Inspection on 31/01/07 for Limber

This inspection was carried out on 31st January 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 12 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Limber 26/11/08

Limber 28/11/07

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 Kay Mehrtens Unannounced Inspection 31 January 2007 10:00 st Limber DS0000017866.V331435.R02.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.V331435.R02.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.V331435.R02.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.V331435.R02.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 6th March 2006 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.V331435.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the report of the statutory key inspection. This unannounced inspection took place on the 31st January 2007 at 10.00 am. The inspection lasted 7 hours. The Key National Minimum Standards (NMS) for Young Adults and the intended outcomes were assessed in relation to this service during the inspection. The inspection process included discussion with the manager, Martin Grinold, care workers and service users; examination of a sample of staff and service users’ records, supporting documentation and other records required to be kept in the home; direct and indirect observation. This report has been written using accumulated evidence gathered prior to and during the inspection. In addition, the commission received 5 service users’ surveys. Their comments will be included in the report. The fees for this home are £310 to £517 a week. Additional costs include personal items and some payment towards trips and outings. The inspector was concerned to note that the rquirement, stated at previous visits, with regard of staffing levels has not been addressed. The provider was advised in the last report that failure to meet this requirement would lead the commission to take further action. The provider is advised that the commission will request an improvement plan following this inspection report. What the service does well: • • • • The service users are very supportive to each other. The service users said that the manager and staff were good at listening to them. The service users were pleased with the new furniture and decorations. The staff are caring and supportive of the needs of the service users. Limber DS0000017866.V331435.R02.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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.V331435.R02.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.V331435.R02.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): 1, 2 and 3 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Potential service users have access to information to enable them to make an informed choice with regard to the service offered. There have not been any admissions since the last inspection. Staff training does not meet the needs of the service users. EVIDENCE: Information regarding the home is available within the Statement of Purpose. This is made available for any prospective service users and placing agencies. The service users’ files contained a signed licence agreement that reflects the charges made for their accommodation and care. Standard 2, with regard to needs assessments for new service users cannot be fully inspected, as the home has not had any new service users admitted since the last inspection. Limber DS0000017866.V331435.R02.S.doc Version 5.2 Page 9 The staff have not received sufficient training to meet the needs of service users with dementia. The care plan and interventions sampled did not reflect the assessed needs and changes noted for the service user concerned. The staffing levels, particularly for the evening shift, limit the opportunity for service users to go out into the community and to participate in social activities. The current staffing levels also limit the opportunity for service users to receive any meaningful support or on going assessment and review of their physical and mental health needs and skills. Limber DS0000017866.V331435.R02.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 and 9 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Care plans and daily recording did not provide enough information to assist staff in meeting the needs of residents. Identified risks are discussed with residents. EVIDENCE: Two care files were sampled at this inspection. There was no evidence of any recent reviews and so the care plans did not accurately reflect the needs of the services users. Comments from the manager and some staff, alongside some daily recording, indicated an awareness of changes in the individual needs of some service users, particularly with regard to their physical health. However, this knowledge had not been used to review or reflect the current situation for service users on their care plans. This is not good practice, as it does not ensure that service users’ needs are consistently met or reviewed. Limber DS0000017866.V331435.R02.S.doc Version 5.2 Page 11 The key worker system was not working effectively as systems for monitoring, review and recording were not consistently followed. There was no evidence of any key worker sessions, as stated in the homes’ policy and on service users’ care plans. There was no evidence of any input regarding the cognitive and developmental needs of service users with dementia. The daily recording did not reflect the service users’ mental and emotional well-being. The records showed little evidence of any interaction or assessment by staff of the daily living skills for those service users that access the community or wish to develop their independent living skills. The care plans did not provide staff with clear actions, interventions or the required observations to effectively assess and review service users’ progress or deterioration with regard to their mental health or living skills. There was more evidence of input and involvement by service users with regard to their life in their home. For example, service users told the inspector that regular meetings now take place and that they have been involved in the interview process for new staff. Service users are consulted with regard to 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. Some service users are now involved in advocacy and rights work organised by the provider at a national level. They were aware of the local advocacy services and Mind centre where some go for support and to meet friends. Limber DS0000017866.V331435.R02.