Inspection on 13/12/05 for Maplestead Road

This inspection was carried out on 13th December 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Maplestead Road 30/05/07

Maplestead Road 20/02/07

Maplestead Road 01/07/05

Maplestead Road 03/03/05

Maplestead Road 02/09/04

Maplestead Road 29/03/04

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

CARE HOME ADULTS 18-65 Maplestead Road 36 Maplestead Road Dagenham Essex RM9 4XR Lead Inspector Ms Harina Morzeria Unannounced Inspection 13th December 2005 10:15 DS0000027907.V274100.R01.S.doc Version 5.1 Page 1 DS0000027907.V274100.R01.S.doc Version 5.1 Page 2 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 DS0000027907.V274100.R01.S.doc Version 5.1 Page 3 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. DS0000027907.V274100.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Name of service Maplestead Road Address 36 Maplestead Road Dagenham Essex RM9 4XR 0208 595 7645 0208 595 7645 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) Outlook Care Ms Jadesola Ezerioha Care Home 6 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (6) of places DS0000027907.V274100.R01.S.doc Version 5.1 Page 5 SERVICE INFORMATION Conditions of registration: 1. To include 2 named people over 65 years of age. Date of last inspection 1st July 2005 Brief Description of the Service: Maplestead Road is a purpose built home in a residential area of Dagenham. The property is a large house, which offers a service for 6 adults with mental health needs. The service users at Maplestead Road require supervision and encouragement from staff in most aspects of daily living. It is the aim of the home to promote independence with some service users to improve their daily living skills. The home is well equipped, homely and comfortable, there is a large well-maintained garden at the rear of the home, and this has a purpose built bar-b-q, which the service users enjoy using for social gatherings. The staff team work hard to ensure that service users independence is maintained, and liaise with other professionals to maintain service users health and wellbeing. The home is staffed 24 hrs a day with a waking member of staff at night. Outlook Care lease the property from the Local Authority and have full maintenance and repairing responsibility. DS0000027907.V274100.R01.S.doc Version 5.1 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This was the second statutory inspection visit to the home in the inspection programme for 2005/06. Over the course of the two visits, all core standards have now been assessed. Three requirements were set at the previous inspection and the registered person has complied with all of the required action. The inspector spoke with service users and was shown around the downstairs part of the premises by a service user. On the day of the inspection two support staff were present, one of whom was competently able to assist and provide relevant information during the inspection process. What the service does well: What has improved since the last inspection? All the fencing round the home has been completed to improve security. There is a full complement of staff, although one person is on maternity leave, whose hours are well covered by the existing staff group, as well as the employment of a consistent group of agency staff. DS0000027907.V274100.R01.S.doc Version 5.1 Page 7 There has been a review of the different types of services provided by Outlook Care and the management have identified the need to develop a service provided specifically for service users with mental health needs which should result in a more focused approach to care planning. It is hoped that this will then improve the training opportunities for staff, working within the mental health field. 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. DS0000027907.V274100.R01.S.doc Version 5.1 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection DS0000027907.V274100.R01.S.doc Version 5.1 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 4, 5 Detailed assessments are carried out of all prospective service users by the manager to ensure that their needs can be met by the home. Prospective service users are given information that enables them to make an informed decision as to whether the home is appropriate for them. They are given an opportunity to visit the home, prior to admission in order to get a feel of how things are done. They are also given a statement of terms and conditions if they decide to come and live at the home. EVIDENCE: Service users are given information about the home via the service users’ guide which helps them to make an informed choice about where to live. One new service user who moved in to the home since the last inspection was assessed for suitability by the manager. Evidence was seen when tracking her file, that she was given the opportunity to visit the home and invited for tea and dinner on separate occasions to meet the other service users. A gradual introductory process took place whereby she came to the home for overnight stays enabling her to have a gradual transfer into the home from her previous placement. On tracking the service user’s file, there was also evidence of terms and conditions in place which contained obligations of both the provider and service user. Family and friends are also offered the opportunity to visit with a prospective service user. Hence a two way facilitated introduction is undertaken to enable DS0000027907.V274100.R01.S.doc Version 5.1 Page 10 the prospective service user to get to know about the service as well as giving the current service users an opportunity to get to know the prospective service user. DS0000027907.V274100.