Inspection on 26/09/06 for Greengates

This inspection was carried out on 26th September 2006.

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 no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Greengates 17/03/06

Greengates 16/08/05

Greengates 30/03/05

Greengates 12/07/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Greengates 26 Fore Street North Petherton Bridgwater Somerset TA6 6PY Lead Inspector Pippa Greed Key Unannounced Inspection 26 September 2006 09:15 th Greengates DS0000033922.V308361.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Greengates DS0000033922.V308361.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Greengates DS0000033922.V308361.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Greengates Address 26 Fore Street North Petherton Bridgwater Somerset TA6 6PY 01278 663871 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) Somerset County Council (LD Services) Mrs Josephine James Care Home 7 Category(ies) of Learning disability (6), Physical disability (1) registration, with number of places Greengates DS0000033922.V308361.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 17th March 2006 Brief Description of the Service: Greengates is a care home providing personal care and accommodation for seven people with learning disabilities including one person with physical disabilities. Greengates is a home run by Somerset Social Services (now Community Directorate). The responsible individual is Mr. David Dick. The registered manager is Mrs Josephine James (nee Gillett). The home is situated on the main road in the village of North Petherton. The home is within walking distance of all the amenities in the large village. The house is set back from the road and has ample parking for staff and visitors. Greengates is a large detached house. All of the bedrooms are single. Bedrooms are located on the ground and first floor. Greengates DS0000033922.V308361.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced Key Inspection was conducted over one day (7.5hrs) by CSCI Regulation Inspector Pippa Greed. On the morning of the inspection two support workers and one deputy manager were on duty and during the afternoon there were three support workers. The registered manager was not on duty but her deputy Mr. Welland was available to assist the inspector during the unannounced visit. On the day of the inspection seven service users were at home. The atmosphere was relaxed and informal. Staff were seen to work professionally and demonstrated good rapport with the service users. The inspector viewed all communal areas and also some service users rooms. The inspector met all service users (seven) and engaged with five service users. The Inspector met with two staff members, and deputy manager. A selection of records was examined. These included three service users care plan and four staff recruitment files. CSCI sent out feedback cards for three service users, three relatives, two GPs and two social workers. One relative comment card has been received and this reflected positively on the service provided, ‘There is always a good atmosphere at Greengates, staff seem happy’. The inspector would like to thank the staff for their time and hospitality shown to the inspector during her visit. The current scale of charge is £92.35 per week (including transport component for those on low rate DLA) to £128.35 (including transport component for those on high rate DLA). There are currently no vacancies at the home. Two requirements and five recommendations have been raised at this inspection. The following is a summary of the inspection findings and should be read in conjunction with the whole of the report. What the service does well: Greengates DS0000033922.V308361.R01.S.doc Version 5.2 Page 6 The aim of the home is to support and encourage service users to maintain and develop daily living skills. The home is situated in a residential area and is only a few minutes walk from local shops. Service users are enabled to attend day centre, local college and access the local community where possible. The home provides a good range of activities such as horseriding, local walks, and social club. Service users are encouraged to exercise choice. There are visual communication systems in place throughout the home. This is provided in the form of photographs and symbols. The home is maintained to a good standard of cleanliness. What has improved since the last inspection? What they could do better: Two recommendations from the last inspection have not been implemented. These relate to staff update training in the protection of vulnerable adults and the re-locating of a boiler, currently in a cupboard in one resident’s room. These recommendations remain. The provider has moved the thermostatic control panel for this boiler, however, to a more suitable place. Two requirements were made at this inspection. It is required that the staff team are provided with Adult Protection training. It is required that all staff recruitment files should contain information and documents as outlined in Schedule 2 in the Care Homes Regulation. Five recommendations were made at this inspection. Greengates DS0000033922.V308361.R01.S.doc Version 5.2 Page 7 It is recommended that the Residents Guide be further improved to meet specific service users communication needs. It is recommended that more inhouse activities and resources be provided. It is recommended that one service user care plan details what learning takes place during the day at the day centre. It is recommended that reasons for returns medication be added in the returns book, and it is also recommended that variable dosage is recorded and specified on the Medication Administration Record. 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. Greengates DS0000033922.V308361.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Greengates DS0000033922.V308361.