also take into account the beneficial effects of ensuring a consistent approach and regular routine for people who, if they did not have this, might become distressed. The absence of waking night staff is seen as being potentially restricting. Specialist equipment to help people move around the home is provided. Case files show service users are supported to access a range of primary and specialist medical services that they need. The quality of assessment documentation is consistently very high indeed. The service has an effective key worker system in place. The manager reports very good working relationships with the local GP practice. There are records kept of past or planned medical appointments, weight charts and medication. The Trust has a well developed policy on death and dying which tells staff what to do if a death Dramsdon D51 D01 s28600 Dramsdon v240313 110805 Stage4.doc Version 1.40 Page 15 occurs. Case documentation outlines peoples understanding of death and any expressed wishes about disposal. Some service users have a prepaid funeral plan in place, which shows these events are prepared for and help to promote dignity - beyond life. Dramsdon D51 D01 s28600 Dramsdon v240313 110805 Stage4.doc Version 1.40 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 standard(s) 22 and 23 The ethos of the home is to capture any complaints and to protect service users from harm. This appears to be a rarely complained about service. EVIDENCE: The file recording complaints was seen. The Trust has a detailed policy on complaints, which has been recently reviewed. There have been no recent complaints. The complaint policy includes responding to concerns within 28 days. If a service user needs help to complain or to make other representations it is the policy of the Trust that they should be given assistance to do so. Support staff impress as people who would take forward any concern relating to a service users. Records show that in December last year the manager alerted the local social services manager of a concern regarding a service user being found locked in a room at a day centre run by the council. The use of advocates is encouraged though in practice these are in short supply through no fault of the home. The service also has a ‘whistle blowing’ procedure in place. Dramsdon D51 D01 s28600 Dramsdon v240313 110805 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, 25, 26, 27, 29 and 30 Overall the home continues to provide very good standards of accommodation that is suitable for the people who live at the home. However a lack of attention to a couple of areas and some wheelchair damage compromises the very high standards that are mostly evident throughout. EVIDENCE: All bedrooms were seen. Each service user has their own room and can include the option of a double bed if needed. All bedrooms are highly personalised and individualised. They reflect the occupant’s character and interests. For example, in one room there was a set of drums and in another some artwork. Colours and fabrics were different in each room. All rooms appeared clean and well ordered. Furnishing, fabrics and decorations were of a good standard, except that the large bathroom would now benefit from some redecoration. Plans exist to further improve some of the bedrooms with some redecoration before the end of the year. All bedrooms have fire detection and heating. No bedroom has any phone points. The inspector was told that no current service user was able to use a phone safely. One exit door did not have a working alarm raising the possibility that a service user could leave the building at night without staff knowing. The ramp leading from the rear of the house was found to have moss growing on it and it Dramsdon D51 D01 s28600 Dramsdon v240313 110805 Stage4.doc Version 1.40 Page 18 had an accumulation of leaves indicating it had not been swept for some time. Some corridors show wheelchair damage. The garden appeared well maintained. It provides suitable garden furniture in shaded areas (to prevent sun burn). On arrival it was noted that a service user was in the garden without a staff presence and with the gate held in the open position. Since the last inspection some upgrading of the windows and other remedial work has taken place. Staff were observed to be cleaning bathrooms and toilets with due regard to preventing cross infection and maintaining high standards of cleanliness in these areas. Grab rails and other equipment have been provided where needed. Dramsdon D51 D01 s28600 Dramsdon v240313 110805 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, 33, 35, and 36. The inspectors found examples of very good staff interventions but also found some inconsistencies in attitude, effort and standards of recording. The supervision of staff falls short of what is required. The absence of any waking night staff for people with such complex needs may not be able to be justified much longer. EVIDENCE: Rotas show that during the daytime there is sufficient staff cover. The home tries hard never to use agency staff to cover for shortages. If there are shortages the manager deploys regular bank staff or else staff work overtime. This helps ensure better continuity of care. At the time of the inspection there was one unfilled staff vacancy. There is evidence that indicates that, on occasions, there has been some night time disruption that has challenged staff. It has been partly remedied by changing the person’s medication. There is evidence to show that all current staff had undertaken a satisfactory Criminal Record Bureau (Criminal Record Bureau) check. There was no deputy in post at the time of the inspection. The absence of a deputy was one reason put forward by the manager for not being able to provide all staff with the supervision they need. The inspectors’ were told the deputy manager’s post Dramsdon D51 D01 s28600 Dramsdon v240313 110805 Stage4.doc Version 1.40 Page 20 had been filled but the person was awaiting completion of all the necessary checks before starting work at the home. Records show that all staff are aged at least 18 years. The manager was not clear about who has responsibility for supervising bank staff who may work in other homes within the Trust. Discussion with the manager suggests that the training of bank staff is a bit hit and miss. The manager was unable to verify all the training that bank staff have had, especially in respect of fire safety. But