Inspection on 23/02/06 for Harefield House

This inspection was carried out on 23rd February 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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Harefield House 14/12/06

Harefield House 25/11/05

Harefield House 20/01/05

Harefield House 28/06/04

Harefield House 08/01/04

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

CARE HOMES FOR OLDER PEOPLE Harefield House 47 Harefield Road Brockley London SE4 1LW Lead Inspector Unannounced Inspection 23rd February 2006 14:00 X10015.doc Version 1.40 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 Harefield House DS0000025622.V276902.R01.S.doc Version 5.1 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 Older People. 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. Harefield House DS0000025622.V276902.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Harefield House Address 47 Harefield Road Brockley London SE4 1LW 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) 0208 6926923 maggiestone@tiscali.co.uk Mrs Margaret Rose Stone Mr Raymond Julian Stone Mrs Margaret Rose Stone Care Home 13 Category(ies) of Dementia (2), Old age, not falling within any registration, with number other category (13) of places Harefield House DS0000025622.V276902.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. This home is registered for 13 elderly people of whom up to 2 may have dementia 25th November 2005 Date of last inspection Brief Description of the Service: Harefield House is a privately owned registered care home, located in a quiet residential area of Brockley, South London. The home provides support and care for up to 13 older women, with elderly care needs. The home takes only women, two of who can be suffering from dementia. The home also provides respite care for up to one service user. There is lots of street parking available near the home. The home is comprised of three floors, with bedrooms on the ground floor and first floor. All accommodation is in single rooms, all of which have a sink and one of which has a shower en-suite. There is no lift access between the ground and first floor. The ground floor has four bedrooms, two large living rooms, and a dining room. There is a toilet/bathroom with a hoist, which is wheelchair accessible, and a separate toilet. The first floor has nine bedrooms and one bathroom/toilet with a mobile hoist. The second floor consists only of an office/sleepover room for staff, with toilet facilities. There is a basement, which is used mainly for freezer storage. There is a garden to the rear of the home. Public transport links include a bus service, which stops in Harefield Road, with main line train service and Docklands Light Railway in nearby Lewisham. Lewisham centre is also close by with a selection of shops, cafés and bars Harefield House DS0000025622.V276902.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced, and took place over one day. It was facilitated by the assistant team manager, with the registered care manager also in attendance. The inspection included a tour of the home and examination of records on care plans of four service users, building maintenance and staff training and recruitment records. Observations were made of staff working with service users in the living room/dining room area, where many of the service users were present throughout the inspection. Two staff contributed information and there was a brief group discussion with all service users present. One service user who had recently moved in, and was staying over for short-term respite, while awaiting a permanent placement, was interviewed. At the time of this inspection there were two service user vacancies. Comments were also received from one social worker involved with the home. What the service does well: What has improved since the last inspection? The home has carried out some improvements to the care planning and risk assessment systems to help safeguard service users. The new system still needs some further improvement. (Refer to “What they could do better” below) Harefield House DS0000025622.V276902.R01.S.doc Version 5.1 Page 6 The home has contacted social services, to ask for their involvement in annual care reviews, and is awaiting their response. The home’s medication policy has now been reviewed, and the requirements from the London Fire Brigade regarding fire doors has been clarified and met. The home has engaged the services of an Occupational Therapist to carry out an overall assessment of the facilities provided in the home, and is committed to making any improvements necessary. Two managers are now involved in the interview process. What they could do better: The home still needs to include more information in its documentation regarding it’s value base and ethos for care provision in order to better help prospective service users to make a decision about whether to live there. There needs to be more improvements to the Care Planning system as the current system reads more like an assessment, and would not be easily understood by service users. It is also produced in a small font type, which is hard to read. Two newer service users, who are on respite care, do not have enough clear written information for staff in how to support them, and do not have risk assessments in relation to the support they will receive at the home. This presents some risk and should be looked at quickly by the home. Generally written guidance for staff needs to