CARE HOME ADULTS 18-65
Lyme House Grange Road Haydock St Helens Merseyside WA11 0XF Lead Inspector
Mr Mike Perry Unannounced Inspection 8th March 2006 10:00 Lyme House DS0000022413.V286290.R01.S.doc Version 5.1 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 Lyme House DS0000022413.V286290.R01.S.doc Version 5.1 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. Lyme House DS0000022413.V286290.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Lyme House Address Grange Road Haydock St Helens Merseyside WA11 0XF 01744 609954 01744 609953 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.trurehab.com TRU Limited Mrs Elizabeth Ann Kettle Care Home 21 Category(ies) of Physical disability (21) registration, with number of places Lyme House DS0000022413.V286290.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. Service users to include up to 21 PD One named service user sectioned under 117 Mental Health Act 1984 The service should employ a suitably qualified and experienced manager who is registered with the CSCI 14.9.05 Date of last inspection Brief Description of the Service: Lyme House is registered to provide personal care and support to 21 service users with physical disabilities. Ages can range between 18 and 65 years. The home specialise in rehabilitation for service users who have acquired brain injuries and aim to assist them back to independent living. The home is owned by TRU (Transitional Rehabilitation Unit). The Registered manager is Ann Kettle and the Responsible individual is Mr Bill Kenyon. Service users are encouraged to undertake paid work at the home linked to achieving agreed aims and objectives on individual care plans. The home is part of a comprehensive rehabilitation service involving another Care Home and community services as well as a variety of work based units. The home is located in the rural area of Haydock and is set in its own grounds with gardens. The home receives referrals nationwide due to the specialist area of care given. Lyme House DS0000022413.V286290.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection was unannounced and was conducted over a period of 8 hours on one day. Day and recreation areas were seen. Records kept in the home were also viewed as well as staff records held at Margaret House, which is the administration sector for the organisation. In total the inspector spent time with residents and spoke with 3 in more depth. There were no visiting relatives on the day. The manager and 6 –7 care staff were also interviewed as well as administration staff [at Mgt House]. The inspector also left some comment cards for residents. The inspector was also able to attend the review process [held monthly] for one of the residents. 9 of the 20 Core standards that were not reviewed on the previous inspection were covered on this inspection. There were also some outstanding requirements from the previous inspection, which were also reviewed. For a fuller picture of the home this report should be read in conjunction with the previous report from September 2005. What the service does well:
The system of care at Lyme House is very structured around the setting of behavioural targets for each resident who are supported by appropriate staff and professionals. Within the care programmes residents can set selfdetermined goals and targets and so exercise some control and choice over the overall care. Any limitations in the right of residents to make decisions are addressed through the care plan and agreed. Some residents find some of the limitations frustrating but can see the overall benefits. One comment received perhaps summed this up: ‘ You can’t always do what you want and seeing progress can be difficult but this is the best place in the country for me’ Lyme House DS0000022413.V286290.R01.S.doc Version 5.1 Page 6 Continual feedback is given to residents by staff that interact well and appropriately. Staff are adept at intervening in difficult situations and can gain the trust of the residents. Staff interviewed were clear about their role in carrying out personal care for residents. The home is part of the larger Transitional Rehabilitation Unit [TRU], which operates on a token economy system whereby money can be earned for the attainment of the set goals and targets for each resident. Links are maintained with friends and family who are given regular feedback. Residents reported regular trips home and times when visitors could come to the unit. Daily routines are organised around the residents individual care plans and diaries. These include maintaining and learning skills around cooking for example. Residents interviewed felt confidant that staff would assist and help them and that they could raise any concerns. There is a complaints procedure available. The manager of the home is Anne Kettle. She has the experience and qualifications to ensure that Lyme House is run satisfactorily and that residents best interests are maintained. Anne has come through the same training process at TRU as all staff and has worked in all of the various staff care roles. There are quality systems in place to ensure good monitoring and ongoing improvements take place so that resident care can be progressed. The quality of the ongoing clinical review of residents is of a high standard and is consistent. The clinical management team and owners of the business spend time on the unit and complete various audits so that they can get the views of the residents. What has improved since the last inspection?
