Inspection on 29/11/05 for George Beal House

This inspection was carried out on 29th November 2005.

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 but made no statutory requirements on the home.

Other inspections for this house

George Beal House 18/04/08

George Beal House 19/04/07

George Beal House 10/04/06

George Beal House 16/04/05

George Beal House 04/10/04

George Beal House 17/04/04

George Beal House 08/03/04

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

CARE HOME ADULTS 18-65 George Beal House Off Williamson Road Kempston Bedford MK42 7HL Lead Inspector Rachel Geary Unannounced Inspection 29th November 2005 15:15 George Beal House DS0000033055.V269184.R01.S.doc Version 5.0 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 George Beal House DS0000033055.V269184.R01.S.doc Version 5.0 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. George Beal House DS0000033055.V269184.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service George Beal House Address Off Williamson Road Kempston Bedford MK42 7HL 01234 857300 01234 843225 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) Bedfordshire County Council Care Home 16 Category(ies) of Learning disability (16) registration, with number of places George Beal House DS0000033055.V269184.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. 6. 7. 8. Care Home Category: LD - Learning Disablilty (Longstay) (10) Category: LD - Learning Disability (Respite) (6) Period of stay for respite service users - maximum six weeks Gender: Male and Female Age: over 18 years Service Users may also have additional physical disabilities Repite Care: - Named young people (2) under the age of 18 who currently user respite care may continue to do so. The manager must inform the CSCI when these young people reach adulthood, and this exception will be removed. 16th April 2005 Date of last inspection Brief Description of the Service: George Beal House is a local authority care home providing long term residential accommodation for ten adults with profound, multiple disabilities (learning and physical). The home also provides respite care for up to six adults at a time. The home is situated in Kempston town in close proximity to local facilities and transport routes. The building consists of three interlinked bungalows, each with its own lounge/dining area, bedrooms, bathrooms and kitchenette. In addition, there is a shared lounge, link area, sensory room, laundry facilities, staff rooms/offices and an industrial kitchen. The organisation of the home and building is institutional in a number of aspects, and the long term plan is to reprovide this service. At the time of writing, there were no known timescales for this to happen. A good sized sensory garden surrounds the building, and there is parking space to the front of the home. George Beal House DS0000033055.V269184.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced, and took place from 15.15 to 19.40. The inspector met service users, spoke to staff on duty - including the resource manager and an assistant manager, observed practice, looked at records, and had a partial tour of the premises. The majority of the inspection took place in ‘C’ bungalow, which is the respite unit. A total of 23 adults and 1 person under the age of 18*, were receiving regular respite care at George Beal House. A further 3 referrals were also being processed. On the evening of this inspection, there were 3 service users staying in the respite bungalow. *This person is due to turn 18 later this year. At this point the home’s condition of registration to provide support to individuals under the age of 18 will be removed, and the service will only provide support to service users who are aged 18-65. What the service does well: What has improved since the last inspection? Unlike the previous inspection, there was limited evidence of significant improvements being made in a number of areas. Since the last inspection, a number of changes have taken place, particularly with regard to the management arrangements. The resource manager said that the home was going through a period of consolidation, but that they were ready to progress again once fully staffed. One thing that the resource manager felt had improved, was the opportunities for long stay service users to access a variety of external activities. This was not checked on this occasion however. George Beal House DS0000033055.V269184.R01.S.doc Version 5.0 Page 6 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. George Beal House DS0000033055.V269184.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection George Beal House DS0000033055.V269184.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 and 5. The home has developed some useful information to enable prospective service users and their representatives, to make an informed decision about the services offered at the home. However, there are inconsistencies in the amount of information being provided to respite service users. EVIDENCE: An updated copy of the home’s Statement of Purpose was given to the inspector during this inspection. It contained some comprehensive and useful information, and included the majority of information required by Schedule 1 of the Care Homes Regulations 2001. Information regarding the home’s assessment procedure was included in the Statement of Purpose. In addition, there was evidence that appropriate and detailed information is obtained regarding service users, prior to admission. As previously reported, the home had developed a Service User Guide, and a Service User Contract. Both documents were illustrated with pictures to help service users to understand them. On this occasion, there was no evidence that either of these documents had been provided to respite service users. George Beal House DS0000033055.V269184.