Inspection on 12/07/05 for Kingscourt

This inspection was carried out on 12th July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Kingscourt 25/04/07

Kingscourt 27/10/06

Kingscourt 16/11/05

Kingscourt 02/03/05

Kingscourt 12/10/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Kings Court 100/102 Kings Drive Bishopston Bristol BS7 8JH Lead Inspector Karen Walker Announced 12 July 2005 09:30 th 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 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 Stationary 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. Kings Court D56_40011_Kingscourt_230286_120705_Stage4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Kings Court Supported Independence Residential Home 100/102 Kings Drive Bishopston Bristol BS7 8JH 0117 923 2132 Address Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Supported Independence Nicola Stanworth / Catherine Twine PC Care Home 11 Category(ies) of LD Learning disability (10) registration, with number LD(E) Learning dis - over 65 (1) of places Kings Court D56_40011_Kingscourt_230286_120705_Stage4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: May accommodate up to 10 persons with Learning Disabilities aged 19 to 64 years. May accommodate 1 named person with Learning Disabilities who is over 65 years of age. This will be removed if this person moves on. Date of last inspection 2 March 2005 - Unannounced Brief Description of the Service: Kings Court is registered with the Commission for Social Care Inspection as a care home for up to eleven service users with a diagnosis of a learning disability. The home is able to accommodate people aged 18 to 64, with one named person aged over 64. The home is based in one of two adjourning semi detached houses in a residential area in North Bristol. It is approximately quarter of a mile to local shops and a variety of community facilities. Public transport links (buses) are available in Kings Drive close to the home. All service users have to be physically able as the home is based over three floors with stairs being the sole means of access to each floor. There are three ground floor bedrooms. There is a social care facility on site. Supported Independence is the registered organisation. The home has four services under the umbrella of Supported Independence including Kings Court. The other services are for service users who wish to live within more independent housing. Kingscourt is presently the only service registered with the Commission for Social Care Inspection as personal care is given to one or more service users. The philosophy of care for Supported Independence is that a continuum of care is available to provide service users an opportunity to progress towards greater levels of independence from within a consistent and planned environment. Kings Court D56_40011_Kingscourt_230286_120705_Stage4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Records relating to individual residents were examined and discussions were held with them and the relevant staff member. Other records relating to the home were examined including risk assessments and records relating to health and safety. The purpose of the visit was to review the requirements and recommendations from the last inspection and to monitor the quality of the care provided to the individuals living at Kings Court. What the service does well: What has improved since the last inspection? The inspection provided evidence that Kingscourt continues to be well managed and that progress had been made since the last inspection with achieving compliance with regulations. A ‘quality assurance tool’ is being developed and the manager is attending training in the ‘key result’ areas, which include staff development and compliance with regulations. Resident questionnaires have been completed and responses are yet to be collated. This should ensure residents benefit from a needs led service. Kings Court D56_40011_Kingscourt_230286_120705_Stage4.doc Version 1.30 Page 6 Staff and residents spoke positively about the support they were given. What they could do better: 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. Kings Court D56_40011_Kingscourt_230286_120705_Stage4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Kings Court D56_40011_Kingscourt_230286_120705_Stage4.doc Version 1.30 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 standard(s) 1,2,3,4,5 Residents have all the necessary information given to them to enable them to make an informed choice about where to live. EVIDENCE: Contracts of residence are in place signed by residents. The statement of purpose provides adequate information to ensure residents are aware of the aims and objectives of the home. Residents are able to make an informed decision on their choice of home and are able to ‘test drive’ the service. The statement of purpose makes the admissions process very clear in that a comprehensive assessment must be in place prior to moving in, this ensures an accurate care plan can be drawn up and that the residents needs can be met. The statement of purpose needs to be updated to separate the manager’s qualifications and skills from the registered providers. The service user guide details the ‘house rules’ and this is given to the prospective resident prior to admission to ensure they are in agreement. Kings Court D56_40011_Kingscourt_230286_120705_Stage4.doc Version 1.30 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 standard(s) 6,7,8,9,10 Residents are consulted on and participate in all aspects of life in the home. Care plans do not provide clear action plans and outcomes which may lead to inconsistency and affect the residents understanding of the care and support to be given. EVIDENCE: Residents spoken with confirmed they have read and have ‘signed up’ to care plans and risk assessments in place. Care plans are of a ‘set format’ and do not accurately describe the goals, action to be taken, support to be given or the desired outcome. One care plan states ‘develop coping strategies achieved through counselling for old traumas’ it does