The unit continues to develop in terms of the facilities on offer. There are more onsite developments including the activity / therapy unit which is now operational. The supplying pharmacist has now been included in the staff-training programme and also completes regular audits of the storage and stock in the home. Lyme House DS0000022413.V286290.R01.S.doc Version 5.1 Page 7 What they could do better:
The management have chosen to install CCTV in all public areas of the home. There is ongoing debate about the right of resident’s to have privacy, which is compromised to varying degrees given the structure of the care programmes. This development is part of that debate. It is surprising that staff and residents reported that there was little consultation on the instillation of CCTV and that this had been imposed more or less by the management. Staff could only supply limited rational for the cameras being present. The instillation of CCTV cameras does appear an unnecessary invasion of resident’s privacy. The rationale of protection of residents in terms of security is not convincing given residents views and also the high staffing ratios on the unit. These cameras must therefore be removed. Staff records were inspected and the necessary checks required to ensure staff suitability were not clearly recorded. This was disappointing as Criminal Record [CRB] checks had been a requirement of the last inspection. Records must now be updated and made clear. Fire safety records were available. The routine checks on fire alarms [testing], emergency lighting and fire extinguishers need to be recorded more frequently in line with the ‘fire schedules’ listed in the logbook. There are two recommendations in the report. The unit is mixed sex in terms of residents although at present there are only male residents on the unit. The inspector advised any future planning of the service should be guided by the ‘Safety, Privacy and dignity’ document given to the manager. The policy and procedure on the reporting of allegations of mistreatment and abuse need to be updated and revised. Lyme House DS0000022413.V286290.R01.S.doc Version 5.1 Page 8 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. Lyme House DS0000022413.V286290.R01.S.doc Version 5.1 Page 9 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 Lyme House DS0000022413.V286290.R01.S.doc Version 5.1 Page 10 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 the following standard(s): Not assessed at this inspection. EVIDENCE: Lyme House DS0000022413.V286290.R01.S.doc Version 5.1 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 the following standard(s): 7 Staff agree a structured care programme with residents that also includes setting personal goals and targets so that residents are able to exercise some choice and control over the overall care strategy. EVIDENCE: The care at Lyme house is very structured around previously agreed goals and targets for each resident. The therapy team sets some goals although residents interviewed stated that this follows discussion. Some of the goals are ‘self determined’. These are personal targets that residents set for themselves in terms of progressing through the care programme. Because these are self determined they are open to choice and the resident exercises some control over the care programme. Any limitations are agreed and also entered as part of the care plan. This was evidenced with one resident who had limited socialisation restricted to the TRU sites. Some residents interviewed were frustrated by some of the limitations of the care plan but could see some benefits from the programme overall and were able, to varying degrees, state how they had progressed.
Lyme House DS0000022413.V286290.R01.S.doc Version 5.1 Page 12 One comment received perhaps summed this up: ‘ You can’t always do what you want and seeing progress can be difficult but this is the best place in the country for me’ The home together with the other sites under the TRU banner operate an internal token economy system aim at rewarding met targets agreed on the care plan. All residents interviewed had a clear concept of this and were able to understand how it worked. Lyme House DS0000022413.V286290.R01.S.doc Version 5.1 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 the following standard(s): 15, 16,17 Residents report appropriate links with family and the inclusion of relatives in the feedback from the home ensures that relationships are maintained. The daily routine in the home is organised around individual daily care plans prompted by written diaries so that individual responsibilities for residents are identified. The meal times and food served in the home are varied and incorporate a lot of residents own planning and cooking. Staff oversee these programmes so that nutrition is monitored. EVIDENCE: The service does not have an open visiting policy. Residents reported that they did not always benefit from unplanned visits due to the wide variety of structured activities which they participate in. Many of the activities are often away from the unit. Residents reported regular contact with their families however including visits home. Staff reinforced the idea that family support and awareness is vital to progress made by residents and so contact is
Lyme House DS0000022413.V286290.R01.S.doc Version 5.1 Page 14 facilitated. Relatives are also given a lot of feedback through reviews and formally through reports and therefore there are ‘no surprises’ with the care carried out, as everything is transparent and agreed through care plans. One resident reported regular visits home to see his partner and young child and this was seen as integral to the progress made on the unit. The unit is registered for both male and female residents although on the inspection there were only male residents in the home. Staff reported that any female admissions to the home would probably result in mostly 1:1 observation by staff to ensure not only therapeutic input but also safety. There are no female only areas in the home. The inspector recommended a publication that might be useful in terms of any future planning for safe integration of both sexes. The inspectors spoke to service users who explained that the daily routine is individually planned through the daily diaries in conjunction with coaching staff. Each service user therefore has a routine for the next day, which includes behavioural targets and times of activities. For the purposes of experiencing a ‘normal day’ the diaries are written with respect to routine daily activities of living such as getting up, washing, having breakfast etc with the purpose of reinforcing accepted social norms and behaviours. Residents reported various comments about the food in the home. Some liked the food and the choice and others didn’t. Residents reported regular unit meetings however where preferences could be discussed. The planned menu offers one main hot meal and then a choice of a snack type meal or a sandwich if this is preferred. On the day of the inspection a buffet lunch was provided for everybody and the residents and staff enjoyed this. A lot of time is given over to residents doing their own cooking with varying degrees of help from the staff and the kitchen is organised for this. Lyme House DS0000022413.V286290.R01.S.doc Version 5.1 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 the following standard(s): 18,20 Staff interventions are appropriate and are geared towards supporting residents in daily care tasks so that personal support is given as required. EVIDENCE: The inspector was able to witness staff interacting with service users appropriately and spending time in constructing diaries and addressing service users in an appropriate manner. Service users interviewed felt that staff interacted and supported them and dealt with difficult interactions well. An example of this was observed on the day when a resident became agitated during the lunchtime period and staff were quick to intervene and reassure the resident. Appropriate feedback was given to the resident. Staff informed the inspector that physical personal care intervention is limited as most residents can manage basic personal care themselves with support and supervision. Daily care plans are built around reinforcing these activities. When asked staff reported that personal care such as showering etc would only be carried out with same sex staff. Medication was discussed with respect o the recommendations in the last inspection report. The supplying is pharmacist now involved in staff training and also completes audits of the stock and storage of medicines.
