CARE HOME ADULTS 18-65
Mantley Chase Ross Road Newent Gloucestershire GL18 1QY Lead Inspector
Mr Paul Chapman Key Unannounced Inspection 24th January 2007 09:00 Mantley Chase DS0000049949.V308043.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 Mantley Chase DS0000049949.V308043.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. Mantley Chase DS0000049949.V308043.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Mantley Chase Address Ross Road Newent Gloucestershire GL18 1QY 01531 822112 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.holmleigh-care.co.uk Holmleigh Care Homes Ltd Mrs Mary Ann Theresa Badham Care Home 12 Category(ies) of Learning disability (12) registration, with number of places Mantley Chase DS0000049949.V308043.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 9th January 2006 Brief Description of the Service: Mantley Chase is a large detached property in extensive grounds. It offers accommodation for up to twelve service users whose behaviour may challenge. The home has been adapted for it current purpose and opened in January 2004. The home has access to transport which enables them to make use of the local and surrounding areas. Since the previous inspection the provider has converted the coach house in the grounds to provide accommodation for three service users. This building was registered with the CSCI last year. Mantley Chase DS0000049949.V308043.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. New service users are provided with sufficient information to make a decision about the home before they move into the home. The home has a Service User’s Guide and a Statement of Purpose. The fees for living at the home range from £1000.00 to £2000.00 per week. This unannounced inspection took place over seven hours on a day in January 2007. A few of the people living at the home are able to express their thoughts and feelings, others have limited verbal expression. Where possible service users were spoken with, whilst interactions between service users and staff were observed throughout the day. These interactions were seen to be positive. The registered manager and her deputy were present throughout the inspection. The principle method used to gather evidence was case tracking. This involves examining the care notes and other related documents for a select number of people living at the home. This is followed up by talking to them or their relatives/representatives, or observing them. This provides a useful, in depth insight as to how people’s needs are being met from more than one source of evidence. The surveys returned to the CSCI from other professionals, relatives, staff were positive about the service. In addition to examining service users records a sample of staff records were examined. These included recruitment and training, both areas were seen to be in order and minimise potential risks to the people living at the home. What the service does well:
A service user stated, “I was given the information I needed before I moved into the home”. The service user was positive about the experience and said they were enjoying living in the home. The home provides people with challenging needs a quality service that allows them to lead active and fulfilling lives. Service users are supported by a stable, experienced staff team that are appropriately trained to meet the current needs of the service users. Service users needs are reviewed regularly. Mantley Chase DS0000049949.V308043.R01.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. Mantley Chase DS0000049949.V308043.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 Mantley Chase DS0000049949.V308043.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users are provided with information to help them decide whether they wish to live in the home. Needs assessments for prospective service users minimise the risk of people being admitted to the service whose needs cannot be met. Contracts between the home and service users identify the responsibilities of each party. EVIDENCE: 3 new service users have been admitted to the home since the previous inspection. The inspector spoke to one of the service users who was positive about their admission to the home. They stated “I visited the home before I moved in” and “I was given a copy of the Service User’s Guide”. Examination of a new service user’s file showed that the home had completed assessment of the person’s needs before they moved in and the funding authority had provided a community care assessment. Service user contracts seen on this occasion had been signed by both parties. Mantley Chase DS0000049949.V308043.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans are developed to meet peoples’ needs but reviews must make it clear if any needs, or staff inputs need to be changed to ensure peoples’ need are met consistently. Service users are supported make decisions about their lives by the staff team. Comprehensive risk assessments are in place but the manager must ensure that all new service users have risk assessments completed as and when required. EVIDENCE: Examination of two service users files showed that care plans had been written to meet the following needs: Mantley Chase DS0000049949.V308043.R01.S.doc Version 5.2 Page 10 • • • • • • • • • Personal Hygiene Maintaining a safe environment Communication Daily living skills Eating and drinking Activities Behaviour Health Family contact The manager reviews the care plans at least twice a year and more regularly where required. Evidence in service users files supported that these reviews were being completed. All of the care plans had been reviewed on a number of occasions by the manager, when a care plan is reviewed a “review sheet” is completed that states any updates. A problem with this system is that only the last review sheet can be read/seen and