Inspection on 11/03/08 for Ellens Court

This inspection was carried out on 11th March 2008.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Ellens Court 16/12/08

Ellens Court 17/09/07

Ellens Court 06/10/06

Ellens Court 22/11/05

Ellens Court 07/06/05

Ellens Court 15/03/05

Ellens Court 09/02/05

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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 Ellens Court Lady Margaret Manor Doddington Sittingbourne Kent ME9 0NT Lead Inspector Sandra Crosby Unannounced Inspection 11 March 2008 09:15 th Ellens Court DS0000023931.V359325.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 Ellens Court DS0000023931.V359325.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. Ellens Court DS0000023931.V359325.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ellens Court Address Lady Margaret Manor Doddington Sittingbourne Kent ME9 0NT 01795 886220 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) Mrs Lynn Brooks Mrs Lynn Brooks Care Home 9 Category(ies) of Learning disability (9) registration, with number of places Ellens Court DS0000023931.V359325.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 17th September 2007 Brief Description of the Service: Ellen’s Court is a 9 bedded home providing 24 hour care and support to adults who have a learning disability. The home is owned and managed by Sally (Lynn) Brooks. A team of care staff and ancillary staff support her. The home is located in a rural setting approximately one and a half miles outside the village of Doddington. The property is detached and the accommodation is located on 2 floors. The upper floor consists of 5 single bedrooms and a W.C. The ground floor has four single bedrooms, a large comfortable lounge, a separate smaller lounge, a shower room, a bathroom, further W.Cs, a kitchen, laundry and a dining room. There are several outbuildings including a games room, a workshop, and a kitchenette that is used to promote independent living skills for the service users. The property has extensive grounds that are attractively laid out and well maintained. The statement of purpose and service user guide is kept in the office. service users have an individual copy of the service user guide. Weekly fees range from £722.75 to £1336.00. All Ellens Court DS0000023931.V359325.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means that people who use this service experience adequate, quality outcomes. This report contains the findings of the home’s key inspection and takes account of information obtained from various sources since the last inspection of 17 September 2007, including a visit to the home. An unannounced visit took place on the 11 March 2008 between 09.15 hours and 14.00 hours. The visit included talking to the manager, staff on duty and residents, plus observing the interactions between them. An accompanied tour of some areas of the home was made, and various records wee seen. The complete Annual Quality Assurance Assessment (AQAA) documentation was received together with a comprehensive Improvement Plan received following the last inspection visit. Information in these two documents has been used when compiling this report. Nine service user surveys completed with the assistance of staff were received all containing positive comments about the home for example ‘ I spent the day with everyone at Ellens Court before I moved in’, ‘staff help me to make positive choices’, ‘I have no need to complain’, ‘I love living here’, ‘very happy here’, ‘good treatment’. Six completed relative surveys were received containing mainly positive comments for example ‘they care about their social life, they go on holidays’, ‘when they went to hospital everyone staff and residents showed they all cared about them like a family would’, ‘he is very happy there’, ‘staff look after him well’, ‘the home is doing a good job’, ‘the manager keeps me informed about any important information’, ‘they are very understanding and support their needs. Ten completed staff surveys were received containing positive comments for example ‘there is an amazing family atmosphere’, ‘residents like living here and have a good rapport with staff’, ‘the care home provides a warm, safe and friendly home for nine people’, ‘good relationship with the local community’. Three completed care manager surveys were received containing positive comments for example ‘no concerns have been raised by me or my clients’, ‘home have made sure that aids and adaptation have been put in place to meet care needs’, ‘very supportive home’, ‘many activities outings and holidays organised, large grounds and in house activities organised’, ‘the staff I have met certainly do know my clients needs’. Ellens Court DS0000023931.V359325.R01.S.doc Version 5.2 Page 6 The findings of this report indicate that following the last inspection visit when a large number of requirements were made, the manager and her team have worked very hard to address many of the issues raised. It is indicated that improvements have been made and that this is ongoing with some work still to be completed. What the service does well: What has improved since the last inspection? The Statement of Purpose documentation has improved, but requires further amendments to fully comply with regulation. The format for the service user plans has improved, however further improvement is needed in order for this documentation to comprehensively reflect the needs of residents and the support to be provided. Health care plans have been completed. Staff have undertaken a range of mandatory training. The home has recognised the need for quality assurance. Re-decoration is ongoing. Ellens Court DS0000023931.V359325.R01.S.doc Version 5.2 Page 7 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Ellens Court DS0000023931.V359325.