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): 6, 7, 8, 9 The needs of service users are well documented in their individual service user plans, which are reviewed as changes occur. They are involved in negotiating their daily routines and objectives and are encouraged to live life to their full potential subject to a risk assessment. EVIDENCE: Service user’s files examined showed that the needs of service users are recorded in their individual service user plans. Two of the service users’ care plans were tracked and their changing needs were documented. Comprehensive Person Centred Plans are compiled which reflect the individual’s needs, including a section where the service user identifies what help they need as well as their wishes and feelings. Service users’ individual goals are also documented and linked directly to their care plans. Evidence was seen that service users are consulted on and participate in all aspects of life in the home. They are encouraged to be independent as well as take responsibility for “their home” and their environment. They are treated individually by the support staff and encouraged to participate in the daily DS0000027907.V274100.R01.S.doc Version 5.1 Page 12 routines and life within the home as much as possible with close attention being paid to their moods, wishes and feelings on a daily basis. Two service users are fairly independent and are able to go out into the town centre or other places independently whilst some others require assistance and encouragement from the staff team. Care plans are reviewed regularly and documented accordingly, and risk assessments are carried out to reflect any changes in assessed needs of service users. The inspector was informed that there are forthcoming changes to take place in the current format of the Person Centred Planning programme in order to reflect more accurately the changing needs of service users mental health needs. Regular service user meetings take place within the home and are documented, and there is a notice board within the home informing all service users of any forth coming events. On the day of the inspection most of the service users and staff were looking forward to their Christmas meal outing in the evening. All service users have an individual programme of activity internally which is largely linked to carrying out chores around the house and some outdoor activities through which they are encouraged to reach their full potential of living in the community. DS0000027907.V274100.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): 12, 15, 16, 17 Service users at Maplestead Lodge are encouraged to participate in appropriate activities and have opportunities to develop and maintain social and personal networks of their choosing. Service users are offered a healthy, varied and nutritious diet and menus are planned in advance. The service users are given opportunities to participate in activities of their choice which are age appropriate and suited to their interests, enabling them to live life to its full potential within the community. EVIDENCE: Each service user has an individual planned programme which is more to do with household chores that they are all required to participate in. This allows each person to take an interest in their environment and surroundings and enables them to re-learn independence within the home, as most of the current service users living at Maplestead House come from an institutional background. Hence support staff encourage them to treat Maplestead Road as their own home and offer an inclusive environment where by they are DS0000027907.V274100.R01.S.doc Version 5.1 Page 14 encouraged to participate in all aspects of the home and relearn some of the skills they may have lost whilst living in their previous environment. Evidence was seen that service users are encouraged to take part in interesting and appropriate activities outside in the community according to their preferences and interests, subject to risk assessments. However the inspector was informed that, with the exception of two service users who are quite independent, most others prefer to stay indoors and only venture out occasionally or as far as the corner shops. Services users are supported and encouraged to develop networks, which include visits from friends and relatives. A good example of this is where most service users have immediate members of their families who visit them and one particular service user who does not go out much is encouraged to keep in regular phone contact with her son. The inspector was also informed by the manager that many service users have friends living at a similar neighbouring property and are encouraged to mix with each other by the staff team. It was clear that the rights of service users were respected, as they were involved in decision making with respect to how the home is run and indeed their personal lives. The inspector observed interaction between both support staff and the service users and noted that the staff were encouraging them to make decisions all the time. The service users spoken to were happy with the meal arrangements in the home which included their involvement in the planning and preparation of the food. Although staff prepare the meals, service users are encouraged daily to help staff prepare the meals. One service user also confirmed that they have a variety of take away meals on their take away night which is Thursday night usually. DS0000027907.V274100.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, 19, 20 The service users’ physical and emotional needs are closely monitored and this ensures that service users needs are recognised and met. They are encouraged to take responsibility for their health. The medication policies and procedures are clear and all staff have received medication administration training. EVIDENCE: The service users living at the home require very minimal assistance with personal care. The inspector noted interaction between the support staff and the service users whereby they were being gently reminded that they were all going out for their Christmas party and to start getting ready for this, allowing sufficient time for people to adjust to the idea of going out and thinking about the process towards achieving this. The inspector noted that the interaction process showed respect, dignity and choice towards the service user, as well as allowing them plenty of time and opportunity to exercise choice in terms of choosing clothes etc. From the records viewed there was evidence that the physical and emotional health needs of the service users were being met. One of the service users at the home, who is fairly independent, makes her own GP appointments and follows up any hospital appointments with some support from the staff. DS0000027907.V274100.R01.S.doc Version 5.1 Page 16 However, from viewing her records it was not evident that all her medical appointments were clearly logged, which would then make it difficult for staff to track her progress or future medical referrals. Hence, a recommendation is made that staff log all medical appointments attended by service users including any follow up action or outstanding information that they are waiting for. As stated above the policies and procedures for the handling and recording, as well as