Inspection on 18/11/05 for Hilton House

This inspection was carried out on 18th November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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 25 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Hilton House 21/02/08

Hilton House 13/04/07

Hilton House 26/07/06

Hilton House 04/05/06

Hilton House 18/06/05

Hilton House 22/02/05

Hilton House 26/04/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Hilton House 175 Shrub End Road Colchester Essex CO3 4RG Lead Inspector Jenny Elliott Unannounced Inspection 18th November 2005 10:00 Hilton House DS0000017850.V268003.R01.S.doc Version 5.0 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 Hilton House DS0000017850.V268003.R01.S.doc Version 5.0 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. Hilton House DS0000017850.V268003.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Hilton House Address 175 Shrub End Road Colchester Essex CO3 4RG 01206 763361 N\A 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) Mr Wills Clarel Gopaul Mrs Sylvia John Mr Wills Clarel Gopaul Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Hilton House DS0000017850.V268003.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Persons of either sex, under the age of 65 years, with learning disabilities (not to exceed 8 persons) 18th June 2005 Date of last inspection Brief Description of the Service: Hilton House is a former family dwelling that has been extended and altered to form the current accommodation. The property is located approximately one mile to the west of Colchester Town Centre, in an established residential area. Public transport is frequent and a bus stop is within walking distance. The closest rail station is Colchester Town. The front garden provides off-road parking. The rear garden is of good size, but neglected. The accommodation comprises five single bedrooms and one double occupancy bedroom with an en-suite bathroom. Communal rooms (sitting room and dining room) are situated on the ground floor, toilet and bathing facilities are upstairs. The home is registered to care for adults between the ages of 18 and 65, who have a learning disability. It does not purport to accommodate any person who has very complex or challenging behaviours. Hilton House DS0000017850.V268003.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection began with a site visit on the 18th November 2005. A second visit to the home was made on the 28th November to follow up issues from the first visit. It was extended until the 10th February 2006 to allow for investigations into the recording of staff deployment to be completed. During the visit staff and service users were spoken with about the service. Records held by the home and the accommodation provided were also inspected. Overall, the service provided by the home was considered to be poor to satisfactory. Following advice provided by Inspectors at the first site visit, photographs of work in progress to improve the hard area and front wall to the front of the premises, dossett boxes with printed information about medication and new bedding have been submitted to the Commission. The home also provided updated policies and procedures, a care plan review template and a calculation of staffing hours required. These will be reviewed at the next inspection. What the service does well: What has improved since the last inspection? What they could do better: The home should ensure that full information is available to current and prospective service users about how the home is run, and that this includes full information about the costs (in addition to the fees of the home) that service users are expected to fund. For example the cost of toilet rolls, soap powder and the replacement of furniture and bedding. The home should develop the way in which it plans and provides care for service users. In particular the home should identify ways in which service users can be included in the process and ensure that all needs and aspirations are identified and met in the plan. Hilton House DS0000017850.V268003.R01.S.doc Version 5.0 Page 6 The home should ensure that vulnerable service users are not exposed to unnecessary risk through a lack of support staff, inappropriate access to the community or poor systems for the administration of medication. The home should ensure that sufficient staff are employed and on duty to cover care, cleaning, laundry and other household tasks. The home should continue its programme of redecoration. 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. Hilton House DS0000017850.V268003.R01.S.doc Version 5.0 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 Hilton House DS0000017850.V268003.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 and 5 The home did not provide sufficient information for people living there, or prospective service users. The home took steps to assess whether or not it was able to meet the needs of people living there. EVIDENCE: Mr Gopaul advised that both the Statement of Purpose and Service Users guide were being updated and improved and therefore were not available for inspection. The provision of information in the prescribed format is a long standing issue initially identified as requiring completion by 31st March 2005. Of the records inspected there was adequate evidence to demonstrate that risk assessments had been undertaken to ensure that the home could meet the needs of people living there. Contracts and terms of conditions, usually located within the Service Users guide were unavailable for inspection (see above). However a contract was in place within the sampled care plans. This was written in some sections in the first part and in others, in the third part, and should be reviewed to ensure it is written in a format suitable for people living at the home. Hilton House DS0000017850.V268003.