Inspection on 20/05/05 for Gibson House

This inspection was carried out on 20th May 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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 18 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Gibson House 18/01/07

Gibson House 20/04/06

Gibson House 06/10/05

Gibson House 07/09/04

Gibson House 27/05/04

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

CARE HOME ADULTS 18-65 Gibson House 12 The Grange Bermondsey London SE1 3AG Lead Inspector Lisa Wilde Unannounced 20th May 2005 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. Gibson House G52-G02 S60232 Gibson Hse V225018 200505 Stage4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Gibson House Address 12 The Grange, Bermondsey London SE1 3AG 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) 020 7252 3762 Odyssey Care Solutions for Today Mrs Phyllis Mary Phillips CRH Care Home 8 Category(ies) of LD Learning Disability, Si Sensory Impairment registration, with number of places Gibson House G52-G02 S60232 Gibson Hse V225018 200505 Stage4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 07th September 2004 Brief Description of the Service: Gibson House is a purpose-built detached home with its own very large gardens. It is close to a lot of bus routes and street parking is available but on meters. There are no train or tube stations very close to the home. The home is spacious, built for for eight service users with learning difficulties and sensory impairment accomodated in large single bedrooms with ample bathroom and communal facilities, including a sensory room. There is a lift for people who live on the first floor. There is a kitchen on each floor and generally the home is run as if the upstairs and downstairs are two units. The home was designed as a “home for life” where service users are supported to attain as much independence as possible. The vision statement of Odyssey is an aspiration to:“ A society where a learning disability is not a barrier to somebody’s perceived value or ability to make a meaningful contribution” Gibson House G52-G02 S60232 Gibson Hse V225018 200505 Stage4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was caried out over seven hours on one day in May 2005. The manager of the home was at a meeting on that day but one of the the deputy managers was on duty. The home manager came to the CSCI’s office a few days later to talk to the inspector. On the day of the inspection the inspector spoke with a number of staff and telephoned relative’s of five of the seven service users. The service users at the home at the moment generally cannot speak but the inspector spoke to or saw six service users. What the service does well: What has improved since the last inspection? What they could do better: The building needs work to make the environement as homely as possible. The toilets and bathrooms in particular are institutional and the fittings are worn or need replacing. Some of the furniture in the bedrooms is broken and must be replaced. Gibson House G52-G02 S60232 Gibson Hse V225018 200505 Stage4.doc Version 1.30 Page 6 Although a good level of personal care is provided to service users the staff team need further training and input in understanding and working with the needs of people with learning disabilities and programmes of care must develop service users’ skills to allow them to achieve as much independence as possible. There are weekly activity plans in place for all service users but staff reported that sometimes these activities do not always take place. None of the service users at this home can go out to do things in the community by themselves so the home must improve the ways that it makes sure that all service users are getting the right amount of staff support to go out and to do useful or entertaining things in the home. The staff team at the moment are demotivated and morale is low. If the staff don’t feel happy in their work they will not be able to support service users in the best way possible. The management of the home must do work over the next few months to make sure that any problems are worked on so that the staff can feel that they are able to do a good job. 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. Gibson House G52-G02 S60232 Gibson Hse V225018 200505 Stage4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Gibson House G52-G02 S60232 Gibson Hse V225018 200505 Stage4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1 and 4. The Service User Guide is not in a language or form that could be understood by the service user group at this home and it does not include some of the areas required by the standard meaning that service users and their families are not provided with all the information they need to make an informed choice about where to live. The home has a system where any new service user would be able to visit and ‘test drive’ the home meaning that they would have a better idea of what the place was like before they finally decided to move there. EVIDENCE: Most of the current service users at this home are non-verbal and cannot read or write; however, the home is registered for learning disabilities