Inspection on 06/07/05 for Halland House

This inspection was carried out on 6th July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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 23 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Halland House 10/07/07

Halland House 03/05/06

Halland House 28/11/05

Halland House 20/01/05

Halland House 28/06/04

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

CARE HOME ADULTS 18-65 Halland House Halland East Hoathly East Sussex BN8 6PS Lead Inspector Elaine Green Unannounced 6 July 2005 10:00 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. Halland House H59-H10 S21424 Halland House V234479 060705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Halland House Address Halland East Hoathly East Sussex BN8 6PS 01825 840268 01825 840630 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) Gary Richard Homes Limited Mrs Sonia Johanna Williams Care Home 30 Category(ies) of Learning Disability (LD) 30 registration, with number of places Halland House H59-H10 S21424 Halland House V234479 060705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. The maximum number of service users to be accommodated is thirty (30) 2. Service users will be aged eighteen (18) to sixty five (65) years on admission 3. That service users will have a learning disability Date of last inspection 20 January 2005 Brief Description of the Service: Halland House is situated on the main Eastbourne to Uckfield road in the village of Halland. There are two public houses within walking distance and a bus service providing links to the towns of Eastbourne, Lewes, and Uckfield. The home provides accomodation for up to 30 adults with a learning disability. The property is divided into three areas, a large detached house with two floors and a smaller lodge where the most independant residents live. The lodge has its own kitchen but main meals are prepared in the house. There are large gardens providing an area for relaxation and recreation as well as an area for a gardening project. There is a day centre within the grounds which some of the service users attend and it has a dedicated stafff team. Halland House H59-H10 S21424 Halland House V234479 060705 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out on the 6th July from 10 am to 4pm by two Inspectors, against the background of concerns brought to the attention of the Commission for Social Care Inspection (CSCI), in respect of the adequacy of staffing, and an adult protection alert. During the inspection, discussions took place with 5 service users, the manager, deputy manager and two members of staff. A selection of the homes records and documents were examined including 4 service users’ Care Plans, 3 staff recruitment files, the accident book, staff duty rota, the staff communication book, and records detailing incidents both within the home, and at the day care facility. What the service does well: What has improved since the last inspection? What they could do better: The home needs to ensure that where the medication prescribed for individual residents is altered, staff are fully aware of possible side effects, in advance of the medication being administered. Care plans need to be clearer, be based on comprehensive assessments and reviewed on a regular, needs lead, basis. They must include risk assessments in relation to challenging behaviour displayed by service users. There must be guidelines, including any interventions that may be needed, for staff to follow in relation to minimising the risk posed by service users to themselves or to others. The home is advised to review its current systems for the recording of incidents and accidents, to ensure that such information can be readily accessed and retained by staff. Nothwithstanding the work that has been done with the home by social services to explain the procedure and the local guidance as specified in the Brighton & Hove, East Sussex Multi Agency Policy and Procedures for the Protection of Vulnerable Adults, the home is not being consistent in its reporting of significant incidents of challenging behavior and suspected abuse. Halland House H59-H10 S21424 Halland House V234479 060705 Stage 4.doc Version 1.30 Page 6 As a consequence external support and advice has not always being sought. The home needs to ensure that all staff are clear about its reporting policy and procedure, where abuse is suspected, and that staff are being consistent in its application. The home is aware of the requirement to ensure that all the appropriate checks are carried out for prospective employees before they commence work in the home. On the day of the inspection there was an individual working in the home for whom no CRB check or POVA First check, written references, or proof of identity obtained. Only one of the three recruitment files inspected contained all the relevant documentation that is required. The manager and management team needs to ensure that they maintain a close oversight of how the day to day needs of service users and staff are being met, particularly in respect of incidents of challenging behaviour and their effect on service users and staff. 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. Halland House H59-H10 S21424 Halland House V234479 060705 Stage 4.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 Halland House H59-H10 S21424 Halland House V234479 060705 Stage 4.