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 and 10 Care plans did not sufficiently reflect service user needs, aspirations or choices. Information was stored appropriately within the home. EVIDENCE: The service user plan was adequately structured and logical in layout with the information relating to individual decisions being easily accessed. There was evidence of assessment relating to specific care requirements and there were links from this to care decisions, for the most part, although this could be further developed. A key worker system appeared to be in operation, but there was no opportunity to test the understanding of the system with care staff. The plans did not evidence consultation with the service user, although there were several examples of where the service user had signed documents, for example forms associated with cash held. These were cross referenced with internal review documents. Hilton House DS0000017850.V268003.R01.S.doc Version 5.0 Page 10 The review documents, again signed by the service users, were quite good in reporting various perspectives, although did not include the views and aspirations of service users. Review dates were not adhered to. One sample indicated that a review undertaken on 19th January 2005 should have been reviewed in July 2005, but no review had taken place. The methodologies to achieve care outcomes were variable in quality and would benefit from greater clarity. The narratives written by staff were quite good, being full and descriptive for the most part. The care plan did not cover gender or sexual issues and were basic in terms of social and leisure outcomes. Issues relating to physical and personal care were in place, although the document was rather biased toward a medical model. Some special needs were evident, including continence management and challenging behaviour and the individual records for these were poor. However, Mrs John advised that the continence advisor had taken some data away for analysis. Although there was a policy regarding infringements to the rights of service users, there were no recorded infringements. One service user assessment, undertaken by the home, suggested that the service user required care and personal support by way of aggressive behaviour, irresponsible and anti-social behaviour, self-injurious behaviour and confirmed as having a past and present mental illness. Apart from the service not being registered to provide care for a person with a mental health illness, there was a clear lack of suitable arrangement to protect this person from the potential harm or risk they may be exposed to whilst unsupported in the community. There was evidence to show that one service user was undertaking unsupervised, unsupported visits to Colchester town centre, at times when their behaviour, treatment and demeanour were unpredictable and volatile, without adequate assessment of risk. There was some discrepancy between the support details within the care plan and the advice and description of support given by Mrs John. At best, the care and support provided was not being adequately recorded and evidenced within the plan. At worst there is an absence of monitoring data linked to the specific known care requirements. Service user financial matters were explored. Service users have a lockable tin, located in their bedroom, the keys of which were held by the service user. The service does not strictly hold cash in safe custody, although there is some procedural aspect to the process whereby receipts are obtained and records are held. Service users do not control this process, but it is undertaken by care staff in order to demonstrate how service users spend their cash. Based upon the sample, the fairly limited check undertaken indicated that cash balanced with the book and that the receipts seen corresponded with Hilton House DS0000017850.V268003.R01.S.doc Version 5.0 Page 11 purchases. However, a detailed examination was not undertaken of the whole financial arrangements. The inspection concluded that the principle of service users taking as much control and responsibility for their own money is a positive one, but the home must ensure that appropriate assessment of arrangements to safeguard service users continues to be monitored and regular checks undertaken. Records were chiefly held within the office and there were lockable cabinets to hold sensitive information. There were examples of practice that require review. The main difficulty rests with a concern regarding the confidentiality of service users’ information and is linked to a poor consultative ethos within the service. There was evidence to show that relatives of service users were endorsing decisions on behalf of service users when, for example, other evidence demonstrated that service users signed documents on their own behalf. Good practice maintains that the service must assume capacity for service users to make their own decisions, with support from advocates or other suitable person, unless there is evidence to the contrary. Hilton House DS0000017850.V268003.R01.S.doc Version 5.0 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16 and 17 Service users’ wishes and interests in respect of their lifestyle were not fully integrated into the service provided. Service users’ diets did not reflect their medical needs. EVIDENCE: Discussions with service users and records inspected indicated that community activities were undertaken, although the care plans sampled did not always set out the wishes and feelings of service users. There was one positive example of a service user developing a particular interest and there was evidence of some development of this interest, although there were missed opportunities in terms of community access and support to engage with the activity more fully. Some of the suggested developments were stated by Mrs John to have been achieved, but there was not a report of these within the care plan. Relatives and friends of service users were not available at the time of the inspection; however, documentation did indicate that families were involved in the care reviews. The care plans sampled did not include care decisions Hilton House DS0000017850.V268003.R01.S.doc Version 5.0 Page 13 associated with gender or relationship issues and it is recommended this be considered at the next review of care. The menu planning did not take account of a service user who was diagnosed with a chronic bowel difficulty. Hilton House DS0000017850.V268003.R01.S.doc Version 5.0 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 The home’s arrangements for supporting the healthcare of service users were not satisfactory. EVIDENCE: The home’s arrangements for healthcare need tighter monitoring. One sample showed that a service user had undergone two invasive treatments at the local hospital some months apart, with no follow up notes included in their care plan. There was no medical or nutritional screening data on the records of a service