not detail what the coping strategies will be or what support the resident will receive. It is recommended in this case that the Community Learning Disability Team be accessed and the necessary referrals made to support this person through her ‘old traumas’. From talking with staff, the manager and the residents it is clear that the home enables and supports individuals to be as independent as possible. Residents are supported to move to more independent settings within the organisation. Kings Court D56_40011_Kingscourt_230286_120705_Stage4.doc Version 1.30 Page 10 Staff stated that this is done based on the wishes of the individual and within a risk assessment framework. Risk assessments seen were based on enabling and did not appear to hinder residents from any activity. However some risk assessments had not been reviewed for over 12 months and some contained outdated information. This was discussed with the manager and a requirement made to adequately review all risk assessments and remove those that are not relevant. The home has a missing person policy. There was information in care records that could be shared with others giving a full description of the individual. One staff member was unaware of the precise action to take should one particular resident go missing. It is recommended that a copy of the missing persons procedure be included in the individuals care records. Weekly house meetings are held where residents are supported to make decisions on the running of the home including décor, menus and activities. One to one ‘supervision’ meetings are held on a weekly basis between residents and their key-worker. The manager stated that the term supervision had been adopted so that there was no distinction between the staff and the residents. Meetings were recorded and used to discuss residents concerns and goals. Residents agreed that they found these meetings valuable and keyworkers thought it was a good way of ensuring needs are being met. Staff were observed conducting conversations of a confidential nature in the office with the door closed. The home has a policy on confidentiality and access to information. This was seen on a previous inspection. Records of a confidential nature were kept in a lockable facility. Kings Court D56_40011_Kingscourt_230286_120705_Stage4.doc Version 1.30 Page 11 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 standard(s) 11,12,13,14,15,16,17 Residents’ benefit from an environment that encourages personal development and independence. Residents feel a part of the local and wider community and have the appropriate support to make and maintain friendships. EVIDENCE: Although there are ‘house rules’ in place residents agree to the rules before moving in as they are clearly identified in the service user guide. When a ‘rule is broken’ or an ‘unacceptable’ behaviour is displayed there is a ‘sanction’ to pay. Agreements were seen in care planning folders where residents agree to the ‘sanctions’ chosen i.e. loss of a personal stereo or TV for a limited period. One resident was asked about these ‘sanctions’ and said “ we need to be more structured here as a step to moving on, they give you the tools of the trade”. Another said, “Staff want you to do well if you lag behind they push you”. Residents ‘feedback’ sheets received by the CSCI were positive one stating, “The service I have received here is very good”. Kings Court D56_40011_Kingscourt_230286_120705_Stage4.doc Version 1.30 Page 12 The inspector was invited to join residents for lunch, which was a sociable occasion. Residents confirmed they take part in the cooking and the cleaning of the home. There are two ‘training kitchens’ available and one resident said he often cooked his own meals. Another resident confirmed she was supported to carry out her own washing and ironing and other household chores. She added that she would like to ‘have more support’ and this was discussed with the manager. The manager confirmed she had made the necessary referral to try and gain more funding to provide more one to one support. This has been shared with the family and joint decisions made. The menu plan was examined and a varied diet was on offer. It was noted that the menu recorded ‘vegetables’; it is recommended that the vegetables be named to ensure a variety is offered. It is also recommended that any changes or individual choices be recorded. At the last inspection the home was commended on the strategic planning of social activities to ensure that all residents could attend their placements. There were guidelines for staff on planning the day including times for residents to leave and return to day placements. The day care plans were individually led and based on their interests. One resident who has retired still enjoys being active. He told the inspector that he attended luncheon clubs, a day centre and college. It has been recognised that the needs of this resident has changed and an alternative placement has been identified. Records of expenditure, conversations with staff and residents demonstrated that residents had access to regular social outings in the local community including the theatre, cinema, swimming and pubs. One of the residents stated that he had many friends both in the home and the local community. Residents have access to two vehicles the costs of which are included in the fee for the home. Residents said they are consulted on social activities both in the home and the community. Kings Court D56_40011_Kingscourt_230286_120705_Stage4.doc Version 1.30 Page 13 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 standard(s) 18,19,20 Residents who have epilepsy would benefit from ‘additional recording of observations’ to enable professionals who carry out healthcare reviews to be better informed. Residents are protected by stringent medication procedures and the safe handling and storage of medication. EVIDENCE: The medication was appropriately stored in the office and a random check of three ‘as and when’ (PRN) medications were found to balance correctly. The manager confirmed that stack checks take