Inspection on 20/07/05 for Duckyls Farm Centre

This inspection was carried out on 20th July 2005.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Duckyls Farm Centre 03/07/09

Duckyls Farm Centre 30/07/08

Duckyls Farm Centre 13/06/06

Duckyls Farm Centre 21/12/05

Duckyls Farm Centre 04/11/04

Duckyls Farm Centre 28/06/04

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Dovedale Court

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

CARE HOME ADULTS 18-65 Duckyls Farm Centre Selsfield Road West Hoathly West Sussex RH19 4QY Lead Inspector Ms V Khan Unannounced Wednesday, 20 July 2005 V225410 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. Duckyls Farm Centre H60 H11 S14490 Duckyls Farm Centre V225410 200705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Duckyls Farm Centre Address Selsfield Road, West Hoathly, West Sussex, RH19 4QY 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) 01342 811111 Mr Brian James Jack Mr Brian James Jack Care home only (PC) 7 places Category(ies) of Learning Disability (LD) 7 places registration, with number of places Duckyls Farm Centre H60 H11 S14490 Duckyls Farm Centre V225410 200705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 4th November 2004 Brief Description of the Service: Duckyls Farm Centre is a care home registered to provide accommodation and personal care for up to seven people between the ages of 18 and 65 years with learning disabilities. It is privately owned by Mr Brian Jack, who also manages the service. Duckyls Farm Centre is in a rural area, located on the outskirts of the village of West Hoathly in West Sussex. The home has many of the characteristics and features of traditional farmhouse. Communal rooms are on the ground floor and seven single bedrooms are on the first floor. There are extensive grounds with an organic vegetable garden and livestock. Duckyls Farm Centre H60 H11 S14490 Duckyls Farm Centre V225410 200705 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Two inspectors visited Duckyls Farm Centre for an unannounced inspection on the 20th July 2005. The inspection started at 10 am and lasted for seven and a half hours. Six residents are currently living at Duckyls Farm Centre. Five were at the centre at the time of the inspection and one resident was away visiting family. Inspectors talked with five residents, Mr Jack, the assistant manager and other staff members on duty. One visiting professional was also spoken to during the inspection, who said he was a regular visitor and had no concerns about the home. Time was also spent reading records and walking around the home and grounds. What the service does well: What has improved since the last inspection? What they could do better: Care Plans need to be developed for each resident. The staff recruitment records need to be more organised, with all the required documentation in place and pre-employment checks carried out. Staff training needs to be further developed, to include induction and foundation training, behaviour management including restraint, and infection control. Duckyls Farm Centre H60 H11 S14490 Duckyls Farm Centre V225410 200705 Stage 4.doc Version 1.30 Page 6 The formal supervision of staff is required and annual appraisals should be undertaken. The arrangements for the administration and storage of medication, including the self-administration of medication by one resident needs to be reviewed. The visitors book needs to be used for all visitors to the home. All notifications as per Regulation 37 should be notified to the Commission. Risk assessments need to be reviewed and amended. Policies and procedures need to be reviewed and amended. The laundry must not be used for the preparation and storage of food. 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. Duckyls Farm Centre H60 H11 S14490 Duckyls Farm Centre V225410 200705 Stage 4.doc Version 1.30 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 Duckyls Farm Centre H60 H11 S14490 Duckyls Farm Centre V225410 200705 Stage 4.doc Version 1.30 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 A brochure has been produced to give to people thinking about living at the home, their families and representatives. EVIDENCE: One inspector read the Statement of Purpose and Service User Guide. The Statement of Purpose and Service User Guide provide information about the ethos of the home. “The Centre was created to provide a living, learning and working environment where adults with learning difficulties can realise their potential and live fulfilled lives. The community life and work is aimed at achieving mutual respect, dignity and quality of life for both staff and residents”. All current service users have been living at the home for a number of years since it was first registered, being placed and funded by various Local Authorities. They were assessed prior to moving in under the care management process. Duckyls Farm Centre H60 H11 S14490 Duckyls Farm Centre V225410 200705 Stage 4.doc Version 1.30 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7, 8, 9 Members of staff make every effort to involve residents in making choices and decisions and to be involved in all aspects of life in the home. Failure to produce care plans means that members of staff may not receive sufficient guidance to provide the right care and support to meet residents needs. Risk assessments need to be further developed, to ensure that residents safety and well-being is not put at risk. EVIDENCE: Duckyls Farm Centre has not written care plans for residents, but recent reviews have taken place involving Social Services on five out of the six residents living at Duckyls Farm. The need for a working care plan to be in place for each resident was discussed