CARE HOME ADULTS 18-65
Farm House Highlands Farm Woodchurch Ashford, Kent TN26 3RJ Lead Inspector
Sally Gill Announced 15/08/05 at 11.50hrs 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. Farm House H56-H05 S61263 Farm House V233278 150805 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Farm House Address Highlands Farm, Woodchurch, Ashford, Kent, TN26 3RJ 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) 01233 861493 Canterbury Oast Trust, Highland Farm, Woodchurch, Ashford, kent, TN26 3RJ Registered Care Home 5 Category(ies) of Adults with a Learning Disability 18-65 registration, with number of places Farm House H56-H05 S61263 Farm House V233278 150805 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 30th March 2005 Brief Description of the Service: Farm House is registered to provide accommodation for up to 5 adults with a learning disability and admits people with low dependancy needs. Currently all Service Users are male. The company Canterbury Oast Trust owns the business. The Manager who has day-to-day control of the Home took up post in April 2005 and is not registered with the Commission. Farm House is an old farmhouse with accommodation on two floors. All bedrooms are singles. The Service Users have the use of two bathrooms, kitchen, lounge and dining room. The house has a private garden, which is laid to lawn, vegetable patch, flower and herb borders and a patio area; one Service User has a shed. The Home is situated at Highlands Farm, which is a well-known tourist attraction in a rural area on the outskirts of the village of Woodchurch. A short drive will take you to the towns of Ashford or Tenterden, and approximately 3 miles away is Hamstreet train station. Within the village of Woodchurch there is the local GP’s surgery, post office, church and two pubs, the Home has transport which can be used for Service Users if they wish and a local bus service passes the farm. Farm House H56-H05 S61263 Farm House V233278 150805 Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an announced inspection, which took place on Monday, 15th August between 11.50am and 5.00pm and Tuesday, 16th August 2005 between 9.20am and 4.50pm. Additional time was spent in preparation and report writing. During the inspection the Inspector spoke to 4 residents, 3 in private and the remainder in company. Also, she spoke to the Manager and three support workers. Surveys were received back from one relative and four Service Users, which indicated that they are satisfied with the care at Farm House. The care of one Service Users was case tracked and others looked at in parts. The Inspector examined various records including care plans, risk assessments, residents finances, staff files including training, and supervision, menus, the fire safety logbook, Medication Administration Record (MAR) charts and accident reports. One to one and small group activities were observed. A part tour of the building was undertaken including the lounge, dining room, bathrooms, toilet, kitchen, garden and three bedrooms (all by invitation). What the service does well:
Service Users benefit from a clean and homely environment where they are fully involved in the running of the home and say they are consulted about any changes and plan daily things like menus and events such as holidays and day trips. Service Users have regular opportunities to get out into the community and experience interesting and enjoyable activities; key worker days are used for Service Users to enjoy individual activities/day trips of their choice. A variety of developmental opportunities are available for Service Users through working at the various Canterbury Oast Trusts and outside schemes. Staff have good working relationships with professionals such as the Community Learning Disability Team (CLDT) and have developed and implemented programmes helping Service Users develop positive behaviours aided by a consist approach from staff.
Farm House H56-H05 S61263 Farm House V233278 150805 Stage 4.doc Version 1.30 Page 6 Service Users appreciate the Managers availability to them, stating she listens and “has brought a new lease of life” to the home and is “forward thinking” and “tries to expand us”. What has improved since the last inspection?