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 9 and 10. Care plans and risk assessments require further work to provide clear and consistent information, and to ensure that service users’ holistic needs are met. EVIDENCE: George Beal House DS0000033055.V269184.R01.S.doc Version 5.0 Page 10 The resource manager said that service user files were in the process of being updated (starting with permanent service users), to include a number of required documents such as a service user contract, a Service User Guide, and decision-making and complaints information. This information was not found within respite service user files on this occasion. The care plan for one of the service users using the respite service on the day of the inspection was examined. It had recently been updated, and contained some detailed information regarding the person’s needs and preferred routines. The plan did not include personal goals however, and did not make clear links to outcomes from the most recent review. In this case, the last review notes on file were dated 2003. There was evidence that the person’s family had contributed to the plan and the resource manager said that they were writing to all families requesting input into care plans. A care plan for one new service user had not yet been completed, and care plans were not user friendly. A potential risk for staff was noted when a member of staff was observed supporting a service user to walk to and from the dining table. It was discussed that a mobility assessment was being arranged for the person in question, which might then minimize this risk. In the mean time, this practice should be risk assessed. Limited up to date risk information was in place, and some information on file was dated, and required archiving. Only current information relating to the service users using the respite unit during this inspection was found within the unit on this occasion. All other information relating to service users, was appropriately stored elsewhere. George Beal House DS0000033055.V269184.R01.S.doc Version 5.0 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 13, 14, 16 and 17. There is limited evidence that respite service users have regular access to a variety of meaningful activities. In addition, choice and participation arrangements for service users with regard to meal preparation and planning, continue to be poor. EVIDENCE: Records indicated that respite service users were not accessing community facilities and external activities on a regular basis. The resource manager said that one reason for this was that service users often came in with insufficient funds. It was not clear if anything was being done to try to address this. Staff said that activities did take place within the unit, and there was evidence that staff had been working with service users, to make some Christmas decorations, and to use some sensory equipment, which had been donated, to the home. George Beal House DS0000033055.V269184.R01.S.doc Version 5.0 Page 12 It was previously reported that some of the communal entertainment equipment had been old or broken. On this occasion, the TV in the respite bungalow had broken. A replacement had been borrowed from another area of the home, but the reception was noted to be poor. A video recorder and a music system were available, but there was no DVD player. The home had still not provided telephone points in bedrooms or a cordless telephone for use by service users. The resource manager said that the home had a mobile phone that service users could use however; staff often needed to use this when outside of the home. Staff were observed talking to, and interacting positively with service users. Services users were also being supported at a pace that appeared to reflect the needs of each individual. As previously reported, due to a lack of adequate facilities within the individual bungalows, meals were being prepared in a central industrial kitchen. External suppliers delivered food to the home in bulk, and meal times were arranged to fit in with the cook’s shifts. There were limited opportunities therefore, for service users to participate in meal planning, or preparation. It was noted on this occasion, that neither staff nor service users knew what the evening meal was until a hot trolley was brought into the unit. Once again, there was only one choice of meal. A separate plate containing potato, carrot and broccoli, had been prepared for one service user who required soft or pureed food. Staff then liquidised some savoury mince pie to add to this meal. It was pleasing to see that the ingredients had been liquidised individually in order to give the meal an attractive appearance, and to enhance the individual’s sensory experience. Appropriate support was provided to service users who required assistance with feeding. It was discussed that if service users did not like the meal on offer, then they would be offered a snack such as soup, or a sandwich as an alternative. The resource manager said that a meeting was being arranged with Beds Advocacy Alliance because of shared concerns regarding the meal arrangements within the home. George Beal House DS0000033055.V269184.R01.S.doc Version 5.0 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 and 19. Service users’ personal and health care needs are adequately met. EVIDENCE: Staff were observed to be delivering support in an appropriate and respectful manner. Staff explained that within the respite unit, daily notes relating to all aspects of a service user’s care, were photocopied at the end of a person’s stay, and sent home for the main carer to read. It was discussed that although there is a need to pass on ‘need to know’ information, this should also reflect the adult nature of the service, and promote service users’ rights regarding privacy and dignity. Service users’ health care needs were being addressed within care plans and related documentation. Appropriate equipment and support appeared to be in place with regard to pressure care for service users, although there was no clear pressure care management plan for one service user, who was using the respite service during this inspection. Clear moving and handling guidance was found on one service user’s file. George Beal House DS0000033055.V269184.R01.S.doc Version 5.0 Page 14 Service users did not require medication during this inspection, so this standard was not assessed on this occasion. George Beal House DS0000033055.V269184.R01.S.doc Version 5.0 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. The home had a satisfactory complaints system. EVIDENCE: As previously reported, information about the home’s complaints procedure was available within the Service User Guide. The Statement of Purpose did made reference to the procedure, but did not include the procedure itself. Since the last