this means that some critical updates from previous reviews are missed. This was brought to the attention of the manager and the inspector recommends that this system is reviewed. Each month key workers complete a review of significant events for each service user. Examination of these reviews showed that they provided some useful information but could be made better by following the titles of the care plans. By following the titles of the care plans each month there could be summary of the service users progress towards meeting goals, or any changes specific to that care plan. This becomes a good practice recommendation of this report. One shortfall was identified where a psychologist’s report had identified a change in approach when working with a service user. The care plan had not been re-written/updated to reflect this approach. The manager stated that all staff had been issued with a copy of the report and that they were working to these guidelines. There was no evidence of this and the manager stated that this care plan would be addressed. This becomes a requirement of this report. Other behaviour management plans were examined and seen to be appropriate to meet the needs of the service users. Staff have clear guidelines about indicators of behaviour escalation to be aware of, and actions to take to maintain the service users and their safety. Any incidents where restraint has been required are well recorded and all staff are trained appropriately. The records in the service user’s file showed they were supported to make choices and decisions over their own lives. Speaking with one service user they stated that the staff were supportive and that they could talk to them about what they would like to do. Risk assessments were examined. One service user had 17 risk assessments that provided good detail in minimising risks. The manager must monitor these
Mantley Chase DS0000049949.V308043.R01.S.doc Version 5.2 Page 11 documents as only 4 of the risk assessments were dated. Recently while staff had been supporting a new service user in the local community there had been an incident where they had become verbally aggressive towards staff. No risk assessments had been completed to identify and minimise potential risks and the inspector was told that with new service users risk assessments are completed at the end of the 3-month probationary period. The deputy manager said the risk assessments should be written as required. The manager must ensure that risk assessments are written when a risk is highlighted. Risk assessments for other service users were in place and being reviewed appropriately. Mantley Chase DS0000049949.V308043.R01.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16, 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home offers a flexible and individualised service that enables service users to lead varied and fulfilling lives. EVIDENCE: Service users confirmed that the home offers a very flexible and individualised lifestyle for them, giving them every opportunity to maintain and develop social, emotional, communication and independent living skills. A range of opportunities are available, including attending the local day services and College. Mantley Chase DS0000049949.V308043.R01.S.doc Version 5.2 Page 13 Service users gave the inspector a number of examples of the local facilities that they use. These tend to be in Gloucester and service users use the transport provided by the home to access them. The staffing rota that was seen confirmed that the team are flexible about the times they work, enabling service users to take part in activities. The daily routines in the house are led by people’s needs and the service users and their records confirmed this. Staff complete activity records for each service user every day. Examination of a sample of these documents confirmed that people lead active lifestyles. It is recommended that staff record how many times the same activity takes place. E.g. if the service user has been out with staff one to one, how many times? In addition to this the phrase “in house activity” was being recorded for different times, staff should record exactly what that activity was. By using the phrase it is impossible to judge whether this activity was worthwhile. The home’s policy confirms that family and friends are welcome at the home, and people are able to see them in private if they wish to. At previous inspections staff confirmed that the service users are supported to maintain family links with varying degrees of assistance from them. Support may include help with making phone calls, writing letters/cards and providing transport and staff support where appropriate. CSCI Surveys received by the inspector confirmed that parents felt welcome to visit the home. Menus examined were seen to provide service users with choice and a healthy and varied diet. The inspector spoke to the manager about the menus for the gatehouse. The manager stated that the service users join the people from the main house for meals, but they are in the process of developing menus specifically for the gatehouse. The manager said that they planned to speak to staff about this at a staff meeting following this inspection. Mantley Chase DS0000049949.V308043.R01.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users personal care needs are assessed and care plans ensure that needs are met consistently by the staff. The home involves other professionals to ensure the needs of the service users are fully met. Effective management of the service users medication minimises risks to their safety. EVIDENCE: Service users personal care needs are addressed in their care plans. Records in the service users files sampled showed input from other professionals including psychiatrists, psychologists, doctors, community nurses, dentists and opticians.
