Inspection on 04/05/06 for Marlin Lodge

This inspection was carried out on 4th May 2006.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 15 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Marlin Lodge 04/05/07

Marlin Lodge 20/09/06

Marlin Lodge 21/02/06

Marlin Lodge 05/10/05

Marlin Lodge 30/11/04

Marlin Lodge 10/08/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Marlin Lodge 31 Marlborough Road Luton Beds LU3 1EF Lead Inspector Dragan Cvejic Unannounced Inspection 4th May 2006 09:00 Marlin Lodge DS0000060196.V291734.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 Marlin Lodge DS0000060196.V291734.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. Marlin Lodge DS0000060196.V291734.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Marlin Lodge Address 31 Marlborough Road Luton Beds LU3 1EF 01582 723495 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) Quality Care (Surrey) Ltd Vacant Care Home 10 Category(ies) of Learning disability (10) registration, with number of places Marlin Lodge DS0000060196.V291734.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Number of places: 10 Age: 18 - 65 years Category: Learning disability Date of last inspection 21st February 2006 Brief Description of the Service: Marlin Lodge is a large detached house that has been extensively enlarged to provide residential accommodation for up to 10 adults with learning disabilities. All accommodation is in single bedrooms. There is a lounge and dinning area/conservatory on the ground floor. The property is within easy reach of local amenities and Luton town centre. The home provides care for adults between the ages of 18 to 65 with learning disabilities, most of whom attend day activities outside of the home during weekdays. All of the bedrooms on the first floor the home cannot take people who have significant physical disabilities in addition to their learning disabilities. Marlin Lodge DS0000060196.V291734.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out during one day by two inspectors. The home was inspected after the manager on probation had been degraded to a carer position, and the home was temporarily being managed by an experienced and skilled consultant. The temporary manager and the proprietor were present in the home and provided information about the home used for this inspection. One member of staff on duty and 3 service users were in the home and contributed with their comments to the inspection. A partial case tracking of two service users was the main methodology used for this inspection. The inspectors also observed and discussed care practices with 3 service users, checked home’s documents and made a tour of the building. Six visitors/relatives cards were sent to the CSCI with their comments about the service. CSCI intend to introduce a quality rating for care services from April 2007. In 2006/07 we will decide a proposed Quality Rating based on our assessment of the performance we saw during this inspection. We will not publish this proposed Quality Rating, but where a service is poor, we may share information with councils and PCT’s acting as commissioners of services. In line with this, CSCI judge this to be a 2 star service, which provides adequate outcomes for people who use the service. This judgement has been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. What the service does well: The home provided excellent information about the service. They used picture formats for all major information and procedures. A service user stated: “I have this in my room. It is very good”, about the picture format booklet “What you need to know and expect at Marlin Lodge”. Service users had regular health-checks and relevant medical professionals were involved in their care whenever it was necessary. The home encouraged service users to use their initiative. They attended various day centres and colleges. A user stated:” I love going to college”. The complaints procedure was displayed in picture format for service users and they knew of it. Marlin Lodge DS0000060196.V291734.R01.S.doc Version 5.1 Page 6 New flooring in the conservatory made it more comfortable. The home was clean and bright. Service users loved their rooms and made them very personal with their private possessions. The level of NVQ trained staff exceeded the required 50 and staff were very interested to gain and improve their standard of qualifications. What has improved since the last inspection? What they could do better: The home generally had good care plans that needed only slight adjustments, such as to obtain signatures, to produce a summary-overview and to address a night care programme. An immediate requirement was issued to the home to re-organise medication procedure, as the current system was not safe for service users. A service user stated that she was happy with the financial system in place, but that she would like to know her total income and what happens with her money. Staff training was not done on LDAF (Learning Disability Award Framework) principles and did not meet the staff expectations, nor did it provide them with Marlin Lodge DS0000060196.V291734.R01.S.doc Version 5.1 Page 7 up to date and sufficient knowledge to work in line with modern care principles. Specific training related to users’ conditions was particularly underpresented in the home’s training programme. All mandatory training, such as fire safety and food hygiene, must be up-dated for all staff. The home must continue with the recruitment process to find a permanent and experienced manager, regardless of the temporary management offered currently by the consultant. The recruitment process generally needed improvements in relation to its outcome. Records kept in the home for service users must be up-dated and further regular reviews planned. The generic fire risk assessment must be reviewed and up-dated. 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. Marlin Lodge DS0000060196.V291734.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 Marlin Lodge DS0000060196.V291734.