Inspection on 28/09/06 for East Court

This inspection was carried out on 28th September 2006.

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 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

East Court 25/01/06

East Court 02/08/05

East Court 14/02/05

East Court 22/10/04

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 East Court Doctors Hill Wookey Wells Somerset BA5 1AR Lead Inspector Judith Roper Key Unannounced Inspection 28th September 2006 10:00 East Court DS0000015998.V312758.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 East Court DS0000015998.V312758.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. East Court DS0000015998.V312758.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service East Court Address Doctors Hill Wookey Wells Somerset BA5 1AR 01749 673122 NA 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) THE ORCHARD VALE TRUST Lesley Reece Care Home 17 Category(ies) of Learning disability (17) registration, with number of places East Court DS0000015998.V312758.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25th January 2006 Brief Description of the Service: East Court is a large listed building located on the edge of Wookey. The house is set in extensive grounds which include a productive vegetable garden. Accommodation in provided in four units. The main house accommodates nine people; stable cottage is shared by two, the coach house offers two separate bed sits and the garden house offers a quieter environment for four people. All service user rooms are single occupancy and fifteen have en suite facilities. Service users are encouraged to develop and maintain daily living skills and are able to participate in a wide range of activities. East Court is registered with the Commission for Social Care Inspection to provide accommodation for up to seventeen people with a learning disability aged 18-65 years. The Registered Provider is Orchard Vale Trust. East Court DS0000015998.V312758.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key unannounced inspection was carried out by one inspector and took place over one day for a total of 6.5 hours. Seventeen residents were at the home on the day of the inspection. There are currently no vacancies at the home. The inspector was able to see and spend time interacting with the residents throughout the day. Many staff on duty were able to give time to speak with the inspectors. The registered manager Mrs. Reece was available for comment during the inspection. The inspector would like to thank Mrs. Reece and the staff for their time and hospitality shown to the inspector during her visit. The atmosphere at the home was relaxed and friendly. Staff carried out their duties in a pleasant, unhurried and professional manner. Prior to the inspection the Commission forwarded service user surveys to the home inviting comments on the service. Eleven responses were received, all giving positive comments about the service provision. Comment cards were also sent to health and social care professionals in contact with the home. Views reflected in survey/comment card returns have been reflected in this report. It is clear that at East Court residents are given opportunities and support to express their views on the conduct of the service through regular consultation by the organisation as well as being able to approach staff and management at the home informally. Records examined during the inspection were a selection of care plans, quality assurance processes, medication management records, staff training records and staff recruitment records, staffing rosters, service user menus, equipment servicing records, fire safety records and information provided by the home to prospective admissions. Prior to the inspection the home completed and forwarded a CSCI pre-inspection questionnaire. The aim of this inspection visit was to inspect key National Minimum Standards as part of the Commission’s ‘Inspecting for Better Lives’ strategy. Inspectors focus on outcomes for service users and measure the quality of the service under four general headings. These are - excellent, good, adequate and poor. The judgement descriptors for the eight chapter outcome groups are given in this report. Any standards where a requirement or recommendation was made at the last inspection were also inspected. What the service does well: East Court DS0000015998.V312758.R01.S.doc Version 5.2 Page 6 East Court continues to provide a high standard of care to service users within a spacious and pleasant environment. The home is set within large grounds. The facilities provided at the home include a pottery, bakery, weavery and a large vegetable garden. There are also numerous supported opportunities to access the full range of community based leisure, educational or work pursuits. Service user rooms have en suite facilities. Rooms have been decorated to reflect service users individual tastes and preferences. Service users participate in all household tasks, and independence is promoted. The service has a record of responding to requirements or recommendations to further improve the services in a positive manner. What has improved since the last inspection? What they could do better: As a result of this inspection four recommendations are made to the home. In order to make care plans easier to use it is recommended that the plans be reviewed with the service user monthly and that unnecessary non-current information be archived elsewhere. It is recommended that consent be obtained from the service user for the use of monitoring devises for health and safety reasons and also for invasive clinical procedures. Continuing consent should also be reviewed. It is recommended that the registered manager arrange for the Community Nurse accesses staff competencies where the Community Nurse’s responsibility is delegated to the home. East Court DS0000015998.V312758.R01.S.doc Version 5.2 Page 7 It is recommended that the standard reference request form used by Orchard Vale Trust be amended slightly to ask an ex-employer the reason why the person left their employment, if their job involved working with vulnerable people. 