with the manager and assistant manager. Residents are encouraged to make decisions and are supported by staff as necessary. Each resident can choose what jobs around the home they would like to do each day and complete activity schedules. Duckyls Farm Centre H60 H11 S14490 Duckyls Farm Centre V225410 200705 Stage 4.doc Version 1.30 Page 10 Risk assessments are held on residents and the environment. Risk assessments were completed in 2002 for individual residents challenging behaviour. Individual risk assessments need to be more comprehensive, agreed with residents and any other relevant professionals, recorded in care plans, and reviewed on a regular basis. Action must be taken to minimise any identified risks and hazards. Inspectors read the personal allowances policy, which was also explained by Mr Jack. All residents allowances are paid into a central account. Mr Jack then distributes individual allowances into residents bank accounts. Records are kept of all incoming and outgoing payments. Duckyls Farm Centre H60 H11 S14490 Duckyls Farm Centre V225410 200705 Stage 4.doc Version 1.30 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14, 16, 17 Opportunities are provided to residents to take part in activities, for personal development and for leisure. A good choice of food, drinks and snacks are offered to residents. EVIDENCE: Residents participate in therapeutic activities on the farm, for which they are paid a small allowance. Each resident can choose what they wish to do each day. All residents attend a local college. Residents are encouraged to join in local events and be involved in the local community. One resident said he “ really liked the discos they had.” One resident really enjoys going to the village social club to watch football. Transport is provided to enable residents to access community facilities and amenities. Duckyls Farm Centre H60 H11 S14490 Duckyls Farm Centre V225410 200705 Stage 4.doc Version 1.30 Page 12 Residents enjoy craft activities at the farm, such as weaving. One of the farm outhouses is being lent to a sculptor for the winter, who is also going to teach some of the residents whilst there. One resident has her own pet guinea pig at the farm. Five residents went on holiday to Weston super mare early in July 2005, the other resident chose to go on holiday with family instead. One resident talked about how he had enjoyed the holiday. In particular he said how much he “ liked the food and swimming”. The menus showed that residents receive a varied and balanced, nutritious diet. Inspectors ate lunch with residents, staff and one German student. Lunch was homemade meat or vegetable quiche, new potatoes and coleslaw, followed by shortbread, strawberries and cream. Lunch was unhurried and support was provided to those residents requiring assistance. Duckyls Farm Centre H60 H11 S14490 Duckyls Farm Centre V225410 200705 Stage 4.doc Version 1.30 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20 Residents may be put at risk because of the gaps in the medication administration sheets, storage of the medication cupboard key and also due to one resident self medicating without appropriate assessment having first been completed. Members of staff respond to signs of a resident being ill and call the doctor or take advice quickly. Residents are supported to see the dentist, optician and other health professionals as necessary. EVIDENCE: All residents are registered with local General Practitioners. Additional support and advice is available from the Community Team for People with Learning Disabilities. A new medication storage cupboard is in use. However, it is recommended that the arrangements for the storage of the keys be reviewed. The medication administration records were seen to have some gaps and the staff were unable to verify that residents had received their required medication on these dates. Residents consent to medication needs to be obtained and recorded in their care plans. The manager and assistant manager said that one resident self-medicates and that this had been agreed with his community psychiatric nurse. The inspectors were unable to find any details of this in the Duckyls Farm Centre H60 H11 S14490 Duckyls Farm Centre V225410 200705 Stage 4.doc Version 1.30 Page 14 records. Inspectors learned that he is allowed to keep medication with him throughout the day in his pocket. There is no procedure to facilitate selfadministration of medicines by residents. No risk assessment had been conducted before allowing the resident to self-administer. The accident book recorded one accident to a service user in April 2005. The residents records examined showed that appointments with dentist, optician and other health professionals are made as and when necessary. No key worker system is in place, but this fits into the home’s philosophy of being one large family. Duckyls Farm Centre H60 H11 S14490 Duckyls Farm Centre V225410 200705 Stage 4.doc Version 1.30 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 23 Staff training on adult abuse has further developed their knowledge on this subject area. EVIDENCE: A West Sussex Social Services policy with procedures is held in the home. Evidence showed that ten members of staff have received training in adult abuse. Training consisted of watching a video and completing questionnaires. There was no documentary evidence of training for staff in the use of restraint, although Mr Jack said he had personally instructed staff. One restraint had been carried out in June 2005 and was recorded in the medical book. Physical intervention should be used only as a last resort by trained staff in accordance with department of health guidance, to protect the rights and best interests of the residents