place on a monthly basis after each medication delivery from the chemist. The medication administration sheets were found to be in order and the manager was reminded to instruct staff that creams and lotions must be signed as administered. Residents confirm their attendance at dentist, opticians and allied healthcare professionals. One resident said he attended an ‘aromatherapy for men’ course and really enjoyed it. Professionals involved in the home varied depending on the needs of the residents but included physiotherapists, occupational therapists, social workers, district nurse and consultant psychiatrists. Kings Court D56_40011_Kingscourt_230286_120705_Stage4.doc Version 1.30 Page 14 Through case tracking it was noted that one resident requires additional support to manage his epilepsy. This resident is subject to frequent falls and is awaiting investigation at the Burden Institute. Although there is a simple tick chart in place used to record seizure activity it is strongly recommended that a fuller record be kept which should include the time, description of the seizure if seen, any injuries sustained as a result, the recovery time and any observations, length of seizure and staff signature. This can be used to inform the appropriate professional at medication reviews and at the Burden Institute. It is also recommended that the Community Learning Disability Team be accessed and a referral made to the epilepsy nurse. It is a requirement to record any accident or incident that is detrimental to the health of any resident and complete the accident/incident book. Where injury has been sustained a regulation 37 must also be sent. All residents had a distinctive individual style this was noted with the choice of haircut and clothes. A member of staff said residents are enabled to choose their own clothes on a daily basis and can purchase their own clothing and toiletries. Bedrooms were individualised and staff were observed knocking on doors before entering. Kings Court D56_40011_Kingscourt_230286_120705_Stage4.doc Version 1.30 Page 15 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 standard(s) 22,23 The atmosphere was one of openness where residents feel they will be listened to and their concerns acted upon. EVIDENCE: The house rules make it clear that staff are trained in the use of physical intervention and that approved control and restraint methods may be used under certain circumstances. The new policy on ‘physical intervention’ was viewed and the manager and responsible individual must ensure it is reviewed regularly so that it is in line with the Department Of Health’s guidance on Restrictive Physical Interventions for people with a Learning Disability. A copy has been sent to the home for reference. Although there is an emphasis on ‘physical intervention’ it must be known that the home do not use this course of action without seeking multidisciplinary support and agreement when it is thought it may be necessary. The manager said any such intervention would be fully recorded detailing the reason, action taken and the outcome. One staff member spoken with was able to explain the ‘protection of vulnerable adults’ policy but was a little unsure of the ‘No Secrets’ in Bristol DOH guidance. The home must ensure this document is available for all staff and it is recommended that the staff team attend ‘abuse awareness’ training provided by Bristol Social Services. This service is free to care homes and highly recommended. Kings Court D56_40011_Kingscourt_230286_120705_Stage4.doc Version 1.30 Page 16 Residents confirmed they knew how and who to complain to should it be necessary. Feedback forms confirmed residents were happy with their care and did not wish to make a complaint to the CSCI. Health and Social Care feedback comment cards confirmed no complaints were received about the service. The complaints procedure is detailed in the statement of purpose and the service user guide and is available in ‘symbol’ format. The home ensure Complaints cards are given to residents who then have the opportunity to discuss any concerns at their one to one sessions with their key-staff member. One resident confirmed this. Kings Court D56_40011_Kingscourt_230286_120705_Stage4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,25,26,27,28,30 Residents have the benefit of having personal bedrooms that are individualised and a shared space that is homely and comfortable. EVIDENCE: A tour of the building was undertaken with support from residents. It was noted that one bathroom had no soap or toilet roll available to residents and they had to ask staff. This was discussed with the manager who said this was due to one resident who liked to block the toilet with toilet roll or other items which then led to flooding. The manager said she was reintroducing toilet roll and would monitor the effect. Toilet roll, soap and towels must be made available in all toilets and if necessary extra support given to the one person that blocks the toilets. All areas of the home were clean and tidy. The shared rooms were large and comfortable. The dining room was a sociable area where residents ate and talked together. Kings Court D56_40011_Kingscourt_230286_120705_Stage4.doc Version 1.30 Page 18 Residents have access to a large garden surrounding the property. There were sheds and a summerhouse available. One resident stated that everyone who wants to get involved in the garden is encouraged and pointed out the fruit and vegetables that were being grown. The home operates a no smoking policy however; residents and staff can smoke in the garden. Residents showed the inspector their bedrooms and it was noted that these were individualised and furnished according to taste. The rooms seen had the added benefit of being en-suite. Kings Court D56_40011_Kingscourt_230286_120705_Stage4.