Inspection on 07/01/09 for Hollybrook House

This inspection was carried out on 7th January 2009.

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

Other inspections for this house

Hollybrook House 09/07/08

Hollybrook House 18/07/07

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 13/03/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Hollybrook House 85 Silver Road Norwich Norfolk NR3 4TF     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Lella Hudson     Date: 0 7 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: Hollybrook House 85 Silver Road Norwich Norfolk NR3 4TF 01603767578 01603611620 hollybrook@swantoncare.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Victoria Shucksmith Type of registration: Number of places registered: Swanton Care and Community Ltd care home 43 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability mental disorder, excluding learning disability or dementia Additional conditions: 4 named residents who are now over 65 years of age who have resided at this Home for a number of years. Hollybrook House may accommodate up to forty-three (43) service users of either sex aged between 18 and 65 years who have a mental disorder. Up to fifteen (15) services users may also have a learning disability. The conditions and safeguards for this condition are as set out in a letter from Andrew Frederick Care Homes Ltd to the Commission dated 2nd September 2003, a copy of which is on file. These 15 service users are included within the overall total of 43 service users. Date of last inspection Brief description of the care home Hollybrook House provides care and support to up to 43 adults with mental health needs, some of who may also have learning difficulties. The resource consists of a Care Homes for Adults (18-65 years) Page 4 of 28 Over 65 0 0 15 43 Brief description of the care home main house catering for up to 12 people and a series of shared houses and flats that offer the opportunity for more independent living. Hollybrook House is located within walking distance of Norwich city centre. Fees are £307 - £1600 per week but are agreed on an individual basis dependent on need. Care Homes for Adults (18-65 years) Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This report contains information gathered about the Home since the last Key Inspection (9th July 2008). It also contains information gathered during our unannounced visit to the Home on the 7th January 2009. This visit was carried out by two Inspectors. We looked around the accommodation, spoke to residents and staff, spoke to the acting manager and looked at records. Care Homes for Adults (18-65 years) Page 6 of 28 What the care home does well: What has improved since the last inspection? What they could do better: Improvements to the accommodation still need to be carried out although there is now a plan for this to take place. Many areas of the accommodation are in need of refurbishment and redecoration. Many of the residents have to carry their meals from the main house to their own flats, whatever the weather. The care planning and risk assessment process would still benefit from further clarity and guidance for staff to ensure that residents are receiving a consistent level of Care Homes for Adults (18-65 years) Page 7 of 28 support. The Home needs to have a permanent manager appointed as soon as possible. The acting manager has done a very good job but he is also managing another Home within the organisation at the same time. It would also be of benefit for the Home to have their administrator replaced as well so as to free up the deputy managers time. Staff training needs to continue to improve so that staff receive training in both mandatory and specific subjects. The whole staff team needs to receive training about mental health issues and this training needs to be regularly updated. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 28 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. An appropriate procedure is in place to ensure that adequate assessments are undertaken prior to anyone moving into the Home. Evidence: The organisation has procedures relating to the effective admission of any new residents. No residents have moved to the Home since the last Inspection. Care Homes for Adults (18-65 years) Page 10 of 28 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The care plans provide guidance to staff about how to meet the residents needs. The residents are now more involved in the running of the Home and their views are sought on a more regular basis. Evidence: We looked at two of the care plans which includes the risk assesments and daily notes which staff keep. There have been improvements in the care planning process. The residents are now more involved in this process and told us that they can meet with their keyworkers to review these if they wish to. The deputy managers have been responsible for reviewing the format and quality of the care plans. They have spent time with the care staff to ensure that they understand the process and they carry out regular audits to ensure that the care plans are being reviewed and kept up to date. The daily notes are written in a positive and respectful style. Care Homes for Adults (18-65 years) Page 11 of 28 Evidence: The deputy managers and the acting Manager have access to training about the Mental Capacity Act via e-learning. They need to attend more formal training about this issue to ensure that they are able to understand the process and to be able to carry out mental capacity assessments when needed. Currently there is no evidence of these within any of the care plans. Risks are considered and ways of managing these are recorded within the risk assessments. However there are still some areas in which these need to be more detailed, for example, with regard to medication