Inspection on 06/06/08 for Highland Mist

This inspection was carried out on 6th June 2008.

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

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 7 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Highland Mist 03/12/07

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 28/09/2008.

CARE HOME ADULTS 18-65 Highland Mist Highland Mist Bronshill Road Torquay Devon TQ1 3HA Lead Inspector Stella Lindsay Key Inspection (unannounced) 6th June 2008 10:30 Highland Mist DS0000018370.V364505.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.V364505.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.V364505.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Highland Mist Address Highland Mist Bronshill Road Torquay Devon TQ1 3HA 01803 328156 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.V364505.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3rd December 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 five bedrooms. There is a staff sleeping in room on the ground floor. 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.V364505.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 1 star. This means the people who use this service experience adequate quality outcomes. However, enforcement action is underway due to the home owner’s failure to pay the CSCI fees that were due in 2007. This inspection took place over two days in June 2008. We met the Registered Provider, all six residents, and three staff on duty. We looked at care records, health and safety records, the medication system, and made a tour of the building. Further information about the home was provided in the Annual Quality Assurance assessment. What the service does well: What has improved since the last inspection? The home had provided an improvement plan as required by the previous inspection. This showed the home’s commitment to introduce the improvements necessary. Care planning had improved, showing that staff had considered the goals of each resident, and discussed their plans with those would were prepared to. Recording of risk assessment had improved, showing how risks associated with particular individuals was to be managed, for instance with relation to smoking, or possible self-harm. A maintenance book was in use, and showed that tasks were being dealt with promptly. Painting had continued, with the hallways recently redecorated. Highland Mist DS0000018370.V364505.R01.S.doc Version 5.2 Page 6 A recording method for food hygiene and cleanliness in the kitchen had been introduced, to promote a safe and pleasant environment. What they could do better: There is no front door bell or knocker, and security of the front door and postal deliveries must be improved urgently, to make sure that people receive their post. The medication must be brought back to a secure place on the ground floor, in order to enable safe administration to residents who find it difficult to get up the stairs. A medicine cupboard that meets regulations must be provided. One upstairs bedroom is well below the National Minimum Standards of 10 square metres. Alternative accommodation, or additional space such as a private lounge, should be offered to the occupant. Since the fire safety risk assessments had been done, an office area had been created on the first floor landing under the stairs to the loft. This must be assessed for any risk, and in particular all electrical equipment must have upto-date PAT tests. The office nearby had no window, and is not suitable for supervision sessions or meetings of any kind. An extractor fan should be installed. It may be necessary for the undersized bedroom to revert to being an office, and for the number of residents to reduce to seven. Professional fire safety training must be provided to raise staff awareness and protect residents from potential harm. The stair carpet is worn and must be replaced. Residents’ cash held on their behalf must be always kept in the home’s safe, to keep it safe and accessible to them, and all transactions must be recorded at the time. Any incident that affects the well being of residents must be reported to the Commission for Social Care Inspection in accordance with regulation 37, so that actions taken in response can be monitored. Activities outside the home had reduced since the previous inspection, and further encouragement and ideas for opportunities needed to be followed up. It is current practice for staff to take hot drinks to residents at certain times of day. Residents’ own access to facilities for making hot drinks and snacks should be reviewed. Highland Mist DS0000018370.V364505.R01.S.doc Version 5.2 Page 7 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.V364505.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 Highland Mist DS0000018370.V364505.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 and 5 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home owner had made decisions 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 had been agreed with them, so that they are clear about terms and conditions. EVIDENCE: The home has produced information for the public, but it is in need of updating to ensure accuracy and avoid misleading prospective residents. The Statement of Purpose must include a reference to the bedroom which does not meet the National Minimum Standard for size. There had been no admissions since the previous inspection. Good information had been received before the most recent admission, including a report from a Community Psychiatric Nurse. The person felt they had settled well. The home had provided statements of terms and conditions for the residents, and some had been signed by the resident or their relative since the last inspection. Highland Mist DS0000018370.V364505.