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Inspection on 11/08/05 for Harmony Care Home

Also see our care home review for Harmony Care Home for more information

This inspection was carried out on 11th August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 18 statutory requirements (actions the home must comply with) as a result of this inspection.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The manager and proprietor should be congratulated for the assessments they complete when checking potential new service users suitability. The assessment process is thorough and includes as assessment on compatibility with people already living at the home ensuring their needs are taken into consideration along with prospective service users. Care plans maintained by the home are both detailed and comprehensive ensuring staff have the appropriate information in order that the care needs of service users can be met. In addition to this each service user has a Person Centred Plan that includes photographs of individuals, demonstrating their participation in many aspects of care provision. All the staff that were interviewed stated that the residents were the best things about working at the home, with comments received including, "I feel that I am making a difference". The inspector found that this comment reflected practices within the home, where staffs dedication to service users was demonstrated throughout the visit. The building is furnished and maintained to a very high standard, creating a pleasant place for service users to live. The home also excels in ensuring service users lead full and active lives. Many of the people who live at the home cannot access external day-care, however the home has built its own Snoozlum (sensory room) and Ball Pit to ensure service users receive daily sensory stimulation. In addition to this activity timetables are maintained that offer a wide range of choices both in house and external to the home.

What has improved since the last inspection?

Since the last inspection the home has purchased new laundry equipment that enhance infection control systems already in place. The manager has also devised quality assurance monitoring forms, which will be used to collate information when assessing if the home is meeting its aims and objectives.

What the care home could do better:

The home must introduce nutritional assessments for all service users in order that their dietary needs are not only assessed as part of the care planning process but to ensure a holistic approach to health management is maintained. More effort must be made to ensure the skill mix of staff is sufficient to meet the needs of service users in full (in particular on an evening and at weekends when the manager is not on duty) and that recruitment records are robust and protect service users from harm.