administering medication in the home are satisfactory. Staff have received basic medication training and most recently a number of staff undertook a distance learning course, “safe handling of medicines” course, which is a self assessment, very detailed and comprehensive course completed over a number of weeks completed by the staff after which they undertake an exam. The inspector was informed that most of the staff group within the home have undertaken this course and those who haven’t are scheduled to complete this in the new year. Staff are aware of any medication changes for any of the service users as they have a good rapport with the consultants who generally inform staff. Communication within the team is very good. The pharmacist carries out monthly visits and does medication audits as well as general medication training. However through discussion, it emerged that staff would benefit from specific training regarding medication interactions and reactions as well as side effects of many of the anti psychotic drugs taken by service users with mental health needs. Hence, the inspector recommends that further training is provided to the staff group regarding medication interactions and reactions as well as side effects of many of the anti psychotic drugs taken by service users with mental health needs. Through discussion it also emerged that although the medication course attended by staff is beneficial, it is not specifically related to dealing with service users with mental health needs. Therefore the inspector recommends that the registered person arranges medication training for staff, which is specifically targeted to deal with service users with mental health needs. DS0000027907.V274100.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 manager and staff make every effort to sort out any problems or concerns and make sure that service users and their relatives feel confident that their complaints and concerns are listened to and will be acted upon. Staff in the home receive training in adult protection/abuse awareness at the time of their induction to ensure that there is a proper response to any suspicion or allegation of abuse. EVIDENCE: A pictorial complaints procedure is in place and is given to all the service users and pinned up in their rooms. Staff ensure that all service users are aware of how to complain. The inspector was informed that there are minor issues and arguments arising between the service users on a regular basis and they are encouraged to talk about and resolve these amongst themselves. However staff are vigilant and do intervene where matters get out of hand. The inspector examined the complaints log and the last complaint recorded in this was in March 2005. This issue was handled appropriately, according to the complaints procedure, by the manager. As a matter of course, service users and/or relatives are encouraged to talk about issues they may have concerns about. This allows the management and staff an opportunity to make early interventions to reduce the risk of problems arising. One of the key forums used is the service users’ meeting where issues about the home are discussed and dealt with. DS0000027907.V274100.R01.S.doc Version 5.1 Page 18 The inspector was informed that service users are offered the opportunity to make formal complaints if they wish to. There is a written policy and procedure for dealing with allegations of abuse and whistle blowing. The manager and the support staff have received training in adult protection/abuse awareness. The procedure is also pinned up in the staff room and the one support worker who assisted with the inspection was clear about the action to be taken if there were concerns about the welfare and safety of any service user in the home. This was evidenced when an allegation of sexual abuse was made against another service user which was appropriately dealt with by the manager who followed the adult protection procedure. The home have experienced a large number of malicious incidents and break ins, largely from local youths who have damaged the property and tried to break in to the office twice. However they have not yet managed to get in to the building and nothing has been taken. The building has now been secured with the installation of fencing all around it as well as a CCTV camera. Further security measures are also being considered. Upon examining the risk assessments, the inspector noted that although there are a number of health and safety risk assessments for service users and staff, the manager must ensure that a lone working risk assessment is developed particularly in view of recent break ins and the fact that there is only one member of staff on duty at night. This is to ensure staff and service users’ safety. See also standard 42 and its associated recommendation. DS0000027907.V274100.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, 30 Service users enjoy a clean, homely and comfortable environment. EVIDENCE: The standard of the décor, furnishings and fittings in the home are maintained to a good standard. The inspector was shown around the downstairs part of the home by a service user who said she liked the home and it was clean and cheerful. Smoking is allowed in the downstairs part of the home but not in the bedrooms. The home is well ventilated by keeping the windows and kitchen door open. The inspector did not view the upstairs part of the home or the other bedrooms except one downstairs which was personalised by the service user. Throughout the inspection all areas of the home were found to be clean, tidy and free from odour. Service users are responsible for maintaining the cleanliness of their bedrooms and communal areas. However, the home also employ a cleaner who does the deep cleaning around the home. The home have experienced a large number of malicious incidents and break ins, largely from the local youths which have damaged the property and tried to break in to the office twice. However they have not managed to get in to DS0000027907.V274100.R01.S.doc Version 5.1 Page 20 the building and nothing has been taken. The building has now been secured while the installation of fencing all around it and the installation of a CCTV camera. Upon examining the risk assessments, the inspector noted that although there are a number of health and safety risk assessments, the manager must ensure that a lone working risk assessment is developed, particularly in view of recent break ins and the fact that there is only one member of staff on duty at night. This is to ensure staff and service users’ safety. See recommendation. DS0000027907.V274100.