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported in maintaining contact with family and friends who are made welcome when visiting. Residents’ choice is respected in many aspects of their life in the home. Opportunities for residents to participate in activities in the home and the local community are limited due to staffing levels. Catering arrangements have improved. EVIDENCE: This inspection has again highlighted the concerns regarding the limited activities available for service users, especially at weekends and evenings. Some service users told the inspector, at the inspection and in surveys returned to the commission, that things had not changed. They said that they would like to go out at weekends, evenings and holidays. The homes’ Limber DS0000017866.V331435.R02.S.doc Version 5.2 Page 13 Statement of Purpose continues to state, “ Service users activities, hobbies and interests are supported through the service users plan. However, the continued staffing levels at the home do not allow service users the opportunity to achieve these goals with the support they require. Some service users attend different daytime activities and work opportunities. Staff had supported service users to access college courses and the local support centre, during the day. The inspector commented upon the gradual changes, made by the manager and staff, to the culture of the home. The service users are more involved in the operation of the home and care practices have become less institutional. The manager and staff demonstrated a good understanding of their role in supporting service users’ rights and dignity. For example, service users are represented at staff meetings and the representative’s feedback to the rest of the group. Service users’ community meetings are regularly held and service users feel that their comments and opinions are generally listened to. The inspector observed good interaction between the service users, tier peers and the staff team. The atmosphere was very relaxed and friendly. Service users help out with household chores, if they choose to. Service users told the inspector that they could have friends and family visit them and that they are made welcome. The catering arrangements had improved since the last inspection. The staff have worked with the service users to produce a healthier menu. The home does not employ a cook so the staff, sometimes assisted by service users, do the cooking. The home does accommodate service users with specific dietary needs. There was no evidence of staff receiving training with regard to meeting their dietary needs or of all staff undertaking food hygiene training. Some service users are supported in catering for themselves and told the inspector that they enjoy cooking. The different meals and snacks prepared on the day of the inspection looked good and were enjoyed by the service users. The service users are provided with facilities to make drinks throughout the day. The inspector observed staff and service users sitting and chatting over cups of tea at different times of the day, clearly relaxing and enjoying each others company. Limber DS0000017866.V331435.R02.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. 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. Service users felt well supported by the home. Systems for monitoring and recording of health care needs were not satisfactory. Medication was well managed. EVIDENCE: The staff were observed to assist and listen to service users in a caring and respectful manner. They responded quickly to service users’ requests for assistance. The service users told the inspector that they felt well supported and that staff respected their privacy and rights. The service users said they staff helped them with shopping and cleaning, if they wanted them to. Some service users were out shopping with staff during the inspection. Limber DS0000017866.V331435.R02.S.doc Version 5.2 Page 15 The health care section of service users’ files was generally well maintained. They contained information regarding appointments with health care specialists though this information was not consistently recorded on all files sampled. However, as previously stated in this report, some health issues for service users had not been reviewed or recorded on their care plans. There was no evidence of on-going assessments of the needs and skills of service users with dementia. The staffs’ comments indicated a good understanding of the physical and mental health needs of service users. The manager informed the inspector that the home had good links with heath care professionals and was continuing to develop these links on behalf of some service users. The service users were aware of the homes’ policy regarding smoking and alcohol. The medication records and storage were well organised. The system for the administration of medication had improved since the last inspection with the exception of the teatime medication, which was still very institutional in its approach with service users. This was discussed with the manager who recognised the need to continue challenging and changing some care practices, including medication, with both the staff and service users. 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.V331435.R02.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. 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. Residents felt able to voice any issues with the manager and staff. The manager and staff have a good understanding of the need to protect residents from abuse. However, staff training was not sufficient to ensure the protection of residents. EVIDENCE: The service users told the inspector that they know how to complain. They said that they felt able to talk to the manager and staff if they were unhappy. The complaints procedure is made available for service users and visitors to the home. The manager had received few complaints since the last inspection. The complaints records were examined. The records only contained details of the complaint. There was no evidence of any action taken by the manager in dealing with the complaints. The staff spoken to on the day of the inspection demonstrated a good understanding of the need to protect service users in their care. one member of staff was attending training in adult protection on the day of the inspection. However, the staff training records indicated that some staff had not received Protection of Vulnerable Adults training. Limber DS0000017866.V331435.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Improvements in décor and furnishings were noted. Not all parts of the home were clean. EVIDENCE: The standard of décor and fittings were in the process of being upgraded. Indeed, new carpets were being laid during the inspection and the manager hoped all would be completed by the end of the week. Several areas of the home had been prepared for redecoration and new furniture had been purchased. There was an on-going programme in place for the redecoration of service users’ bedrooms, with their involvement. The service users told the inspector that they had chosen some of the furniture and decorations. They were looking forward to the work being completed and to choosing more pieces of furniture and decorations. Limber DS0000017866.V331435.R02.S.doc Version 5.2 Page 18 Whilst it was difficult for the inspector to fully inspect this standard due to the ongoing work. It was evident that the home will be much improved and the service users much happier on completion of the work. The communal areas of the home were clean and tidy and service users are supported with cleaning their rooms, as required. However, the inspection highlighted the need for deeper cleaning with regard to bathrooms and the laundry area. Limber DS0000017866.V331435.R02.S.doc Version 5.2 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 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 34 and 35 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staff need additional training to meet the needs of service users. Staff recruitment procedures have improved since the last inspection. EVIDENCE: As stated in other parts of this report, the staff levels at weekends and evenings are not sufficient of meet the needs of the service users accommodated. The manager and provider had