CARE HOME ADULTS 18-65 Harmony Care Home 91 Highgate Road Walsall West Midlands. WS1 3JA Lead Inspector Lesley Webb Unannounced 11 August 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Harmony Care Home E55 S56459 Harmony Care Home V241513 010805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Harmony Care Home Address 91 Highgate Road Walsall West Midlands. WS1 3 JA 01922 474336 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) Harmony Care Home (2003) Ltd. Ms Carolyn Swinton Care Home 6 Category(ies) of LD Learning Disability (6) PD Physical Disability registration, with number (6) Si Sensory Impairment (6) of places Harmony Care Home E55 S56459 Harmony Care Home V241513 010805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. The manager must undertake and complete the NVQ 4 in care and the Registered Managers Award within 18 months of the date of registration. 2. Staff may not commence working within the home without receipt of a CRB clearance, and two written references (including one from the most recent employer). 3. The home is registered to people with complex needs and/or challenging behaviour. 4. That the home be registered for one service user (name supplied) aged over 65 years. 5. The home shall revert back to its original registration age category if the named service users moves out. 6. That the invasive practice (administration of insulin) required to meet the named service users needs is carried out in line with CSCI and Department of Health guidance. Date of last inspection 10th February 2005 Brief Description of the Service: Harmony Care Home is a privately owned six-bedded residential home that provides care for service users with learning and/or physical disabilities and/or sensory impairment. facilities within the home consist of six en-suite bedrooms (including three which have been adapted for wheelchair users), two large lounge/dining rooms, separate laundry, kitchen, sensory room, ball pit, service user visitors room and kitchen and adapted bathing rooms. there are parking facilities to the front and rear of the building along with a small enclosed patio area. The home is located in a residential area of Walsall, close to shops, public transport and other amenities including the local park. Harmony Care Home strives to provide care, comfort and security for those in need of long term care, with emphasis on the individuality of each service user. Harmony Care Home E55 S56459 Harmony Care Home V241513 010805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspector arrived unannounced at 9.15am and stayed until 3.45pm. On arrival there were four service users at home and five members of staff. The registered manager was out for the day on a team building exercise with other staff that work at the home so the inspector was shown assistance during the visit by the senior support person on duty. Due to the communication difficulties of the people who live at the home the inspector was unable to talk to them to find out their views and opinions of the service so spent additional time formally interviewing all staff on duty as well as looking at records, observing care practices and touring in the building. An additional visit to the home was undertaken the next day in order to give feedback on the inspection to the registered manager and proprietor. What the service does well: The manager and proprietor should be congratulated for the assessments they complete when checking potential new service users suitability. The assessment process is thorough and includes as assessment on compatibility with people already living at the home ensuring their needs are taken into consideration along with prospective service users. Care plans maintained by the home are both detailed and comprehensive ensuring staff have the appropriate information in order that the care needs of service users can be met. In addition to this each service user has a Person Centred Plan that includes photographs of individuals, demonstrating their participation in many aspects of care provision. All the staff that were interviewed stated that the residents were the best things about working at the home, with comments received including, “I feel that I am making a difference”. The inspector found that this comment reflected practices within the home, where staffs dedication to service users was demonstrated throughout the visit. The building is furnished and maintained to a very high standard, creating a pleasant place for service users to live. The home also excels in ensuring service users lead full and active lives. Many of the people who live at the home cannot access external day-care, however the home has built its own Snoozlum (sensory room) and Ball Pit to ensure service users receive daily Harmony Care Home E55 S56459 Harmony Care Home V241513 010805 Stage 4.doc Version 1.40 Page 6 sensory stimulation. In addition to this activity timetables are maintained that offer a wide range of choices both in house and external to the home. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Harmony Care Home E55 S56459 Harmony Care Home V241513 010805 Stage 4.doc Version 1.40 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 Harmony Care Home E55 S56459 Harmony Care Home V241513 010805 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2 and 4. The homes Statement of Purpose, Service User Guide and assessment processes are excellent providing service users and prospective service users with details of the services the home provides, enabling an informed decision about admission to be made. Trial visits to the home are flexible to individual service users needs supporting individuals to make decisions on the suitability of the home. EVIDENCE: The home has a very thorough assessment process, which includes liaising with other professionals in order that the appropriate decisions can be made as to whether it can meet the needs of prospective service users. Due to the complex communication difficulties of service users living at the home assessments and care plans are discussed with their next of kin and social workers. In addition to this information about the home such as the Statement of Purpose and Service User Guide give comprehensive information about services and facilities on offer. Trial visits are offered tailored to each person’s needs that have included tea visit, overnight stays and weekend visits. Presently there is a vacancy at the home and although the manager has received several referrals no one has yet been offered this bed space as the manager would rather have a vacancy than offer it to someone who is not compatible with the people who already live at the home. Harmony Care Home E55 S56459 Harmony Care Home V241513 010805 Stage 4.doc Version 1.40 Page 9 Harmony Care Home E55 S56459 Harmony Care Home V241513 010805 Stage 4.doc Version 1.40 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7 and 9. Care plans are excellent within this home, providing staff with the information they need to satisfactorily meet service users needs, within a risk managed framework. The home takes responsibility to support service users with communication difficulties to become involved in decision-making processes. EVIDENCE: The home maintains comprehensive care plans that detail aims and goals for service users however when interviewing staff not everyone was able to give examples of these aims and goals. Staff that found it difficult to give