Mantley Chase DS0000049949.V308043.R01.S.doc Version 5.2 Page 15 The files seen by the inspector contained completed OK Health checks that highlight the service users needs in respect of their health. Medication administration was examined and found to be managed correctly at the time of this inspection. One minor shortfall was that creams should be labelled with the date they are opened. The files seen contained plans to meet people’s needs in ageing and illness. Mantley Chase DS0000049949.V308043.R01.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a complaints procedure in place that enables service users to voice their concerns if they are unhappy. Accurate records are kept of service users monies which minimises the risk of financial abuse. Staff complete training in the protection of vulnerable adults which minimises potential risks. EVIDENCE: The home has a complaints procedure and speaking with a service user they said they had a copy of the procedure and knew how to make a complaint if they were unhappy. The manager and the CSCI have not received any complaints since the previous inspection. A sample of the service users financial records showed that they were being managed correctly. Where the home are managing the service users finances the manager should complete an assessment of the service users skills and identify why the home need to manage the service users finances. Staff complete training in the protection of vulnerable adults.
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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, 25, 26, 27, 28, 29, 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Some areas of the home are in need of redecoration, as they currently do not meet the minimum standard. Service user’s bedrooms reflect their personalities and meet their current needs. The home provides people with more than adequate communal space that allows them privacy if they require it. EVIDENCE: As part of the inspection a tour of the home was completed. All of the rooms were seen. Since the previous inspection all of the period internal wooden doors have been replaced with new sturdier ones. The bedrooms reflect the characters of the people living in them and one person has a four-poster bed.
Mantley Chase DS0000049949.V308043.R01.S.doc Version 5.2 Page 18 Two shortfalls were identified in the service users bedrooms and these are listed below: • • The ceiling above a window in one room needs to be repaired. The rear bath panel for one of the en-suite bedrooms needs to be repaired. At the top of the house is a flat that one service user uses. This has a bedroom, lounge and one bedroom. Due to the needs of this person there is limited facilities that consist of their bed and two armchairs and a television. The reasons for this are recorded in their care plans. The manager stated that a new floor covering was to be fitted. From looking around the flat the following issues were pointed out to the manager: • • The decoration was poor and in need of refurbishment. Cleanliness was poor with what appeared to be faeces on one door. The manager stated that it was planned that murals were to be painted on the wall. This should make the place more friendly and warm. Communal rooms are large and provide service users with a range of comfortable furniture. People that use the service have access a quiet room, lounge and a conservatory. The lounge has a television. The quiet room needs to be decorated and the light fittings need to be replaced. The kitchen is a kitchen/diner with a large table that all service users sit around to have meals. The kitchen and dining area is divided by a kitchen work surface and gate to minimise the risk of vulnerable people being injured in the kitchen. The kitchen/diner is the “hub” of the home and both staff and service users gather here. As a result of this the room looks a little tired and in need of decoration now. This becomes a requirement of this report. One shortfall was identified whilst visiting the bathrooms and showers. The bulb in to the downstairs shower room did not work. This must be addressed. The laundry was seen. At the time of the inspection there was a hole in the ceiling where water was dripping through. The manager brought this to the attention of the organisation’s maintenance team whilst the inspector was present. At the time of the inspection the home’s tumble dryer was not working and a temporary one had been placed in the quiet room. The manager assured the manager that this was only short-term and the tumble dryer would be repaired. The home has extensive grounds that service users are able to access. There is a substantial summerhouse at the top of the garden. One service user explained that they plan to have a vegetable patch as they really enjoy gardening.
Mantley Chase DS0000049949.V308043.R01.S.doc Version 5.2 Page 19 As identified previously in this report the proprietor has converted the gatehouse into accommodation for three people. It provides each person with a bedroom, lounge and bathroom. In addition to this there is a communal kitchen and a lounge/diner with floor to ceiling windows that look out on to a courtyard. A tour of this building was completed and a number of shortfalls were identified: • The carpet in the lounge/diner has become dirty from people entering the building and the manager stated that they have asked the proprietor to replace it with a laminate floor. • The curtain poles in the front room were broken, or missing and the manager stated that they had arranged for them to be replaced. • One of the bedrooms had some holes in one of the walls and the maintenance team were due to make this good in the days following this inspection. One bedroom had been decorated whilst the other two service users were to be asked how they would like their rooms. All of the bedrooms/lounges reflected the interests of the people living in them containing televisions, music systems and games consoles, pictures and other personal possessions. Service users spoken with said that they liked their rooms. The gatehouse was clean and hygienic with no offensive odours. Mantley Chase DS0000049949.V308043.R01.S.doc Version 5.2 Page 20 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 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): 32, 34, 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Potential risks to the service users are minimised through a thorough recruitment process. Staff are provided with training to enable them to meet the current needs of the service users. EVIDENCE: Records for a staff member employed since the previous inspection were examined and seen to be in order meeting the criteria of the regulations. A record of induction training was present and had been completed. Nine staff have completed their NVQ training in care and the manager stated that another four were due to start. Three of the staff teams training records were examined and were seen to be well organised with certificates present for training they had completed. All of the files sampled contained certificates for staff completing training in the protection of vulnerable adults. The CSCI surveys received from staff highlighted the training as a strength.