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 Ellens Court DS0000023931.V359325.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1,2 and 5 were inspected at this visit. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Prospective service users can be confident that the home will provide the right information they need to make a choice about where to live. Service users cannot always be assured that the home will assess or meet their needs. EVIDENCE: The improvement plan for the home completed by the manager states that the Statement of Purpose has been updated and a copy sent to the Commission. This document was viewed and discussed. The manager agreed to make further amendments to this document in order to comply fully with the requirements of Regulation 4, Schedule 1. The information seen was an improvement on the documentation previously used. The manager said that the Service User Guide is in the process of being updated. No new residents have been admitted since the previous inspection. It was seen for a resident that recently returned from hospital that written comprehensive reassessment information was not available, however the manager was knowledgeable as to the needs of the person. It was further evidenced that although comprehensive daily records had been maintained Ellens Court DS0000023931.V359325.R01.S.doc Version 5.2 Page 10 following readmission to the home, the care plan and risk assessments had not been updated. A requirement was given in the previous report in relation to Standard 2, and the manager agreed to address this issue. A contract of residence was seen as part of one of the individual service user plans, the manager needs to ensure that these contracts are signed and dated. Ellens Court DS0000023931.V359325.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6, 7 and 9 were inspected at this visit. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users would benefit if the home recorded fully how staff supported individuals with regard to their assessed and changing needs and personal goals. EVIDENCE: All residents living at the home have complex needs. Support is required in most areas of daily living, therefore the service user plans and risk assessments need to provide clear guidelines regarding how to support individuals. Two service user plans were seen. The manager said that she had worked hard following the last inspection to improve the format of the plans. It was seen that the service user plans contained all components as required by regulation, however shortfalls were identified during the inspection of care plans and risk assessments. It was seen that not all risk assessments for Ellens Court DS0000023931.V359325.R01.S.doc Version 5.2 Page 12 example one for medication and one in relation to body weight were in place together with insufficient information provided in some risk assessments to support staff in providing the required care. These were discussed with the manager, and she agreed to address these issues. Evidence was seen that efforts were being made to update the care plans and risk assessments, but they did not always reflect changing needs. The recording of the daily records has improved. Residents regularly meet with their keyworker; choices and decisions are made in this forum and residents confirmed this. As the staffing level at the home has improved, the home has been enabled to promote more choices and flexibility around residents needs. On the day of the inspection visit four residents were going out with staff to the library, and then for a meal out. Ellens Court DS0000023931.V359325.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 14, 15, 16 and 17 were inspected at this visit. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users can mainly be confident they will have satisfactory opportunities regarding lifestyle choices because the staffing level has improved. EVIDENCE: It was indicated that improvement has been made in relation to opportunities regarding lifestyle choices, enabled by the improved level of staffing at the home. Discussions were held with a number of residents, staff and management. Activities are mainly offered Monday to Friday, and it was confirmed that all residents take part in activities. A range of activities is available in the Games Room including snooker, darts, and use of computers. Outside persons come to the home and provide for example arts and craft session, music and movement and music therapy sessions. Ellens Court DS0000023931.V359325.R01.S.doc Version 5.2 Page 14 As the staffing level has improved residents are able to go out more in the evenings, and it was evidenced that trips to the pub and to the cinema have increased. There may still be difficulty in providing outside activities at the weekend as the staffing level although having increased, still relies on one member of staff to undertake ancillary duties therefore it is not always possible to facilitate weekend outings. The completed improvement plan for the home states that mealtimes are to be more flexible and that this instruction has been given verbally during staff handover meetings; together with residents choice of menu being discussed at 1-1 time and during residents meetings. Residents confirmed this. The home employs a cook Monday to Friday. All meals are prepared. Residents have their main meal at lunchtime. All residents spoken with expressed satisfaction with the food. At weekends the care staff prepare meals. The food records were seen and indicated that a variety of food was provided, and the storage of food items seen also confirmed that there was plenty of choices available. Care plans demonstrated the homes’ commitment to enabling and supporting residents to maintain contact with their families. It was clear from conversations with residents and staff that family ties are strong, and contact in the form of visits and letters are encouraged and supported. An issue seen recorded in the daily records was discussed with the manager in relation to resident choice, dignity and respect for people. She agreed to take action in relation to this issue. Ellens Court DS0000023931.V359325.