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4, 5 The quality in this outcome group is good. Service users and their families are provided with relevant information regarding the home. Social and health assessments are completed to ensure that the home is able to meet service users’ needs. EVIDENCE: The home has a Statement of Purpose that provides details of the services and facilities provided at Greengates. The service users care plan included a contract, which outlined what the service provides. These have been read and signed by the service users families. The contract was provided in easy to understand format including symbols. The Residents Guide is provided in a simple easy to understand format. However, it is recommended that the Residents Guide be further improved to meet specific service users level of understanding. This could include tape recording, symbols, pictures or photographs. Each service user has their own Residents Guide in their bedroom. This promotes good practice. Greengates DS0000033922.V308361.R01.S.doc Version 5.2 Page 10 There has been one new admission to the home this year. Introductory visits were planned and the admission followed a process that fully involved the service user, their family and care manager. There is no vacancy at present. Greengates DS0000033922.V308361.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9, 10 The quality in this outcome group is good. The home has a detailed care plan for each service user. Service users are encouraged to exercise choice and participate in all aspects of life within the home. Service users are supported in taking risks. Records relating to service users are stored securely and appropriately maintained. EVIDENCE: Care plans are maintained for each service user. Three care plans were examined in detail. Care plans included a photograph of the service user, and provided information regarding service users needs. This included social assessment, personal care, dietary needs, behaviour, emotional, social, health, personal interests, relationship and life skills. The care plan also includes a summary of risks. Service users are encouraged to exercise choice, and independence is promoted. Staff spoken with explained how service users are consulted Greengates DS0000033922.V308361.R01.S.doc Version 5.2 Page 12 regarding the meals and menu planning. Service users are involved in weekly menu planning and shopping at local stores. Service users were observed participating in tasks within the home, and they were consulted making choices using objects of reference. The home operates a Key worker system to ensure that the home continues to meet the needs of each service user. It is also recommended that one service user care plan details what learning takes place during the day at the day centre. Also, one service user care plan will need updating. Staff will support service users in managing their finances where required. Financial records were examined for one service user. Receipts and two staff signatures supported all entry. The money was checked and the final balance was correct. The service users care plans are kept in their bedroom, which promotes good practice. A visual communication board are provided in some service users bedroom to display photos of staff working on duty that day. Greengates DS0000033922.V308361.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16, 17 The quality in this outcome group is good. The home offers service users opportunities to engage with peers, access appropriate leisure activities, and exercise choice. Service users rights and responsibilities are respected. Service users are offered a choice of menu, and demonstrated that they enjoyed the meals provided. EVIDENCE: Service users are supported in developing and maintaining daily living skills. Staff from the home will assist service users in continuing to access social, and educational resources. On the day of the inspection, seven service users were at home. The inspector met all service users and engaged with five. Staff explained to the inspector how one service user has been involved in growing her own flowers and vegetables outside of her bedroom windows. All bedrooms were personalised Greengates DS0000033922.V308361.R01.S.doc Version 5.2 Page 14 with service users involvement be it textured mural, hanging decorations, rope lights, photographs or horseriding rosettes. The service users access a range of timetabled activities for example; local walks, day service, horseriding, social club, Fullbrook College, swimming and gardening. However, it is recommended that the home consider providing more in-house activities to offer more range of stimulation outside of timetabled activities. Somerset Total Communication is used at the home. Service users are encouraged and supported to engage in daily living activities such as maintaining their own rooms, laundry, and preparing meals. Greengates also provides link with other social services and support a gardening and recycling project. Service users from Huntspill visit Greengates once every two weeks to provide this service. The home has regular contact with most service users family members. Care plans provide details of service users personal and family relationships. Service users rights and views are respected. Care plans seen included a service user agreement, outlining their rights and wishes. Also, one care plan has a Life Experience checklist and action plan created by the British Institute of Learning Disability (BILD). One service user accessing the service has support from a befriender. The home has a menu that provides a balanced and nutritious diet. The menu board is attractively presented with symbols and colour photographs of the meals planned for the week. The home has a booklet that contains many photographs of various meals and ingredients. Service users are involved in planning the menu for the upcoming week. Staff confirmed that they are able to choose alternative meals if they wished. The inspector observed lunchtime routine, which was relaxed and unhurried. One service user was seen to make an alternative option. Greengates DS0000033922.V308361.