user diagnosed with a bowel problem. As previously mentioned, the mental health needs of at least one service user were not adequately addressed. Interaction between staff and service users was appropriate, but sparse, during both visits to the home. Staff should also ensure that whilst at the home and in earshot of service users, in order to promote the dignity of people living at the home, they carry out conversations in a language understood by service users. The arrangements for the administration of medication at the home were not satisfactory. Medication was in dossett boxes that were only identifiable by the first name of service users. Inspectors were advised that three service users Hilton House DS0000017850.V268003.R01.S.doc Version 5.0 Page 15 self-medicated (although medication was kept in the office) and staff Further, that administered medication to the remaining service users. prescriptions go directly from the GP to the pharmacist. The home did not have copies of prescriptions or printed details from the pharmacist in respect of medication held at the home. Information on medication administration records was handwritten by staff following contact from the GP. Hilton House DS0000017850.V268003.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Records and observation did not evidence that service users’ views were listened to or acted upon. Policies and practice do not sufficiently protect service users from abuse, neglect or self-harm. EVIDENCE: At the first visit to the home, attention was paid to the level of interaction between staff and service users. Inspectors arrived at 10am, apart from conversation related to what people would like for dinner, there was no other interaction between staff and service users. At the second visit to the home, one Manager and one member of staff were on the premises. The member of care staff was in overalls painting the hallway and the Manager was with a contractor. The second Manager arrived mid-way through the visit. As described previously in this report, service users’ goals and aspirations were not recorded in care plans, and there was a conflicting approach to the inclusion of service users in making decisions about their lives. There were documents with service user signatures provided as evidence that the home was meeting some standards, but other examples of where relatives had made decisions on behalf of service users. Service users did not have advocates to support them in making decisions about their lives. Documents were not produced in a format that made them easy to read. One entry in staff meeting notes gave rise to concern in respect of how the home interprets the behaviour of service users, and the extent to which the Hilton House DS0000017850.V268003.R01.S.doc Version 5.0 Page 17 home is that of service users. The entry read “[service user] stealing food again from kitchen. He admitted the offence when questioned.” In discussion, a member of staff provided a good example of how they had promoted the dignity of one service user and described basic support (in terms of prompting and reminding) provided to another service user. The home’s policy in respect of adult protection states ‘robust procedures are in place for responding to suspicions of abuse’, but does not state what these are. The policy did not make references to the responsibility of staff to report suspicions or to the local authority procedures. Records relating to two staff were inspected, both of these contained certificates of attendance at a half-day seminar entitle ‘Abuse in vulnerable adults – a hidden problem’. Reference has already been made to the need for the home to review practices in relation to the management of service users finances, poor practice in respect of the administration of medication and unsupported trips into the community for vulnerable people living at the home. Hilton House DS0000017850.V268003.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25 and 30 Much of the accommodation, some furniture and most bedding was of poor standard. The home was generally clean, but some practices did not serve to promote good infection control. EVIDENCE: The outside of the premises was in a poor state of repair, this had been identified in the previous report. Internally, some redecoration had taken place and where this had happened it was a notable improvement, however, there remained a number of bedrooms and communal areas that required attention. Many of the duvets and pillows were thin and some were stained, new bedding was in the wardrobe of one service user, the Manager advised the service user had purchased this. Some bedrooms had new furniture (wardrobes and chest of drawers) the Manager advised that these had been purchased by service users and that where replacement furniture was planned this would also be purchased by service users. The home must ensure that the expectation of service users to purchase replacement furniture is included in information about the home and that a clear inventory of belongings is maintained in records belonging to service users. The bedroom furniture that Hilton House DS0000017850.V268003.R01.S.doc Version 5.0 Page 19 had been provided by the home was old, of poor quality and not homely. The bath on the first floor was stained. The home was clean, although the condition of some furniture and the state of decoration in some parts of the home gave it a shabby appearance. However, staff were observed carrying dirty laundry, in their arms, through the home to the laundry area. Hilton House DS0000017850.V268003.