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18, 19 and 20 were inspected at this visit. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users cannot always be sure they will receive personal support in the way they prefer and require, nor can they always be confident that their physical and emotional needs will be met. EVIDENCE: New individual health care folders have been implemented, and provide comprehensive information, about all visits from professionals, however it was seen that this information was not always up to date, and a further issue that needs addressing is the regular recording of body weight as necessary. Many of the residents have complex mental health needs. Although care plans and assessments make reference to individuals’ mental health, there are not always sufficient support guidelines in place. Staff have received training in Epilepsy during October 2007, and there is planned training in relation to Autism booked for April 2008. Ellens Court DS0000023931.V359325.R01.S.doc Version 5.2 Page 16 Work is currently being undertaken with residents to provide documentation that residents may keep in their rooms, and will contain information about their wishes regarding support needs. The medication records were seen and indicated that they were appropriately signed for and up to date. Discussion took place in relation to the medications that were being taken out at lunchtime, and the manager agreed to put further documentation in place to cover medication administration in this circumstance. The manager said that all staff had undertaken medication training, and following the last inspection visit had undertaken training in administering stesolid. Ellens Court DS0000023931.V359325.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22 and 23 were inspected at this visit. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users cannot be sure they will be protected from harm. EVIDENCE: Residents spoken with said what they liked doing, what they didn’t like doing, and what they did if they were unhappy. One resident said they would talk to the manager if they were unhappy. The completed improvement plan for the home states that all residents have been given a copy of the complaints procedure, and that this is now an item on the agenda at all resident meetings. The AQAA documentation states that there have been no complaints during the last twelve months, and the manager confirmed this. The majority of staff have undertaken training in relation to Adult Protection, and further training is booked for April 2008 for those that did not receive the training last year. Discussion took place in relation to information seen written in the daily records of one resident, and the manager agreed to take action in relation to this issue. This may indicate there is a skills and knowledge gap in the staff team regarding protection of vulnerable adults. This is not acceptable, and places vulnerable residents in an increased vulnerable position. The manager must ensure that staff are competent, not only in recognising signs of abuse, and their role in reporting, but of all the protocols surrounding safeguarding adults. Ellens Court DS0000023931.V359325.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24 and 30 were inspected at this visit. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users live in a clean and comfortable home but cannot be sure that the environment is safe. EVIDENCE: Environment standards were not fully inspected. Some communal areas were looked at, and residents showed the inspector their bedroom. Residents spoke to the inspector about their rooms and communal areas. The bedrooms seen contained many personal items and the residents talked about some of their possessions and where they had come from. No concerns were raised, and residents seemed happy with the environment at Ellens Court. Ellens Court DS0000023931.V359325.R01.S.doc Version 5.2 Page 19 The lounge presents as comfortable and homely. It clearly is a focal point of the home, with residents choosing to spend time in there socialising with others and watching the television. Furniture is comfortable and in good order. Ornaments and pictures make this a cosy room to spend time in. Adaptations seen included a special mattress for a person who suffers from epilepsy, and although the home does not have a call bell system measures have been put in place for a couple of the residents who need this facility. The manager said that the ground floor bathroom was due for re-decoration, and that plans for future development of the home were being put in place. Ellens Court DS0000023931.V359325.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 32, 33, 34, 35 and 36 were inspected at this visit. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. An effective staff team, in sufficient numbers to meet their needs, may not always be available to support residents. EVIDENCE: Since the last inspection action has been taken to improve the staffing levels at the home. The manager confirmed that there are now always three carers on during the day shifts. Although this is the same at the weekend, the carers at this time have also to undertake domestic, laundry and cooking duties and this was discussed with the manager. To improve the staffing structure at the home a deputy manager was appointed but unfortunately due to health reasons, this post is being readvertised. Two senior carers have been appointed and provide on site cover whilst the manager is not at the home. Ellens Court DS0000023931.V359325.R01.S.doc Version 5.2 Page 21 Two staff files were seen for two new members of staff. These contained all information required by regulation including application form, interview notes, two references, CRB checks etc. Completed induction documentation was seen and was appropriately signed and dated. Since the last inspection the manager has put together a comprehensive staff training matrix detailing all staff training together with planned training over the coming months. Six staff members have NVQ Level 2 and two staff have commenced on NVQ Level 2. Five staff members have now commenced NVQ Level 3. The completed improvement plan for the home states that a revised supervision proforma has been developed and will be implemented. The manager confirmed that supervision with written records maintained was now being undertaken on a regular basis, and that currently she was completing staff appraisals. The improvement plan also states that twelve staff meetings have been scheduled to take place over the next 12 months, and the manager confirmed that these are taking place. Ellens Court DS0000023931.V359325.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 37, 38, 39 and 42 were inspected at this visit. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users cannot always be confident that their home is well run. EVIDENCE: The manager has worked hard following the last inspection to address the issues raised, and it is indicated that many improvements have been made however this is still work in progress. Action has been taken by the manager to promote effective communication with the staff team, and has provided a number of training sessions in order to ensure that the staff team are adequately trained. The completed Ellens Court DS0000023931.V359325.R01.S.doc Version 5.2 Page 23 improvement plan for the home states that annual fire training was provided together with basic food hygiene, moving and handling and first aid. The management structure has improved with the appointment of two senior carers and will hopefully improve further when a suitable deputy manager has again been appointed. An external person carries out regulation 26 visits and it was seen that the reports have a formal structure. Two of these reports were seen. The quality assurance system is still in process of being fully implemented. The manager said that surveys are sent to relatives; but that the information is not as yet collated together with other monitoring systems for example staff meetings, resident meetings and Regulation 26 visits. The manager is working towards meeting the required standard. Ellens Court DS0000023931.V359325.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 2 2 2 3 X 4 X 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 2 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 2 32 3 33 2 34 3 35 3 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 2 X 2 X LIFESTYLES Standard No Score 11 X 12 2 13 2 14 2 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 2 2 X 3 2 2 X X 2 X Ellens Court DS0000023931.V359325.R01.S.doc Version 5.2 Page 25 YES 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 YA2 Regulation 14(2)(a)14(2)(b) Timescale for action The registered person 30/04/08 must ensure that the assessment of residents needs are kept under review and revised at any time when it is necessary to do so having regard to any change of circumstance The registered person 30/04/08 must ensure that residents assessed and changing needs are reflected in their care plan The registered person must ensure that care plans provide clear information on how the staff team support residents assessed needs 3. YA9 13(4)(c) The registered person 30/04/08 must ensure that risk assessments provide clear information regarding how to support individual residents in minimising risks DS0000023931.V359325.R01.S.doc Version 5.2 Page 26 Requirement 2. YA6 15(1) Ellens Court 4. YA16 16(2)(h) The registered person 30/04/08 must ensure that the daily routines and house rules promote independence and individual choice Resident’s independence and choice must not be limited because staff do not wish to provide what has been requested 5. YA19 12(1)(a)12(1)(b) The registered person 30/04/08 must ensure that the healthcare needs of service users are assessed and recognised and that procedures are in place to address them Health care plans and any accompanying risk assessments must be up to date 6. YA23 12 The registered person 30/04/08 ensures that service users are safeguarded from physical, financial or material, psychological or sexual abuse, neglect, discriminatory abuse or self harm, or inhuman or degrading treatment, through deliberate intent, negligence or ignorance, in accordance with written policy The home has an effective 30/04/08 staff team with sufficient numbers and complementary skills to support service users’ assessed needs at all times Review the weekend Version 5.2 Page 27 7. YA33 18 Ellens Court DS0000023931.V359325.R01.S.doc staffing level 8. YA39 24(1)(a)24(1)(b) The registered person 30/06/08 must ensure that appropriate and effective quality monitoring systems are established and maintained RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Ellens Court DS0000023931.V359325.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Ellens Court DS0000023931.V359325.R01.S.doc Version 5.2 Page 29 - 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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