and to financial arrangements. The views of the residents are now being sought on a more regular basis. For example, residents meet with their keyworkers, there are regular house meetings and staff have more time to spend on a one to one basis with residents. Residents confirmed that they feel more involved in what happens in the Home now. We looked at the arrangements in place for looking after residents money. Often this is paid into the organisations bank account and then paid to the resident from petty cash. We were told that the aim is for all residents to have their own bank accounts. We checked the records against the cash held for one of the residents and this was found to be accurate. Confidentiality of information has improved. We saw from the minutes of staff meetings that staff are being reminded of the importance of confidentiality on a regular basis. The location of the new offices means that it is easier for staff to meet somewhere that is more private than the office in the main house. Care Homes for Adults (18-65 years) Page 12 of 28 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are supported to take part in a range of meaningful activities. Healthy meals are provided and the residents have a choice of meals. Evidence: We spoke to residents about the support that they receive to take part in meaningful activities. They said that this has improved since the last Inspection due to the fact that there are now more staff on duty and that one of the staff takes a lead role in coordinating activities. This was confirmed through discussions with staff and the acting manager. There are now usually six staff on duty from 8am to 8pm which is an increase since the last Inspection. Two of the residents have 3 hours 1:1 one support each day and another two residents have 1:1 time for shorter periods across the week. The member of staff Care Homes for Adults (18-65 years) Page 13 of 28 Evidence: responsible for providing this support is now identified during handover each day which means that it is much more likely to take place. However, the shifts change at 8pm and so evening activities do not take place on a regular basis. There are also still some days, particularly at weekends, when the staffing is less than six on duty from 8am to 8pm. The member of staff who is now responsible for co-ordinating activities is very enthusiastic about this role and has worked hard to ensure that residents are able to take part in a range of activities. All staff are responsible for supporting residents to take part in activities, both away from the Home and within the Home. The care plans that we saw contain detailed information about activities that the residents are interested in and records of activities that residents have been involved with. The organisation provides a budget for activities and so the staff and residents have been able to purchase games and activities for use within the Home as well as use the money to fund activities within the community. The Home is situated close to the city of Norwich and is on a bus route. The Home has the use of a vehicle. The chef has reviewed the menus and these have been changed with the involvement of the residents. The chef knows the likes and dislikes of the residents as well as any specific dietary needs of residents. Although there is a menu the chef is always happy to provide alternatives and we saw this happening during our visit. The residents in the main house have access to cold and hot drinks in the dining room. The residents in the flats have their own kitchens and access to drinks and snacks. Some of the residents are responsible for their own shopping and cooking. All of the meals are provided from the kitchen in the main house and this means that the residents in the flats who do not self cater have to go to the main house to pick up their meals and carry them back to their flat whatever the weather. Care Homes for Adults (18-65 years) Page 14 of 28 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents personal and healthcare needs are adequately met. The provision of risk assessments would mean that medication was more safely managed. Evidence: We looked at two of the care plans and these contain information relating to the phsyical and mental health needs of the residents. The care plans have been greatly improved since the last Inspection but there is still room for further improvements. For example, one of the residents is diabetic but there is no information within the care plan about how to recognise the signs of hypo/hyper attacks and the support needed at that time. The majority of the residents said that they feel that their needs are met at the Home and that the staff are kind. One of the residents needs are not able to be met at the Home and the acting manager has taken the appropriate steps to work with the residents social worker to find somewhere more appropriate for the resident to live. Discussions with the staff and residents show that residents are supported to attend Care Homes for Adults (18-65 years) Page 15 of 28 Evidence: regular appointments with dentists and opticians. Residents are also supported with appointments with mental health professionals as necessary. The District Nurse visited the Home on the day that we were there to provide some nursing care to one of the residents. This was being provided in the lounge with other residents present but we were told that this was because the resident refused to remove from this room. The care plans contain information relating to the personal and mental health care needs of the residents and how these should be met. However, again, these would benefit from being further developed so that they provide more detailed guidance about how each residents mental health impacts on their daily life and how their needs should be met