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20, 21 The quality in this outcome group is good. Service users are provided with appropriate assistance to meet their personal care needs. The home supports service users in accessing healthcare services. The home has a medication policy. Medication Administration Records are managed safely. EVIDENCE: Service users are provided with support to undertake personal care tasks as required. Many service users have complex behavioural and psychological care needs. Staff supports service users in accessing healthcare services and ensure that specialist advice is sought as necessary. Care and support plans demonstrated regular support from community learning disability and mental health specialists as well as GP or community nursing support. A record is maintained in care and support plans of healthcare appointments and outcomes. Greengates DS0000033922.V308361.R01.S.doc Version 5.2 Page 16 Staff are provided with medication training. Currently medication is stored securely. No current service users are able to self-medicate. The inspector sampled the Medication Administration Record and found this to be well maintained. The Medication Administration Record file had medical footnote, list of staff signatures and photograph ID. The medication records are signed by two staff signatures and the cabinet is doubly locked. Two recommendations are made as a result of this inspection. To further enhance systems in place, it is recommended that the returns book includes reasons for return and also variable dosage to be recorded and specified on the Medication Administration Record. The home have policies in place regarding death and dying. Care plans sampled evidenced the service users and their family’s consented wishes. Greengates DS0000033922.V308361.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 The quality in this outcome group is adequate. Policies and procedures are in place for the protection of vulnerable adults from abuse. Many staff have not received an update in abuse training for some years and an update training session remains recommended from the last inspection report. The home has a complaints procedure and policy relating to the Protection of Vulnerable Adults. However, the Somerset County Council ‘Whistleblowing’ leaflet does not include the Commission’s contact detail. EVIDENCE: The Complaint log was seen and the home has not received any complaint since the last inspection or in recent years. The home has appropriate policies relating to the Protection of Vulnerable Adults, Whistle Blowing, and Raising Concerns policy. There are polices and procedures available for staff in the protection of vulnerable adults. The Community Directorate Whistle Blowing policy is displayed in a staff area. For staff that have been employed for several years, the majority have not had a formal update training session in abuse awareness and the protection of vulnerable adults for some years. This was recommended in previous inspections. It is therefore required that staff at the home receive a training update in the protection of vulnerable adults. Greengates DS0000033922.V308361.R01.S.doc Version 5.2 Page 18 Four staff recruitment files were sampled and these had some of the information required by schedule 2, Care Homes Regulations 2001. The recruitment files did not evidence the staff member’s start date at the home. One staff file had no written references and another only had one undated reference. Criminal Records Bureau (CRB) checks are in place for all staff. Greengates DS0000033922.V308361.R01.S.doc Version 5.2 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 the following standard(s): 24, 25, 26, 27, 28, 29, 30 The quality in this outcome group is good. The home has been decorated and furnished to a good standard. The home has sufficient communal areas and bathrooms to meet service users’ needs. The home was found to have a good standard of cleanliness. EVIDENCE: Greengates is a domestic style, detached property situated in the village. Service user accommodation is provided over two floors. The home comprises of a lounge, dining room, lean to conservatory, ground floor toilet, two bathrooms on both floors, laundry room and kitchen. There are sufficient communal space for service users to access. The conservatory provides alternative space to relax in. There is a large enclosed garden at the rear of the property that provides a large patio area with picnic table and benches. Service user have been actively involved with gardening and growing vegetables. Service user rooms are single occupancy. Most rooms have an en-suite wash sink. Service users rooms have been decorated to a good standard and are Greengates DS0000033922.V308361.R01.S.doc Version 5.2 Page 20 personalised with their own belongings, sensory lighting and decorative posters. The communal bathrooms on both floors and the ground floor toilet have been upgraded and redecorated since the last inspection. The lounge has also been redecorated recently. Staff sleeping-in provision with en-suite facility is provided at the home. This room doubles as the home’s office. At night there is one waking and one sleeping-in staff on duty. The laundry area was secure, clean and well organised. Appropriate hand washing facilities had been provided for staff throughout the home. The home had been maintained to a high standard of cleanliness. In the kitchen the inspector saw records of daily fridge and freezer temperatures and food in fridges were date labelled to promote good food hygiene practice. The kitchen is clearly labelled with photographs to help service users identify cupboard contents. The kitchen is also equipped sufficiently. Greengates DS0000033922.V308361.R01.S.doc Version 5.2 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 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35, 36 The quality