CARE HOME ADULTS 18-65
Larklands & Churchview St Johns Road Ilkeston Derbyshire DE7 5PA Lead Inspector
Brian Marks Unannounced 13 April 2005 08:45 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. Larklands & Churchview C52 C02 S2171 Larklands Churchview V220843 130405 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION
Name of service Larklands & Churchview Address St Johns Road Ilkeston Derbyshire DE7 5PA 0115 9323209 0115 9323209 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) United Health David Wagstaff care home 10 Category(ies) of LD - Learning Disability (10) registration, with number of places Larklands & Churchview C52 C02 S2171 Larklands Churchview V220843 130405 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION
Conditions of registration: None Date of last inspection 27 October 2004 Brief Description of the Service: Churchview and Larklands is a purpose built home offering 10 places for adults with a severe learning disability, set in 2 bungalows linked at the rear through the enclosed garden areas. The physical environment of the home was designed with the group of residents in mind, and is spacious and comfortable with a good range of facilities and accesible for people with mobility difficulties. It is close to the town centre of Ilkeston with easy acces to local facilities. The current residents were all admitted as part of the closure of Aston Hall Hospital, near Derby, and all had spent a long time living in the hospital environment; there have been no changes in the resident group since opening in 2000. Because of the high levels of learning disability in the resident group, the home offers an intensive package of support, and staffing support is accordingly set very high. The initial registration was as a residential home but, with changes in the physical needs of some of the service users, this is now one of a care home with nursing, and a qualified nurse is on duty at all times. Larklands & Churchview C52 C02 S2171 Larklands Churchview V220843 130405 Stage 4.doc Version 1.20 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced visit that took place at the home over half a day. Additionally five hours was spent in preparation for the visit, looking at previous reports and other documents and, after the visit, in telephone calls to 2 care managers from Social Services who are involved with residents at the home. Apart from examining documents, care files and records, time was spent looking around the 2 buildings that make up the home and speaking to 7 staff who were on duty and to the manager. Because all of residents had a lot of difficulties expressing themselves in words, they were not able to contribute directly to the inspection process, but they were observed throughout the visit working with and being cared for by staff. What the service does well:
The staff are a committed group of people and they work hard to make the home a happy and safe environment for the residents to live in. They help each other to care for the residents and to treat each person at the home as an individual with a unique personality. Because they work successfully as a team, the staff are able to deal with difficulties around the home in a calm and consistent way. The nurses, in particular make sure that health problems are attended to properly. Staff are helped to care for the residents successfully by a good system of documents and records. The problems faced by residents are identified in clear care plans and staff use these to all work in the same way. The home is well run because every one has a clear idea about what is needed to keep the residents safe, and to give them the care that they need. The home itself was opened only a few years ago and was built with the present group of residents in mind. All of the rooms are large and have been fitted out with good quality furniture that, for some of the residents, is designed to meet any special requirements. Equipment has been provided to help staff care for people who have difficulty moving around and this is particularly true in the bathrooms which have had a lot of money spent on their fixtures and fittings. Standards of decoration of the home are good. Staff have made efforts to provide interesting and stimulating activities for the residents and because the home had a lot of staff on duty they are able to go on outings and to have individual 1-to-1 time. Residents go on holidays, accompanied by staff and this year a number have been planned to foreign destinations. Larklands & Churchview C52 C02 S2171 Larklands Churchview V220843 130405 Stage 4.doc Version 1.20 Page 6 What has improved since the last inspection? What they could do better:
Managers at the home need to make sure that staff give out and record medicines properly to ensure the well-being and safety of residents. The home provides a complex range of care services to the residents and staff have to spend time on learning and developing in order to do their work better and to develop their skills and knowledge. Training opportunities have been provided at the home, but the managers need to be able to monitor this and to review and plan training more formally so that staff time is used most effectively. In addition the home is required by law to ensure that half of its staff have a formal qualification and a deadline has been set for the end of this year. This also applies to the manager. For the home to operate in an efficient way for its residents the managers should be planning ahead and to make priorities about what is most important to happen