Mantley Chase DS0000049949.V308043.R01.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 41, 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager’s leadership of her team with the support of relevant policies and procedures allows service users to live in a safe environment. Potential risks to the service users are monitored by staff regularly therefore minimising these risks. EVIDENCE: The manager has considerable experience in working with this service user group and is appropriately qualified with the Registered Manager’s Award. Service users spoken with during the day were positive about the manager and staff team stating that they felt they could talk to the manager and staff if they
Mantley Chase DS0000049949.V308043.R01.S.doc Version 5.2 Page 22 had any issues. As part of the inspection process the CSCI surveyed staff about the home. All of the comments were positive and this is supported by the fact of there being a stable staff team with the majority of staff being employed for a substantial amount of time. This helps to provide the service users with a consistent approach. The manager ensures that health and safety checks are completed at the appropriate intervals. These include portable appliance testing, monitoring fridge/freezer temperatures and fire alarms. Since the previous inspection the manager has completed a fire risk assessment for the home. When examining service users records the deputy manager was in the process of archiving a number of documents. The deputy manager explained how and why they were doing this and supported the inspector to find a number of documents. This led to a discussion about archiving documents and the inspector suggested that the deputy manager reviewed the process to ensure that service users files still contained all of the documents needed to provide their care. Mantley Chase DS0000049949.V308043.R01.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 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 2 ENVIRONMENT Standard No Score 24 2 25 3 26 2 27 3 28 3 29 3 30 2 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 2 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 3 X X X 3 3 X Mantley Chase DS0000049949.V308043.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No 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(2) b, 12(1) a Requirement The registered manager must ensure that care plans are updated to reflect the advice of other professionals where it is appropriate. The registered manager must ensure that risk assessments are completed for new service users, as they are required. The registered manager must ensure that that the following areas are addressed: • The kitchen/diner must be decorated. • The quiet room/second lounge must be decorated and the light fittings replaced. The registered manager must ensure that the following areas are addressed: • The flat at the top of the house must be redecorated. • The ceiling above the window in one bedroom must be repaired. The registered manager must ensure that all areas of the home are clean and hygienic.
DS0000049949.V308043.R01.S.doc Timescale for action 23/03/07 2. YA9 13(4) b 23/03/07 3. YA24 23(2) d, c 01/06/07 4. YA26 23(2) d 01/06/07 5. YA30 13(3) 23/03/07 Mantley Chase Version 5.2 Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. Refer to Standard YA6 YA6 YA9 YA12 Good Practice Recommendations The registered manager should ensure that any changes to a service users care plan through the review process are easily identifiable to the reader. The registered manager should review the monthly reviews completed by staff and change the titles of the areas being reviewed to match those of the care plans. The registered manager should ensure that all of the risk assessments are dated when they are written. The registered manager should ensure that when the activity sheets are completed they detail how many times an activity was completed. And, that staff should not write “house activity”, but actually what the activity was. The registered manager should ensure that all creams are labelled with the date they are opened. The registered manager should complete assessments to support the need for the home managing service users finances. The registered manager should ensure that when archiving records sufficient records are left in service users files to enable their care to continue. 5. 6. 7. YA20 YA23 YA41 Mantley Chase DS0000049949.V308043.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Gloucester Office Unit 1210 Lansdowne Court Gloucester Business Park Brockworth Gloucester, GL3 4AB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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