Major redecoration/refurbishment work has been completed to a good standard. Service Users now benefit from a clean but homely dining room, lounge, bathrooms, hallway and stairs. A vacant bedroom has been reduced in size (although still leaves a good sized bedroom) to give a new office for the Manager and staff which gives space to work and store records; the old office is now sleep-in facilities for staff. The standard of cleanliness and tidiness has improved and Service Users are taking a far more active role in household and cooking responsibilities. Service Users have always been empowered at Farm House they appear more relaxed within the home during the inspection but they are also now motivated and looking to their future and development, which is the best outcome a home can achieve. There was particular improvement in the care and quality of life for one Service User which has been achieved through professional guidance and staff adopting a consist approach. The home has produced a Statement of Purpose and Service User Guide in order that prospective Service Users have information regarding the home. Service Users now have a tent, which was up in the garden, and are looking forward to sleeping out and also weekends away. Joint working has been adopted with other homes on the farm, which has facilitated Service Users building friendships with others. The Manager has strengthened the staff team resulting in higher numbers of qualified or those undertaking NVQ qualifications and further staff training has been delivered. These improvements together with formal supervision sessions have helped ensure the safety and welfare of Service Users. The Trust has developed a questionnaire for quality assurance, which Service Users have completed. There are also questionnaires for families and professionals. The Manager said feedback would be used to feed the
Farm House H56-H05 S61263 Farm House V233278 150805 Stage 4.doc Version 1.30 Page 7 development plan for the home. Feedback on the results will be via a newsletter the Manager develop and will send out. 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
Farm House H56-H05 S61263 Farm House V233278 150805 Stage 4.doc Version 1.30 Page 8 contacting your local CSCI office. Farm House H56-H05 S61263 Farm House V233278 150805 Stage 4.doc Version 1.30 Page 9 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 Farm House H56-H05 S61263 Farm House V233278 150805 Stage 4.doc Version 1.30 Page 10 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2, 3, 4 and 5 The information given to prospective Service Users to make an informed decision could be enhanced. Service Users rights are not protected with signed agreements in place. There are shortfalls in the homes ability to demonstrate its capacity to meet Service Users needs. Prospective Service Users are able to “test drive” the home. EVIDENCE: The home has produced a Statement of Purpose and Service User Guide however minor adjustments are required to fully reflect the home and meet the standard. A new Service User stated that although he had looked through a copy he had not receive one to read and refer to at his leisure. Existing Service Users have also not received a copy to ensure they are aware of their rights and what the service can offer or not as the case may be. Records showed that a Care Management full assessment of needs was obtained prior to admission for the new Service User. The home also completed their own although this does not cover all areas of standard 2.3, which it should as discussed at previous inspections. It is a requirement that all assessments are available on Service Users files and although the Inspector has seen these previously they are no longer available. Assessments must be retrieved or new copies requested this is urgent for one Service User highlighted.
Farm House H56-H05 S61263 Farm House V233278 150805 Stage 4.doc Version 1.30 Page 11 Since the last inspection one Service User has moved to a more appropriate placement. The home has accessed professional support and guidance for another Service User with good results. In order that the home can fully demonstrate that it can meet the needs of one Service User a copy of the Care Management assessment must be obtained. A Service User who recently moved the Farm House confirmed that he was able to visit the home on a couple of occasions to meet and get to know the other Service Users and staff. Service User agreements are still not in place with Service Users. Farm House H56-H05 S61263 Farm House V233278 150805 Stage 4.doc Version 1.30 Page 12 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 and 10 Service Users quality of life could be further developed and aided by a consistent approach from staff, which should be supported by detailed care plans. Service Users are consulted about decisions affecting the home and their day-to-day lives. Risks are managed in a way that does not limit individual development. Information is held securely. EVIDENCE: Ongoing work is taking place to streamline and make care plans more accessible. The Manager will shortly be introducing the new style care plans. Discussions with staff have already commenced regarding the level of detail required in a care plan to ensure that all needs can be met but that also independence is always promoted and Service Users do not suffer from neglect. The Manager felt that the care plans would be completed by September. Consist approaches from staff has already improved with good results and the Manager feels this will be further enhanced by working to a detailed care plan. Service Users spoken to say they were aware of their care plans. Reviews for all Service Users have recently taken place and any recommendations form professionals have been followed through into the care plan.
Farm House H56-H05 S61263 Farm House V233278 150805 Stage 4.doc Version 1.30 Page 13 As part of the new care plan any restrictions on rights and choices will be recorded and agreed with Service Users. Work has already started on this with one Service User. Goal planning is in place however this is not geared to aid Service User development but more achievements of staff. Types of specific, short-term goals were discussed. All Service Users spoken to felt that they were consulted in both the way the home is run and the recent changes to the environment. Menus are planned weekly with Service Users. As each Service User has a house day to undertake their chores they also prepare and cook the evening meal with staff assistance if required. Risks both in and out of the home have been assessed and a management strategy, where appropriate is in place. Improvements have been made to the recording in communal message book. Farm House H56-H05 S61263 Farm House V233278 150805 Stage 4.doc Version 1.30 Page 14 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11, 12, 13, 14, 15, 16 and 17. Opportunities for Service Users to aid personal development have improved. A variety of activities are chosen by Service Users, which are appropriate. Service Users have access to participate in the local and wider community. Friendships and family contact are supported by the home. Rights and responsibilities are promoted and welcomed by Service Users. The menu reflects a variety of nutritious meals. EVIDENCE: Individual development is encouraged through day-to-day participation in household tasks and practical life skills. This has been improved since the last inspection with a schedule of daily tasks that need to be achieved to keep the home clean and tidy and also a more structured and consistent approach by staff. Service Users were excited about a new tent, which was erected in the garden and will be used to camp out both in the garden and hopefully for weekends away. One Service User has a shed in the garden, which is used for woodwork
