Inspection on 28/11/07 for Limber

This inspection was carried out on 28th November 2007.

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

Other inspections for this house

Limber 26/11/08

Limber 31/01/07

Limber 06/03/06

Limber 11/08/05

Limber 21/01/05

Limber 23/06/04

Limber 29/03/04

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

CARE HOME ADULTS 18-65 Limber 49 Church Lane Loughton Essex IG10 1PD Lead Inspector Sara Naylor-Wild Unannounced Inspection 28th November 2007 10:00 Limber DS0000017866.V356355.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Limber DS0000017866.V356355.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Limber DS0000017866.V356355.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Limber Address 49 Church Lane Loughton Essex IG10 1PD 020 8502 4533 020 8508 1203 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) www.together-uk.org Together Working for Wellbeing Mr Martin Grinold Care Home 11 Category(ies) of Dementia (1), Mental disorder, excluding registration, with number learning disability or dementia (11), Mental of places Disorder, excluding learning disability or dementia - over 65 years of age (11) Limber DS0000017866.V356355.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Persons of either sex, under the age of 65 years, who require care by reason of a mental disorder, excluding learning disability or dementia (not to exceed 11 persons) Persons of either sex, aged 65 years and over, who require care by reason of a mental disorder, excluding learning disability or dementia (not to exceed 11 persons) One person, under the age of 65 years, who requires care by reason of dementia, whose name was provided to the Commission in February 2004 The total number of service users accommodated in the home must not exceed 11 persons 31st January 2007 2. 3. 4. Date of last inspection Brief Description of the Service: Limber is a large detached family style house, situated in a residential area of Loughton, close to local shops and transport facilities. The home is registered to provide residential care and support for 11 adults and older people with mental health needs. Limber has a large lounge, a separate dining room, and a small quiet room. Service users are accommodated in nine single bedrooms and one double bedroom. The front and back gardens are maintained and accessible, with a large patio area. The home provides 24-hour care and support for people experiencing mental health difficulties. Although staff do provide support or assistance with personal care where required, the home does not aim to meet the needs of those with a physical disability or illness, and is therefore not equipped to meet such needs (i.e. the home does not have a passenger lift, or other aids or equipment). Limber DS0000017866.V356355.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report includes the unannounced inspection site visit on the 28th November 2007. The evidence contained in this report was gathered from discussions with the Manager, staff and people living at the service, a visit to the home, observation of residents interaction with staff, questionnaires completed by residents, their relatives and professionals visiting the home and information contained in the Annual Quality Assurance Assessment (AQAA) sent by the provider to the Commission for Social Care Inspection (CSCI). Mr Martin Grinold the Registered Manager assisted the inspector at the site visit. Feedback on findings was given to him during the visit with the opportunity for discussion or clarification. The inspector would like to thank Mr Grinold, the staff team and people living at the service for their help throughout the inspection process. What the service does well: What has improved since the last inspection? The way in which people are supported by staff has been written into their plans of care in greater detail. This enables people to have a say in how they are supported and helps all staff understand how to provide their support in the best way. The staffing arrangements to support people going out of the home as part of their plan of care have been reviewed and alterations made to allow greater flexibility in staff time. The refurbishment of the premises has continued and communal areas were brighter and refreshed. Limber DS0000017866.V356355.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Limber DS0000017866.V356355.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Limber DS0000017866.V356355.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 and 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who are considering coming to live at the home can be assured that the service will be able to meet their needs. EVIDENCE: There had not been any new people admitted to the home in the last three years so it was not possible to determine how successful the admission process was implemented in reality. The service policy on admission had recently undergone a large-scale review and was at the time of the inspection out for consultation to stakeholders. The manager outlines a process that included invitations to visit the home and a member of the staff team visiting the person in their own home prior to any agreement to admit them to the home. All the people living at the home had been supported by a Community Mental Health Team in their placement. As such the financial contract for the placement is between the home and the placing authority rather than the individual. The service does have Tenancy agreements in place with each resident. Limber DS0000017866.V356355.R01.S.doc Version 5.2 Page 9 These offer information about the weekly charges and what is included in these fees and items that the person would be liable to fund separately. These included for example toiletries, newspapers and some activities. People living at the home had read and signed the agreements. The service contracts with the local authority have been due for review for some time, but this has been delayed and the current understanding is that these will not be updated until a full scale review of the funding arrangements for residents under the Individual performance contract (IPC) has been completed. Limber DS0000017866.V356355.