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 and 9 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Care planning was being carried out in consultation with residents. Handling of residents’ money remains unreliable. EVIDENCE: Care plans and risk assessments had been entirely rewritten since the last inspection and were much improved. The staff managed to engage some of the residents in this work, and had included their input. The care plans had been reviewed monthly, and though these reviews did not demonstrate an advanced understanding of residents’ problems, the residents themselves said that they found that the staff understand them well. The home owner said that she is no longer appointee for any resident. An advocate was due to visit the resident whose financial affairs needed reorganising, by arrangement with their Care Manager. All residents now have bank accounts in their own name. Staff help some of the residents with budgeting. This cash was not in the safe at the time of this inspection, so was not properly safeguarded or accessible to Highland Mist DS0000018370.V364505.R01.S.doc Version 5.2 Page 11 residents. Accounts were not kept of the daily transactions, so it was not possible to be sure that the correct amount was there. All residents are consulted about life within the home, informally during each day, and at regular house meetings. Risk assessments were seen, covering self-harm, smoking, abuse of alcohol. There was a list of actions for staff to take to avoid difficult situations, but these should be developed to include more clear advice to staff on how to respond to incidents. Incidents had not been reported to the CSCI, in accordance with regulation 37, which must be done so that the home’s actions can be monitored. Highland Mist DS0000018370.V364505.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 and 17 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents’ motivation was low, and they were involved in few activities in or out of the home. EVIDENCE: Daily diaries were kept for residents. These showed that little activity was going on, but people had their own routines, for example one person liked to go to the shops, sit in the garden, and go to their room for a rest. People’s attendance at a daily social group had stopped. Residents said it was because of transport problems, but the home owner said there had been some problems for residents at the centre. There is a minibus available, though it could only be driven by the home owner. The residents were positive about their life in the home. They said they get on with each other - ‘I love it here,’ said one. ‘The residents try to help me – I’m mates with them.’ Highland Mist DS0000018370.V364505.R01.S.doc Version 5.2 Page 13 A worker from Opportunities Plus had visited the home regularly, and was looking at options for people. One resident had an interview with the Cinnamon Trust during the previous month, and was awaiting an opportunity for voluntary work. Another had stopped their regular voluntary work with the Forestry Commission, because of the early start of the transport to get there. One person had been involved with voluntary work, but had sustained an injury at work and was attending hospital for treatment. The residents stated emphatically that they were happy with their food. The inspector saw tinned food and cakes served for lunch. There was some fresh fruit in the house. The resident who had previously enjoyed cookery was not able to do this, due to injury. Another who was hoping to work towards independent living had not yet agreed practical steps to learn kitchen skills. It is current practice for staff to take hot drinks to residents at certain times of day. Residents’ own access to facilities for making hot drinks and snacks should be reviewed. Highland Mist DS0000018370.V364505.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): 18, 19 and 20 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Support is reliably provided with personal and health care. The safe administration of medication was jeopardised by the storage arrangements. EVIDENCE: One resident said that at Highland Mist they had received the support they needed to get on top their problem with substance misuse, and that now they have the right medication they are feeling much better. Another had been offered support to address problems from their earlier life, with collaboration between the local Community Mental health and Learning Disability teams. Encouragement is given with personal hygiene, and residents said they were happy with the bathing/showering arrangements. Staff ensure that residents attend their specialist appointments, and are supported in their health care reviews. The medication cupboard had been moved upstairs. This is not safe as some residents are not able to go upstairs to receive their tablets, and there are Highland Mist DS0000018370.V364505.R01.S.doc Version 5.2 Page 15 increased risks of mistakes when medication cannot be directly administered. A medicine cupboard which meets the regulations must be provided. A filing cabinet is not appropriate. Highland Mist DS0000018370.V364505.