Lyme House DS0000022413.V286290.R01.S.doc Version 5.1 Page 16 Lyme House DS0000022413.V286290.R01.S.doc Version 5.1 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 the following standard(s): 22,23 The home has a complaints procedure and this is used by residents to raise issues of concern, which are acted on. The policies around adult protection procedures in the home are not clear and the manager needs to update them so that residents can receive clear protection from locally agreed protocols. EVIDENCE: There is a complaints procedure in the home and residents were aware of how to raise issues of concern. Complaints are recorded. Both verbal and written complaints are responded to and staff questioned were able to explain the process. The management team are involved in all complain to and aim to respond within one week. There have been no complaints received by the Commission since the last inspection. There were no complaints received on the day of this inspection. The policy file was reviewed with a member of the staff team with respect o procedures for dealing with allegations of mistreatment or abuse. The policy file is accessible to staff and information is available. This is a bit confusing as two policies/ procedures are referred to – one written by TRU and the other is the locally agreed policy from St Helens Social Services – which seem to contradict each other. The TRU policy talks about an ‘investigation’ being carried out by TRU management which is contrary to the St Helens Procedure which advises that the Adult Protection Team, through Social Services, are contacted at an early stage so that a ‘strategy meeting’ can determine the course of events in terms of an investigation.
Lyme House DS0000022413.V286290.R01.S.doc Version 5.1 Page 18 It is important that the locally agreed joint procedures are followed in all allegations of abuse and this should be reinforced. The St Helens document is dated 2001 and the inspector advised that Social Services be contacted and any updating of this policy be acquired. The manager should also enquire about any training that may be available regarding the policy. Staff interviewed felt that any allegations would be dealt with openly and residents felt that staff could be approached if they had any concerns. Incidents involving aggression that occur and involve staff having to intervene are reported and followed up in some depth by the clinical management team and appropriate feedback is given to residents. Lyme House DS0000022413.V286290.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 The environment at Lyme House is generally being developed along appropriate guidelines and principals which helps ensure therapeutic, comfortable and safe living conditions for residents. There is an issue of privacy for residents at times due the highly structured nature of the care and the introduction of CCTV cameras must be reviewed in the context of this. EVIDENCE: The development of the unit was discussed with the manager during the inspection. All areas were not visited. Although not reviewed in any depth it is noted that the unit continues to develop on site with the addition of the new activities unit, which is now functional. During the visit it was noted that the management have installed CCTV cameras in all areas of the home apart from bedrooms and toilet / bathroom areas. Residents spoken to were generally of the opinion that this was not a good idea and felt that it impinged on their privacy. Some of the residents
Lyme House DS0000022413.V286290.R01.S.doc Version 5.1 Page 20 have been in the unit for a number of years [7 – 8 years in some cases] and to all intensive purposes Lyme House is their home. This would appear to be an unnecessary measure. Staff interviewed gave rationale for the placing of cameras in corridors but could not explain the reason for placement in lounge areas. Both staff and residents stated that they had not been consulted over this and that they were simply told this was to happen. The inspector understands that further CCTV cameras are to be installed in other TRU residences. Given the intensive nature of the therapy at TRU there is always going to be a trade off in terms of the amount of privacy afforded residents at times. The instillation of CCTV cameras does appear an unnecessary invasion however. The rationale of protection of residents in terms of security is not convincing given residents views and also the high staffing ratios on the unit. These cameras should therefore be removed. Lyme House DS0000022413.V286290.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 34 The recruitment processes in the home are not robust in that they do not record the necessary checks required prior to employment and therefore do not provide sufficient protection for residents. EVIDENCE: The recruitment processes were reviewed with respect to requirements made in the last report around ensuring that all staff receive necessary checks with the Protection of Vulnerable Adults [POVA] register as well as the Criminal Records Bureau [CRB]. Staff records were viewed at Mgt House with the administration staff. Again it was not clear whether the required checks had been made as only one file out of three inspected of recent staff recruitments had the information recorded. There was again some discussion about the importance of thorough checking and vetting of all staff employed by the company in order to protect vulnerable service users and such information being recorded on file. The inspector was assured this is the case but the staff files need to be arranged so that the information is recorded satisfactorily. It was agreed that administration would review all staff records and send an updated list of all staff POVA reference numbers to the Commission.
