Inspection on 18/03/09 for Highcroft and Valley View

This inspection was carried out on 18th March 2009.

CSCI found this care home to be providing an Good service.

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

Other inspections for this house

Highcroft and Valley View 11/12/07

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

CARE HOME ADULTS 18-65 Highcroft and Valley View Whetley Road Broadwindsor Beaminster Dorset DT8 3QT Lead Inspector Jo Johnson Key Unannounced Inspection 18 and 19th March 2009 10:00 th Highcroft and Valley View DS0000071383.V374748.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Highcroft and Valley View DS0000071383.V374748.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Highcroft and Valley View DS0000071383.V374748.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Highcroft and Valley View Address Whetley Road Broadwindsor Beaminster Dorset DT8 3QT 01460 77033 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) www.twas.org.uk Wessex Autistic Society Ms Michelle Louise Maglo Care Home 9 Category(ies) of Learning disability (9) registration, with number of places Highcroft and Valley View DS0000071383.V374748.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following categories: 2. Learning disability (Code LD) The maximum number of service users who can be accommodated is: 9 11th December 2007 Date of last inspection Brief Description of the Service: Highcroft and Valley View are registered for personal care for up to nine people who may have complex needs including Autistic Spectrum Disorder (ASD). Wessex Autistic Society is a voluntary organisation that runs several ASD specific services in the locality. The Wessex Autistic Society is affiliated to the National Autistic Society and has received accreditation by the National Autistic Society. The home is situated in a rural area, with open views of the surrounding countryside, approximately one mile from Broadwindsor village. The home is divided into two units, Valley View, which accommodates up to four people and Highcroft, which accommodates up to five people. The home is now split into three separate living units with their own bedrooms, bathrooms, toilets, kitchen and lounge areas. ‘Valley View’ accommodates three people, ‘High’ accommodates two people and ‘Croft’ accommodates one person. All three living units have connecting doors but also have their own private access. The connecting doors are not routinely used. The home has private gardens and also share the extended grounds, which have large apparatus and a cycling track. Highcroft and Valley View DS0000071383.V374748.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means the people who use this service experience Good quality outcomes. The focus of inspections undertaken by us is upon outcomes for people who live at the home and their views of the service provided. This process considers the homes capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provisions that need further development. This report uses information and evidence gathered during the key inspection process, which involves a visit to the home and looking at a range of information. This includes the service history for the home and inspection activity, notifications made by the home, information shared from other agencies and the general public and a number of case files. The manager supplied the commission with an AQAA (Annual Quality Assurance Assessment). Information from this has been used to make judgements about the service, and have been included in this report. This inspection visit was unannounced (we did not let the home know that we were coming) and took place on 18th February between 10:00 am and 11am, the manager and five of the six people who live at the home were out. We returned on 19th March at 10:30 am so that we could spend time with people at the home, manager and staff. The inspection involved; Communicating with people (where possible as people have complex ways of communicating). Observing the six people who live at the home. Talking with and observing the staff on duty and the acting manager. Three people were identified for close examination by reading their care plan, risk assessments, daily records and other relevant information. This is part of a process known as ‘case tracking’, where evidence is matched to outcomes for people. A tour of the environment was undertaken, and home records were sampled, including staff training and recruitment, health and safety, and staff rotas. This inspection was carried out by one inspector, but throughout the report the term we and ‘us’ is used, to show that the report is the view of the Commission for Social Care Inspection. Highcroft and Valley View DS0000071383.V374748.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: Risks need to be assessed and managed so staff know what to do so they can keep people safe. Highcroft and Valley View DS0000071383.V374748.R01.S.doc Version 5.2 Page 7 There needs to be ‘as needed’ medication plans in place, so that staff know when to safely give people their medication. 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. The summary of this inspection report can be made available in other formats on request. Highcroft and Valley View DS0000071383.V374748.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Highcroft and Valley View DS0000071383.V374748.