inspection of this home, the CSCI has received 2 anonymous complaints regarding George Beal House. The first related to staffing issues including adequate numbers of medication-trained staff being on duty. The second related to concerns about the night time monitoring of service users. In both cases, it is the opinion of the CSCI, that senior managers have appropriately addressed the issues raised, and where required, implemented a number of proactive measures to address the concerns raised. No concerns were raised about either matter on this occasion. A compliment that was recently received by the home from the family of one respite service user was seen. There was also evidence that satisfactory arrangements were in place with regard to potential POVA (Protection of Vulnerable Adults) incidents. George Beal House DS0000033055.V269184.R01.S.doc Version 5.0 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24. The environment does not adequately meet the requirements of the National Minimum Standards for Younger Adults, and is institutional in a number of aspects. EVIDENCE: As previously reported, a number of aspects regarding the organisation of the home and building are dated and institutional. It is understood that the longterm plan for this service is re provision, but the timescale for this to take place was not known at the time of this inspection. In the mean time, the resource manager confirmed that plans were in hand to refurbish all three bathrooms. It was said that this work would be completed before the end of this financial year. A curtain in the lounge area of the respite bungalow had come away from the track and was in need of repair. A slight draft was also noted by the inspector and a staff member within this area. The radiator by the TV was not on. The environment was noted to be clean, tidy and free from offensive odours. George Beal House DS0000033055.V269184.R01.S.doc Version 5.0 Page 17 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): 33, 34 and 35. Staff have a good understanding of service users’ support needs. EVIDENCE: On the afternoon/evening of this inspection, there were 2 members of staff supporting 3 service users within ‘C’ bungalow (respite). One member of staff had worked at the home for a number of years, and had recently been appointed as acting team leader. The other member of staff was an agency member of staff who had been working at the home on a regular basis, for approximately a year. The staffing arrangements appeared to adequately meet the complex needs of the individuals on this occasion. Staff commitment to each other and the service users was evident. Once again, staff demonstrated a good awareness of individual service user’s needs, and the needs of the service. They were observed to be attentive and respectful, and spoke to service users as they supported them. The resource manager said that there were a number of staff vacancies at the time of this inspection, which included an assistant manager, and all three team leaders. Plans to recruit to these positions were in hand, and some of the positions had been filled in an acting capacity. Staff vetting records were still being held centrally and not in the home as required. The resource manager said that they had begun to keep some of the George Beal House DS0000033055.V269184.R01.S.doc Version 5.0 Page 18 required records in the home but not all. It was discussed that the CSCI had recently developed some new guidance, which allows for greater flexibility about the storage of staff vetting records, subject to agreement with the local CSCI office. Once an agreement has been reached, certain records may then be held centrally rather than in the care home. A staff training and development plan could not be found on this occasion. The inspector is aware from previous inspections of other BCC services, that a database of staff training is maintained off site however; this information must also be made available within the individual services. The resource manager said that copies of staff training certificates were now being kept within the home. George Beal House DS0000033055.V269184.R01.S.doc Version 5.0 Page 19 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): 37,39 and 42. A number of changes have take place since the last inspection of this home, particularly with regard to the management arrangements. As a result, there is limited evidence of progress being made in a number of areas during this period. However, managers and staff do appear to have maintained the status quo, and it is expected that progress will be made again once the staff vacancies are filled. EVIDENCE: Since the last inspection, there had been another change in management. The temporary manager, Stuart Tripcony, had been appointed as resource manager for the service, and one of the assistant managers, Violet Masters, had been appointed as manager. George Beal House DS0000033055.V269184.R01.S.doc Version 5.0 Page 20 In addition, Kate Walker, operations manager, had been officially nominated as the ‘Responsible Individual’ (RI) for this service. The manager had not yet submitted an application to register with the CSCI, and her experience and qualifications were not verified on this occasion. Once again, positive comments were made about Mr Tripcony, who appeared to be having a positive effect on the home and the staff team. A relaxed and friendly atmosphere was noted, with staff working well together as a team. Only one report as required by regulation 26 of the Care Homes Regulations 2001, had been received by the Commission in respect of this home, since the last inspection. A number of actions had been identified within this report which included policy updates, work on communication passports for long stay service users, PCP (person centred planning) to be further developed for more long stay service users, a day care section to be added to care plans, and for all care plans to be signed, and dated with review dates. Previous concerns regarding the legibility and storage of accident/incident records had been addressed. However, it was noted that the recording of incidents, and/or subsequent information relating to follow up actions, sometimes lacked sufficient detail. One of the assistant managers said that she was in the process of completing a 4-5 day health and safety