and sensory impairment and it is possible to draw up a service user guide in a language and format that could be understood by some people from those groups who may wish to use this home e.g. by using pictures, Braille and language that is more simple. (See Requirement 1) The Service User Guide does not cover the required areas of the numbers of places provided; the relevant qualifications and experience of the staff; key contract issues of occupancy and termination; fees charged what they cover and fees for an ‘extras’; service users (or their families) views of the home and a copy of the complaints procedure and information about how to contact the local CSCI office and local health and social services. (See Requirement 2) Gibson House G52-G02 S60232 Gibson Hse V225018 200505 Stage4.doc Version 1.30 Page 9 The deputy manager of the service talked about how they now have a vacancy at the home and the plan now is to allow any new potential service user to visit the home for a flexible programme of visits such as day visit, overnight, weekend visit and so on. This series of visits would depend on how comfortable the service user was and how they and their family wished to progress. As long as this does actually happen in practice the standard is met. This standard will be assessed further at the next inspection to ensure that the planned visits did take place. Gibson House G52-G02 S60232 Gibson Hse V225018 200505 Stage4.doc Version 1.30 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6 and 8 There are service user plans do not address fully how identified goals are to be worked towards and how the plans are to be changed if the plan does not work. Not all individual areas of need (particularly aggressive or potentially harming behaviour) are addressed in the service user plans in a way that describes a plan to eventually change the behaviour. Plans focus on managing the behaviour on a day-to-day basis without emphasising positive behaviour and ability which means that service users aren’t being helped to move on or develop independence as much as is possible and more work must be done in this area. As far as possible service users participate in aspects of life in the home. EVIDENCE: The service user plans are reviewed annually or six-monthly and some goals are identified. The service user plan drawn up from this review does not identify what staff are going to do to ensure that any goals are worked towards and the plan is not changed until the next review, by which time the goal may not have been achieved. Staff described how they work on a day-to-day basis and do not work towards any goals identified in care plans. Gibson House G52-G02 S60232 Gibson Hse V225018 200505 Stage4.doc Version 1.30 Page 11 The service users files do include guidance around how to work with service users but again these focus on maintaining a status rather than including guidance around programmes of support that include steps to be taken to enhance service users skills, develop independence and minimise any negative behaviour. (See Requirement 3) Staff talked about how the current service users are not verbal and do not understand much language but they felt that service users could make their views clear at certain times. Staff said that service users would remove themselves from situations, take clothes off that they didn’t want to wear, not eat food that they didn’t want and express themselves in other ways to show that they were or were not happy with a situation. Gibson House G52-G02 S60232 Gibson Hse V225018 200505 Stage4.doc Version 1.30 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11, 12, 13, 14 and 15 The home’s system for ensuring that all service users have opportunities for personal development, are able to take part in activities and can access the community is not currently working effectively and it is not possible to confirm that service users are going out enough or are being usefully occupied while in the home. Service users are supported to see their families and friends and visiting hours at the home are appropriate. EVIDENCE: The service user files show weekly activity plans and the board in the office shows the plan for the entire home for the week. However, several staff talked of how often planned activities would not take place because certain staff did not want to undertake the activities and yet they would mark the daily record as if the activity did take place. Staff talked of low morale in the home currently and how they felt that staff turnover and the number of agency staff on duty added to the feeling that the staff group as a whole was demotivated. As the service users at this home are non-verbal it was not possible to ask them what they felt about activities and the service users’ families did not comment on activities as they said they could not know what was going on at Gibson House G52-G02 S60232 Gibson Hse V225018 200505 Stage4.doc Version 1.30 Page 13 the home when they weren’t visiting. The manager said that she was aware that some staff were not working as they should be but did not describe any current plans to address the activities issues. (See Requirement 4) All families