Inspection on 03/12/07 for Highland Mist

This inspection was carried out on 3rd December 2007.

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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Highland Mist 06/06/08

Highland Mist 15/05/07

Highland Mist 11/01/07

Highland Mist 19/06/06

Highland Mist 21/02/06

Highland Mist 02/08/05

Highland Mist 09/03/05

Highland Mist 16/06/04

Highland Mist 26/03/04

Highland Mist 09/03/04

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Highland Mist Bronshill Road Torquay Devon TQ1 3HA Lead Inspector Stella Lindsay Key Inspection (unannounced) 3rd December 2007 11:15 Highland Mist DS0000018370.V350834.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 Highland Mist DS0000018370.V350834.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. Highland Mist DS0000018370.V350834.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Highland Mist Address Bronshill Road Torquay Devon TQ1 3HA 01803 328156 F/P 01803 328156 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) Mrs Susan Irene Ann Hill Mrs Susan Irene Ann Hill Care Home 8 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (8) of places Highland Mist DS0000018370.V350834.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15th May 2007 Brief Description of the Service: Highland Mist provides care for up to eight adults with mental health needs. The premises are in a residential area of Torquay within walking distance of shops, and the town centre. There is parking to the front of the home, and a garden with a grassed area, greenhouse and a patio. There is also a shed at the bottom of the garden for smokers. Entrance to the house is up several steps into the conservatory, which has a table that can seat four and is used for meals. There is a comfortable lounge. A new kitchen had been provided, spacious enough to enable residents to work alongside staff. The ground floor also has a shower room with toilet and three bedrooms. The laundry facilities are outside in the yard, accessed through a staff room. Stairs lead to the first floor, which has a bathroom with toilet, and four bedrooms, one of which is en-suite. The Manager has an office on the first floor, and there is a care office on the ground floor that is also used for staff sleeping in. Current charges are £260 - £420. The Home has a Statement of Purpose and Service User Guide for the public to view, but previous inspection reports were not available. Highland Mist DS0000018370.V350834.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over two days in December 2007. It involved a tour of the premises, and examination of care records, staff files and the medication system. The inspector met with five of the residents, the home owner, and three staff on duty. Information about the running of the home had been requested from the home owner prior to this inspection, but had not been provided. What the service does well: What has improved since the last inspection? What they could do better: Highland Mist DS0000018370.V350834.R01.S.doc Version 5.2 Page 6 The Home owner must be more responsive to the regulator and to the commissioning body. She has failed consistently to respond to letters and to requests for information. Where the home owner is appointee to any resident, she must safeguard their money and ensure that their bills are paid. Records must be kept of all incoming and outgoing payments, and independently audited, and supplied to the Commission for Social Care Inspection on request. The information provided to prospective residents needs to be up-dated to give an accurate impression of the service offered. The home owner had produced contracts for each resident six months ago, but still needs to discuss these with them and record their agreement. Risk assessments need to include advice for staff on how to reduce risk while enabling the resident to engage in the activity of their choice. Staff supervision sessions should be offered at least six times per year, and should include a consideration of the staff member’s training needs. Further progress is needed with National Vocational Qualifications, and staff should have specific training on the areas of equality and diversity so they can demonstrate how resident’s rights are being supported. Fire training must be provided, to ensure that staff and residents know how to react in an emergency. 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. Highland Mist DS0000018370.V350834.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Highland Mist DS0000018370.V350834.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,5 Quality in this outcome area is adequate. The home owner made the decision to offer accommodation based on professional assessment, in order to provide a suitable service. Information produced about the service did not provide entirely accurate information for the public. Contracts issued to residents need to be agreed with them, so that they are clear about terms and conditions. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has produced information for the public, but it is in need of updating to ensure accuracy and avoid misleading prospective residents. A Statement of Purpose had been produced which provided information as required by the regulations. The owner said that she intended to up-date it to include the new aims of the service including encouraging community involvement and support for residents to work towards independence. Residents had been given copies of ‘the prospectus’ - or ‘Service Users’ Guide’. This includes photos, and local contact information about self-help groups. Both need to be checked for accuracy, and to ensure that they are clear about what is available at Highland Mist. There had been one new admission since the previous inspection. The care manager provided information by phone for the home owner to make the decision about whether suitable care could be offered, and brought with them Highland Mist DS0000018370.V350834.R01.S.doc Version 5.2 Page 9 a risk assessment that had been carried out previously. A personal profile had been written, and the admission was reviewed and continued during the course of this inspection. The resident was not able to visit beforehand, but was seen to be settling well. New contracts had been drawn up for each resident at the time of the previous inspection. These were still awaiting the signature of the occupant, and their room number and the agreed fee. Highland Mist DS0000018370.V350834.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 Quality in this outcome area is poor. Good practice was not consistently seen with respect to review of care plans, risk assessments were not useful in promoting activities in safety, and evidence was lacking with respect to proper care of residents’ finances. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Care plans are being developed, though further progress is necessary, including evidence that residents have been involved. Personal profiles were included, and family connections and personal relationships recorded. Each resident has a keyworker. They are expected to complete monthly client reports, and this was seen to have been done on behalf of some residents, showing progress in their emotional well being and social accomplishments. The newly returned member of staff has been detailed to reconsider and update care plans and risk assessments. She needs to do this in consultation and teamwork with residents and staff. Risk assessments still need to include advice for staff on how to reduce risk while enabling the resident to engage in the activity of their choice. Highland Mist DS0000018370.V350834.R01.S.doc Version 5.2 Page 11 The Court of Protection manages one resident’s affairs. They send a cheque each week to Highland Mist, which is cashed and given to the client. The home owner is still appointee for one resident, though this is under review, and she has said she wants to give up this responsibility. The Commissioning body allege that she has withheld money that the resident owes to them. The home owner said that she had made this money available, but it had not been withdrawn. The resident was unaware of this situation, believing their fees to be paid by the NHS. They are left with a large outstanding debt. The home owner said that she would pay this ‘as a matter of urgency to resolve the problem.’ Two residents manage their own money, and have bank accounts, which they access themselves. Highland Mist DS0000018370.V350834.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17 Quality in this outcome area is good. Residents were motivated to join activities outside the home on a regular basis, and opportunities were being provided according to individual interests. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Contacts and activities outside the home had been built up since the last inspection. Residents were pleased to tell the inspector of their regular commitments. One was doing voluntary work two days per week, cooking for people at the Cool House, which is run by an independent charity providing support for those recovering from mental health problems. Another was going weekly to do conservation work with the Forestry Commission, and was working towards a City & Guilds qualification in this area. A day centre that provides social and leisure activities was proving successful with all residents, who were looking forward to their Christmas party. Highland Mist DS0000018370.V350834.R01.S.doc Version 5.2 Page 13 A computer course was being arranged on behalf of a resident by Opportunities Plus. An art course was planned for another. A new resident had interests in music and animals, and opportunities in these areas were being arranged. Residents are able to go to local pubs and shops. One resident was pleased to be meeting a family member to go shopping and to the library, and two other residents went out for coffee together. Within the home, games of pool had been enjoyed, and a karaoke machine had been obtained. Records are kept of residents’ activities each morning, lunch time and evening. Residents were happy with their meals. Staff were trying with varying success to provide a balanced diet. Lunch on the day of this inspection was a choice of tinned ravioli or baked beans, followed by shop bought cake and a banana. For tea there were individual pies. Fresh fruit was seen in the garden shed. Residents said they enjoy their Sunday lunch. There is not a choice, but the menu of the day is written on a white board by the entrance, and residents said that they are given an alternative if they do not like the main meal. One of the residents often helps with the cooking, and was seen preparing vegetables on the second day of this inspection, when salad was served with lunch. A menu record is kept for each resident, which shows that all have some fresh fruit and vegetables, but not consistently. Highland Mist DS0000018370.V350834.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. Resident’s health and personal needs are identified, and they are encouraged to access healthcare services. Medication is administered competently. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Residents health personal and mental health needs were recorded in the care plans and risk assessments examined. Medical records showed that residents attended Community Nurse, Doctor, Psychiatrist, optician, and dental appointments, with support. One resident was finding it more difficult to get up and down the stairs so they had agreed to move to a downstairs bedroom. Residents’ mental health care is reviewed by Community Psychiatric Nurses from the Mental Health team, who provide treatment as required. CPA assessments were seen. One included the statement that the individual was ‘well supported in the residential home’. The local drugs and alcohol support service were involved in an advisory capacity on behalf of one resident. The medication was seen to be stored and recorded with care. Pages with a photograph of each resident had been produced to divide the records, to Highland Mist DS0000018370.V350834.R01.S.doc Version 5.2 Page 15 improve clarity. Coloured highlights are used to show the times of day for administration of medication. Each month a new sheet was started for the PRN (as required) drugs, and a record was kept of the reason and the time they were given. Highland Mist DS0000018370.V350834.R01.S.doc Version 5.2 Page 16 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): Quality in this outcome area is poor. Resident’s views are listened to, but recording of action taken could be improved. Residents could not be assured that the Registered Person would protect them from financial abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Complaints procedure was on display in the home. A box is in the entrance so that residents may make private complaints or suggestions, though none had been received. No complaints had been received by the Commission for Social Care Inspection since the last inspection. It would be good practice to keep a record of any concerns that are expressed, and what action has been taken in response, so that people know that their voice has been heard. A Residents’ Meeting was in progress when the inspector arrived for the second day of this inspection, with all residents present, and being encouraged to share views. Training in the Protection of Vulnerable Adults had been provided on 23rd February 2007, and an ‘Abuse’ handbook given to all staff, to refer to if in doubt of what to do. The staff handbook included a section on whistle blowing. The staff knew what must be done in the event of any allegation of abuse. One resident’s money was kept in an account from which it could be used by the bank to offset money owed to them on other accounts. Therefore residents could not be assured that the Registered Person will protect them from financial abuse. The bank confirmed that this person now has an account in their own name. Highland Mist DS0000018370.V350834.R01.S.doc Version 5.2 Page 17 Highland Mist DS0000018370.V350834.R01.S.doc Version 5.2 Page 18 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 adequate. Highland Mist provides a basic but comfortable home for the residents, who appreciate the on-going improvements. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Highland Mist is a terraced house in a residential area of central Torquay. Residents were all able to get to local facilities. There is a small parking area by the front entrance. The entrance has been marred by a skip full of rubbish for several months due to the on-going refurbishments. There is a garden to the front of the house, much appreciated by the residents. The shed by the gate, known as the ‘smoke house’, provides a safe but separate area for residents to sit. The new kitchen had been completed since the last inspection, and was in use with staff and residents preparing food together. There is a hatch for serving meals close to the lounge and porch. The walls of the porch had been improved and further refurbishment was planned, as residents like to sit here, Highland Mist DS0000018370.V350834.R01.S.doc Version 5.2 Page 19 and some take their meals here. The others eat in the lounge, or in the garden when the weather allows, as there is no dining room. The bedrooms are all for single occupancy, but do not have en suite facilities. One more bedroom had been redecorated and re-carpeted. The care office/sleeping in room had been moved downstairs. This room has access to the backyard, where the washing machine is. This is an improvement as laundry is brought this way, and no longer through a kitchen area. The back yard is for rubbish and storage only, but could be kept clearer, as access to the back lane might be needed in an emergency. The bathrooms and kitchen were found to be clean, and there were suitable hand washing facilities, and paper towels available in communal areas. Highland Mist DS0000018370.V350834.R01.S.doc Version 5.2 Page 20 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): 32,34,35,36 Quality in this outcome area is adequate. Staff were available to help meet the needs of the residents, and the recruitment procedure was being followed. Assessment of training needs and provision to meet these needs was incomplete. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There had been a major change in the recent past, with the departure of the Deputy Manager, and return from retirement of a Senior Administrator. A written rota was not available, but staff told the inspector that they knew their working hours as they work a fixed two week rota. There are always two staff available, and at night there is one person on sleeping-in duty, with the home owner on-call. Two staff files were examined and it was seen that checks were made and references taken up when recruiting staff, to protect residents from potential harm. Codes of Practice and job descriptions had been provided. One of the current four staff members has NVQ2 and is working towards NVQ3. Further progress is needed with National Vocational Qualifications, and staff should have specific training on the areas of equality and diversity so they Highland Mist DS0000018370.V350834.R01.S.doc Version 5.2 Page 21 can demonstrate how resident’s rights are being supported. A training programme in Safe administration of medication had been followed in June 2007. Mental Health professionals from the locality team provided a session of Mental Health Awareness on 09/07/07. The home owner carries out an appraisal of each staff member annually, but had not managed to provide six supervision sessions per year as planned. A supervision record showed that training achievements had been recorded, but future needs had not. Highland Mist DS0000018370.V350834.R01.S.doc Version 5.2 Page 22 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 poor, as the home owner does not communicate satisfactorily with the regulatory body. She has not yet completed her qualifying training, does not regard quality monitoring as a core management tool, and staff training and supervision are inconsistent. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home owner, Mrs Sue Hill, said that she has completed the Registered Managers’ Award, and is awaiting her certificate. She is now engaged in working for the NVQ 4 in Promoting Independence, and is also taking an Advanced Diploma in Integrative Counselling. A self assessment questionnaire, known as the Annual Quality Assurance Assessment was due for completion by the home owner on 11th October 2007 but was not returned to the Commission for Social Care Inspection in spite of a letter that was sent as a reminder. Highland Mist DS0000018370.V350834.R01.S.doc Version 5.2 Page 23 A strategy for quality assurance had been produced, but no formal process had been followed. Residents are consulted in the events and organisation of daily life. A residents’ meeting took place during the course of this inspection, to share matters of concern as well as discuss plans for Christmas. Fire drills had been carried out three monthly, including staff and service users, the latest having been on 30/10/07, but professional training had not been provided since June 2006. Fire alarms had been tested weekly but this had lapsed since 30/10/07. The fire precaution system had been tested professionally, and the fire extinguishers had been checked on 6th November 2007. Fire risk assessments had been carried out in respect of one of the residents who was considered vulnerable, and were being carried out for each room, as required to protect residents from potential harm. Highland Mist DS0000018370.V350834.R01.S.doc Version 5.2 Page 24 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 2 2 3 3 X 4 X 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 2 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 x 32 2 33 X 34 3 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 1 X 2 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 1 X 2 X X 2 X Highland Mist DS0000018370.V350834.R01.S.doc Version 5.2 Page 25 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 YA7 Regulation 17 Requirement Timescale for action 07/02/08 2. YA9 13(4)(c) 3. YA37 24(3) 4. YA39 24(1) Where the home owner is appointee, records must be kept of all incoming and outgoing payments, and independently audited, and supplied to the Commission for Social Care Inspection on request. Risk assessments must include 29/02/08 the measures to be taken to reduce risk. Previous timescale; 30/06/07 The Manager must complete the 07/02/08 Annual Quality Assurance Assessment when required to do so by the Commission for Social Care Inspection. An annual report based on the 30/09/08 analysis of the Quality Assurance system must be produced, with a copy available for CSCI and other interested parties to demonstrate that the service provided is being monitored and improved. Previous timescales 02/08/05, 31/10/05, 30/04/06, 20/09/06 & 31/12/06 & 30/11/07. Highland Mist DS0000018370.V350834.R01.S.doc Version 5.2 Page 26 5. YA42 23(4) 6. YA42 23(4)d Fire risk assessments must be carried out for each room and area of the house. 30/06/07 Professional fire safety training must be provided, to protect residents from potential harm. 29/02/08 29/02/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. 5. 6. Refer to Standard YA1 YA5 YA6 YA22 YA24 YA32 Good Practice Recommendations The Statement of Purpose should be up to date and accurate, to avoid misleading prospective residents. The home owner should agree the up-dated contract with each resident. All care plans should be updated regularly and agreed with the service user. All concerns as well as complaints should be investigated with records kept of action taken. Maintenance and improvements to the premises should continue, with records kept. At least 50 of care staff should have NVQ 2. Staff should have specific training on the areas of equality and diversity and demonstrate how resident’s rights are being supported. The staff training plan should indicate the training required and completed by staff members. The Manager should have gained NVQ 4 in Promoting Independence. 7. 8. YA35 YA37 Highland Mist DS0000018370.V350834.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Highland Mist DS0000018370.V350834.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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