first. They should also be looking at what has been good at the home and what needs improvement and changing. They can do this by talking to staff and listening to what relatives and other visitors to the home think about the way the home is run. This will allow them to develop a plan for the future of the home that can guide everyone in the way they care for the residents. Larklands & Churchview C52 C02 S2171 Larklands Churchview V220843 130405 Stage 4.doc Version 1.20 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Larklands & Churchview C52 C02 S2171 Larklands Churchview V220843 130405 Stage 4.doc Version 1.20 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Larklands & Churchview C52 C02 S2171 Larklands Churchview V220843 130405 Stage 4.doc Version 1.20 Page 9 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2 and 5 Residents’ needs were met through a system of assessment, carried out both before and after coming to the home, that formed the basis of the residents’ care plans. These enabled staff to care for them in a consistent and individual way. All residents had properly drawn up contracts of residence, that ensured their rights were established and responsibilities clearly described. EVIDENCE: Information received from previous inspections and from the examination of case files indicated that residents had extensive assessments of their requirements carried out before they came to the home. For example, in one of the case files examined there was a report from a psychiatrist at the hospital where she had lived for a long time, outlining the help she would need at the home. The case files examined also had documents from the care managers who became involved after the residents had settled at the home, indicating that the difficulties faced by the residents had continued to be examined. Any changes that had occurred had been built into the programme of help offered by the home’s staff on a day-to-day basis. This programme was summarised in each resident’s file as a set of ‘action plans’ and ‘risk assessments’, individual to them. Contracts between authorities sponsoring residents’ care arrangements, and individual terms and conditions relating to their stay at the home had been examined at a previous inspection. Because of their lack of capability, these
Larklands & Churchview C52 C02 S2171 Larklands Churchview V220843 130405 Stage 4.doc Version 1.20 Page 10 had been signed on behalf of residents, and copies given to them or their representatives, as recommended at the last inspection. Larklands & Churchview C52 C02 S2171 Larklands Churchview V220843 130405 Stage 4.doc Version 1.20 Page 11 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 and 9 Detailed individual care plans were developed at the home so that consistent patterns of support could be given and the welfare and safety of residents maintained. These included the management of risk areas that also contributed to overall safety of residents. All residents had poor verbal communication skills and staff had developed individual ways of understanding what they wanted from their lives at the home. Staff are committed to helping the residents become more independent. EVIDENCE: Examination of case files indicated that residents had a care plan, individual to them, which was complied as a series of ‘action plans’ and ‘risk assessments’. The topics covered within these plans were varied but included aspects of personal and health care specific to individuals. The manager confirmed that a process of revising the amount of documentation held within these plans had been carried on since the last inspection and staff commented that the changes had helped them provide consistent and individual help to residents. Although documentation was subject to regular review by the home’s staff the arrangements for 1 resident had not been looked at with her care manager and other key people since April 2003. Her welfare is potentially put at risk by staff acting on information that is not current.
Larklands & Churchview C52 C02 S2171 Larklands Churchview V220843 130405 Stage 4.doc Version 1.20 Page 12 All of the residents of this home had great difficulty with verbal communication, and staff were observed making use of a number of ways of understanding individual characters. This involved simple verbal prompts and gestures as well as the use of pictures and symbols. Staff also described how they had built up ways of responding to choices being made by residents that involved an element of ‘trial and error’. Newly appointed staff described how they had been helped to gradually learn about the residents by working alongside more experienced staff and not being left working alone. The development of holiday plans, currently under discussion, was a specific example given of how resident reactions had been used to make judgements about personal preferences. The process of risk assessment was an important part of caring for residents and this was carried out to ensure individuals did not come to harm, and to guide staff in safe ways of working. The risk assessments indicated key areas of concern and ways in which staff could minimise or eliminate any problems arising from these risks. Examples of the areas covered included choking on food, falling/tripping and wandering away from the building. Larklands & Churchview C52 C02 S2171 Larklands Churchview V220843 130405 Stage 4.doc Version 1.20 Page 13 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) 13, 14,15 and 16 Because of the capability of the group of people who lived at this