it was verified that if bank staff are required to give out medication they would not do so unless they have undertaken the Trust’s medication training. Based on the small sample of staff files seen all had photographs of the person and documentary evidence showing their proof of identity. Support staff praise the service for the amount of training offered to them. Records show that 4 staff so far have successfully obtained their National Vocational Qualification level 2 or above and that 3 more were in the process of completing this award. The Trust has produced a recent training plan. It shows any desired training, identifies who needs it and whether it has been scheduled or not. Records show that all current staff have undertaken training in basic first aid and fire safety. Those who have not completed training in food hygiene or drug administration have places already booked for such training. There are records of regular staff meetings taking place. These show that relevant topics are discussed and actioned. Support staff report that they are able to put agenda items forward for these meetings and that issues arising from the care of service users are also regularly discussed. Records show that formal ‘one to one’ supervision is not taking place every couple of months. Some staff are recording “fuzzy” details in service users daily records, i.e. details that do not adequately explain events or feelings. For example there are entries which state the person was, “fine overnight” or “had a nice time today” Dramsdon D51 D01 s28600 Dramsdon v240313 110805 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, 38 and 42 This is a service where the needs of service users are well known. It is a home that benefits service users. The home is quite a well run service but care needs to be taken to ensure the proper supervision of staff and sufficient numbers of permanent staff are in place. EVIDENCE: Outcomes from recent case reviews show that people living at the home continue to benefit from their placement. Key-workers and support staff report progress for many service users in many areas. There is evidence that shows when difficulties emerge people are helped with these difficulties. There is also evidence that shows when people are vulnerable outside the home staff take their concerns forward. Support staff praise the manager. The manager is deemed a fit person by the Commission to manage this service, but has yet to obtain the required National Vocational Qualification level 4 award. The Trust has a range of comprehensive policies that underpin good service standards. It is apparent the manager works hard to follow these policies, but is failing to ensure proper Dramsdon D51 D01 s28600 Dramsdon v240313 110805 Stage4.doc Version 1.40 Page 22 supervision arrangements. The Trust provides the Commission with regular and thorough management reports on the home. Health and safety is taken seriously, especially in regard to fire safety, environmental health matters and protecting service users from harm. The Trust has a range of policies that are designed to get a good balance between identifying hazards, managing risk and encouraging independence and having new experiences. Assessment of risk is being managed well and includes good supporting documentation. The local fire officer and the local environmental officer confirm that the home meets their statutory requirements. Support staff ensure that all parts of the house are kept clean and attention is given to reducing any risk arising from cross infection. The home and its environs are kept well maintained. All support staff practice fire drills and fire detection equipment is routinely serviced. Less clear is to what extent bank staff are trained in fire procedures and general health and safety. Dramsdon D51 D01 s28600 Dramsdon v240313 110805 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 3 4 3 x 4 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 4 3 3 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 4 3 3 x 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score x 2 2 3 3 1 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Dramsdon Score 4 4 x 3 Standard No 37 38 39 40 41 42 43 Score 3 2 x x x 3 3 D51 D01 s28600 Dramsdon v240313 110805 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 YA9 Regulation 13(4) Requirement That each night a person is delegated to check that the alarms fitted on all fire exit doors are kept in working order. The registered manager ensures that the rear ramp is periodically swept and any build up of moss is removed. The manager must take measures to find out what training, if any, the staff who work at the home as bank staff have had, what training they need to carry out their duties and to make arrangemets to provide them with such training. The manager must make arrangements to ensure that all bank staff receive appropriate supervision suited to the work they perform in the home and; that a record is kept of when such supervision is provided. The manager must make arrangements to ensure that all support staff receive appropriate supervision suited to the work they perform in the home and that a record is kept when such supervison is provided. Timescale for action 12/10/05 2. YA24 13(4) 12/10/05 3. YA32 19(5)(b) 18(1)(c) 12/10/05 4. YA36 18(2)(a) 12/10/05 5. YA36 18(2)(a) 12/10/05 Dramsdon D51 D01 s28600 Dramsdon v240313 110805 Stage4.doc Version 1.40 Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard YA9 YA38 Good Practice Recommendations It is recommended that the manager takes measures to ensure that the garden gate is kept closed when service users are using the garden unsupervised. It is recommended that all support staff are reminded how best to record events and feelings in the daily record book so as to ensure what is recorded is clearly understood and accurate. It is recommended that the supervision of staff takes the form of one to one meetings with a competant and experienced person at a period of not less than every 8 weeks; and that a record is kept of areas discussed, and any agreed action. 3. YA36 Dramsdon D51 D01 s28600 Dramsdon v240313 110805 Stage4.doc Version 1.40 Page 26 Commission for Social Care Inspection Suite C, 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 Dramsdon D51 D01 s28600 Dramsdon v240313 110805 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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