and is the minimum consistent with safety. All restraints should also be notified to the Commission as a Regulation 37 notification. Duckyls Farm Centre H60 H11 S14490 Duckyls Farm Centre V225410 200705 Stage 4.doc Version 1.30 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 25, 26, 27, 28, 29, 30 The standard of the environment is satisfactory providing the service users with a comfortable, spacious and homely place to live. EVIDENCE: The home is located on a farm. The house is a large L shaped building and is lived in by some staff and residents. Each of the residents have their own rooms and share the large communal spaces with everyone else living at the community. The house is decorated according to the Steiner based ethos which looks at different colours representing moods and the use of rooms. Each of the residents rooms are of an adequate size and contain the basic recommended furniture such as a bed, wardrobe, chest of drawers etc. However the rooms do not have any en-suite facilities. It was clear from viewing the rooms with the residents that in the majority, rooms were based on individual taste. One resident expressed how much he liked living at the farm. There are currently plans in place to decorate each of the residents rooms. This will be done whilst they have a spare room to use to move people in and out whilst the work takes place over the summer. Duckyls Farm Centre H60 H11 S14490 Duckyls Farm Centre V225410 200705 Stage 4.doc Version 1.30 Page 17 There are locks on each of the residents rooms but there are no keys held by residents. The manager holds a skeleton key in the case of an emergency. There are two bathrooms that are used by the residents, both have sinks and toilets and one has a bath and the other a walk in shower with safety flooring; these have been recently upgraded. Both rooms have safety locks which can be opened from the outside in an emergency. The home is situated in fantastic grounds which include the farmyard, fields and a wood. All of the residents have access to these facilities and each person has a patch within the kitchen gardens to grow what they like. The house has a large kitchen and dining/lounge area, which is used for listening to music and watching television. There is a further lounge that is a quiet area for reading and relaxing. During the inspection some of the residents were helping to clear out the arts and craft room for the wintertime. The home has a separate sleeping-in room and bathroom facilities for the staff. The home is generally clean and tidy. The cleaning is undertaken by the staff and voluntarily by the residents. There is no clinical waste at the moment. The laundry is sited to the side of the kitchen and on the day of the inspection was being used as a food preparation and storage area. This is not acceptable due to guidelines of control of infection. Hand-washing facilities and appropriate flooring are in place. Risk assessments need to be in place and the room should only be used as a laundry area not an extension of the kitchen. Duckyls Farm Centre H60 H11 S14490 Duckyls Farm Centre V225410 200705 Stage 4.doc Version 1.30 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 34, 35, 36 The home does have in place systems for the recruitment of staff and staff training. Both areas need some work alongside the introduction of supervision, to maintain the safety of working practices in the service, to keep service users safe and so that staff can meet their required care needs. EVIDENCE: The home does retain some information relating to checks upon the staff and in the case of staff starting after 2002 there are files that contain more of the required documents. However the information is not stored in one place so it is very hard to obtain a clear picture of the records. The service does receive copies of the code of conduct undertaken on the German students who work at the service for a month at a time. There is some evidence of a training programme in place, which is mainly based on in-house training using BVA videos and course work. Through this programme the home have introduced adult protection training. It was felt that the in-house training did need to be given by someone who had undergone outside training through recognised training bodies. A training needs assessment should be carried out for the staff team as a whole, with a training and development plan developed. Duckyls Farm Centre H60 H11 S14490 Duckyls Farm Centre V225410 200705 Stage 4.doc Version 1.30 Page 19 The staff are currently undertaking NVQ training and during the inspection one of the staff met with her NVQ assessor to look at her progress on the course. The home does not have a supervision programme in place, an appraisal system or written induction records. New staff do shadow more experienced staff for a period of three weeks before working with the residents. There is guidance in place for the disciplinary and grievance process for staff. The prospective manager would need to undertake training to gain a basic understanding of supervision before implementing a programme within the home. The assistant manager was seen to have a good knowledge of all the residents needs. Staff were observed during the inspection to have a good rapport and appropriate interaction with residents. Duckyls Farm Centre H60 H11 S14490 Duckyls Farm Centre V225410 200705 Stage 4.doc Version 1.30 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 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, 40, 42, 43 The registered manager needs to review the policies and procedures and risk assessments, to ensure residents are protected and their needs are met. Staff need to be trained in infection control, to ensure that they