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. East Court DS0000015998.V312758.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection East Court DS0000015998.V312758.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2. The overall outcome for these assessed Standards is good. Service users and their families are provided with appropriate information to make a decision regarding admission to the home. The home has developed an appropriate Admissions procedure. EVIDENCE: The home has a Statement of Purpose and Service User Guide that provide details of the services and facilities offered at East Court. These documents are currently being reviewed and re-printed. The home has an Admissions policy, which was discussed at the inspection. Service users are admitted on a three-month trial basis. There have been no new admissions to the home for several years. East Court DS0000015998.V312758.R01.S.doc Version 5.2 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 the following standard(s): 6, 7, 8, 9, 10. The overall outcome for these assessed Standards is good. The home has developed a detailed care plan for each resident. Service users are encouraged to exercise choice and participate in all aspects of life within the home. Records relating to service users are appropriately maintained to safeguard confidentiality. EVIDENCE: Care plans are maintained for each service user. Three care plans were examined in detail. Care plans provide details of service users needs, daily routines and preferences. Health care needs are separated into a separate plan. Service users are able to access their care plans, and may store these in their bedroom, or the office, as they prefer. At the inspection residents were observed actively consulting their care plans and had demonstrated a good awareness of plan contents. East Court DS0000015998.V312758.R01.S.doc Version 5.2 Page 11 Care plans are reviewed informally on a regular basis and some plans inspected held a lot of information about the residents that was no longer current. In order to make care plans easier to use it is recommended that the plans be reviewed with the service user monthly, and this review be signed, and that unnecessary non-current information in the care plan be archived elsewhere. Some residents have been assessed as needing a nocturnal listening devise in their room in order to protect their health and safety, due to epileptic fits occurring at night. Rectal diazepam is also prescribed to manage epilepsy in some cases. It is recommended that consent be obtained and recorded from the service user for the use of monitoring devises and also for invasive clinical procedures. Continuing consent should also be reviewed. Service users are encouraged to exercise choice regarding the activities they participate in and their daily routine. Service users have a key worker. Service users views are sought on a regular basis at the residents meetings. During the inspection residents were observed being comfortably assertive in their interactions with staff. Feedback from comment cards by visiting professionals said that the service was ‘holistic’ and ‘person centred’, The home assists eleven service users in managing their monies. Records are maintained of all transactions involving service user finances. These are supported by receipts and staff signatures and are audited on a daily basis. The inspector witnessed a residents being supported to manage their shopping money for the day and the written procedure for the home was appropriately followed. East Court DS0000015998.V312758.R01.S.doc Version 5.2 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 the following standard(s): 11, 12, 13, 14, 15, 16, 17. The overall outcome for these assessed Standards is excellent. Service users are able to participate in a wide range of activities, and have regular opportunities to access the local community. Independence is promoted. Service users are encouraged to develop and maintain daily living skills. Meals provided are of a high standard and offer a well balanced diet. Residents grow much of their own produce in the home’s extensive gardens. EVIDENCE: Service users participate in a wide range of activities and have full weekly schedules that include evening commitments. The facilities provided at East Court include a pottery, bakery, weavery and a large vegetable garden. A nearby Batik workshop is being integrated into the facilities on-site. East Court DS0000015998.V312758.R01.S.doc Version 5.2 Page 13 Service users are also provided with regular opportunities to access the local community, to attend a number of clubs and activities, including at weekends and evenings. The home has an Activities Co-ordinator. She works with service users to ensure that the range of opportunities offered continues to meet service users interests and needs. An Activities Week is held each year, where service users may try out a wide range of activities. Residents had participated in the region’s Art Week in September; displaying and selling arts and crafts made at East Court. The home provides service users with £150 each year towards a holiday. Service users go away in small groups, and are involved in choosing and planning the breaks. Previous holidays have included stays in Normandy, Guernsey, Cornwall and Blackpool. Some service users attend college. Service users are encouraged to develop and maintain independence. Two service users at the home are in employment. Service users are fully involved in the growing, preparation and cooking of foods. An upgraded kitchen was installed at the home in the past year. This has improved the facilities and increased opportunities for service users to participate in meal preparation. Some staff and service users at the home belong to the Healthy Living Club. Meals are seen as an opportunity to meet up and enjoy social interaction. Service users spoke highly of the meals provided. The inspector took lunch with residents and staff. The meal choice reflected healthy eating principles, was filling and tasty. Four relatives at the home during the time of the inspection gave positive comments to the inspector about the service; it’s standards of care and support for residents and qualities of staff working at the service. East Court DS0000015998.V312758.