management course, and would be assuming responsibility for this area within the home. No significant concerns relating to health and safety were noted during this inspection. George Beal House DS0000033055.V269184.R01.S.doc Version 5.0 Page 21 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 3 X X 2 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 X X 2 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 1 X X X X X X LIFESTYLES Standard No Score 11 X 12 X 13 1 14 2 15 X 16 3 17 Standard No 31 32 33 34 35 36 Score X X 3 1 1 X CONDUCT AND MANAGEMENT OF THE HOME 1 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 George Beal House Score 3 2 X X Standard No 37 38 39 40 41 42 43 Score 3 X 1 X X 3 X DS0000033055.V269184.R01.S.doc Version 5.0 Page 22 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 YA27 Regulation 23 Requirement Provide toilet and bathroom facilities that are in good decorative order. (Previous timescales of 1.4.05 and 30.6.05 not met). Ensure that an effective quality assurance programme is developed. (Previous timescale of 31.5.05 not met). Ensure (with regard to) all accidents/incidents, that there is (adequate infoprmation and) evidence of follow up action as required. (Previous timescale of 31.5.05 not fully met). Ensure that service users are actively supported to help plan, prepare and serve meals in the home. (Previous timescales of 31.5.04 and 30.6.05 not met). Ensure that care plans are completed for all service users which fully meet the requirements of NMS 6 for Younger Adults. This must include any restrictions on choice and freedom, and identify clear goals with regard to the individuals development of skills and abilities. In addition, plans DS0000033055.V269184.R01.S.doc Timescale for action 31/03/06 2 YA39 24 28/02/06 3 YA41 17 15/12/05 4 YA17 16 28/02/05 5 YA6 15 31/01/06 George Beal House Version 5.0 Page 23 6 YA34 19 should be produced in a language and format that the service user can understand. (Previous timescales of 1.7.04 and 30.6.05 not fully met). Demonstrate that that 31/01/06 satisfactory recruitment procedures (for all staff) have been followed. *Please note that from 26/7/04 ‘Schedule 2’ has been updated within the amended Care Standards Act 2000 (Establishments and Agencies) (Miscellaneous Amendments) Regulations 2004. Also, from November 2005, new CSCI guidance is in place regarding the storage and retention of staff vetting records. Arrangements should now be made in line with this guidance. (Previous timescale of 30.4.05 not fully met). Provide a telephone point (in 31/12/05 service users bedrooms) or access to a cordless phone handset for use in rooms. (Previous timescales of 30.10.04 and 30.6.05 not met). Introduce a training and 31/01/06 development plan for all staff that incorporates induction, LDAF, mandatory, specialist and NVQ training. The plan must also identify how 50 of the care staff will hold an NVQ award in care by 2005. (Previous timescale of 31.5.05 not fully met). Ensure that the homes policies 28/02/06 and procedures are specific to the home, up to date, signed and regularly reviewed. Policies and procedures should cover the topics set out in Appendix 2 of the NMS for 7 YA26YA15 16 8 YA35 18 9 YA40 17 George Beal House DS0000033055.V269184.R01.S.doc Version 5.0 Page 24 10 YA17YA7 12 and 16 11 YA3YA5YA1 4 and 5 Younger Adults. (Previous timescale of 30.6.05 not met). Service users must be offered a 15/01/06 varied choice of meals, which meet their dietary and cultural needs. (Previous timescale of 15.5.05 not met). Information required by service 31/01/06 users (or their representatives) to be able to make an informed choice about their home, i.e. a Service User Guide and Contract, must be provided to all service users. In addition, paperwork and systems within the respite unit must be brought up to the same standard as the rest of the service. Individual risks and hazards must be assessed prior to admission for all service users. Risk management strategies must then be agreed, recorded, and reviewed on a regular basis. All service users must have the opportunity to access the local community, and to engage in appropriate activities both in and out of the home. With regard to pressure care, service users must be assessed by a person trained to do so, to identify those individuals who are at risk of developing pressure sores, and appropriate intervention must then be recorded in each person’s care plan. Visits as specified by Regulation 26 of the Care Homes Regulations 2001, must be carried out on a monthly basis. Copies of the reports must then be forwarded to the CSCI. 12 YA9 13 31/01/06 13 YA14YA13 12 and 16 15/01/06 14 YA19 12 and 13 31/12/05 15 YA39 24 31/01/06 George Beal House DS0000033055.V269184.R01.S.doc Version 5.0 Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA41YA6 Good Practice Recommendations Consideration should be given to maintaining all current information regarding individual service users within just one file per person. (This is a recommendation from the 16.4.05 report). Review the current day time opportunities for the individual outlined in the lifestyle section of this report. (This is a recommendation from the 16.4.05 report and was not assessed on this occasion). Provide entertainment equipment within communal areas that is in good working order, and that meets the needs and preferences of the service users. (This is a recommendation from the 16.4.05 report). The most recent review notes for each service user should be obtained and held on file. There should be clear links between this information and individuals’ care plans. Consideration should be given to reviewing the current arrangement of directly photocopying respite service users notes to give to their main carers. This should balance the need to pass on important need to know information, against individuals rights regarding consent and dignity. 2 YA12 3 YA14 4 5 YA6YA3 YA41YA18 George Beal House DS0000033055.V269184.R01.S.doc Version 5.0 Page 26 Commission for Social Care Inspection Bedfordshire & Luton Area Office Clifton House 4a Goldington Road Bedford MK40 3NF 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 George Beal House DS0000033055.V269184.R01.S.doc Version 5.0 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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