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 35 and 36 There were not sufficient staff at the home to carry out all of the necessary roles (cleaning, decorating, cooking, laundry and care) and to adequately meet needs of service users. There was not sufficient evidence to demonstrate that staff were adequately supervised, trained or supported in their roles. EVIDENCE: Records provided during the inspection, relating to the deployment of staff, were misleading leading to a protracted investigation in respect of staffing levels at the home. The formula used to determine appropriate staffing levels was not available during the inspection. The subsequent examination of records relating to the deployment of staff as part of the investigation indicated that, on occasion, no care staff were present at the home. The Managers advised that where care staff were not recorded as working, the shifts would be covered by one of the Managers, but this was not recorded. At the second visit to the home, one Manager and one member of staff were on duty, both were occupied with tasks relating to the maintenance of the building. The home does not have dedicated maintenance, catering, cleaning or laundry staff. The Managers must be able to demonstrate that the allocation of these tasks to care staff does not impinge on the quality of care provided to service users. Hilton House DS0000017850.V268003.R01.S.doc Version 5.0 Page 21 Roles and responsibilities were not clearly defined in the home. In addition to the comments above, the job description for a night worker made reference to a ‘named nurse’. Mrs John said this was a document she had produced as part of her National Vocational Qualification (Level 4) and that she was a registered nurse. Mrs John was reminded that the home was not registered to provide nursing and that she was not registered by the Commission as a nurse at the home. Mrs John said she realised this and would take the reference out. A further paper headed ‘Key-worker role’ stopped mid-sentence at the end of the first page and had no subsequent pages, this paper also referred to the responsibilities of a named nurse. The incompleteness of this document and their inappropriateness in relation to the care home environment, bring into question their currency at the home. The home has a supervision policy that states supervision ‘will be taken while on duty, but at a time that is convenient to other staff...and to service users.’ Records of three supervision sessions related to a shift when only one of the two people involved were on duty. Supervision records did not have any clear action, learning or professional development, there was also no reference to key working or the support of individual service users. There were a range of training certificates held on the records inspected. Many, but not all, of these were ‘in-house’ courses. The certificates did not include details of areas covered, of how competency was assessed or the learning implemented or monitored. There was no apparent link between training and practice. Staff said they felt listened to and supported, by Managers of the home, and included in discussions about developments within the home. Hilton House DS0000017850.V268003.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37 The home is not satisfactorily managed. EVIDENCE: This inspection has raised concerns about a number of areas of practice within the home. Some of these have been issues raised at previous inspections. A number of the standards inspected are assessed as having major shortfalls, which call into question the leadership and management skills of the Registered Managers. The home was providing a service to people whose needs fell outside of its current registration. Hilton House DS0000017850.V268003.R01.S.doc Version 5.0 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 1 X 3 X 1 Standard No 22 23 Score 1 1 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 1 X 1 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 2 2 X X X X 2 LIFESTYLES Standard No Score 11 1 12 1 13 2 14 2 15 1 16 1 17 Standard No 31 32 33 34 35 36 Score 2 2 X X 2 1 CONDUCT AND MANAGEMENT OF THE HOME 1 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Hilton House Score 1 1 1 X Standard No 37 38 39 40 41 42 43 Score 1 X X X X X X DS0000017850.V268003.R01.S.doc Version 5.0 Page 24 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 YA1 Regulation 4 Timescale for action The registered persons must 01/05/06 ensure that the Statement of Purpose and Service User Guide provide information required by the Care Home Regulations and National Minimum Standards. Previous timescale of 31/03/05 not met. The registered persons must 01/05/06 ensure that clear, accessible statements of terms and conditions are in place for each person living at the home. Previous timescale of 01/03/05 not met. The registered persons must 01/05/06 ensure that care plans cover all needs, aspirations and risk and that action plans are fully documented. Previous timescale of 31/08/05 not met. The registered persons must 31/03/06 ensure that people living at the home are provided with diets that promote their health and wellbeing. Requirement 2 YA5 5 3 YA16YA15YA 14YA13 YA12YA11YA 7YA9YA6 15,13,18 4 YA17 12,16,17 Hilton House DS0000017850.V268003.R01.S.doc Version 5.0 Page 25 5 YA19YA18 12,13 6 YA20 13 7 YA22 16,24 8 YA6YA20YA2 3 YA25YA24 18,13 9 23 10 YA30 16,23 11 YA36YA35YA 32YA31 18 12 YA37 Registration Regs. The registered persons must ensure that arrangements are made to promote the health and wellbeing of service users. The registered persons must ensure that in all matters relating to the administration of medication, they adhere to the requirements of the relevant legislation and guidelines from the Royal Pharmaceutical Society. Previous timescale of 01/03/05 not met. The registered persons must take steps to ascertain and respond to the views of people living at the home. The registered persons must ensure that service users are protected from abuse, neglect and self-harm. The registered persons must ensure that the premises are kept in a good state of repair and decoration, externally and internally, and that they provide satisfactory furniture and bedding for service users. Previous time-scale of 01/07/05 not met. The registered persons must ensure that practices within the home promote good infection control. The registered persons must ensure that staff are available in sufficient numbers and with sufficient skills to meet the needs of service users. The registered persons must make an application to the Commission to vary the home’s condition of registration to meet the needs of current service users. 31/03/06 31/03/06 31/05/06 31/05/06 31/05/06 31/03/06 30/04/06 30/04/06 Hilton House DS0000017850.V268003.R01.S.doc Version 5.0 Page 26 13 YA37 12 The registered persons must 31/05/06 ensure that the home is run in such a manner as to meet the needs of service users. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Hilton House DS0000017850.V268003.R01.S.doc Version 5.0 Page 27 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Hilton House DS0000017850.V268003.R01.S.doc Version 5.0 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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