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20. The overall outcome for these assessed Standards is excellent. Service users are provided with appropriate assistance to meet their personal care needs. The home supports service users in accessing healthcare services and plans ahead in consultation with service users for continuing health care needs. The home has an appropriate medications policy, which is adhered to. All medications are stored securely. EVIDENCE: Service users are provided with support to undertake personal care tasks as necessary. The level and type of assistance required is specified in their care plan. Some residents showed the inspector their written daily routine and indicated where they needed staff support. Health care services are accessed appropriately. Written records demonstrated where specialist advice is sought and on-going dialogue between East Court DS0000015998.V312758.R01.S.doc Version 5.2 Page 15 the resident, family, care manager and the home is maintained. A record is maintained of all professional visits. The home has a medications policy. Senior staff are provided with medications training. Medication records and medication storage was inspected. A signature had been recorded for all medications given and medication administration records were completed in good order. The home is providing appropriate levels of supervision and monitoring to those service users who self-medicate. All medications are stored securely. East Court DS0000015998.V312758.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23. The overall outcome for these assessed Standards is good. The home provides service users with regular opportunities to provide feedback on the service provided. The home has developed an appropriate complaints procedure. The home has appropriate policies relating to the Protection of Vulnerable Adults and whistleblowing. EVIDENCE: The home holds monthly meetings where service users may express their views. Service users confirmed that they enjoyed these meetings and felt that their views were listened to. The home has a complaints procedure, which includes details of external agencies that may be contacted, including CSCI. This is displayed on the noticeboard in the hallway and has been discussed at service user meetings. The home has not received any complaints since the last inspection. The Commission has not been approached directly with concerns or complaints about the service either in this interim period. The home has policies relating to the Protection of Vulnerable Adults and Whistleblowing. The current Public Disclosure policy contained within the staff handbook has been amended to contain details of external agencies that staff may contact to ensure that it complies with the Public Disclosure Act 1998. East Court DS0000015998.V312758.R01.S.doc Version 5.2 Page 17 East Court DS0000015998.V312758.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28, 29, 30. The overall outcome for these assessed Standards is excellent. The home has been decorated and furnished to a high standard. A range of accommodation is provided at the home. There are sufficient communal areas to meet service users’ needs. Service user rooms have been decorated to reflect individuals’ lifestyles and needs. The home is maintained to a high standard of cleanliness. EVIDENCE: East Court is a large listed building, situated within spacious grounds. Accommodation is arranged in four units. The main house accommodates nine people; stable cottage is shared by two, the coach house offers two separate bed sits, and the garden house offers a quieter environment for four people. East Court DS0000015998.V312758.R01.S.doc Version 5.2 Page 19 Staffing levels are provided to each unit in accordance with service user need, enabling some service users to live with greater independence. Service users’ rooms have been decorated and furnished to a high standard. Each room is for single occupancy and fifteen have en suite facilities. Service users are fully involved in choosing the décor for their rooms. Those service user rooms seen had been individualised with photographs, pictures and personal belongings. All service user rooms have locks fitted. There are separate communal areas within each of the units, and an additional games room within the main house. The home is set in large grounds that are accessible to service users. The home also has a guest room that is available for visitors. There is an on-going program of re-decoration and refurbishment within the home. Since the last inspection there has been decoration to the lounge and kitchen in the garden house, a bedroom and bathroom in the garden house and the kitchen and bathroom in the stable house. There has been refurbishment of the weavery and ground floor of the coach house. There is planned refurbishment of offices in the main house as the Orchard Vale trust head office will soon move their premises to East Court. The home was found to have a high standard of cleanliness, and follows good practice with regard to infection control. East Court DS0000015998.V312758.