examples gave reasons including, “there is so much information that we need to be aware of that it is sometimes difficult to remember specifics” and “I’m fairly new and I have only been concentrating on the person I key work”. The inspector was concerned about this due to the high needs of the people living at the home and felt that the lack of regular supervision for some people and staff meetings (see Standard 33 and 36) evidenced that the appropriate support is not being given to staff to ensure they fully meet the needs of the people living at the home. Staff also informed the inspector that they are not involved in the reviewing of care plans, that the manager undertakes this. Harmony Care Home E55 S56459 Harmony Care Home V241513 010805 Stage 4.doc Version 1.40 Page 11 When questioning the manager about this practice the manager stated that she did not want to overload the seniors with responsibilities and that until they were competent with other duties such as medication she did not feel it would be fair to increase their responsibilities. Every care plan sampled had a corresponding risk assessment in place that had been reviewed within agreed timescales. In addition to this the home has excellent Person Centred Plans, which include photographs of service user involvement. When asked how service users are involved and supported to make decisions about their lives and life in the home, a variety of explanations were given including, “even though a lot of the clients cannot speak they can express what they want for example one person will display behaviours ” and “we look for facial expressions or body language”. Throughout the day the inspector witnessed staff respecting service users wishes, supporting them to make decisions and offering choices. Harmony Care Home E55 S56459 Harmony Care Home V241513 010805 Stage 4.doc Version 1.40 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14, 15 and 17. The provision of activities within this home is excellent, enriching service users social and educational opportunities. The meals in this home are good offering both choice and variety and catering for special dietary needs. Further work must be undertaken to ensure nutritional needs of service users are met in full. EVIDENCE: The home should be congratulated for its efforts to ensure service users lead full and active lives. All staff interviewed confirmed people participate in the local community using services such as local shops, restaurants, leisure centres cinemas and parks. As well as external activities the inspector saw evidence of an abundance of in-house activities including music therapy, use of the homes sensory room, ball pit and exercise routines. Due to the disabilities of people living at the home staff take responsibility for ensuring service users maintain links with families. For example one member of staff stated, “we telephone one service users relative on a regular basis to Harmony Care Home E55 S56459 Harmony Care Home V241513 010805 Stage 4.doc Version 1.40 Page 13 keep them informed, send birthday and Christmas cards on behalf of all service users and arrange transport so that overnight and weekend visits can take place”. The inspector verified this comment by looking at records and observing practices throughout the day. Staff also confirmed that although service users cannot be actively involved in menu planning they are able to express if they like meals offered. For example one person stated, “one client will push the plate away and we take that to mean he does not want what is being offered so we try an alternative. Another person turns his head away”. Records and discussions with staff confirmed that service users are offered a variety of meals that are healthy and nutritious. There are several service users with specific dietary requirements however written nutritional assessments are not in place. The manager stated that the Dietician advises the home on individuals needs however the inspector instructed that assessments should be completed as part of the pre-admission process in order that all needs are identified prior to service users moving to the home. Harmony Care Home E55 S56459 Harmony Care Home V241513 010805 Stage 4.doc Version 1.40 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) Standards not assessed at this inspection. EVIDENCE: Harmony Care Home E55 S56459 Harmony Care Home V241513 010805 Stage 4.doc Version 1.40 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. Arrangements for protecting service users are satisfactory, providing a safe environment to protect service users from abuse. EVIDENCE: When asked how they ensure service users are protected from abuse staff gave answers including, “ be vigilant, report anything to the manager” and “we look for signs like changes in behaviour and report everything to the manager”. Three of the five staff interviewed also confirmed that they had undertaken training in Adult Protection and were also able to explain how the Whistle blowing policy supported staff to report suspected abuse by other employees. Harmony Care Home E55 S56459 Harmony Care Home V241513 010805 Stage 4.doc Version 1.40 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24 and 30. The overall quality of the furnishings and fittings within this home are good, creating a comfortable and safe environment for those living there and visiting. EVIDENCE: After touring the building the inspector was satisfied that generally the home is maintained to a very high standard. Since the last inspection the home has purchased new laundry equipment, which includes sluicing facilities that have specified disinfection programmes. Previous Requirements relating to monitoring the temperatures in the rear corridor and repair work in the kitchen remain outstanding. The inspector was informed that the Environmental Health Department had visited the home August 2005, with the home awaiting their report. The inspector identified two areas that require attention: * Items must not be stored on top of service users wardrobes as this practice poses a safety risk to staff. * Temperatures must be monitored and recorded for both freezers (presently this is completed for one) to ensure appropriate health and safety monitoring. The inspector recommended that alternatives be sought in relation to the seating arrangements in the home. On the day of inspection one lounge had Harmony Care Home E55 S56459 Harmony Care Home V241513 010805 Stage 4.doc Version 1.40 Page 17 both suites in it resulting in the room appearing cramped. Also throughout the day the inspector did not witness the other lounge being used. Harmony Care Home E55 S56459 Harmony Care Home V241513 010805 Stage 4.doc Version 1.40 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) 32, 33, 34, 35 and 36. Not all staff working at the home are competent and suitably qualified putting service users at risk of not having their care needs met in full. Recruitment practices have the potential at placing service users at risk. Further work must be undertaken to ensure staff receive the appropriate training and support in order to fulfil their roles and meet the needs of service users. EVIDENCE: As previously mentioned in the summary of this report the manager and the majority of permanent care staff were on a team building exercise on the day of inspection. Of the five staff on shift one had been employed for approximately 12 months with the remaining staff being