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2 Quality in this outcome area is good People’s care and support needs are comprehensively assessed to ensure that individual needs can be met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Statement of Purpose and Service User Guide have been reviewed since the last inspection. They are supported by pictures, which may make it easier for some people with learning disabilities to understand the services in the home. The Manager told us that she would develop an individual service user guide for any person referred to the service. This acknowledges that each person with learning disabilities communicates and understands in different ways. Since the last inspection the home has been split into three distinct living units. There has been an ongoing assessment process to establish the best way of accommodating and supporting people at the home. Three people live together in Valley View, two people share ‘High’ and one person lives alone in ‘Croft’. Highcroft and Valley View DS0000071383.V374748.R01.S.doc Version 5.2 Page 10 From discussion with the manager although the home is registered for nine people there are no further planned admissions into the home as people are settled with who they live with or living on their own. There have been no new people admitted to the home since the last inspection so the outcomes for any new person coming to live in the home could not be assessed. However, there are ongoing and regularly updated assessments in people’s care records that have been amended as their needs have changed so that staff have up to date information about them. As staff discover something new about an individual this is added to their assessment. Highcroft and Valley View DS0000071383.V374748.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 Quality in this outcome area is good There is a care planning system in place that gives staff the information they need to meet peoples’ needs. Risk management strategies are in place to meet the assessed and changing needs of the people living at the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Three peoples care records were seen, one person from each of the living units. As the people have complex ways of communicating their needs and this can present challenges for others. Each file contained a care plan detailing personal, health, social, communication and emotional care needs and how staff are to meet and support those needs. There are descriptions of how staff are to support people to make choices and decisions and promote their independence in their every day lives. Sensory Highcroft and Valley View DS0000071383.V374748.R01.S.doc Version 5.2 Page 12 cues and or communication boards are used for some people to make sure that they are actively involved and informed of what is happening in their lives. People’s care plans and risk assessments were in the main up to date. They included good descriptions of the support people need during their day to day lives. For one person there was one area of risk that was identified in their care records that had not been assessed or planned for. The records stated that there had been allegations made against male staff members. From discussion with the manager this appears to be historical and has not happened recently. However, if it is felt that it is a current area of risk this must be assessed and planned for. One person’s daily routines referred to when they shared there living unit with another person. This should be updated as they person now lives alone and some of the plan refers to supporting the individual to live with another person. Peoples’ plans should reflect how they express their sexuality and how staff support them to do this in a safe and appropriate manner. This is so that people are given clear guidance and kept safe from harm and or inappropriate behaviours. A life history book is being developed for one person. From discussion with the manager and staff other people may find it difficult to keep such a book without destroying it. Other means of producing accessible life history or life story work such as using DVD/ video formats should be developed for other individuals. These life history works will assist both the person and staff in acknowledging significant events their past and will assist staff to have a greater understanding of them as an individual. Highcroft and Valley View DS0000071383.V374748.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,14,15,16,17 Quality in this outcome area is good People participate in a range of social, leisure, and educational and occupational opportunities. People have opportunities to maintain their lifestyles in and outside the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Since the last the inspection staff have been providing 24 hour support to people. They had previously accessed a day service operated by the organisation. There are now a number of resource building and spaces within the grounds for people to use. From observation, discussion with staff and from the information AQAA people are now taking part in more community activities. On the first visit all but one Highcroft and Valley View DS0000071383.V374748.R01.S.doc Version 5.2 Page 14 of the people were out and about. People use local shops, village hall, leisure centre and the local environment for walks. Some people at the home have their own cars and there are house cars as well. Everyone has an individual activity programme. We saw that that three of the people have a communication board with photos that shows them what activities they have planned for the day. One person told us they were ‘making balls and going swimming’ when they were asked. Wherever possible contact with family and friends is supported. Visitors are welcomed. If relatives do not have transport staff assist by providing transport to and from the home. A wholesome and nutritious diet is provided. Where possible people are given a choice of meals and preferences catered for. Staff told us that some people are taking more of an active role in the preparation of food now that they have one to one support during the day. Highcroft and Valley View DS0000071383.V374748.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Quality in this outcome area is good The health and personal care that people in this home receive is based on their individual needs. In the main medication systems in place are safe. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Most of the people have complex non-verbal ways of communicating and some can present some challenges. People observed appeared relaxed with staff and made their needs known. The staff observed were confident and relaxed with the people they support. Staff are using objects of reference and or sensory cues for some individuals so they are aware of what they are doing next. Positive interactions and relationships were seen between the people and staff. People and staff clearly enjoyed each other’s company. All of the staff were Highcroft and Valley View DS0000071383.V374748.R01.S.doc Version 5.2 Page 16 positive about the strengths and skills of the people they support and all commented that they all have fun together. Staff observed treated individuals with respect and dignity. Assistance with personal support was provided in private, sensitively and discreetly. There is only one female living in the home and there is a mixed gender staff group. There is guidance in place for male staff supporting the female who lives at the home. People’s health records and care plans showed that their right to good-quality physical and mental health care is being promoted. The records show that as part of promoting their health people make regular visits to a dentist, optician, specific health consultants, their GP and a chiropodist when needed. The day before the inspection all of the people had an annual health check with the local GP. The staff told us that it was the first time that the GP had been able to undertake routine examinations of people and had commented that people living at the home seemed very settled and more relaxed to allow these examinations. One person who does not like to go into the dentist was seen by the dentist in the car. Staff are being creative with how they support people so they ensure that they receive healthcare. This is good practice. Staff have been trained in the administration of medication. The medication administration ad storage seen was correct. The PCT pharmacist had completed a pharmacy inspection the previous week. The manager had already completed their recommendations. A number of people have ‘as required’ medication prescribed. There must be PRN (as needed) medication plans in place. These plans need to include under what circumstances it is to be given, how long between doses, what is the maximum dose in 24 hours and whether it can be taken with other medications. These should be agreed with the prescribing practitioners or learning disability health practitioners where possible. It is recommended that these plans be kept with the administration records so that staff can easily refer to them. Highcroft and Valley View DS0000071383.V374748.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is good Within the context of individual’s communication abilities and comprehension their views and wishes are obtained and taken seriously and where appropriate are acted upon. Complaints and adult protection systems in the home serve to safeguard the people who live there. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Wessex Autistic Society has detailed complaints and adult protection procedures. These are available for staff use. Reference is made to the procedures in the Statement of Purpose and Service User Guide. As people who live at the home communicate in complex ways written and or pictorial information is not necessarily accessible to them. There are good descriptions in people’s plans as to how they let people know when they are unhappy and unsettled. Staff spoken with were very knowledgeable about the people they support and how they let them know if they are unhappy. They explained that due to the way people communicate they are not always able to understand what someone is unhappy about but they try everything to try and understand. We observed this in practice during the visit. Staff were very patient with an Highcroft and Valley View DS0000071383.V374748.R01.S.doc Version 5.2 Page 18 individual who was unhappy and gave them space and tried to find out what the problem was. There have been no complaints made to us about the home since the last inspection. Staff have been provided with safeguarding training and staff have also received refresher training. Staff spoken with were clear on the actions they needed to take to refer any allegations of abuse. There have been 13 adult safeguarding notifications/referrals since the key inspection. These related to incidents between people at the home, as people living at the home have complex behaviours, which sometimes result in verbal and occasionally physical aggression towards each other and staff. The manager has informed the funding authority care managers, learning disability team and the commission appropriately. Highcroft and Valley View DS0000071383.V374748.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24,30 Quality in this outcome area is good People live in a homely, comfortable and safe environment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Since the last inspection the home has been split into three distinct living units. Three people live together in Valley View, two people share ‘High’ and one person lives alone in ‘Croft’. Each living unit has been furnished and decorated to meet the needs of the individuals living there. For example, one person has a low stimulus environment as not to overload their sensory environment. Staff are constantly trying to re introduce additional furnishings at the individuals pace. People are having sensory assessments completed by the learning disability Highcroft and Valley View DS0000071383.V374748.R01.S.doc Version 5.2 Page 20 team so that staff can have a better understanding on how the sensory environment impacts on individuals. This is good practice. There has been major works at the home and in the grounds to develop new activity areas and clear old buildings. The décor in the home is subject to high wear and tear and there is ongoing programme of redecoration and repair. The home was clean and free from offensive odours. Highcroft and Valley View DS0000071383.V374748.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,33,34,35 Quality in this outcome area is good The people living in this home are in the main protected by robust recruitment practices. They are supported by a skilled, knowledgeable and competent staff team. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has had some turnover of staff but the manager told us that this has stabilised recently. This means that a more consistent staff team that people know well supports them. Regular agency staff are used to cover staff absences and holidays. We spoke to an agency member of staff during the visit. They were knowledgeable about the person they were supporting and told us that they work regularly at the home. Highcroft and Valley View DS0000071383.V374748.R01.S.doc Version 5.2 Page 22 There is a photographic staff rota on display in the hall in valley view so that people know who is on duty when. The AQAA (Annual Quality Assurance Assessment) and the training chart in the home shows that staff have accessed training in the full range of mandatory, health and safety related training, (e.g. first aid, food hygiene and fire safety) as well as specialist care courses, such as autism, epilepsy and team teach (behaviour management). There is a comprehensive induction programme that meets skills for care induction standards. Staff work alongside staff for four weeks before they work on a one to one basis with individuals. Two new staff were spoken with and confirmed that they had enough support and knowledge before they worked alone with people. The four most recently recruited staff records were seen. They included all of the necessary documentation to demonstrate that the staff are suitable to work with people at the home. There were CRB (Criminal Records Bureau) and POVA (Protection of Vulnerable Adults) checks. For one member of staff recruited in 2007 there was only one reference and this was not from their last employer. For all of the staff recruited since then, two references have been obtained but not all from people’s last care sector employer. Two references should be obtained and always requested form their current employer and last care sector reference. There are staff team meetings every two weeks and the minutes of these were seen. Staff and records told us that staff have regular supervision. Staff spoken with told us they felt well supported by the management team at the home. Highcroft and Valley View DS0000071383.V374748.R01.S.doc Version 5.2 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 Quality in this outcome area is good People benefit from living in a well run home. Peoples’ best interests are promoted and there are good monitoring systems in place at the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager has an NVQ (national Vocational Qualification) level 4 in care. She has a “registered manager award” qualification. The manager provides leadership to the staff team and staff spoke of good communication and effective teamwork. The manager has worked for Wessex Autistic Society for many years in various roles and is familiar with the philosophy and aims and objectives. Highcroft and Valley View DS0000071383.V374748.R01.S.doc Version 5.2 Page 24 The organisation’s quality assurance system includes formal consultation with staff, families and professionals involved with people. There are monthly monitoring systems in place for all accidents and incidents. The manager produces a monthly monitoring report. The AQAA was completed to good standard and accurately reflected the improvements over the last year and what they could do better. Information provided by the manager in the AQAA shows that relevant Health and Safety checks and maintenance are being carried out at the home. A sample of Health and Safety records were checked. These records showed that health and safety matters are well managed. Highcroft and Valley View DS0000071383.V374748.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 3 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x 3 x 3 x x 3 x Highcroft and Valley View DS0000071383.V374748.R01.S.doc Version 5.2 Page 26 No 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 YA9 Regulation 13 Timescale for action Any areas of risk identified for an 01/06/09 individual must be assessed and these assessments must include clear descriptions of the action staff need to take. This is so that any risks are minimised and staff know what action to take to keep people safe whilst promoting positive risk taking. 2 YA20 13 There must be PRN (as needed) medication plans in place. These plans need to include under what circumstances it is to be given, how long between doses, what is the maximum dose in 24 hours and whether it can be taken with other medications. This is to make sure that staff know in what circumstances to administer ‘as need’ medications and the maximum dosage people can safely be given at any time. 01/05/09 Requirement Highcroft and Valley View DS0000071383.V374748.R01.S.doc Version 5.2 Page 27 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 YA6 YA6 YA6 Good Practice Recommendations One person’s daily routines profile should be updated as they person now lives alone and some of the plan refers to supporting the individual to live with another person. Other means of producing accessible life history or life story work such as using DVD/ video formats should be considered for other individuals. Peoples’ plans should reflect how individual’s express their sexuality and how staff support them to do this in a safe and appropriate manner. This is so that people are given clear guidance and kept safe from harm and or inappropriate behaviours. Other means of producing accessible life history or life story work such as using DVD/ video formats should be developed for other individuals. These life history works will assist both the person and staff in acknowledging significant events their past and will assist staff to have a greater understanding of them as an individual. PRN ‘as needed’ plans should be agreed with the prescribing practitioners or learning disability health practitioners where possible. It is recommended that these plans be kept with the administration records so that staff can easily refer to them. 6 YA34 Two references should be obtained and always requested form their current employer and last care sector reference. This is to make sure that staff are suitable to work with vulnerable people and their experience in the care sector is taken into account. 4 YA6 5 YA20 Highcroft and Valley View DS0000071383.V374748.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Highcroft and Valley View DS0000071383.V374748.R01.S.doc Version 5.2 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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