in this area. Very few of the residents require physical support with personal care although a lot of the residents do require verbal support and reminders about this aspect of their care. The staff work hard to encourage the residents to maintain their independence in this area. Risk assessments need to be further developed with regard to those residents who make a choice not to maintain their personal hygiene to what may be considered to be an acceptable level. The two deputy managers have attended training provided by MIND which they both said has been very helpful and interesting. This training is about working with people with mental health problems. The acting manager said that there are plans in place to provide training about mental health to all staff but this has not yet taken place. We looked at the medication and found that there have been a lot of improvements in this area. The room in which the medication is kept has been reorganised so that there is less of a muddle for staff to work in. One of the deputy managers now has responsibility for the medication system and has very recently started to carry out regular audits of the system to ensure compliance with a satisfactory standard. Staff are now expected to complete three observed assessments of administration of medication as well as attendance at formal training. There is still a need for further improvements. For example, there are no risk assesments for the residents who are self medicating or for the use of PRN (as required) medication. Care Homes for Adults (18-65 years) Page 16 of 28 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The organisations procedures and the provision of training to staff provide increased protection to the residents from abuse. Evidence: The Commission has not received any complaints since the last Inspection and the acting manager confirmed that the Home has not received any either. The complaints record includes the outcome of investigations that were being carried out at the time of the last Inspection. At least one of these has led to disciplinary action being taken against members of staff. The residents told us that they know who to talk to if they have a problem. Residents have more opportunities for raising concerns with the implementation of regular residents meetings and one to one time with their keyworkers. Staff are aware of the action to take if anyone wants to make a complaint. The complaints procedure is on display around the Home in an easy read format. The training records show that all, except for four members of staff, have attended training about Safeguarding vulnerable adults. The acting manager said that all staff will have attended the training within the next few months. The staff who spoke to us said that they are aware of the need to raise any concerns that they may have and of the Whistle Blowing procedure. Care Homes for Adults (18-65 years) Page 17 of 28 Care Homes for Adults (18-65 years) Page 18 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The Home provides basic accomodation for the residents in a range of communal and private living areas Evidence: We looked around the communal areas of the main house and of the two houses known as Mousehold. Three of the residents showed us their bedrooms. We did not go into any of the flats on this occasion. Many areas of the Home are in need of redecoration and refurbishment. Even some of the areas which have been refurbished eg. bathrooms, need to be made more homely and comfortable areas. The Home has a smoking area, the conservatory, which has a system for smoke extraction but there is a smell of smoke throughout the main house. Whilst the standard of accommodation has not improved since the last Inspection there are now plans in place for improvements. The acting manager confirmed that the organisation has given agreement for new flooring and for redecoration and refurbishment of the bedrooms. Residents told us that there is a problem with the hot water in the showers in the two Care Homes for Adults (18-65 years) Page 19 of 28 Evidence: houses known as Mousehold. The acting manager said that he was aware of this and that the plumber is due to visit the day after our visit. The radiators are covered but the thermostats are also covered over and so residents do not have any control over the radiators in the Home, even in their bedrooms. Care Homes for Adults (18-65 years) Page 20 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff are provided in sufficient numbers to meet the needs of the residents. Training is not yet sufficient to ensure that staff have the right skills and experience to meet the needs of the residents. Evidence: We spoke to staff and residents about the staffing levels and they all confirmed that these have been increased since the last Inspection. There are now usually six care staff on duty between 8am and 8pm with four waking night staff on duty from 8pm to 8am. There are occasions at weekends when there are only five staff on duty. In addition to this staffing level there are also domestic and catering staff on duty so that there is not an expectation that care staff will have to do these tasks. However, again at weekends, there are less catering and domestic staff on duty so care staff may be expected to do some of these tasks. Following the last Inspection agency staff were used to immediately increase the number of staff on duty but the acting manager has recruited new staff and so now the use of agency staff has greatly reduced. Residents told us that the support that they receive has greatly improved since the increase in staff numbers as the staff now Care Homes for Adults (18-65 years) Page 21 of 28 Evidence: have more time to spend talking to them on an individual basis and to support them to go out. Staff told us that they enjoy their