home Standard 12 does not apply. Their lifestyle involved giving them new and varied opportunities, in order to increase their independence and extend their skills. Opportunities were tailored to individual interests and abilities and where possible risks had been identified and managed. Residents were encouraged to maintain contact with families. EVIDENCE: All of the people living at this home were disabled by a severe learning disability and had no interest or capability in paid employment, formal further education or vocational training. Examination of activity programmes and from discussion with staff indicated that the use of local facilities outside the home had continued to be made. The days at the home were structured around staff support, the availability of transport and subject to the management of risks (mentioned previously in this report). The manager and staff reported that, with 3 staff leaving during the past month and others on long-term sick leave, outside activities had been
Larklands & Churchview C52 C02 S2171 Larklands Churchview V220843 130405 Stage 4.doc Version 1.20 Page 14 curtailed. The manager reported, and the rota indicated, that this was to be resolved in the near future and that the level of outside activities could be resumed. A plan for the home to have a second vehicle had not been achieved and a number of staff were not willing to drive the large minibus. The care managers spoken to stated that they had previously commented about the lack of activities for residents but that staff at the home had shown them plans as to how this was being improved. Indoor activities within the home remained a major part of the day for the service users and a variety of activities were observed during the inspection. Staff stated that these were aimed at sensory stimulation and improving communication. The sensory rooms had been recently redecorated to further increase options available for residents. Records and individual files examined indicated that people living at the home were encouraged to maintain family links and most had been able to do so, to varying degrees. The recently deceased father of another resident had been a very regular visitor also and had been a keen advocate, not only for his son but also on behalf of the others as well. The support of a local Advocacy Service had been available to the home since it had opened, giving residents another route for resolving difficulties. Whilst staff stated that some of the residents demonstrated friendships to each other, their level of disability restricted them from developing genuinely mature feelings and the acquisition of friendships outside the home. Examination of daily programmes indicated that they were not over structured and staff stated that the edges between leisure and ‘therapy’ were blurred. At all times during the inspection staff were respectful in their communication with residents and privacy of service users was respected by the closing of doors, particularly bathrooms. Some residents continued to spend periods of time alone in their rooms and 1 was observed listening to music and resting. Larklands & Churchview C52 C02 S2171 Larklands Churchview V220843 130405 Stage 4.doc Version 1.20 Page 15 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 and 20 Residents’ health and personal care are well managed by the nurses and staff at the home and they are able to get the assistance of outside professionals when it is appropriate. They are also able to obtain special equipment for certain individual residents that is used to make the their lives easier. The administration of medicines by staff is well organised but a small number of recording gaps were noted that may lead to unsafe practice. EVIDENCE: Information in individual care plans indicated how both carers and nurses at the home would care for and support residents, and the care managers spoken to specifically said how well staff did this and how they were willing to try new approaches to achieve successful outcomes. Visits to bedrooms indicated how specialist equipment and furniture had been supplied to individuals in order to make their lives easier. Plans were in place for outside professionals to help residents; a physiotherapist, occupational therapist and a psychiatrist are currently involved and they assist the home’s staff to work effectively. Some of the residents have complex health problems and the nurses and staff are well supported by the local GP practice. These include epilepsy and difficult behaviours as well as 1 service user who had had a number or recent stays in hospital for surgery and the treatment of cancer; staff said she was at the present time stable and partially mobile. The care managers spoken to