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) These standards were not inspected EVIDENCE: Halland House H59-H10 S21424 Halland House V234479 060705 Stage 4.doc Version 1.30 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 standard(s) 6,9. Service user’ individual plans of care do not adequately reflect the levels of support that they require, with particular regard to risk taking, and the management of challenging behaviour. EVIDENCE: One service user, who presents with a high level of challenging behaviour, is receiving a high level of support from the staff team and there are guidelines in place for how staff should seek to manage this service user’s behaviour. However, for others there were no risk assessments in relation to challenging behaviour nor guidelines for how to minimise any risk they may pose to themselves or to others. This information is crucial for the protection of individuals, and the safe running of the home. Care plans examined did not contain the guidance required for staff to follow when supporting service users in all areas of their daily living. Some of the information had not been reviewed or updated for upwards of two years. It was not possible to establish how relevant the information in the care plans was in relation to a number of service users’ current needs. The home has been inconsistent in sharing significant information with other agencies, following incidents of challenging behaviour, and suspected abuse. Halland House H59-H10 S21424 Halland House V234479 060705 Stage 4.doc Version 1.30 Page 10 Arising from this inspection, and a recent adult protection alert, the home’s manager has had the opportunity to clarify, with the Community Learning Disability Team and CSCI, the requirements regarding the reporting of incidents of suspected abuse, under the local Multi-Agency Adult Protection guidance and procedures, and significant events under the Care Standards Act 2000. Halland House H59-H10 S21424 Halland House V234479 060705 Stage 4.doc Version 1.30 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 standard(s) 11,13,14,16, The home promotes independence and choice and supports service users to develop social and independent living skills. Community participation is facilitated. Daily routines are not adequately detailed in individuals care plans. EVIDENCE: The home offers a range of educational and life skills training within it’s day care provision and through local colleges. Activities programmes for service users are reassessed on a regular basis and tailored to suit the individual. Staff offer service users new activities to participate in, and places to visit on a regular basis. A group of service users were observed engaged in a leisure activity. The staff interacted with this group in an appropriate way. Independence was seen to be promoted, and staff engaged and communicated with service users on an individual and a group basis. Individuals’ were listened to and participated in the activity as much as they wanted to. Service users stated they were enjoying the activity. Support is given to one service user with specialist needs, through the allocation of one member of staff to work with them individually during each shift. Halland House H59-H10 S21424 Halland House V234479 060705 Stage 4.doc Version 1.30 Page 12 However throughout the inspection, and from discussions with the manager and staff, it is apparent that the level of challenging behaviour with which this service user presents is having a negative impact on both other residents and the retention of staff. Although service users have a programme of daily activities, care plans lack the detail required to identify the level of support that individual service users require in their daily routines, in pursuit of their individual pursuits and personal goals. Service users have keys to their own rooms. Halland House H59-H10 S21424 Halland House V234479 060705 Stage 4.doc Version 1.30 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 standard(s) 19,20 Whilst, in general service user’s physical and emotional needs are being met, the arrangements for ensuring that staff are aware of the side effects of newly prescribed medication, need to be improved. EVIDENCE: The home ensures that service users receive medical attention from their G.P, district nurse, dentist and hospital when required. Information relating to any such visits or treatment is documented in the service users daily records and changes in medication etc passed to the staff team through their communication book. The procedure for passing on information relating to medication changes and possible side affects needs to be amended to ensure all staff receive the information they require in the staff handover, and that this information is documented in such a way that it is readily accessible to all staff, in advance of them administering any new medication. A recent change of medication, as an emergency measure on a Friday evening, following a high level of challenging behaviour being displayed by a service user, resulted in staff becoming extremely anxious, and fearful about the well being of the service user, when they began to experience drowsiness as a side affect to this newly prescribed medication, resulting in other service users receiving minimal supervision and support. Halland House H59-H10 S21424 Halland House V234479 060705 Stage 4.doc Version 1.30 Page 14 It is important that where a service user is exhibiting prolonged and high levels of challenging behaviour, staffing levels are reviewed to ensure that they are both adequate in number, and in respect of the levels of seniority and experience of the staff deployed. Staff should have the necessary support, to allow them feel confident in their delivery of care. Halland House H59-H10 S21424 Halland House V234479 060705 Stage 4.doc Version 1.30 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 standard(s) 23 There is a lack of consistency in the recognition, recording and reporting of incidents of challenging behaviour and suspected abuse between service users. EVIDENCE: The examination of care records, and the recording of incidents, showed a high incidence of challenging behavior in both the residential and on-site day care components of the service, and a lack of consistency in reporting incidents of suspected abuse and challenging behaviour, in line with the East Sussex, Brighton & Hove Multi Agency Policy and Procedures for the Protection of Vulnerable Adults, and the Care Standards Act 2000. This is of particular concern, in view of the reduced capacity of many of the current service users, to alert staff to any occurrence of abuse. There is evidence of a lack of consistency in the reviewing of care plans and risk assessments, following incidents of challenging