in this outcome group is good. Staff are experienced and provide a good standard of care. Staffing levels are appropriate to meet service users’ needs. Staff will require further training updates in Adult Protection. Staff receive appropriate support and supervision. EVIDENCE: Duty rotas are maintained appropriately. The home is staffed daily with a minimum of three staff during the day and one waking and one sleeping-in staff at night. It was reported that three new staff have joined the service since the beginning of the year. Staff spoken with confirmed that they had received appropriate support and regular supervision. Staff file evidenced that appraisals and supervision are being provided. Staff meeting are being provided regularly. Observation of care provided throughout the inspection process showed that the staff team are caring and demonstrated good understanding and rapport Greengates DS0000033922.V308361.R01.S.doc Version 5.2 Page 22 with the service users. Staff spoken with confirmed that they fully understood their role. Four staff recruitment files were examined which included evidence of enhanced CRB disclosure being obtained. However, the files were not consistent and did not contain documents required by schedule 2 of Care Homes Regulation 2001. The induction file provides a comprehensive guidance on induction training. However, staff personnel file did not contain evidence of specific induction training or checklist to demonstrate what has been covered. The staff training file was sampled and there is evidence that the staff team are undergoing a programme of training updates throughout the year. Training topics included Food Hygiene, Moving & Handling, Risk Assessment, Control of Substance Hazardous to Health (COSHH), Fire Warden, and First Aid. The PreInspection questionnaire provided stated that five staff from thirteen have completed NVQ 2 or above. The home also has three first level registered nurses. However, there was no evidence of Vulnerable Adult training being provided. It is required that the home provides the staff team Vulnerable Adult training as this had been recommended in previous inspections. Greengates DS0000033922.V308361.R01.S.doc Version 5.2 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 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, 40, 41, 42, 43 The quality in this outcome group is good. The home is well run. There is a relaxed and open atmosphere within the home. Appropriate actions have been taken to promote the health and safety of staff and service users. EVIDENCE: The registered manager is Mrs Josephine James and she is supported by deputy team leader, Mr Adrian Welland. The registered manager has worked for Social Services for seven years and has registered nursing experience. As part of quality assurance monitoring, monthly meetings are carried out by link worker, team leader and network manager to evaluate service users activities, staff training and issues directly relevant to the service. Staff spoken with stated that the manager was approachable, and that they felt listened to. Greengates DS0000033922.V308361.R01.S.doc Version 5.2 Page 24 Staff at the home seek service users’ views on an individual basis, taking account of behaviours, verbal and non-verbal communication. There was a total communication approach and this was evident throughout the inspection process. The home has appropriate policies and procedures in place to safeguard vulnerable service users. All records relating to service users are stored securely in accordance with the Data Protection Act 1998. The home has a current Employers Liability insurance. Fire equipment is serviced and tested as required. All staff members had been provided with updated fire safety training. The electrical hardwiring certificate, portable appliances and landlord gas safety certificates have been appropriately maintained. Accidents have been recorded and an analysis completed on a regular basis. Records are kept of daily fridge and freezer temperatures, food probes and hot water temperatures. The home also arranges for an external agency to carry out test for Legionella annually as part of preventative strategy. Greengates DS0000033922.V308361.R01.S.doc Version 5.2 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 Standard No Score 1 3 2 3 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 1 ENVIRONMENT Standard No Score 24 3 25 4 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 2 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 2 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 2 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 3 3 X 3 3 3 3 3 Greengates DS0000033922.V308361.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? No 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 YA23 YA34 Regulation 13 (6) 19 Requirement It is required that staff receive a training update in the protection of vulnerable adults. It is required that the manager ensures that all staff recruitment file has all the information outlined in Schedule 2, Care Homes Regulation. Timescale for action 31/01/07 31/01/07 Schedule 2 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. Refer to Standard YA20 YA20 YA8 Good Practice Recommendations It is recommended that reasons for returns medication be added in the returns book. It is recommended that variable dosage is recorded and specified on the Medication Administration Record. It is recommended that the Residents Guide be further improved to meet specific service users communication needs. It is recommended that more in-house activities and resources be provided. It is recommended that one service user care plan details what learning takes place during the day at the day centre. DS0000033922.V308361.R01.S.doc Version 5.2 Page 27 YA14 YA6 Greengates Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Greengates DS0000033922.V308361.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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!