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35, 36. The overall outcome for these assessed Standards is good. Staffing levels are appropriate to meet service users’ needs. Staff provide a high standard of care. Staff are provided with opportunities to attend training, and receive regular supervision. Employment of new staff follows equal opportunities guidelines. A slight amendment to information requested from employers would make the employment procedure more robust in protecting vulnerable adults. EVIDENCE: Duty rotas are maintained. There are generally four staff on duty during the day, in addition to two sleeping-in members of staff at night. The high level of staffing has ensured that service users are provided with regular opportunities to participate in social activities and access the local community. Newly appointed staff receive induction training. Staff are provided with regular updates in mandatory training, and there is a good annual staff East Court DS0000015998.V312758.R01.S.doc Version 5.2 Page 21 training plan that is matched to identified individual staff training requirements. Rectal diazepam is prescribed for some residents and staff have been trained in the administration of this medicine. It is recommended that the registered manager requests for the Community Nurse serving the prescribing practice to assess staff competency in administering this medicine, as this is a delegated nursing task. Staff spoken with stated that it was a good place to work and that they received appropriate support. Staff receive an Individual Performance Review, and receive supervision on a regular basis. The recruitment files were examined for three members of staff employed since the last inspection. Appropriate procedures had been followed in the recruitment of new staff. The ex-employer reference request form does not enquire why the staff member left that post. If the post involved working with vulnerable people it is recommended that this question be posed on the reference request. The inspector also suggested to the registered manager that reference returns be date stamped on receipt at East Court in order to demonstrate when the reference had been returned. East Court DS0000015998.V312758.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 40, 41, 42. The overall outcome for these assessed Standards is good. The home is well run. There are appropriate systems in place for consultation with service users and their families. There is a relaxed and open atmosphere within the home. Appropriate actions have been taken to promote the health and safety of staff and service users. EVIDENCE: Lesley Reece is the registered manager at East Court. She has a good knowledge of the service users needs and continues to work one shift each week. Robert Freebury, the former manager has become the Responsible East Court DS0000015998.V312758.R01.S.doc Version 5.2 Page 23 Individual and regularly visits all of the homes owned by the Orchard Vale Trust. Service users and their families are encouraged to provide feedback on the service provided. Service User meetings are held each month, and Family meetings every three months. The families of service users at homes within the Orchard Vale Trust also choose a Families Representative to liaise with the Trustees. Quality assurance processes are formalised and enable the service to continually assess how the service is performing. Several Trust policies have been reviewed since the last inspection to reflect both statutory and best practice guidelines. The home has appropriate policies and procedures in place to safeguard vulnerable service users. All records relating to service users are stored securely in accordance with the Data Protection Act 1998. The home displays appropriate Employers Liability Insurance. One member of staff has taken lead responsibility for health and safety within the home. Fire records were examined demonstrated regular checking of equipment. Staff are provided with regular fire safety training. Residents are included in fire drills. Health and safety records have been appropriately maintained. All accidents have been recorded and reported as required. East Court DS0000015998.V312758.R01.S.doc Version 5.2 Page 24 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 4 2 3 3 N/A 4 N/A 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 4 25 3 26 3 27 3 28 4 29 3 30 3 STAFFING Standard No Score 31 3 32 2 33 4 34 2 35 4 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 2 4 4 3 LIFESTYLES Standard No Score 11 4 12 4 13 4 14 4 15 4 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 4 3 X 3 3 4 3 3 3 X East Court DS0000015998.V312758.R01.S.doc Version 5.2 Page 25 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. Standard Regulation Requirement Timescale for action 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 YA6 Good Practice Recommendations It is recommended that care plans be reviewed monthly and where possible resident and key worker sign to acknowledge this has taken place. It is recommended where a risk assessment for a resident indicates that a surveillance devise be used to alert staff to nocturnal epilepsy and where rectal diazepam is prescribed for a resident for status epilepticus, that this is discussed with the resident and their consent clearly recorded. If the resident is unable to consent a record of this being discussed with next-of-kin or the care manager should be recorded. This should be reviewed at least annually. It is recommended that the Registered Manager arrange for the Community Nurse attached to the prescribing G.P. surgery to assess the competency of staff in the home in administering rectal diazepam, as part of the Community nurse’s delegated responsibilities under NMC codes of DS0000015998.V312758.R01.S.doc Version 5.2 Page 26 2 YA7 3 YA32 East Court practice. 4 YA34 Where an applicant has previously worked with vulnerable adults it is recommended that the home’s reference pro forma asks for information why the applicant ceased to work in that position. East Court DS0000015998.V312758.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 East Court DS0000015998.V312758.R01.S.doc Version 5.2 Page 28 - 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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