Larklands & Churchview C52 C02 S2171 Larklands Churchview V220843 130405 Stage 4.doc Version 1.20 Page 16 were positive about the ways in which staff at the home deal with health related problems. Records on individual files indicated regular contact with the dentist and optician. There are no residents who manage their own medicines and systems operated by staff, apart from a small number of gaps in the administration record, were satisfactory. A specialist pharmacist inspector had visited the home in January 2004 and all of the requirements and recommendations made at that time had been complied with. The manager stated that staff at the home had been working closely with the GP’s and the psychiatrist to review medicines prescribed to residents, in order to reduce and replace some inappropriate and outdated drugs and this was apparent from the records. Larklands & Churchview C52 C02 S2171 Larklands Churchview V220843 130405 Stage 4.doc Version 1.20 Page 17 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) 23. The home has robust policies and procedures in place to protect the residents from harm and these have recently linked well with the Statutory Procedures to practically demonstrate the management and staff’s commitment to safety. EVIDENCE: Policies and procedures for the protection from harm are well established at the home and new staff joining the team promptly receive training in this subject. There have been 2 incidents at the home during the past 12 months when staff have been subject to investigation and the Statutory Procedures have been put into operation, involving the local Social Services Department. Disciplinary procedures resulted in these instances, and the management and staff of the home were seen to act swiftly in order to protect the residents. Larklands & Churchview C52 C02 S2171 Larklands Churchview V220843 130405 Stage 4.doc Version 1.20 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 standard(s) 24 and 30. The home is equipped, furnished and maintained to a high standard and offers homely and spacious facilities for residents to enjoy. This is both a valued and valuing environment in which to live and work. EVIDENCE: The home was built specifically for this group of residents, and its corridors and rooms are large and it was supplied with a good range of equipment, furniture and fittings that are what could be expected in an ordinary domestic setting. Security against both intruders coming in, and residents going into unsafe places or wandering off, is covered by a number of keypad systems. The home is near the town centre of Ilkeston and the home’s transport offers good access to local amenities. The improvement programme of the home has been continued and 3 of the bedrooms visited were being, or had been recently, redecorated. This was also true of communal areas and corridors. A new suite of furniture had been provided in Larklands, as required at the last inspection. The home continued to benefit from the services of a maintenance person who ensures that all repairs are completed quickly and who is also responsible for a number of health and safety activities. Larklands & Churchview C52 C02 S2171 Larklands Churchview V220843 130405 Stage 4.doc Version 1.20 Page 19 The home was observed to be clean, hygienic and free of odours on the day of the inspection and all of the residents were observed to be dressed in clean and clothing. The domestic assistant was spoken to during the inspection and, although her colleague was on holiday she was able to complete the daily cleaning jobs satisfactorily. Both bungalows have well-equipped and maintained laundries, with care staff responsible for the personal laundry and bedding of residents, as well as for cleaning the kitchens. Because of the high standard of the environment of the home these 2 standards are scored as 4. Larklands & Churchview C52 C02 S2171 Larklands Churchview V220843 130405 Stage 4.doc Version 1.20 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32,33,34,35 and 36 The home is well staffed with experienced, skilled and knowledgeable people who are receiving regular training to help them assist residents in more efficient and safe ways. New staff are recruited to the home by robust procedures so that residents are protected from harm, and supported to work effectively by management and other staff. EVIDENCE: Information available at the inspection indicated that with a full complement of nurses was now in post, with both general and specialist qualifications amongst them. There was a good range of skills, knowledge and experience within the staff group to help residents with care and support. This was observed being put into practice during the inspection. Records on staff files showed that 13 care staff had completed or were completing an NVQ qualification at a minimum of level 2, but this is not at the required proportion of 50 of staff. Information from the staff rota indicated numbers of staff on duty in excess of the required standard. There had been 3 staff recently leave the home which, with 4 staff being on extended sick leave, had caused difficulties in maintaining numbers on duty. The manager reported that 2 new staff were due to commence in employment within a week. He had chosen to limit the use of agency staff on daytime shifts and rely on existing staff taking extra shifts,
Larklands & Churchview C52 C02 S2171 Larklands Churchview V220843 130405 Stage 4.doc Version 1.20 Page 21 whom he said offered more consistency of care for residents. The staff meet together on a regular basis and those meetings were recorded. The company operating this home has a well-established recruitment and selection process for staff. The files for 2 newly recruited staff were examined and all the documents required by law were seen to be in place, as required at the last inspection. Staff stated that enjoyed regular access to training and development opportunities and information from staff files also showed this. The manager stated that his deputy had taken responsibility for organising staff training within the home, but there was nothing available to show how training priorities for the home as a whole were being established or monitored. The National Minimum Standards (NMS) recommend that any training provided must reflect the nationally agreed standards of the Learning Disability Award Framework. Information