undertaken a staffing review with regard to night staff levels, as well as a “lone working” risk assessments. The inspector advised the manager of the need for continual review of the staffing levels and the risk assessments in order to ensure that the needs of staff and service users are met. The service users told the inspector that they “can talk to their key worker… staff have a hard job, I wouldn’t like to do their job… can talk to management… I am happy here…I feel supported here” Limber DS0000017866.V331435.R02.S.doc Version 5.2 Page 20 Service users’ comments, throughout the inspection, were very complimentary regarding the staff team. They were observed to sit and chat with staff during the inspection and the interaction was relaxed and friendly. The atmosphere in the home is quiet, calm and supportive. The manager and some of the staff spoken to were aware of the need to change some of their practices to ensure that the rights and dignity of service users are respected. The level of agency staff use has decreased since the last inspection as the home has recruited new staff. The staff recruitment files were well organised and contained all the required checks and information. Service users had been included in the new staffs’ interviews and interview notes were held on the staff files. The inspector recommended that evidence of relevant training and qualifications are requested from staff, at their interview. The staff training records were examined. They were not up to date and did not reflect some of the recent training attended by staff. There was no evidence of all the staffs’ attendance on statutory training courses including food hygiene and Protection of Vulnerable Adults. The records highlighted shortfalls in training for staff on nutrition and special dietary needs of service users, Protection of Vulnerable Adults and dementia care. The manager was aware of the need to ensure staff induction standards for new staff. Two new staff had received the relevant induction training and were working on their induction workbooks. Staff supervision records were sampled and evidenced good support with regard to induction training for new staff. The inspection highlighted the need for further development of National Vocational Qualification training for staff, as there was evidence of only three members of the team holding a relevant qualification of NVQ level 2 or above. The manager informed the inspector that an additional two members of staff were currently doing the training and that another was identified to start. Limber DS0000017866.V331435.R02.S.doc Version 5.2 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 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 and 43 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management style is very much focussed on the best interests and needs of the residents. Some safety procedures were not satisfactory. EVIDENCE: The manager informed the inspector that he had recently completed the Regulation Manager Award and would forward a copy of his certificate to the commission. He recognised the need to develop his awareness of the Skills for Care common induction standards and felt the provider would support him in this. Limber DS0000017866.V331435.R02.S.doc Version 5.2 Page 22 The manager was aware of different care practices in the home that were sometimes over protective and institutional in their approach with service users. He had addressed several since coming into post and recognised the need to effect more changes, as a staff team, but at a measured pace for service users. The provider had completed a quality audit of the home and forwarded a copy to the commission along with a copy of the homes’ business plan. The provider continues to do regular monthly visits and provided a report for the manager and commission. Two service users attend a national steering group, run by the provider, with regard to quality issues and they feedback to the home. Service users’ involvement in many aspects of the home and quality issues has improved since the last inspection. The health and safety files were examined. There was no evidence of any monitoring regarding water treatment since 2001; this was brought to the attention of the manager. There was no current gas safety certificate or evidence of follow up work recommended at the last electrical system check. Other records regarding accidents and COSHH were satisfactory. The fire systems checks had been completed but there was no evidence of fire drills since July 2006. The report from the environmental health officer was satisfactory. Health and safety information was displayed in the staff office and on service users’ notice boards. Limber DS0000017866.V331435.R02.S.doc Version 5.2 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 Standard No Score 1 3 2 X 3 2 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 1 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 1 32 2 33 X 34 3 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 2 14 2 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 3 X 3 X 3 X X 2 3 Limber DS0000017866.V331435.R02.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. Standard YA3 YA6 Regulation 18 15 Requirement The registered person must ensure that the needs of service users with dementia are met. The registered person must ensure that service users care plans are reviewed and updated to reflect the current assessed needs of service users. The Registered person must ensure that there is sufficient staff available to support and enable service users to participate in local community and social activities and outings. This is a repeat requirement for the 4th time. The timescales of 20.09.04/05.05.05 and 03/05/06 were not met. The registered person must ensure that the health care needs of service users are met. The registered person must ensure that records are kept of any complaint investigation. The registered person must ensure that staff receive training with regard to the Protection of Vulnerable Adults. This is a repeat requirement. DS0000017866.V331435.R02.S.doc Timescale for action 27/03/07 27/03/07 3. YA13 YA14 18 27/03/07 4. 5. 6. YA19 YA22 YA23 12 22 13 27/03/07 27/03/07 27/03/07 Limber Version 5.2 Page 25 7. YA30 23 8. YA31 18 9. YA35 18 10. YA42 23 11. YA42 23 The registered person must ensure that all areas of the home are clean. This refers specifically to the laundry and bathroom areas. The Registered person must ensure that there is sufficient staff to meet the needs of service users accommodated in the home. This is a repeat requirement. The registered person must ensure that staff receive training with regard to POVA, healthy eating and dementia care. The registered person must ensure that required safety checks are carried out and recorded. This refers specifically to the need for a gas inspection of the premises. The registered person must ensure that all staff undertake fire drills. 27/03/07 27/03/07 27/05/07 27/03/07 27/03/07 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. Refer to Standard YA6 YA32 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. Limber DS0000017866.V331435.R02.S.doc Version 5.2 Page 26 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.V331435.R02.S.doc Version 5.2 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. 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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