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): 32, 33, 35, 36 Service users at 36 Maplestead Road benefit from having a dedicated manager and staff team who work well together. Staffing levels are satisfactory and there are sufficient, competent and qualified staff on duty to meet the individual needs of the service users. Staff receive appropriate training however a recommendation has been made for to receive specific training related to meeting the needs of service users with mental health needs. Staff receive good support and supervision from the manager. EVIDENCE: Through discussion with staff and service users there was evidence that the manager and staff team work well together to promote the health and welfare of service users. From observation on the day of inspection, the inspector noted that staff knew the service users well and understood their changing needs which were largely dependent on their mood swings on a daily basis. Staff were observed to have a very good rapport with service users and worked skilfully at supporting them as necessary, especially with those service users who had difficult issues to deal with for example, motivation and self esteem. There is a consistent staff team, with only one new member of staff who joined the team 4 months ago. One person is on maternity leave and the hours are DS0000027907.V274100.R01.S.doc Version 5.1 Page 22 covered by regular staff or an agency member of staff who has previously worked at the home and therefore knows the service users. The staff rota was checked against the staff on duty and there are two staff on duty on each shift. All service users had a programme of activity, and although levels of motivation and functioning abilities were varied, it was clear that improvements of varying degrees were made with each individual service user by the staff group. Through discussion with the member of staff who assisted with the inspection, it was clear that the staff team receive good support from the manager which has a positive impact on their work with the service users, as it promotes confidence in delivering the care required, which could be challenging at times to them. Records inspected showed that staff also receive regular formal supervision. There is a good staff training and development programme and all staff are encouraged to undertake regular training. 80 of the staff team have completed their NVQ level 3 qualifications and those who have not are encouraged to enrol on this course within the coming year. The manager is proactive in determining and identifying training needs for staff according to service users individual needs. The inspector was informed that a new training and development programme is being devised in order to ensure that more training which is relevant and specific to support staff dealing with service users with mental health needs is provided to enable the staff to meet their needs appropriately. This is to be in place next year. Staff indicated that although training is good they would benefit from specific training which covers issues relating to mental health care. DS0000027907.V274100.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): 39, 42 There are sound management systems in place to enable service users to receive a high standard of care. The manager is experienced and leads a staff team who are willing and committed to working with service users with mental health needs. The health, safety and welfare of service users are promoted and protected by the homes policies and procedures. EVIDENCE: The inspector did not have an opportunity to meet the manager during this inspection, however the previous inspection report states that the manager is qualified, competent and experienced to run the home and meet its stated purpose, aims and objectives. Positive feedback was received from the staff about the competent way in which the home is run by the manager who is very supportive and proactive. The home is well maintained and provides a safe environment for service users and staff. However as stated in the previous sections the manager needs to ensure that a lone working risk assessment is undertaken in order to protect DS0000027907.V274100.R01.S.doc Version 5.1 Page 24 staff and service users, in view of recent disturbances and attempted break ins. Regulation 26 visits are undertaken by the organisation’s area manager and copies forward to the Commission monthly demonstrating how the organisation monitors its own service. The inspector was pleased to note that staff complimented the manager and the organisation for the support and training they receive and the organisation’s willingness to listen to staff and adopt a proactive approach to deal with any issues. DS0000027907.V274100.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 3 3 X 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 X 35 4 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 X 12 3 13 X 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X X X 3 X X 3 X DS0000027907.V274100.R01.S.doc Version 5.1 Page 26 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. Standard Regulation Requirement Timescale for action 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 20 Good Practice Recommendations The inspector recommends that further training is provided to the staff group regarding medication interactions and reactions as well as side effects of many of the anti psychotic drugs taken by service users with mental health needs. The inspector recommends that the registered person arranges medication training for staff, which is specifically targeted to deal with service users with mental health needs. The registered person to ensure that staff log all medical appointments attended by service users including any follow up action or outstanding information that they are waiting for. The registered person to ensure that a lone working risk assessment is undertaken in order to protect staff and service users, in view of recent disturbances and DS0000027907.V274100.R01.S.doc Version 5.1 Page 27 2 20 3 20 4 42 attempted break- ins. DS0000027907.V274100.R01.S.doc Version 5.1 Page 28 Commission for Social Care Inspection Ilford Area Office Ferguson House 113 Cranbrook Road Ilford IG1 4PU National Enquiry Line: 0845 015 0120 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. 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