work more now as they feel that they have more time to spend with residents. Staff told us that the morale within the team has improved since the time of the last Inspection and newer members of staff said that they receive good support from their colleagues. We were told that new members of staff complete an induction which complies with the Common Induction Standards. The training matrix shows that both mandatory and training about specific residents needs has started to be provided to staff but the requirement for this is repeated in this report. We looked at a selection of staff files and could see that appropriate recruitment procedures are now being followed with checks on staff being carried out prior to them starting work. Staff told us that they receive more regular supervision now and that this is provided by one of the acting managers. Care Homes for Adults (18-65 years) Page 22 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The acting manager has provided improved leadership to the Home and many improvements have been made. The views of the residents are more regularly sought. Health and safety has been given a higher priority. Evidence: There have been a lot of management changes within the organisation. The organisation itself was recently purchased by its sister organisation, Barchester Healthcare and the previous Responsible Individual has left. The Operations Manager has also left. One of the Barchester Healthcare managers is the new Responsible Individual and a new Operations Manager started work during the week of our visit to the Home. The Home still does not have a permanent Manager. The acting Manager said that he expects that this post will be advertised now that the Operations Manager has started work. Care Homes for Adults (18-65 years) Page 23 of 28 Evidence: Mr McCready is the registered manager at another Home within the organisation and has been working as the acting manager at this Home for over six months. He spends a lot of time at this Home and staff said that he provides good support to them and to the residents. The acting manager has been responsible for ensuring that improvements have taken place following the last Inspection. He has provided good management input into this Home whilst maintaining his role at the other Home. The administrator has also recently left the Home and so there is very little administrative support in the Home. This means that the acting manager and the deputy managers spend quite a lot of time carrying out administrative tasks which takes them away from their main roles and responsibilities. The two deputy managers both work Monday to Friday and both said that this is more effective as it means that they can liase with each other on a regular basis as they both have individual responsibilities. The Home employs senior care staff and the need to ensure that they are suitably experienced and trained is even more important now that the acting manager or deputy managers rarely work at weekends. They do provide an oncall system for out of hours situations. Staff receive training about health and safety and there are plans in place to ensure that everyones training is up to date for this subject. We looked at a selection of health and safety records and these show that regular maintenance and servicing of equipment takes place. One of the deputy managers has recently carried out a fire risk assessment. Monthly visits by someone appointed by the organisation have not taken place on a regular basis since the last Inspection although the acting manager said that he expects that these will start again now that the new Operations Manager has been appointed. The views of the residents are being sought on a more regular basis than they were at the time of the last Inspection. Although there is no formal quality assurance system in place at the moment the residents are given opportunities to make comments about the quality of the service in residents meetings and during regular meetings with keyworkers as well as in more informal conversations with staff. Care Homes for Adults (18-65 years) Page 24 of 28 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action 1 24 23 (2)(b) The accommodation must be 31/12/2008 upgraded to ensure that the residents live in accommodation which is homely and comfortable Staff must receive training 31/10/2008 with regard to mental health to enable them to meet the needs of the residents 2 32 18 (1)c Care Homes for Adults (18-65 years) Page 25 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 15 It is required that financial care plans are written To ensure that the residents and staff are clear about the arrangements in place when looking after residents money 31/03/2009 2 20 13 It is required that written guidance about the use of PRN medication is available To ensure that this medication is given at appropriate times and in a consistent way 28/02/2009 3 20 13 It is required that risk assessments are carried out for those residents who self medicate To ensure that risks are being properly considered and that guidelines are in place to safely manage this 28/02/2009 4 24 23 The accommodation must be 31/03/2009 upgraded. Care Homes for Adults (18-65 years) Page 26 of 28 To ensure that the residents live in accommodation which is homely and comfortable 5 35 18 It is required that staff receive training in mandatory subjects and issues relating to individual residents needs To ensure that staff have the appropriate skills to meet the needs of the residents 30/04/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 38 It is recommended that an administrator is employed so as to free up the management teams Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 28 of 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. 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