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): 22 and 23 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents feel safe at Highland Mist; however, staff training needed to be updated to help them to be alert to potential abuse. EVIDENCE: A book is kept in the hall for anyone to write a complaints, but none had been recorded. Residents’ meetings are held at least monthly, and all are able to raise concerns at these times. No complaints had been received by the CSCI. The home’s policy on protection of vulnerable people from abuse did not include the duty to contact the Safeguarding team of the Social Services but it was accompanied by the Alerters’ Guidance, which had the necessary actions and contact numbers. There had been an on-going safeguarding issue concerning a resident’s finances, which is being resolved, due to new arrangements with the commissioning body. Training in the Protection of Vulnerable Adults should be repeated, to ensure understanding amongst the staff. The residents all say that they feel safe. The home owner said that she had brought one resident’s vulnerability to financial abuse outside of the home to the attention of his care manager, in order that they could get good advice and support. Highland Mist DS0000018370.V364505.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24,, 25, 28 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Maintenance and refurbishment had continued, and Highland Mist was providing a comfortable home for residents, but some health and safety issues remain. EVIDENCE: Maintenance requirements had been recorded in a book, and dealt with promptly. Private rooms and communal areas had been repainted. A maintenance worker was working on the garden shed during this inspection. There is no dining room. Some residents eat in the porch, which has been much improved since the last inspection, and now is a pleasant place to sit. The other residents eat at a table in the lounge. They say they are happy with this arrangement and have no wish to sit together to eat. There are eight single bedrooms, 7 with handbasins. One is just over 8 square metres, which is well below the National Minimum Standards. It had no chair Highland Mist DS0000018370.V364505.R01.S.doc Version 5.2 Page 18 or table, or hand basin. The current occupant said they were happy with the room, but it should revert to being an office unless the occupant is offered compensatory accommodation such as an additional private lounge. One resident was delighted with their room at the front of the house, and had rearranged the furniture to suit themselves. The stair carpet was worn and needed to be replaced, as it was becoming a trip hazard. The bathrooms were in good order and had liquid soap and paper towels available. Laundry facilities are in the back yard. They should not be accessed through the kitchen for reasons of good hygiene. There is a way through the staff sleeping-in room next door. At the time of this inspection this was being used by the home owner to store personal effects. This should cease, as this valuable space is needed for a care office as well as sleeping-in room. The computer, care records and medicine cupboard were in a small room with no window or ventilation. It is not suitable for supervision sessions or meetings of any kind. An extractor fan should be installed if its use as an office is to continue. Other office work was being carried out under the stair case to the attic. Highland Mist DS0000018370.V364505.R01.S.doc Version 5.2 Page 19 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 and 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff were available to help meet the needs of the residents, and the recruitment procedure was being followed. EVIDENCE: There is one Support worker on duty day and night, with the administrator additional several mornings per week. The home owner is often on duty as well, either on the premises, taking residents to appointments, or on-call. 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. Relationships between staff and residents were seen to be relaxed and trusting. The small group of staff is stable, staff know the residents well and said that they find their work rewarding. 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. Highland Mist DS0000018370.V364505.R01.S.doc Version 5.2 Page 20 NVQ training was in progress which is good. However, other training had lapsed since the previous inspection, and some up-dates were needed. The supervision records showed staff’s achievement, but there was still not analysis of training needs. Supervision sessions had been re-introduced, which is good. Records showed that staff had been given feedback on their performance. Highland Mist DS0000018370.V364505.R01.S.doc Version 5.2 Page 21 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 and 42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The residents consider that the service is run in their best interests. Mrs Hill has made efforts to comply with requirements made by the CSCI. Some health and safety issues are outstanding, and Mrs Hill has not communicated reliably with us. EVIDENCE: The home owner, Mrs Sue Hill, said that she has completed the Registered Managers’ Award, and is awaiting her certificate. She said that it had been lost in the post, and that she is having to pay for a duplicate. She is now engaged in working for the NVQ 4 in Promoting Independence, and is also taking an Advanced Diploma in Integrative Counselling. Highland Mist DS0000018370.V364505.R01.S.doc Version 5.2 Page 22 Mrs Hill has been consistently late in paying annual bed fees to CSCI. The fees for the year up to 31/03/07 had not been paid by the start of this inspection, and a notice of proposal to deregister was being