be improved, in providing personal care, to help them to provide this support in the same way for service users. The home needs to review its Adult Protection and Whistle Blowing policies to make sure that the current local authority policy is reflected. This will better protect service users. The home’s recruitment policy needs to be updated to reflect adult protection issues, and to show how staff are interviewed and checked before being employed. The home needs to have a registered manager in post who has, or is in the process of acquiring NVQ level 4 in care and management. Service users’ opinions and views on how the home is managed must be regularly taken up, and the home’s owners need to produce a plan for annual improvements. Please contact the provider for advice of actions taken in response to this Harefield House DS0000025622.V276902.R01.S.doc Version 5.1 Page 7 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Harefield House DS0000025622.V276902.R01.S.doc Version 5.1 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Harefield House DS0000025622.V276902.R01.S.doc Version 5.1 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 6 Prospective service users have complete information to make a choice about where they live. The home does not fully maximise independence for respite care residents. EVIDENCE: The home has updated the Statement of Purpose and Service User guide, which now has all the information, needed. It is recommended that the home consider putting in more information on the ethos and values of the home when next reviewing this information to include empowerment, inclusion and consultation with service users. (Refer to Repeated Recommendations OP1) The home provides respite care for service users, provided there are no specialist rehabilitation needs to be met. Usually these service users are admitted on a short-term placement, while awaiting a more appropriate placement elsewhere, or to provide the regular carers with some respite. There are currently two such placements at the home. Discussion with these service users showed that care had been taken by the home, to carry out appropriate assessments of need, before moving in. It is the homes practice Harefield House DS0000025622.V276902.R01.S.doc Version 5.1 Page 10 not to put in place full care plans for these service users. However, there are areas of risk identified on the assessments for these people, which are not included in the homes own risk assessments, or in guidance for staff in how to provide support. For example the risk of falling for one service user is not included, and guidance for providing personal care support, or general mobility support are not in place. The home must address this issue for both of these service users and for all future short-term care placements. (Refer to Requirements OP6) Harefield House DS0000025622.V276902.R01.S.doc Version 5.1 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 AND 10 Service users’ health and personal care needs are set out in a personal care plan but are not being fully met in respect of risk assessments. Service users, where appropriate, are responsible for their own medication and are protected by the home’s policies for dealing with medicines. Service users feel that they are treated with respect, and rights to privacy are upheld. EVIDENCE: The planning system has improved to include better social care and activities planning, but there is a need to consider using more individual activities plans for each service user, and monitor individual levels of activity to check that service users are having maximum opportunity to do the things they want to. (Refer to Repeated Recommendations OP7) The new planning system is written in a very small type font, and is formatted like an assessment rather than a directive care plan. It is necessary to read information about many areas, which don’t apply specifically to individual service users before finding the information that is relevant. While the right information is contained in the care plans it is not easily readable by staff or certainly not by service users. There must be more improvement made to this Harefield House DS0000025622.V276902.R01.S.doc Version 5.1 Page 12 system to ensure that staff can easily read the care instructions, and that service users can understand their own care plans in full. (Refer to Requirements OP7) The home does have fairly comprehensive risk assessments for the support of service users, but there still are areas of risk identified in some service users care assessments, that are not risk assessed by the home. For example one service user’s care assessment showed a “risk of falling”, but the care plan did not refer to how to manage this risk. Risk assessments are supported by guidance for staff but some of this guidance is unclear in some areas and needs improvement. For example one instruction asks the service user to “hold handrails” during the personal care process, but does not clarify where the wheelchair should be positioned, or which handrails are being referred to. (Refer to Requirements OP7) The home provides well for service users health care needs and a range of health care professionals are involved in providing care at the home. It is recommended that all service users be offered the opportunity to have dental visits at the home, and that possibilities of facilitating this are explored. The home has tried to facilitate this through local dental services, but