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9 and 10 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People living at the home can expect to have their needs met and their health care promoted in a way that they prefer. EVIDENCE: The care plans of three people living at the home were considered at this visit. These contained a pen picture describing the person’s life and their personal history. This gave the reader a good indication of the person and their life prior to living at the service. The care planning sheets were divided into areas of the person’s daily living needs such as their physical health, cultural needs, social skills, self-care, mental health, finance, and medication. They were set out with a description of the individual’s abilities and the way in which staff should support them to maintain their maximum independence. All the sheets were signed and dated by the person concerned and their key worker. Limber DS0000017866.V356355.R01.S.doc Version 5.2 Page 11 The language of the plans was very positive and gave emphasis to the individuals’ strengths and described them as a whole person. Although the sample of care plans seen at the inspection provided sufficient detail to provide support to the individuals concerned, the service’s quality assurance report states that “Not all residents risk assessments and management plans are up to date. They have key working sessions that provide opportunity to discuss care planning arrangements, copies of plans are kept in their rooms.” The sample of files also contained risk assessments for activities people living at the home may take part in. These included issues such as medication, going out of the home and social activities. The risk assessment sheets were detailed and asked for a full consideration of the issues and how opportunities to reduce risk in the short and long term had been considered. In its conclusion it sets out the action required for staff to take in the long term and if there is immediate risks. These forms would help staff and people they are supporting to consider the risks and decide if it is appropriate to take precaution and to what level. In turn this supports the people living at the home to have as much independence and support, as they require. From the sample seen the quality of information held in these varied and had been identified by the services internal quality assurance report as an area in need of development. People spoken with at the inspection felt the staff treated them with respect and kindness. One person said, “xxx has helped me a lot we go out and I do more than I used to because of them” People living at the home also spoke about the opportunities they have to influence the way the home runs. These included weekly menu planning meetings, general meetings and being part of the interview process for new staff. People were consulted about their medication, finances and any infringement of their rights, such as staff managing their cigarettes. The manager was very aware of the service users’ rights to access an individual bank account and actively supported service users in setting up individual accounts. Each of the files for people living in the home had been able to indicate their wishes for the support they would like at the end of their lives. These had been recorded in the person’s plan of care so staff would be aware of how best to meet their needs at this stage of their life. Limber DS0000017866.V356355.R01.S.doc Version 5.2 Page 12 The medication plans for people living at the home stated to what extent they required support with their medication. Some people administered medication themselves and in order to ensure this was safely carried out a risk assessment was in place with an associated medication plan that set out clearly how much support staff needed to provide. The observation of people taking their lunchtime medication demonstrated that both staff and the individual receiving the medication were clear about their plan and the medication they received. Limber DS0000017866.V356355.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Most people living at the service have opportunities to take part in meaningful activities. EVIDENCE: The care plans of people living at the home contained a description of the individual’s interests and how they are fulfilled. So for example the erection of a green house for two residents who enjoy gardening. In another the planned outings to shopping centres and the exercise this encouraged was identified. The activities on offer are on a mainly ad-hoc basis although some larger scale events such as an outing to Norwich were planned in advance. People spoken with during the inspection were keen to point out the things they did that they enjoyed. This included painting, going to the cinema and caring for their rooms and belongings. Limber DS0000017866.V356355.R01.S.doc Version 5.2 Page 14 For some residents there were clear understandings of how on a day-to-day basis they were supported in meeting their social needs by staff. However although others had identified interests there was not the same level of supporting information about how these were fulfilled. So for example a person who enjoyed photography and use of computers had the equipment to carry out these pursuits but there was no information about how staff encouraged and stimulated these interests. Staff spoken with stated that their knowledge of the individual indicated this was not the way in which they could best support them. This information should then be included in the aspects of the care plan that tell staff how people like to engage in activities. Family support was recorded in the person’s care plan and examples seen included information to enable staff to support the person living at the home maintain contact as well as how to support the families in doing so. The improvement plans submitted to the CSCI following the previous inspection indicated that there had been a review of staffing arrangements in order to address a requirement made in relating to the support of external activities for residents. The manager reported at this visit that staff numbers have been adjusted to provide a shift that covers the early part of the evening. The manager stated that this was intended to support those residents that wanted to go out in the evening. However from the staff rota it was apparent that this is not a daily occurrence and the hours are also used to cover vacant shifts. The manager reported that this was due to staff vacancies and the recruitment of new post holders should resolve this issue. People living at the home are involved in the day to day running of the home and are included in the decisions about choice of meals. Another example is the opportunity to provide feedback about prospective staff during the recruitment process. Staff and people living at the home had an easy relaxed approach to each other. Staff spoke to people with respect and patience and people spoken with said they found staff kind and helpful. Limber DS0000017866.V356355.