talked about how they can access the home at any time to see their relatives and there have never been any problems with being able to continue their relationships as they choose. Gibson House G52-G02 S60232 Gibson Hse V225018 200505 Stage4.doc Version 1.30 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 Generally service users receive personal support in the way they prefer and require but there are ways in which the systems for monitoring and administering the laundry could be improved. EVIDENCE: Families said that they were happy with the way their relatives looked and they had no complaints about the way personal care was offered. The service users around the home during the inspection were dressed appropriately and their clothes were clean. There had been two requirements from the last inspection that the systems for checking the service users have both sufficient and appropriate clothing are improved and that the system for routinely checking service users’ clothing and discarding any which is old and worn is improved. There was a previous recommendation that an appropriate system for identifying bed linen and flannels is in place. Staff said that the systems have not changed since the last inspection and the same problems with confusing people’s laundry still occur. The records for purchasing clothes showed that service users’ clothes are being bought at different intervals, which may be appropriate but there was no evidence that the clothes are being checked regularly as the times when clothes may have been checked but no new ones bought were not recorded. Staff described a system where keyworkers could check the clothes of their service users once a month and then buy any clothes necessary with the service users as opposed to the system currently where the manager buys all the clothes for the service users. Staff also said that Gibson House G52-G02 S60232 Gibson Hse V225018 200505 Stage4.doc Version 1.30 Page 15 currently all laundry is still done together and placed around the laundry together when there are eight separate places in the laundry designed specifically for the eight service users and it would be easy to buy eight separate laundry baskets to ensure that laundry does not get mixed up. (See repeated Requirements 6 and 7) Gibson House G52-G02 S60232 Gibson Hse V225018 200505 Stage4.doc Version 1.30 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) X Both these standards were assessed and met at the last inspection. EVIDENCE: Gibson House G52-G02 S60232 Gibson Hse V225018 200505 Stage4.doc Version 1.30 Page 17 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, 29, 30 Although the environment was comfortable certain areas of the home, particularly the bathrooms were not decorated in a homely way. Each service user’s room is large enough to meet the requirements and all rooms are single rooms, not shared. Some of the furniture in service users’ rooms was broken meaning, that it could not be used and their clothing was being stored together in their wardrobes. It also means that their rooms did not look or feel comfortable. There are enough bathrooms and toilets throughout the home to meet the needs of the service users although more work is needed on the decoration of the bathrooms. All the bathrooms and toilets are decorated in an institutional manner with some of the equipment and fittings in them being broken or worn meaning that the home was not doing as much as it could to create a comforting, pleasant physical environment. The staff shower is broken meaning that staff have to use the service user’s bathrooms which is not appropriate given that this is the service users’ home. The home could not evidence that the service users have the specialist equipment that service user’s need to meet their individual needs with regard to bathing and showering. On the day of the inspection some areas of the home smelled of stale urine and were not therefore clean and hygienic. Gibson House G52-G02 S60232 Gibson Hse V225018 200505 Stage4.doc Version 1.30 Page 18 EVIDENCE: There had been a previous requirement that a copy of the planned maintenance and renewal programme for the fabric, decoration of the premises and furniture in service user’s rooms must be provided to the Commission. This had not been done. (See Requirement 8) All the toilets and bathrooms were painted and tiled in a beige colour and none of them had any extra fittings or furnishings to make them seem homely. The radiator grills were rusting or dirty and a stool in one of the bathrooms was very battered and worn. The toilet seat in one of the bathrooms had been broken off by a servcie user. (See Requirement 9) The staff shower room has not been operational for many months and staff have to use service users’ bathrooms. (See Requirement 10) Chests of drawers in two of the service users’ room were broken to the point of being unusable and staff said this was because another service user comes into their rooms and breaks them and messes up/wears their clothes. (See Requirement 11) Bedrooms had been individualised to service users’ tastes. Although the home does not offer places to people with severe physical disabilities