said that all local dental practices have said they cannot provide this service within the home. The manager is to continue to explore options for facilitating dental care within the home for those who need it. (Refer to Repeated Recommendations OP8) The home’s medication policy and practices are safe and properly managed and monitored. The policy has now been updated and includes the date of review. The privacy and dignity of service users is respected within the home. Service users commented that staff are very respectful, and sensitive in providing personal care support. They open their own letters, and where they have problems in doing this, they are left for family to open except where staff are requested to perform this task by the service user. All bedrooms are single rooms. Staff said they are told by the homes manager, how to best support service users, when they are first employed. Harefield House DS0000025622.V276902.R01.S.doc Version 5.1 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 14 and 15 Service users feel that the lifestyles experienced in the home matches their preferences and social, cultural and recreational interests and needs. Service users are supported to exercise choice and control, and receive wholesome and appealing meals in suitable surroundings. EVIDENCE: As discussed at last inspection it was found that daily life in the home is flexible and that there were activities that the service users could take part in. Service users confirmed that they are happy with current activities, which are suitable for their age and abilities. One of the staff now takes on the role of activities co-ordinator and this responsibility should be expanded to include more individual weekly or daily plans for each service user and a means of recording when activities don’t happen as planned and the reasons why. (Refer to Repeated Recommendations OP12) Service users themselves or their families are responsible for their own financial affairs, and small amounts of money left in the care of staff, is well protected. Information regarding advocacy is available for those who need it but currently no service users use this service. All information about service users is kept within the home and is available for service users. Service users spoken to confirm that they are aware of how to ask for any information they need. Harefield House DS0000025622.V276902.R01.S.doc Version 5.1 Page 14 Meals are served morning, midday and evening and service users are consulted weekly regarding the menu and are offered choice of food each day. Menus are maintained and service user assessments reflect their individual dietary needs from admission to the home. All service users spoken to say the food is very good and they get to eat things they like. Comments from service users included: “The food is good and I asked for breakfast in my room when I first came here and this was done” Harefield House DS0000025622.V276902.R01.S.doc Version 5.1 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 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 Service users may not always feel that they are protected from abuse by the home’s policy, which may allow inadequate reporting of abuse, as the policy needs to be reviewed. EVIDENCE: The home has an appropriate adult protection policy and training for this is provided. Staff reported that they had already received training on Adult protection and the assistant manager said that all staff have now received this training. The inspector saw that the home now has a clear statement precluding staff involvement in assisting in the making of or benefiting from service users’ wills. However, the local authority’s policy on Adult Protection was revised in 2005 and this is not reflected in the home’s policy. This may cause some confusion regarding the requirement to report to the Adult Protection Team immediately and regarding POVA requirements, which are not reflected in the home’s policy. These comments were made at last inspection and the requirement made is still within the required timescale. (Refer to Repeated Requirements OP18) Harefield House DS0000025622.V276902.R01.S.doc Version 5.1 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 22 The environment is safe and well maintained and service users have the specialist equipment they require to maintain their independence. EVIDENCE: The following information remains consistent with the findings of the last inspection: The home is active in maintaining safety for staff and service users and carries out regular health and safety checks. There is documentation to show that the following tests are regularly done and are up to date: Full electrical wiring five year test done 16/10/02, Gas test done 18/8/05, Emergency lighting and fire equipment tests done 3 monthly, Pest control checks done at least monthly, hoist maintenance is up to date, and service users using the stairs have abilities and risks reviewed monthly to ensure that mobility issues in respect of using the stairs are monitored. The London Fire Brigade visit approximately every five months. The last report of 7/11/05 from the fire brigade officer showed that there is now a requirement for the home to ensure that some fire doors and closers are repaired or replaced, to ensure that all fire doors are functioning safely. The Harefield House DS0000025622.V276902.R01.S.doc Version 5.1 Page 17 manager confirmed that she had been in contact with the fire brigade