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at the service can expect to be able to determine the way they would like to be supported in a way that promotes their abilities and independence. EVIDENCE: During the day of the inspection visit the staffs’ interaction with the people living at the home was very positive, showing interest in what they had to say and providing support where required. As part of the visit the inspector was shown around the home including the bedrooms belonging to people who lived at the service. None of the rooms were entered without first knocking and gaining the persons permission. Staff were respectful to peoples’ privacy and ensured this was protected when showing a visitor around the home. People spoken with were clear that their room was their personal private space and that they chose who entered it. Limber DS0000017866.V356355.R01.S.doc Version 5.2 Page 16 The people living at the home said they found staff to be helpful in the way they supported them. In particular one person said the help they had been provided with by staff in gaining confidence to go on outings had been instrumental in the success of this. The health care sections of service users’ files were generally well maintained. They contained information regarding appointments with health care specialists. The service has continued to develop links with health care professionals for the benefit of people living at the service. Following the changes to the law in terms of smoking the service had developed a dedicated smoking area in the home, that was able to be closed off and had ventilation to extract the smoke. People who lived at the service and staff used this facility. People who lived at the service were aware of the changes to the service’s policy in smoking and the existing policy in respect of alcohol. The medication records and storage were well organised and records were appropriately maintained. Observation of the lunchtime medication dispensing demonstrated a robust system with two staff overseeing the process with people signing for medication they took. The routine was a little institutional with people coming to the office to collect medication rather than the medication going to the person. The staff have received training in the use and side–effects of medication and support has been provided in this area from a visiting specialist nurse. Limber DS0000017866.V356355.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People living at the service can be confident that their concerns will be listened to and that the people working at the service understand how to protect them from abuse. EVIDENCE: People who lived at the home were clear about how they could complain and understood whom they would speak to. They said they were confident that they would be listened to and steps would be taken to “sort things out”. The service maintains a log of complaints received, and the record for this was seen at the inspection. The complaints received are logged with details of the investigation and outcome. Although there is no information in the record of how the outcomes were fed back to the complainant. Staff spoken with understood safeguarding issues and were clear about their duty to inform someone if they witnessed any form of abuse. The company policy in relation to safeguarding states that an investigation should be carried out in the first instance and only when the allegation was substantiated would the referral be made to the Safeguarding unit of the local authority. This does not comply with the safeguarding protocol set out in the Department of Health “No Secrets” paper. Limber DS0000017866.V356355.R01.S.doc Version 5.2 Page 18 In the last year only one allegation was reported under the safeguarding policy and the record contained in the log refers to the investigation and the fact that the staff member resigned before action could be taken. There was no referral to the Protection of Vulnerable Adults list maintained by the Department of Health and a referral was not made to the Local Authority. It was reported that some staff had undertaken training run by the local authority as well as those operated by the organisation. Although records did not exist to support this, those staff spoken with during the inspection were clear about their responsibilities under the Safeguarding policy and believed that whistle blowing was part of their duty to the people living at the home Limber DS0000017866.V356355.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People who live at the home benefit from pleasant personal and communal space. Although the condition of the bathroom facilities does not match the standard presented in the rest of the home. EVIDENCE: There had been some refreshment of the interior of the premises over the last year with carpets and wall coverings being replaced. The communal rooms were bright and cheerful with a homely feel. The bedrooms belonging to people who lived at the service were comfortable and personalised. People took pride in their rooms and were keen to show them to the inspector. Limber DS0000017866.V356355.R01.S.doc Version 5.2 Page 20 However the bathrooms in the building were all very worn and damaged to greater or lesser extent. The manager reported that there were plans to refurbish the equipment, although the budget for this was currently taken up by the replacement of carpets throughout the home. Although in some cases the work required was minimal such as use of a grout cleaner to the shower cubicle. The premises are leased from the Primary Care Trust by the organisation and a maintenance allowance is included in the costs of this. However this is a limited fund and as a not for profit organisation there is not a surplus income to dedicate to the refurbishment of the building. The laundry facilities are domestic in character and with no assessed continence needs amongst the people living at the service, this appears to be sufficient. Limber DS0000017866.V356355.