Farm House H56-H05 S61263 Farm House V233278 150805 Stage 4.doc Version 1.30 Page 15 projects. A Service User informed the Inspector that holiday to the New Forest is planned for September. Service Users talked about a good variety of leisure activities and recent day trips that they have enjoyed. Service Users work within various projects run by the Trust and also outside organisations. Two Service Users will be attending the local college in September and the staff are looking at the possibilities of adult education for another. Recently Service Users independence has been improved with the use of a mobile phone for safety. The menu is planned weekly by Service Users and each evening it is the responsibility of one to prepare and cook with staff assistance if required. The menu evidenced a variety of healthy meals, which the Manager said is now enjoyed by all Service Users. Joint working with another unit from the farm has encouraged informal get togethers for Service Users helping to forge new and existing friendships. Relatives indicated that they are always made to feel welcome within the home. Farm House H56-H05 S61263 Farm House V233278 150805 Stage 4.doc Version 1.30 Page 16 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19 and 20 Personal support is provided in the way individuals prefer. Access to health care professionals is supported. There remain shortfalls in the medication system, which could pose a risk to Service Users. EVIDENCE: Changes have been made to the way personal care support is achieved to aid better independence and also ensure that the homes duty of care is fulfilled. The new care plans will also aid the delivery of support. Service Users health needs are met within the community. An individual Service Users health was discussed with the Manager in particular a proactive approach to health and exercise. There have been improvements to the medication system however further improvement is required. The Inspector viewed the MAR charts. Medication is logged in however the adopted practice of double signature could be misleading and mistaken as a signature for change of instructions. Medication storage has improved significantly. Risk assessments have been reviewed for self-medicating. These must be adopted for self-administration of inhalers. All prescription creams must appear on the MAR chart and a risk assessment in place for self-medicating. The continued use of these creams should be checked with the doctor. All PRN medication must have written instruction to
Farm House H56-H05 S61263 Farm House V233278 150805 Stage 4.doc Version 1.30 Page 17 staff (what’s its for, when it can be given, and what authorisation is required). The competency checks for staff should include observations of administration of medication. All of the above must be address to ensure a safe system. Farm House H56-H05 S61263 Farm House V233278 150805 Stage 4.doc Version 1.30 Page 18 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 ans 23 Service Users views are listened to and they feel safe within the home. There are shortfalls in the protection of Service Users from the prevention of unsuitable personnel working at the home. EVIDENCE: All Service Users said they felt their views were listened to and they had say in things. Service Users confirmed that the Manager is good at sorting out problems. There have been considerable less internal complaints made from one Service User regarding another. The Manager feels this is a result of a more proactive approach by staff to resolve any differences. The Inspector feels it is also a result of more participation by all Service Users in the home. There have been no complaints apart from in-house. Two existing staff, one currently working have not obtained or applied for a CRB enhanced disclosure. See also standard 34. Farm House H56-H05 S61263 Farm House V233278 150805 Stage 4.doc Version 1.30 Page 19 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 and 30 The home is comfortable, bright, clean, homely, and decorated to a good standard. Bedrooms meet individual needs and lifestyles and promote independence. There are sufficient bathrooms and toilets. There is sufficient shared space indoor and a good-sized garden. EVIDENCE: There has been a great deal of redecoration to shared areas of the home resulting in an attractive homely environment. The three bedrooms were seen by the Inspector were highly personalised, comfortable, clean and tidy. One Service Users advised the Inspector that the tidiness had been achieved with a lot of his effort the previous evening. All Service Users said they were happy with their rooms. The two bathrooms and a toilet were all clean and improvements introduced to ensure that they are now more hygienic. The garden is used by Service Users; there is seating and a barbeque. Vegetables and herbs are grown and used in the kitchen.
Farm House H56-H05 S61263 Farm House V233278 150805 Stage 4.doc Version 1.30 Page 20 Farm House H56-H05 S61263 Farm House V233278 150805 Stage 4.doc Version 1.30 Page 21 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 33, 34, 35 and 36 A competent, effective, supported and qualified staff team supports Service Users. There are shortfalls in the system and records of staff recruitment to ensure Service User protection. EVIDENCE: Since the last inspection additional numbers in qualified or those working to a qualification has strengthened the staff team. Numbers have also increased in staff that has attended core training. The Inspector was advised that induction training is to TOPSS specification. The Manager stated that she has made changes to the rota pattern to suit the needs of the Service Users. There is one member of staff on 7am –8am, two 8am – 8pm, one 8pm – 10.30pm plus one sleeping in. Currently there is flexibility within the rota to have up to an additional 28 hours to suit Service Users needs. Service Users said they “felt well supported by the staff and are able to have a laugh and a joke”. Throughout the inspection there was good interaction between Service Users and staff. Staff files showed that staff had recently received supervision with detailed records maintained.