from staff files and staff spoken to indicated that systems for offering staff an annual appraisal of their work performance and regular 1-to-1 meetings with a senior staff member were in place. This was as required at the last inspection. Staff also said that they benefited from the working arrangements within the home so that ‘I never work on my own, there is always someone there to help me’. Larklands & Churchview C52 C02 S2171 Larklands Churchview V220843 130405 Stage 4.doc Version 1.20 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 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, 39 and 42 The manager and his deputy are qualified nurses and they have between them a broad range of skills, knowledge and experience. The home’s line manager regularly visits the home but systems that assess quality of the service have not been used. The managers have not identified an annual plan for the home, in order to ensure that life at the home is as good as it can be. Safety of the home had been improved through specific aspects of staff training, but there is need for further training. EVIDENCE: The manager and his deputy are both nurses with a learning disability qualification and have extensive experience of a variety of residential services. The manager is currently completing a Registered Manager’s course (NVQ4) with a training agency. The company have a quality monitoring system based on monthly audits by the home’s line manager and copies of these reports have regularly been sent to CSCI. An annual plan had not been developed for the home, as required at
Larklands & Churchview C52 C02 S2171 Larklands Churchview V220843 130405 Stage 4.doc Version 1.20 Page 23 the last inspection, but the manager reported that he was due to meet with the qualified staff group later in the day of the inspection when targets for the home’s development would be agreed. There were no other formal systems of consultation and quality assurance in place for the home. Staff files indicated that staff had received training in relation to fire safety, as required at the last inspection and this was now happening on a 3-monthly rolling programme. Not all staff, particularly those recently appointed, had received the training in important aspects of health and safety practices. However records indicated that a manager from an associated home, a qualified trainer in safe moving and handling techniques, was providing regular training. Larklands & Churchview C52 C02 S2171 Larklands Churchview V220843 130405 Stage 4.doc Version 1.20 Page 24 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. Where there is no score against a standard it has not been looked at during this inspection. 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 x 3 x x 3 Standard No 22 23
ENVIRONMENT Score x 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10
LIFESTYLES Score 2 3 x 3 x
Score Standard No 24 25 26 27 28 29 30
STAFFING Score 4 x x x x x 4 Standard No 11 12 13 14 15 16 17 x N/A 3 3 3 3 x Standard No 31 32 33 34 35 36 Score x 2 3 3 2 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Larklands & Churchview Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score 2 x 2 x x 2 x C52 C02 S2171 Larklands Churchview V220843 130405 Stage 4.doc Version 1.20 Page 25 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA20 Regulation 13(2) Timescale for action A complete record of all 30 June medicines administerd by staff to 2005 residents must be maintained by the person responsible for signing the written record. The target of 50 of all care 31 staff achieving an NVQ at a December 2005 minimum of level 2 by the due date. The planned training activities 30 June for staff must be recorded in a 2005 form that allows for easy monitoring and review. A copy of this must be forwarded to CSCI for examination. The registered manager of the 31 home must achive an NVQ in December management and care at level 4 2005 by the due date. The registered person must 31 July redevelop a cycle of annual 2005 planning that covers all aspects of the running of the home.(Previous timescale of 31March 2005 not met). The registered person, must Ongoing provide all staff with instruction/training in relation to manual handling, emergency first aid and food hygiene.(Previous timescale of
Version 1.20 Page 26 Requirement 2. YA32 18(1), 19(5) 18(1) 3. YA35 4. YA37 9(2) 5. YA39 24(1-3) 6. YA42 13(4,5), 18(1) Larklands & Churchview C52 C02 S2171 Larklands Churchview V220843 130405 Stage 4.doc 31 March 2005 not met). RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. Refer to Standard YA14 YA23 YA35 YA39 Good Practice Recommendations The need for a second vehicle at the home should be reviewed and arranged. The registered person should review the arrangements for managing service users’ finances, and arrange individual bank accounts where practicable. Any training provided by staff should reflect the guidelines of the Learning Disability Award Framework (LDAF). Sytems for consultation and surveying the views of all parties intersted in the running of the home should be developed and implemented as part of the development of a quality assuarance programme for the home. A copy of the financial plan for the home should be available for inspection. 5. YA43 Larklands & Churchview C52 C02 S2171 Larklands Churchview V220843 130405 Stage 4.doc Version 1.20 Page 27 Commission for Social Care Inspection South Point, Cardinal Square Nottingham Road Derby DE1 3QT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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