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 and 36 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People living at the home can expect to be supported by staff sufficiently trained to meet their needs. The support provided to staff in supervision and development plans is not sufficient. EVIDENCE: The annual training programme offered by the organisation includes amongst other items supervision, medication, and personality disorder management challenging behaviour. The Manager stated that the application process to attend training is first raised verbally with the staff members line manager who then notifies the head office via email. Training plan tends to be ad-hoc when raised by staff in supervision or in staff meetings. Staff had recently attended a dementia awareness course, which had been agreed due to the residents increased needs, and staff had returned with good feedback of the course. There were no records of staff attending safeguarding training on files although manager states that staff have attended both in house and Essex Safeguarding Unit based training this year. Limber DS0000017866.V356355.R01.S.doc Version 5.2 Page 22 Staff spoken with said that training was a high profile in the service and they felt they were given opportunity to attend training if they wished. The staff files examined at the inspection did not contain up to date staff training records. In some cases these were 12 months out of date. The manager stated that the training matrix that would provide an overall picture of what training staff currently held and when they were due for renewal was in the process for being written up. Staff supervision was not recorded regularly and there was no matrix to identify when dates were programmed for supervision with their line manager. The manager reported that some records were not on file but sessions had taken place with staff although he acknowledged that the consistency of sessions was required. Some staff did not have records for the whole of 2007. The opportunity for staff to one to one time in which they receive feedback on their performance and raise issues of concern to them is an important part of the support staff receives in providing a quality service. There had not been any new staff commencing in post since the last inspection although recruitment had begun for two vacant posts and the process undertaken by the service to check the suitability of applicants was considered at this inspection. These provided evidence of a robust system of recruitment that supported the safeguarding of vulnerable adults living at the home. The files also included copies of the Skills for Care Induction programme that would be implemented when the staff takes up their posts. Limber DS0000017866.V356355.R01.S.doc Version 5.2 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People who live at the home benefit from an open and inclusive management style and the knowledge that health and safety is taken seriously. EVIDENCE: The registered manager had tendered his resignation just prior to the inspection visit and was due to leave the following week. During the previous 12 months Mr Grinold had been seconded to a senior position in the organisation and the deputy manager Ian Jacobs temporarily managed Limber in this period, Mr Grinold informed the inspector that this arrangement will resume when he leaves the service. Limber DS0000017866.V356355.R01.S.doc Version 5.2 Page 24 The service provided the Commission with a quality assurance report that sets out the improvements and developments planned for the service in the coming year. Although it reports that people who live at the service are included in the consultation, the report does not refer to their comments and how the service has responded to these. However, people’s views are included in other aspects of the running of the home such as meetings and a representative on the national steering group of the organisation. The quality assurance report did identify the services strengths and weaknesses such as the opportunities for people who live at the service to participate in the running of the home and the shortfalls in recording in risk assessments and care management plans. This tells us that the management of the service is aware of the steps that are required to develop the quality of their provision. The annual maintenance and safety equipment checks were completed and up to date and the certificate of insurance was in place. Limber DS0000017866.V356355.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 X 3 X X 3 x Limber DS0000017866.V356355.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA6 Regulation 15 Requirement The care plans for people living at the home must be reviewed and updated to reflect their current assessed needs. All areas of the home must be kept clean and in good decorative order. This refers specifically to the bathroom areas. There must be sufficient staff to meet the needs of service users accommodated in the home. Specifically this refers to the arrangements to support their activities in the community on a consistent basis. This is a repeat requirement. Staffs’ development needs must be planned for and committed to a training programme. Staffs practice and development must be supported by the consistent provision of line management supervision sessions that are recorded and used to identify their training needs. Timescale for action 31/03/08 2. YA30 23 31/03/08 3. YA31 YA14 18 31/01/08 4. YA35 18 28/02/08 5. YA36 18 28/02/08 Limber DS0000017866.V356355.R01.S.doc Version 5.2 Page 27 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 YA6 YA32 YA23 Good Practice Recommendations The registered person should ensure that daily recording reflects all aspects of service users’ care. The registered person should ensure the development of National Vocational Qualification training for staff. The service’s safeguarding procedures should adhere to the guidance provided by No Secrets and local arrangements for monitoring allegations of abuse to vulnerable adults. Limber DS0000017866.V356355.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Limber DS0000017866.V356355.R01.S.doc Version 5.2 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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