understand the risks to residents or themselves in this area. EVIDENCE: Mr Jack is the owner and manager of Duckyls Farm Centre. He has worked in various settings in the voluntary sector promoting activities for adults, including being involved in Riding for the Disabled. He communicates a clear sense of leadership and was observed to be popular with the residents. The application to register a new manager is currently being processed by the Commission. Duckyls Farm Centre H60 H11 S14490 Duckyls Farm Centre V225410 200705 Stage 4.doc Version 1.30 Page 21 Mr Jack has produced supplementary procedures, which is an ease of use booklet for staff to use. However, they do need to be reviewed and revised to ensure that they contain the required and current information, e.g. recruitment does not mention CRB/POVA checks, the prevention of abuse does not list all categories of abuse, medication does not include information on selfmedication. Details recorded showed that one resident had broken a finger. Whilst the appropriate treatment was sought, the manager is reminded that all incidents as per Regulation 37 need to be reported to the Commission. The visitors book was examined and showed that visitors to the home are not always recorded. For example a regular visiting professional had not signed the visitors book. The manager is reminded that all visitors to the home need to be recorded. Staff should receive induction and foundation training and training in infection control to ensure safe working practices at the home. Basic risk assessments are held on all residents, e.g. shaving, teeth, bathing, bath water temperature. However, they need to be reviewed, as they had not been reviewed since August 2000. During the inspection, a resident was seen to be driving the mini-tractor. This is contrary to the general risk assessment, which states that residents can only drive the mini-tractor under supervision. Fire records and equipment were reviewed and found to be in order, with regular tests and drills held. The portable appliance testing was overdue by four months, but the manager and assistant manager both confirmed that this was due to be actioned during the coming week. Duckyls Farm Centre H60 H11 S14490 Duckyls Farm Centre V225410 200705 Stage 4.doc Version 1.30 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 x x x Standard No 22 23 ENVIRONMENT Score x 1 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 1 3 3 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 2 Standard No 11 12 13 14 15 16 17 x 3 3 3 x 3 3 Standard No 31 32 33 34 35 36 Score x x x 2 1 1 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Duckyls Farm Centre Score x 3 1 x Standard No 37 38 39 40 41 42 43 Score 3 3 x 2 x 1 3 H60 H11 S14490 Duckyls Farm Centre V225410 200705 Stage 4.doc Version 1.30 Page 23 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. 3. Standard 6 9 19 Regulation 15 13 (4) 13 (2) Requirement Care plans need to be developed for each resident. All potential risks to residents need to be assessed and so far as possible eliminated. The registered person shall make arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the care home. Ensure all staff receive training appropriate to the work they are to perform. A record of all visitors to the home, including the names of visitors must be kept in the care home. All events listed under this Regulation must be notified to the Commission. Restraint must only be used as a last resort by trained staff. The home needs to ensure that all the required records according to Schedule 2 are in place. The home needs to implement a supervision programme for all staff. Timescale for action 20/10/05 20/10/05 20/10/05 4. 5. 35 42 18 (1) 17 (2) 20/1/06 20/8/05 6. 7. 8. 42 23 34 37 13 (7) 19 20/8/05 20/8/05 20/10/05 9. 36 18 (2) 20/10/05 Duckyls Farm Centre H60 H11 S14490 Duckyls Farm Centre V225410 200705 Stage 4.doc Version 1.30 Page 24 10. 16 30 The home needs to change the 20/10/05 practice of using the laundry as an area in which food is prepared and stored to the possible spread of infection. 11. 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. 3. Refer to Standard 40 42 34 Good Practice Recommendations All policies and procedures need to be reviewed and amended as appropriate. All staff receive induction and foundation training and updates on all safe working practice topics. The home needs to implement clear staff files where information required by the inspection process is clear and organised. Staff providing in-house training need to undertake refresher and outside professional training in order to be able to provide staff with accurate updated training on basic issues in the home such as health and safety, adult protection etc. The home needs to implement an appraisal system to sit alongside a supervision system. The potential manager needs to undertake supervision training in order to enable her to implement the supervision system. Residents consent to medication needs to be obtained and recorded in their care plans. The arrangements for the storage of the keys to the medication cupboard needs to be reviewed. A procedure needs to be developed, to include risk assessments, to facilitate the selfadministration of medicines by residents. 4. 35 5. 36 6. 20 7. Duckyls Farm Centre H60 H11 S14490 Duckyls Farm Centre V225410 200705 Stage 4.doc Version 1.30 Page 25 Commission for Social Care Inspection 2nd Floor, Ridgeworth House Liverpool Gardens Worthing, West Sussex BN11 1RY 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 Duckyls Farm Centre H60 H11 S14490 Duckyls Farm Centre V225410 200705 Stage 4.doc Version 1.30 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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