inspection officer and that there are now no issues outstanding from this report. Service users are currently fully mobile. As the home does not have a lift there is an ongoing need to monitor the abilities and risks regarding service users who use the stairs and this is being done monthly involving service users and families. The hoists in bathrooms are being well maintained. Various handrails are installed in bathrooms and the equipment in use appears to meet the requirements of service users. At the last inspection it was recommended that an Occupational Therapist be engaged to review the home, and the equipment used, to ensure service users needs are being appropriately met. The owner has engaged the services of an Occupational Therapist, and an inspection is scheduled over the coming week. The owner is committed to identifying any areas where improvements can be made and taking appropriate action if necessary. It is recommended that a copy of the Occupational Therapists findings be made available for discussion at the next inspection. (Refer to Recommendations OP22) Harefield House DS0000025622.V276902.R01.S.doc Version 5.1 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Service users needs are met by the numbers and skills mix of staff, and are in safe hands at all times. They are not fully supported and protected by the home’s recruitment policy, which could leave service users at risk. Staff are trained and competent to do their jobs. EVIDENCE: The home employs eight full time care staff, and assistant manager and a registered manager, to provide care and support for up to 13 older women, with elderly care needs. The manager is a qualified nurse, and the assistant manager is in the final stages of completing the NVQ 4 course in care and management. Four of the eight care staff are qualified to NVQ level 2/3. A cook and two full time domestic staff are also employed, and the laundry work is contracted out to an external agent, which is appropriate for this home. This staffing level provides for cover of a minimum of three staff in the morning, two staff in the afternoon and two staff at night with one of these sleeping in. The manager is available at the home on a daily basis as extra support. All staff are over 21 years old, and a rota is available showing the staff planned for providing support on each day. The service users comments include that staff are always available when they need them. No new staff have been recruited since last inspection. The following information remains consistent with the findings of the last inspection: The home’s recruitment records are in order. Two references are being taken up for all staff employed. The manager and assistant manager are both involved in conducting interviews. CRB checks are being done including POVA Harefield House DS0000025622.V276902.R01.S.doc Version 5.1 Page 19 checks prior to appointment. The home’s recruitment practices now protect service users, however the homes recruitment policy does not. The recruitment policy does not have a review date and important recruitment procedures do not appear in the current policy, such as POVA checks, a minimum of two people conducting interviews, references being taken up prior to appointment, health screening prior to appointment, maintaining appropriate records on staff’s proof of identity, probation period and review prior to confirmation in post. The policy must be reviewed to take these issues into account. No progress had been made in revising this policy though the deadline for doing this had not yet been reached. (Refer to Repeated Requirements OP29) The home provides adequate training for its staff. There is evidence of good basic training being planned. However there is not an individual plan in place for each member of staff, which addresses all areas of individual training needs. For example some staff may need training in communication, dementia or mental health, but this is not routinely planned for individual staff when they need it. It is recommended that the current training plans be improved to address this issue. (Refer to Recommendations OP30) Harefield House DS0000025622.V276902.R01.S.doc Version 5.1 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33 and 35 The home is well managed but the registered manager does not hold the appropriate NVQ qualification, which is now a requirement of this post. The home cannot currently demonstrate that it is run in the best interests of service users, which may result in important decisions being made without their involvement. Service users financial interests are safeguarded. EVIDENCE: The present registered manager is a registered nurse but does not have and does not intend to obtain a management qualification at NVQ 4 level. She and the joint provider are working to ensure that there is a registered manager who is qualified at this level, and to this end the assistant manager is currently on an NVQ level 4 course, due for completion in June 2005. She has expressed an interest in progressing to become manager of the home, and the owner has agreed that she will support her in doing this. The application to register the assistant manager has not yet been submitted. Until this happens, Harefield House DS0000025622.V276902.R01.S.doc Version 5.1 Page 21 and there is a registration of a new manager, this requirement still stands. (Refer to Repeated Requirement OP 31) The home does engage in conducting service user meetings about