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,34,35,36 Residents benefit from a fully supported and supervised staff team who are aware of their roles and responsibilities within the home. EVIDENCE: It was noted that although there was one resident with epilepsy in the home the staff had not attended any specific ‘epilepsy’ training. It is strongly recommended that the staff team attend epilepsy awareness training to enable staff support that is up to date and knowledge is current. The Community Learning Disability Team have the benefit of an epilepsy specialist nurse who can offer advice and support. It was noted that not all statutory training was up to date and the manager said she is working on a ‘training matrix’ to ensure all staff are up to date with all statutory training and when it needs to be renewed. This will be reviewed at the next inspection and requirements made if necessary. One staff member confirmed she had recently joined the team on a full time basis and would be commencing her formal induction and the NVQ 3. She had information on the General Social Care Council and was aware of its codes of conduct. She was aware of her job description and her roles and responsibilities. Kings Court D56_40011_Kingscourt_230286_120705_Stage4.doc Version 1.30 Page 20 Staff members confirmed formal supervision takes place on a regular basis. One staff member said “I get loads of support from the team they are always happy to help me. The manager will explain things to me again and again if I don’t get something”. The records relating to staff recruitment were examined and whilst it was noted that all staff had received a valid CRB certificate some of the documentation required to be kept by the home was missing. It is a requirement that all documentation as highlighted in schedule 4 of the Care Homes Regulations be kept on the premises. Kings Court D56_40011_Kingscourt_230286_120705_Stage4.doc Version 1.30 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,38,39,40,42, Residents benefit from an ‘inclusive’ atmosphere where they can share their views and contribute to the management of the home. EVIDENCE: The fire risk assessment was examined and found to contain inadequate information. The manager was required to contact the Avon Fire Brigade (AFB) for advice on the content and then to agree the completed assessment. One support worker has the fire logbook as his area of responsibility. The logbook was up to date with all training and drills carried out in the required timescales as set by the AFB. Kings Court D56_40011_Kingscourt_230286_120705_Stage4.doc Version 1.30 Page 22 The manager explained that a ‘quality assurance tool’ was being developed and all managers were attending training in the ‘key result’ areas, which include staff development and compliance with regulations. Resident questionnaires have been completed but were not available for inspection as they are at HQ being examined and areas of concern identified. Staff and residents spoke positively about the support they were given. House meetings were recorded as taking place regularly with staff and residents setting the agendas. Comments from staff and residents confirmed that the atmosphere was one of inclusion; residents’ felt empowered and felt their contributions to the home were valued. A policies and procedures file was in place, which was accessible to residents and staff. Staff stated that policies and procedures were discussed as part of the induction to the home and reviewed where relevant at staff meetings. Kings Court D56_40011_Kingscourt_230286_120705_Stage4.doc Version 1.30 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 3 3 3 3 3 Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 3 2 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 3 3 3 x 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score 3 2 3 2 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Kings Court Score 3 2 3 x Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 x 2 x Version 1.30 D56_40011_Kingscourt_230286_120705_Stage4.doc Page 24 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 6 Regulation 15(1) Requirement For care plans to include an action plan of who will do what and when and detail measurable outcomes to ensure an effective review contact the Avon Fire Brigade (AFB) for advice on the content of the fire risk assessment and get it agreed. adequately review all risk assessments and remove those that are not relevant. record any accident or incident that is detrimental to the health of any resident and complete the accident/incident book. Where injury has been sustained a regulation 37 must also be sent. ensure the ‘No Secrets’ in Bristol DOH guidance is available to all staff. Toilet roll, soap and towels must be made available in all toilets respecting the privacy and dignity of residents. It is a requirement that all documentation as highlighted in schedule 4 of the Care Homes Regulations be kept on the premises. Timescale for action 1/09/05 2. 42 23(4) 8/08/05 3. 4. 9 19 13(4)15(2 )(b) 37 schedule 4 (12) (ac) 18(4) 12(4)(a) 1/09/05 8/08/05 5. 6. 23 24 1/09/05 1/08/05 7. 35 schedule 4 6(a-f) 1/09/05 Kings Court D56_40011_Kingscourt_230286_120705_Stage4.doc Version 1.30 Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard 6 6 17 Good Practice Recommendations necessary referrals to be made to support one person through her ‘old traumas’. copy of the missing persons procedure to be included in the individuals care records. it is recommended that the vegetables offered at meal times are individually recorded to ensure a variety are offered. It is also recommended that any changes to the menu or individual choices be recorded. all staff to attend abuse awarness training provided by Bristol Social Services. It is strongly recommended that the staff team attend epilepsy awareness training to enable staff support is up to date and knowledge is current. 4. 5. 23 32 Kings Court D56_40011_Kingscourt_230286_120705_Stage4.doc Version 1.30 Page 26 Commission for Social Care Inspection 300 Aztec West Almondsbury South Glos BS32 4RG 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 Kings Court D56_40011_Kingscourt_230286_120705_Stage4.doc Version 1.30 Page 27 - 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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