employed between 3 weeks and 9 months (two of which were also bank staff). Through formal interviews with all staff the inspector was concerned that the skill mix of the staff on duty was not sufficient to meet the needs of the service users. For example two staff had no qualifications at all, the senior on duty was still in the process of completing the NVQ level two and no staff on duty had received epilepsy training despite two service users having this condition. In addition to this not all staff were sure of the contents of service users care plans (see Harmony Care Home E55 S56459 Harmony Care Home V241513 010805 Stage 4.doc Version 1.40 Page 19 Standard 6). The inspector recognises that the team building day is not a regular occurrence but reinforced to the manager and proprietor when giving feedback the following day that service users must be supported by competent and suitably qualified staff at all times. Also on the day of inspection a member of staff cancelled their shifts for the day at short notice resulting in five staff being on duty instead of six. When looking at staff rotas the inspector found that this situation had occurred on average twice a week over the past three weeks. When giving feedback to the manager about staffing levels the inspector was informed that some service users regularly go home for overnight stays reducing the amount of staff required. The inspector instructed that this should be recorded on the staff rotas. When examining staff recruitment records all contained CRB disclosures however for half sampled these were issued by previous employers. The inspector explained that CRB disclosures were not transferable since the introduction of POVA in July 2004 or unless the home was experiencing severe staffing shortages that could place service users at risk. The inspector also noted that two staff employed by the home did not undertake personal care due to their age but that their job descriptions were the same as other support workers. All staff that were interviewed confirmed that they receive formal supervision and that staff meetings occur. When looking at records for these the inspector found that only two staff meetings had occurred this year (previously these have taken place approximately every six weeks) and that not all staff have been receiving a minimum of six supervision sessions a year. The inspector felt that the deterioration in formal support for staff could potentially impact on care provision (see Standard 6). Staff that were interviewed did however state that handovers take place on every shift in order that staff have up to date information about service users with several staff stating that these were very thorough and “one of the best communication tools in the home”. Harmony Care Home E55 S56459 Harmony Care Home V241513 010805 Stage 4.doc Version 1.40 Page 20 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) 39. Although the home monitors the quality of service provision this is not based on the views of service users and/or their representatives and therefore no evidence is available that demonstrates its value. EVIDENCE: Since the last inspection the home has introduced monthly and quarterly audits in order to monitor quality. Upon inspection of these documents no evidence could be found that the views of service users and/or their representatives formed part of the quality assurance system. The inspector was informed that families are invited to the home and their views of the service obtained but those records were not presently maintained. Harmony Care Home E55 S56459 Harmony Care Home V241513 010805 Stage 4.doc Version 1.40 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 3 3 x 3 x Standard No 22 23 ENVIRONMENT Score x 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 4 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x x 3 Standard No 11 12 13 14 15 16 17 x 4 4 4 4 x 2 Standard No 31 32 33 34 35 36 Score x 2 2 2 2 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Harmony Care Home Score x x x x Standard No 37 38 39 40 41 42 43 Score x x 2 x x x x E55 S56459 Harmony Care Home V241513 010805 Stage 4.doc Version 1.40 Page 22 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. 2. Standard YA6 YA17 Regulation 15 16(2) Requirement All staff must be aware of the aims/goals contained within service user care plans All service users nutritional needs must be assessed and regularly reviewed. All service users who have specific dietary requirements must be weighed on a regular basis. Records must be maintained of the temperature in the rear corridor (REQUIREMENT ORIGINALLY MADE FEBRUARY 2005) The lid on the freezer requires repairing (unless stated otherwise by the Enviornmental Health Department) The Extractor fan in the kitchen requires repairing The floor covering around the fridge/freezer requires repairing to ensure fluids cannot seep underneath (REQUIREMENTS ORIGINALLY MADE FEBRUARY 2005) Items must not be stored on top of service users wardrobes Temperatures must be monitored and recorded for both Timescale for action 30/11/05 30/11/05 3. YA24 16(1) 31/10/05 4. YA24 16(1) 31/10/05 5. 6. YA24 YA24 16(1) 16(1) 30/11/05 30/11/05 Page 23 Harmony Care Home E55 S56459 Harmony Care Home V241513 010805 Stage 4.doc Version 1.40 freezers 7. 8. 9. YA32 YA32 YA33 18(1) 18(1) 18(1) The home must be able to demonstrate that all senior staff are suitably qualified All staff must undertake epilepsy training The numbers and skill mix of staff on duty must ensure the individual and collective needs of service users can be met Staffing ratios must be maintained as per the assessed needs of individuals A minimum of six staff meetings must take place per year Staffing rotas must include the hours worked by the manager The home must maintain a record when service users are not in the home CRB disclosures are not transferable The home must obtain CRB disclosures prior to staff commencing work Staffs job descriptions must reflect the duties they undertake A training and development plan must be implemented (REQUIREMENT ORIGINALLY MADE DECEMBER 2004) All staff must receive at least six formal supervision sessions per year All staff must receive an annual appriasal The home must implement a quality assurance system that meets all of Standard 39 of the National Minimum Standards (REQUIREMENT ORIGINALLY MADE FEBRUARY 2005) 31/12/05 31/12/05 30/11/05 10. 11. 12. YA33 YA33 YA33 18(1) 18(1) 18(1) 31/10/05 31/12/05 Immediate 13. YA34 Schedules 2,4,6 Immediate 14. 15. YA34 YA35 Schedules 2,4,6 18(1) 31/12/05 30/10/05 16. 17. 18. YA36 YA36 YA39 18(2) 18(2) 24 31/12/05 31/12/05 31/12/05 Harmony Care Home E55 S56459 Harmony Care Home V241513 010805 Stage 4.doc Version 1.40 Page 24 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. Refer to Standard YA24 YA27 Good Practice Recommendations It is recommended that the seating arrangements in the lounge be investigated It is recommended that a shower facility be fitted in the bathroom in order that service users have a ready supply of water to wash their hair Harmony Care Home E55 S56459 Harmony Care Home V241513 010805 Stage 4.doc Version 1.40 Page 25 Commission for Social Care Inspection West Point Mucklow Office Park Mucklow Hill Halesowen. B62 8DA 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 Harmony Care Home E55 S56459 Harmony Care Home V241513 010805 Stage 4.doc Version 1.40 Page 26 - 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!