considered. Mrs Hill consistently denies receiving letters from the CSCI as well as other authorities, including the Finance department of the local Care Trust. She must be more responsive. This may involve better security for incoming post. Mrs Hill has been consistent in failing to respond to letters from the CSCI, often saying that she has not received them. There is a small post box by the front door for deliveries. There is no front door bell or knocker for the post delivery to call for attention. Security of the front door and postal deliveries must be provided urgently. A copy of the Annual Quality Assessment was delivered by hand to Mrs Hill, and she completed it within a fortnight, giving useful information about the home. She completed an improvement plan following the previous key inspection on 3rd December, and work had been carried out to meet the requirements made at the previous inspection, with one exception. Staff meetings are held every month, with the residents then joining for a house meeting. Records had been kept, showing that discussion had covered areas of dissatisfaction with a day facility, with a staff member who had performance issues, and with housekeeping issues. Any incident that affects the well being of residents must be reported to the Commission for Social Care Inspection in accordance with regulation 37, so that actions taken in response can be monitored. Fire risk assessments had been reviewed in December 2007. Safety checks of each room are recorded, including fire safety issues. Some residents smoke in their rooms in spite of the house policy not allowing this, so careful monitoring had been maintained. Residents are required to hand in their cigarettes and lighters overnight. Combustible materials were removed from stairwells during this inspection. These must be kept clear, and fire safety must be observed at all times. Fire drills had been held, most recently on 26/05/08, with two staff members and all six residents. In-house training resources were available, but professional fire training had not been provided since 2006. This was an outstanding requirement from the previous inspection, and must be provided within its timescale. The fire precaution system had been professionally checked on 06/11/07, and the extinguishers on 26/05/08, and the safety lighting had been serviced on 05/05/08. In-house checks of the fire precaution systems and of all rooms are recorded monthly. Since the risk assessments had been done, an office area had been created on the first floor landing under the stairs to the loft. This must be assessed for Highland Mist DS0000018370.V364505.R01.S.doc Version 5.2 Page 23 any risk, and all electrical equipment must have up-to-date PAT tests. The office beside this had no window, and needed an extractor fan to be installed. The use of space within the house needs to be reviewed. It may be necessary for the undersized bedroom to revert to being an office, and for the number of residents to reduce to seven. Highland Mist DS0000018370.V364505.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 3 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 2 26 X 27 X 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 2 X 3 X LIFESTYLES Standard No Score 11 X 12 2 13 2 14 2 15 2 16 2 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 2 X 2 X X 2 X Highland Mist DS0000018370.V364505.R01.S.doc Version 5.2 Page 25 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA7 Regulation 13(6) Requirement When residents need support and tuition in handling their personal allowance, this must be done in a safe and accountable way. Safe and suitable storage for medication must be provided. The stair carpet is worn and must be replaced. Professional fire safety training must be provided, to protect residents from potential harm. Previous time scale 29/02/08 The use of the space on the first floor under the stairs as an office must be risk assessed, and all electrical equipment PAT tested. Any incident that affects the well being of residents must be reported to the Commission for Social Care Inspection so that actions taken in response can be monitored. Security of the front door and the home’s post must be improved. DS0000018370.V364505.R01.S.doc Timescale for action 31/08/08 2. 3. 4. YA20 YA24 YA42 13(2) 23(2)b 23(4)d 31/08/08 31/08/08 31/08/08 5. YA42 23(4)c 31/08/08 6. YA42 37 31/08/08 7. YA42 23(1)a 31/08/08 Highland Mist Version 5.2 Page 26 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. Refer to Standard YA1 YA22 YA23 YA24 Good Practice Recommendations The Statement of Purpose should be up to date and accurate, to avoid misleading prospective residents. All concerns as well as complaints should be investigated with records kept of action taken. Staff training in the Protection of Vulnerable Adults should be up-dated. The use of space within the house should be reviewed, to offer all residents a room that meets the standards for space, and to provide an office that is suitable for meetings and confidential discussions. The staff training plan should indicate the training required by staff members. Staff training in Moving and Handling should be up dated. An annual plan for the home should be drawn up, based on the Quality Assessment and feedback from residents and the professional health and social care staff who support them, and a copy supplied to the CSCI. 5. YA35 6. YA39 Highland Mist DS0000018370.V364505.R01.S.doc Version 5.2 Page 27 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. 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