many of the service users need assistance with bathing and showering. Occupational Therapist’s assessment of the handrails and other fittings through the home have not been conducted so the home does not know if the equipment they are using to assist some service users in bathing and showering is the correct equipment of if there are other things that could be used to make the tasks easier and safer. (See Requirement 12) One area outside of two servcie users rooms smelled of stale urine and it seemed to be coming from the carpet in the hallway as both the rooms nearby had hard flooring. (See Requirement 13) Gibson House G52-G02 S60232 Gibson Hse V225018 200505 Stage4.doc Version 1.30 Page 19 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 Although staff talked of feeling comfortable in offering basic support around personal care and health and safety issues the staff team as a whole is not fuly aware of the specific needs of the service user group with regard to disabiltiy issues and sensory impairment. There are not enough staff trained to NVQ 2 in care meaning that service users are not supported by appropriately trained staff. EVIDENCE: Staff stated that they did not feel, as a team, that they understood the particular issues of the service users around issues of learning disability; that they were able to work with basic issues of personal care but didn’t have knowledge of the wider issues around the disabilities. The manager brought the staff training records to the Commission’s office following the inspection and they showed that staff are currently receiving training (or refresher training) in the mandatory basic training areas such as first aid, food hygiene, fire training, moving and handling and heath and safety but that there is little training being offered around learning disabilites, sensory impairment and other needs of the service user group for which the home is registered. Most of the staff have been booked on Person Centred Planning training. (See Requirement 13) Staff on duty on the day of the inspection spoke of a lot of agency staff being used and that some staff are more motivated and commited that others. Staff Gibson House G52-G02 S60232 Gibson Hse V225018 200505 Stage4.doc Version 1.30 Page 20 spoke of some staff not completing all necessary tasks on the shift such as taking service users out. The manager of the service stated that she has to keep four of the allocated 16 staff places vacant and filled by agency staff to flexibly cover annual leave, sickness and other unplanned absences. She also stated that currently the home is not achieving the taregt of 50 of its care staff undertaking or holding the NVQ Level 2 in Care (or equivalent). (See Requirement 14) One of the deputy managers was due to leave this service in the days following the inspection and the manager did not know whether the organisaton planned to recruit to that post or whether the plan was to have one deputy manager and recruit another support worker instead. (See Requirement 15) Gibson House G52-G02 S60232 Gibson Hse V225018 200505 Stage4.doc Version 1.30 Page 21 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) 38 and 42 The staff team at the home as a whole is demotivated and morale is low meaning that the best service possible is not being offered to the service users. The management of the home is not actively addressing these issues. Generally the home is running in a way that ensures the health and safety of the service users although there were slight problems with the fire procedures. EVIDENCE: Staff described differences in approach and style in the management team of the home and how they were not certain of whether one deputy manager was acting-up or not. They said that they felt the current management was too dictatoral and that staff could be allowed to do more than they currently are given the chance to do. Staff said that there are no opportutnies for meetings to be held when all staff are on duty although the manager stated and the rota indicated that most staff are on shift on Wednesdays. Staff said that the meeting tended to be very brief with staff being told what to do and what they had done wrong with no time being spent on praising or looking at the positives of the work. Gibson House G52-G02 S60232 Gibson Hse V225018 200505 Stage4.doc Version 1.30 Page 22 The manager said that no staff had aproached her with any of these concerns but the organsiaton is planning Team Away Days soon and these could be used to look at issues of concern and the motivation of the staf team as a whole. (See Recommendation 1). Through the tour of the building and examination of the records the home was found generally to be maintaining sytems and practice that ensured the health and safety of service users. The home has met the previous recommendation that the names of people taking part in fire drills be recorded om the forms. On the tour of the building some of the fire doors were propped open with furniture or toys and one fire extinguisher’s instructions (next to the laundry) were stuck on upside down making it harder to read. (See Requirement 16) Gibson House G52-G02 S60232 Gibson Hse V225018 200505 Stage4.doc Version 1.30 Page 23 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 1 x x 3 x Standard No 22 23 ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 x 3 x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 1 3 2 3 x 2 2 Standard No 11 12 13 14 15 16 17 2 2 2 2 3 x x Standard No 31 32 33 34 35 36 Score x 1 x x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Gibson House Score 2 x x x Standard No 37 38 39 40 41 42 43 Score x 3 x x x 2 x G52-G02 S60232 Gibson Hse V225018 200505 Stage4.doc Version 1.30 Page 24 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 YA1 Regulation 5 Requirement Timescale for action 30/09/05 2. 