Lyme House DS0000022413.V286290.R01.S.doc Version 5.1 Page 22 Lyme House DS0000022413.V286290.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 The manager of the home has the experience and qualifications to ensure that Lyme House is run satisfactorily and that residents best interests are maintained. The quality systems in place ensure good monitoring and ongoing improvements take place so that resident care can be progressed and procedures are appropriately managed to ensure smooth running of the home. EVIDENCE: The Registered Manager of Lyme House is Ann Kettle. Ann has been in post for since august 2005. She is currently undertaking an NVQ qualification in management. Her main aims over the past months have been the development of the Thistle unit [small unit integral to the home] for more rehabilitation work. She is also involved heavily with staff training initiatives in the organisation. As with all staff that work for TRU she has come through the organisation experiencing all staff roles and training in order to become the manager of Lyme House. Lyme House DS0000022413.V286290.R01.S.doc Version 5.1 Page 24 The inspector spent some time attending a clinical review for one of he residents. Reviews are held monthly and form part of not only clinical update but also act as a quality assurance tool in terms of ensuring that the service is able to demonstrate development for each resident set against measurable targets and goals. The review process is attended by the resident and all concerned wit the care and support. Both verbal and written feedback is given to all parties including family and funders of the care. Case conferences are also held 3 monthly and referring health professionals, social workers and family can all attend. There are regular audits carried out by the management team in terms of other quality measures such as the facilities on the unit. An example of this is the regular walk abouts by the management team including, for example, attending breakfast session recently with residents and getting their views. Residents also invite the managers to the residents meetings held on the unit. One of the residents has the task of interviewing new admissions to the unit to get their views and report any issues. In terms of staff and systems audits the home has Investors in People status. Staff have regular supervision sessions. Yearly objectives are identified in the development of the unit and an annual report is produced outlining achievements and targets for the forthcoming year. There remain some outstanding issues from the last CSCI inspection report that the management must now address. The fire logbook was seen. Requirements were made on the last inspection for fire alarm testing to be undertaken and recorded weekly as well as routine checks on fire extinguishers and testing of emergency lighting [monthly]. These routines are listed on the ‘fire schedules’ listed at the front of the fire logbook. The records were still incomplete although all of the above are tested periodically. Lyme House DS0000022413.V286290.R01.S.doc Version 5.1 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 X 3 X 4 X 5 X 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 X STAFFING Standard No Score 31 X 32 X 33 X 34 2 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X 3 X X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 X X X 3 X 3 X X 2 X Lyme House DS0000022413.V286290.R01.S.doc Version 5.1 Page 26 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 YA24 Regulation 12(4)a Requirement The CCTV cameras installed in the home in al day areas must be removed to ensure some privacy for residents. All staff employed by TRU must undergo routine POVA and CRB checks to ensure fitness to work with vulnerable people. All existing files must be updated with the necessary checks and information listed in schedule 2 of the Care Home Regulations. A list of all staff and the date and reference of CRB checks must be forwarded to the Commission. [Last requirement date 30.10.05 not met] 3. YA42 23 All fire records must be updated to include testing of the alarm system [weekly], routine checks of fire extinguishers and testing of emergency lighting [monthly] as indicated on the ‘fire schedules’ in the fire logbook. [Last requirement date 14.9.05 not met]. 01/05/06 Timescale for action 01/05/06 2 YA34 19 01/05/06 Lyme House DS0000022413.V286290.R01.S.doc Version 5.1 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 Refer to Standard YA15 Good Practice Recommendations The inspector recommends consulting the document ‘Safety, Privacy and Dignity in Mental health units’ in terms of any future planning and caring of residents on the unit. The policies for reporting and managing allegations of abuse should be reviewed in the light of the comments in the report. Social Services adult protection team should be contacted regarding updating policies and providing any training. 2 YA23 Lyme House DS0000022413.V286290.R01.S.doc Version 5.1 Page 28 Commission for Social Care Inspection Knowsley Local Office 2nd Floor, South Wing Burlington House Crosby Road North Liverpool L22 0LG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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