behaviour and suspected abuse, and the formulation of guidance for staff to follow in supporting individuals to manage their behaviour. The home should review its policies and procedures to ensure that all decisions regarding the actions to be taken by staff, to protect service users from themselves and others are fully documented, and that external agencies and professional, who might assist in assisting service users and staff, are consulted, where necessary. Against the background of the high levels of challenging behaviour noted, during the inspection, it is important that the home is alert to any under reporting of incidents, and any failure by staff to recognise and acknowledge where abuse might be occurring. The manager and management team must take responsibility for ensuring that staff do not become desensitised to what is challenging and unacceptable behaviour, and that at all times, staff respond to incidents or allegations of challenging behaviour and suspected abuse, in an appropriate and timely manner. Halland House H59-H10 S21424 Halland House V234479 060705 Stage 4.doc Version 1.30 Page 16 The home needs to review its’ management approach to these issues and to develop clear strategies and guidance for staff to follow. All staff must receive training in adult protection matters to ensure they have a clear understanding of what constitutes abuse. Halland House H59-H10 S21424 Halland House V234479 060705 Stage 4.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) 24,25,26,28. The homes environment meets service users’ individual and group needs. EVIDENCE: The home provides service users with bedrooms that meet the minimum standards for space required. Some of the bedrooms are en-suite. The bedrooms seen were personalised with service users own furniture and belongings and decorated to their taste. Service users hold keys to their own rooms. One bedroom had been recently redecorated and the service user stated that they had chosen the colour for the walls and the curtains. Service users living in ‘The Lodge’ have access to their own kitchen where they can prepare snacks and drinks with supervision. Each area or unit has it’s own lounge area and dining room and those seen were brightly decorated and homely in style. Service users can move freely throughout the building and gardens that provide areas for recreation, seating and growing vegetables. The home appeared to be in a good state of repair and to be well maintained. The current practice of displaying staff training certificates in residents’ communal areas should be discontinued. Halland House H59-H10 S21424 Halland House V234479 060705 Stage 4.doc Version 1.30 Page 18 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) 31, 32, 33, 34, 35, 36 The high turnover of staff, and the inadequate guidance and support provided to staff in respect of the management of individual service users, and the home’s poor recruitment procedures, do not ensure that the individual and joint needs of service users are being met. EVIDENCE: The home needs to review the manner in which staff are deployed on a daily basis, particularly at weekends, to ensure that the staff members, in overall charge of a shift, have at all times the essential skills and competences to deal with emergencies, and to provide appropriate support to the other staff on duty. The lack of clarity and effective direction to staff, evidenced in the care plans of a number of service users with challenging behaviour seen during the inspection, is of particular concern. The home’s recruitment procedures were found to be inadequate. The staffing files for two recently recruited staff did not on inspection, have a CRB or POVA First check, or an adequate number of written references. Halland House H59-H10 S21424 Halland House V234479 060705 Stage 4.doc Version 1.30 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,38,40,41,42,43 The failure of the home’s manager to ensure that it is following its own policies and procedures, in respect of the management of challenging behaviour, the recording and reporting of suspected abuse, and the recruitment of staff, is compromising the safety, rights and best interests of service users. EVIDENCE: In discussion during the inspection about the level of challenging behaviour with which a number of service users were presenting, the manager was unaware of two incidents of assault by a service user on two other service users, reported and recorded in the previous six months. The recruitment records inspected, in respect of the two most recently appointed staff, showed that they were deployed in the absence of CRB checks and adequate written references. Halland House H59-H10 S21424 Halland House V234479 060705 Stage 4.doc Version 1.30 Page 20 In discussion with staff, concern was expressed about the high turnover of staff, and the difficulties new staff appear to have in managing the high levels of challenging behaviour, presented by a small number of service users. This was of particular concern, given that the Inspectors had investigated concerns received from ex members of staff, two months previously, about the high staff turnover, and had been assured by the home’s management that there was not a significant level of staff turnover occurring. An audit of the home’s staffing record during the inspection showed that nine staff had terminated their employment at the home, since January 2005. Halland House H59-H10 S21424 Halland House V234479 060705 Stage 4.doc Version 1.30 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 x x x x x Standard No 22 23 ENVIRONMENT Score x 1 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 1 x x 1 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 x 3 x x Standard No 11 12 13 14 15 16 17 3 x 3 3 x 1 x Standard No 31 32 33 34 35 36 Score 1 2 1 1 1 1 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Halland House Score x 3 2 x Standard No 37 38 39 40 41 42 43 Score 1 1 x 1 1 1 1 H59-H10 S21424 Halland House V234479 060705 Stage 4.doc Version 1.30 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 YA6 Regulation 15 (1) (2,a,b,c) 14(2,a,b) Requirement Timescale for action 30.11.05 2. YA9 13 (4a,b,c,d) (6) 14 (2,a,b) 3. YA23 13(6) 4. YA16 13 (4,a,b,c) (6) 14(2,a,b) Care Plans must contain guidlines for staff to follow to support service users in all aspects of their daily living. They should be written in consultation with service users and be reviewed on a regular basis. Risk assessments must be 30.09.05 undertaken for all aspects of service users daily living. They must include assessing the risks posed by challenging behaviour presented by themselves or others. These must be used as a base to write guidlines for staff to follow to minimise risks and form part of the care plan. Information directly relating to 06.07.05 service users involved in suspected adult protection issues, must be passed on to the local social services assessment team. Freedom of movement within the 30.08.05 home and grounds must be risk assessed for all service users. Particular regard to be given to potential acts of violence between service users and the need for staff supervision. Any resulting restrictions to service Version 1.30 Halland House H59-H10 S21424 Halland House V234479 060705 Stage 4.doc Page 23 5. YA20 13(2) 12(1,a,b) 14(2a,b) 15(1a) 6. YA23 13(6) 7. YA31 18(1,a, c,(i) 8. YA34 19 all 9. YA36 YA43 18(2) users movement must be documented and recorded in their care plan. Arrangements must be made to ensure information relating to a change in medication is accurately and fully passed on and side affects explained to all staff. Any changes and related guidance must be documented in the service users care plan. The home must conform to local guidance in relation to the Protection of Vulnerable Adults. With particular regard to reporting and alerting suspected abuse to the local social services department and informing CSCI. Staff must be suitably qualified, competent and experienced. Training must be provided to staff to enable them to carry out their roles and responsibilities with particular regard to Adult Protection issues and the management of challenging behaviour. No individual can work in the home until all the required documentation is recieved and checked by the registered manager. In exceptional cases it is possible for a member of staff to work in the home when a CRB has been applied for if the POVA first check and all other required documentation has been recieved and checked. They must, in this case, be supervised at all times and not attend to personal care. This was a requirement at the last inspection. All staff, including the manager, must be appropriately supervised. Supervision must be formal, documented, include issues identified within this 15.08.05 06.07.05 06.07.05 06.07.05 30.08.05 Halland House H59-H10 S21424 Halland House V234479 060705 Stage 4.doc Version 1.30 Page 24 10. YA23 11. YA32 YA33 12. YA34 YA35 13. YA37 YA38 YA40 YA41 YA42 report and related training requirements. 37(1,c,e) The home must inform the CSCI, without delay, of the occurrence of any serious injury to a service user or any event in the care home which adversely affects the well-being or safety of any service user. Any notification biven orally shall be confirmed in writing. 18(1,a,b, The registered manager will c(i),2,4) ensure that there are sufficient experienced, competent and qualified staff on duty to meet service users needs at all times. That staffing levels are increased to meet changing needs as required. Staff must be appropriatley trained to carry out the work they are required to perform. All staff must have clear guidance as to their roles and responsibilities while on duty. 18(1a,b,c) The registered manager will 2 ensure that all staff recruited 19(1a,b(i) receive the appropriate training c) and induction within the required timescales. They will be assessed as competent to undertake their roles and responsibilities before such time as they are expected to work unsupervised, they must not be routinely expected to work in situations for which they have recieved no guidance. 24(1a) The registered manager and management team must ensure that they establish and maintain a system for reviewing and improving the quality of care provided at the home. The CSCI must be provided with a copy of any review conducted by them for this purpose. In light of recent events a full review of the quality of care provided is H59-H10 S21424 Halland House V234479 060705 Stage 4.doc 07.07.05 06.07.05 06.07.05 30.08.05 Halland House Version 1.30 Page 25 14. YA41 YA42 YA43 required to be undertaken as a matter of urgency. Particular attention must be made to all the issues highlighted in this report especialy those relating to the high level of ocurrances of challenging behaviour and the measures the management propose to take to minimise this. 17(1,a,b,2 The registered manager must ,3,a,b) ensure that accidents and incidents are recorded appropriately and that there is clear guidance available to staff as to what constitutes an accident and or an incident. 30.08.05 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. 2. 3. 4. 5. Refer to Standard YA32 YA36 YA37 YA37 YA9 Good Practice Recommendations That a minimaum of 50 of care staff have achieved NVQ Level 2 in care by 2005. That the manager ensures that staff recieve, formal, documented supervision at least 6 times a year. The managers job description to be redrafted as needed to include all responsibilities. That the registered manager obtains the appropriate qualifications by the 30.12.05 That advice be sought from relevant proffessionals on how to support individuals who present challenging behaviour and minimise the risk they may pose to themselves or to others. 6. 7. Halland House H59-H10 S21424 Halland House V234479 060705 Stage 4.doc Version 1.30 Page 26 Commission for Social Care Inspection Ivy House, 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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 Halland House H59-H10 S21424 Halland House V234479 060705 Stage 4.doc Version 1.30 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. 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!