Farm House H56-H05 S61263 Farm House V233278 150805 Stage 4.doc Version 1.30 Page 22 Discussion with the Manager highlighted that she is working closely with all staff to ensure the ethos of the home is carried through into practice and that staff adopt a consistent approach with Service Users. This will be aided by the introduction of appraisals, which the Manager stated should be later this year. The Inspector viewed a staff file, which did not reflect appropriate records, which must be held at the home. Information supplied to the Commission prior to the inspection also indicated that two existing staff had not obtained their CRB enhanced disclosure and one was working in the home unsupervised. An immediate requirement was made in order to protect Service Users. Farm House H56-H05 S61263 Farm House V233278 150805 Stage 4.doc Version 1.30 Page 23 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, 39, 40, 41 and 42 Service Users benefit from well run home with an ethos and management style that promotes and put Service Users above all else at the heart of the home. There are shortfalls in the structure of policies and procedures to safeguard Service Users. Records are kept safe and secure with one shortfall. The home is a safe environment for both Service Users and staff. EVIDENCE: Service Users could not praise the Manager enough with comments including she is “forward thinking” and “what Emma has done here is remarkable”. Emma has completed her RMA NVQ level 4 and is waiting for external verification. The atmosphere within the home also appeared more relaxed and homely and Service Users are beginning to benefit from several changes that have been made over the last few months. The Inspector would judge the most significant as one Service User has been moved onto a more appropriate
Farm House H56-H05 S61263 Farm House V233278 150805 Stage 4.doc Version 1.30 Page 24 placement, another is responding well to recommendations from professionals being implemented and a consistent approach by staff, an improved environment and the belief from Management and Service Users that quality of life does not stop here. The Trust has introduced quality assurance questionnaires and these are completed at the time of reviews. The Manager stated that these will be used to feed her development plan and feedback to participants will be via a newsletter she has also introduced. There are still several policies and procedures that required work in order that they fully reflect the standards including admissions, in the event of a death and gifts. Improvements have been made to the communication book. Health and safety was well managed with documented fire drills and checks in place. Accidents are recorded appropriately. Further staff have received training in core subjects ensure health and safety for all. Farm House H56-H05 S61263 Farm House V233278 150805 Stage 4.doc Version 1.30 Page 25 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 2 2 2 2 1 Standard No 22 23
ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10
LIFESTYLES Score 2 3 3 3 3
Score Standard No 24 25 26 27 28 29 30
STAFFING Score 3 3 3 3 3 x 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score x 3 3 2 3 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Farm House Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score 3 3 3 2 2 3 x H56-H05 S61263 Farm House V233278 150805 Stage 4.doc Version 1.30 Page 26 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. 2. Standard 2, 3 5 Regulation 14 5 Requirement Obtain copies of Service Users Care Management assessments and hold on file Written agreements between the home and Service User to be in place (previous timescale 1/10/05) There must be written instrctions for all PRN medication All medication administered by Service Users must follow the self medicating procedures Competency checks must include observations of administration All medication must be recorded on the MAR chart The continued use of 2 highlighted creams must be checked with the GP It must be clear on the MAR chart what signatures relate to Staff working must be in accordance with CRB guidance Staff files to contain all relevant records Timescale for action 30th September 2005 1st October 2005 30th August 2005 3. 20 13 4. 5. 6. 23,34 34 17, 19 17, Sch 2 Immediate 30th September 2005 Farm House H56-H05 S61263 Farm House V233278 150805 Stage 4.doc Version 1.30 Page 27 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. 4. 5. 6. 7. 8. 9. 10. 11. Refer to Standard 1 2 6 6, 7 6 21 23 23 36 1 4 Good Practice Recommendations Exisitng and prospective Service Users to receive a copy of the Service User Guide Assessment format which covers all areas of 2.3 (outstanding from previous inspections) Goal planning specific to aid the development of Service Users skills (outstanding from previous inspection) All restrictions to be agreed with Service Users and recorded as so (outstanding from previous inspection) Care plans to contain sufficient detail that care needs are met and promoted Procedure in event of death to be expanded to include all areas of the standard (outstanding from previous inspection) Service Users finance records show all monies withdrawn from the bank account as a whole in the records (money in) (outstanding from previous inspection) The gifts policy should contain guidance on witnessing and benefiting from wills (outstanding from previous inspections) Staff to receive appraisals (outstanding from previous inspections) Make slight adjustments to Service User Guide/Statement of Purpose Written admissions procedure which reflects the standards (outstanding from previous inspections) Farm House H56-H05 S61263 Farm House V233278 150805 Stage 4.doc Version 1.30 Page 28 Commission for Social Care Inspection 11th Floor, International House Dover Place Ashford, Kent TN23 1HU National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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