3. YA1 YA6 5 15 4. Ya11, Ya12, YA13 & YA14 16 (2) (m) & (n) 18 (1) (b) The Service User Guide must be drawn up in a format that can be understood by more people from the service user groups for which the home is registered e.g. learning disabilites and sensory impairment. The Service User Guide must 30/09/05 cover all areas required by Regulation 5 and Standard 1. Service User plans must focus on 31/08/05 forward planning and how staff will support service users to achieve identified goals, develop positive behaviour and minimise negative or challenging behaviour and maximise independence. These plans must be reviewed at regular intervals to allow for plans to be changed if they are not working to ensure (as far as possible) that goals are met by the time the next six monthly mutli disciplinary review takes place. The manager of the home must 30/06/05 ensure that the current systems for monitoring service user activites are reviewed so that it is possible to identify if planned activities are not happening as Version 1.30 Gibson House G52-G02 S60232 Gibson Hse V225018 200505 Stage4.doc Page 25 5. YA18 12 (1) (a) 6. YA18 12 (1) (a) 7. YA24 23 (2) (b) 8. YA24 23 (2) (b) & (d) 9. 10. 11. YA24 & YA27 YA26 YA29 23 (2) (j) 16 (2) (c) 23 (2) (n) they should be. If it is discovered that some staff are misusing the systems to avoid taking service users out or engaging in other activites then appropriate management action must be taken. The Registered Manager must ensure that the systems for checking that service users’ have both sufficient and appropriate clothing, including underwear are improved. Previous requirement: Unmet timescale 30/12/04 The Registered Manager must ensure that the systems for routinely checking service users’ clothing and discarding any which is old and worn are improved. Previous requirement: Unmet timescale 30/12/04 The Registered Provider must supply a copy of the planned maintenance and renewal programme for the fabric and decoration of the premises to the C.S.C.I. Previous requirement: Unmet timescale 30/12/04 Work must be done in all bathrooms to ensure that all repairs are carried out and any worn areas/fittings are made good or replaced. Bathrooms must be decorated and/or additions made to provide a comfortable and pleasant, homely environment. The staff shower must be fixed Any broken furniture in service user rooms must be made good or replaced on a regular basis An Occupational Therapists assessment must be made of all service users who need 31/07/05 31/07/05 31/08/05 30/09/05 30/06/05 30/06/05 31/08/05 Gibson House G52-G02 S60232 Gibson Hse V225018 200505 Stage4.doc Version 1.30 Page 26 12. YA30 16 (2) (k) 13. YA32 18 (1) (c) (i) 14. YA32 18 (1) (a) & (c) (i) 15. YA32 18 (1) (a) 16. YA42 23 (4) assistance with bathing. showering, transferring or moving to ensure that the most appropriate aids and fittings are being used in the home. These assessments must be reviewed every time a service users needs change. The home must be cleaned regularly enough or carpets and soft furnishings replaced often enough to ensure that the home does not smell of stale urine. The staff must undertake training that enables them to identify, understand and meet the needs of the servce user group with regard to learning disabilities and sensory impairment issues. The home must ensure that it meets the target of 50 of its care staff holding or undertaking the NVQ Level 2 in Care (or equivalent) The organistion must finalise plans for the management structure of the home and then recruit to the vacant posts. All procedures and systems for ensuring adequate fire prevention and management must be adhered to. 30/07/05 30/09/05 30/09/05 30/08/05 14/06/05 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 YA38 Good Practice Recommendations The manager should adopt a programme of team building and motivation within the planned Team Away Day, team meetings and supervision to ensure that management and staff are assisted to identify and manage issues that are contributing to the low motivation and morale of the G52-G02 S60232 Gibson Hse V225018 200505 Stage4.doc Version 1.30 Page 27 Gibson House current staff team. Gibson House G52-G02 S60232 Gibson Hse V225018 200505 Stage4.doc Version 1.30 Page 28 Commission for Social Care Inspection Ground Floor 46 Loman Street Southwark London SE1OEH 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 Gibson House G52-G02 S60232 Gibson Hse V225018 200505 Stage4.doc Version 1.30 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!