twice a year and regularly meet with families who are included in reviews and risk assessments. At least one service user survey has been carried out in the past year. However, there is not currently any system in place for ensuring that all service users’ views are included, and there is no system for bringing together findings from these systems to plan for development at least annually, or to feed back findings and proposed action to service users or their families. There has been no progress on this since last inspection. (Refer to Repeated Requirements OP33) The home has adequate facilities in place for the protection of service users money and valuables. Service users themselves or their families are responsible for their own financial affairs, and small amounts of money left in the care of staff, is well protected. Service users spoken to confirmed this to be the case. Harefield House DS0000025622.V276902.R01.S.doc Version 5.1 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X X X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 2 3 X X 3 X X X X STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 3 X X X Harefield House DS0000025622.V276902.R01.S.doc Version 5.1 Page 23 Are there any outstanding requirements from the last inspection? Yes 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 OP6 Regulation 15.1 & 13.4 b Requirement The registered manager must ensure that appropriate risk assessments and support plans for personal care are put in place for the two respite-care service users currently resident at the home. The registered manager must ensure that service users care plans are written in a format and type size, which is easily understandable to service users and staff The registered manager must ensure that all guidance for staff in supporting service users with mobility support needs is reviewed to ensure that service users are fully protected. The registered person must revise and update the homes Adult Protection and Whistle Blowing policies in accordance with the local authorities written policies. This was the subject of a previous requirement, Timescale 28/02/06, partially met, still ongoing. Timescale is now revised. DS0000025622.V276902.R01.S.doc Timescale for action 01/03/06 2 OP7 15 30/06/06 3 OP7 13.4 b 31/03/06 4 OP18 13.6 31/03/06 Harefield House Version 5.1 Page 24 5 OP29 17.2 6 OP31 9.2 7 OP33 12.3 & 24.1,2 ,3 The registered provider must 31/03/06 review and update the home’s recruitment policy to ensure it reflects best practice and current legislation, especially in relation to the protection of service users. (Refer to issues discussed in OP Standard 29 of this report) This was the subject of a previous requirement, Timescale 28/02/06, still ongoing. Timescale is now revised. The registered person must 30/06/06 ensure that by 2005 the home has a manager with qualification to the level of NVQ 4 in management and care. This is a repeat of a requirement from the last two inspections, Timescale 31/12/05 unmet, and 30/06/06 still ongoing. 31/03/06 The registered individuals must ensure that an appropriate, professionally recognised quality assurance system based on seeking the views of service users is operated within the home, to include an annual audit and annual development plan. This is a repeat of a requirement from the last two inspections, Timescale 31/12/05 unmet, and 28/02/06 still ongoing. Timescale is now revised. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Harefield House DS0000025622.V276902.R01.S.doc Version 5.1 Page 25 1 OP1 2 OP7 3 4 OP7 OP8 5 OP12 6 OP19 7 OP29 It is recommended that the registered provider and manager consider adding more information on the ethos and values of the home, when next reviewing the Statement of Purpose, information to include empowerment, inclusion and consultation with service users. This is a repeated recommendation. The registered manager should consider using more individual activities plans for each service user and monitor individual levels of activity, in order to check that service users are having maximum opportunity to do the things they want to. This is a repeated recommendation. The registered manager should consider having all risk assessments and guidance for staff typed rather than hand written. The registered manager should try to ensure that all service users are offered the opportunity to have dental visits at the home, as opposed to having to travel to the dentist. This is a repeated recommendation. The registered manager should consider expanding the role of the activities co-ordinator to include more individual weekly or daily plans for each service user, and a means of recording when activities don’t happen as planned and the reasons why. This is a repeated recommendation. The registered provider and manager should address any issues raised from the impending Occupational Therapists visit, and highlight any areas of concern to CSCI as appropriate. The home should consider using a recruitment checklist to monitor and record each check being done prior to appointment. This is a repeated recommendation. Harefield House DS0000025622.V276902.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection SE London Area Office Ground Floor 46 Loman Street Southwark SE1 0EH 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 Harefield House DS0000025622.V276902.R01.S.doc Version 5.1 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. 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