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): 1,2,3,5 The home produced very good illustrated information about services and provisions, reviewed documents regularly and allowed existing and potential users to use documents effectively to obtain information about the home. EVIDENCE: The home reviewed and up-dated the statement of purpose and service users’ guide and chose appropriate illustrations understandable by service users. The contract was also produced in the same, user friendly format. A service user stated:” I have this guide in my room, it is very good.” The assessment form covered all necessary aspects for potential new admissions. Service users’ files contained records that showed how the users’ needs were met. Records of visits by external professionals also showed that the home engaged them to meet the users’ needs. Marlin Lodge DS0000060196.V291734.R01.S.doc Version 5.1 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9 Service users’ plans were good documents and staff used them to ensure that users’ needs were recorded and met, but the users needed to be more involved in the process of recording how they exercised their individual choices. EVIDENCE: The checked files contained appropriate care plans. However, the summary would be beneficial both to staff and to service users. Care plans did not contain signatures to prove service users’ involvement. As users’ needs changed and included increased needs at night, the plans did not address these night needs. Risk assessments were in a handwritten form and the home planned to type them. Service users spoken to confirmed that they were making decisions. They chose the colour for decorating their rooms. They chose the weekly menu on their regular meetings. A service user stated that she wanted the home to keep her money safe and to use this provided provision. Policies relevant directly to service users were provided in picture format and service users used them for their everyday life. Marlin Lodge DS0000060196.V291734.R01.S.doc Version 5.1 Page 11 Two service users were independently going to nearby shops. They expressed their feelings in a survey and questionnaires. Limits were recorded in individual risk assessments. Marlin Lodge DS0000060196.V291734.R01.S.doc Version 5.1 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): 11,12,13,14,15,16,17 Service users continued to engage in activities that they found stimulating and helped them develop independence, with respect for their wishes, aspirations and abilities. EVIDENCE: Service users were actively involved in all house tasks. The home introduced A certificate: “Resident of the month”, which was granted and displayed for the biggest contribution to the home’s life. Service users developed competitiveness and liked the idea. A service user was proud of attending a college. She had a food hygiene certificate displayed in her room. There was a plan for gardening project where all interested service users would take part. Two service users spoken to commented how pleased they were to keep contact with their family members. One user stated that she had friends that she saw regularly. Transport to day centres was arranged through the home. Service users liked going out and staff accompanied them in going for walks and to other places of their choice. Service users were planning the next holiday and were pleased with this provision. Marlin Lodge DS0000060196.V291734.R01.S.doc Version 5.1 Page 13 Users involvement in the house included cooking, cleaning, washing up etc. When the door slammed during the inspection, a service user commented: “Oi, you, careful with that door!”, showing how much they felt a sense of belonging in the home. Most service users kept the keys to their rooms. Staff were observed interacting with service users. Service users chose weekly menus on their meetings. Staff supported them in choosing a healthy, balanced diet. Marlin Lodge DS0000060196.V291734.R01.S.doc Version 5.1 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): 18,19,20,21 Although the home tried to respond to users’ healthcare needs, the practical medication procedure was not safe for service users and an immediate requirement was issued during the site visit. EVIDENCE: Staff offered appropriate support, guidance and care to service users. They respected individuals and acted in an agreed way. Various appointments were arranged for a service user who needed professional external support. However, service users did not have much choice in terms of choice of staff to work with them and were coming from a different cultural and ethnic background. At this time, this issue did not cause problems, but was identified as a potential issue for the future. Service users spoken to were happy with allocated key workers. The home kept records of service users’ healthcare appointments. However, the charts containing records were ambiguous as they contained some entries that did not seem accurate: one file contained dietary requirements, but which did not apply to the service user; the other file contained a weighting chart that showed a big difference and variations in a user’s weight, but staff did not seem to know about that. The staff were issued written warnings after wrongly signing medication. The staff member did not have sufficient knowledge of medication handled in the home. There was no risk assessment for those that were self medicating. The category of homely remedies was not clear to staff. The medication records Marlin Lodge DS0000060196.V291734.R01.S.doc Version 5.1 Page 15 could not provide tracking for auditing purposes. An immediate requirement was issued asking for the medication procedure to be consolidated and to include staff training within the time scale given. The home devised and introduced an ageing policy. Marlin Lodge DS0000060196.V291734.R01.S.doc Version 5.1 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): 22,23 The home had an effective complaints procedure that allowed service users and visitors to confidently raise their potential concerns and complaints. EVIDENCE: The home had a text version of their written complaints procedure and the same procedure presented in picture format that was displayed in the home for service users who found this communication method more effective. The home had received one complaint since the last inspection. The investigation was in progress. The home was dealing with all concerns and complaints seriously to ensure the safety and protection of service users. The system for organising and helping service users with their money was reviewed and changed to improve protection. One user wanted to be regularly informed about the total balance of her money, but emphasised that she wanted to be helped by the existing system and to have her money kept safe in the home’s safe. The home appropriately referred a user who was expressing challenging behaviour for an external professional assessment, to protect other users and staff. Marlin Lodge DS0000060196.V291734.R01.S.doc Version 5.1 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,26,27,30 The building was located in a quieter street, but still close to local amenities, allowing users to be part of the community. There were different improvements made since the last inspection. EVIDENCE: The home was pleasant and fit for its purpose. It was bright and clean. Although the home could not accommodate service users with mobility problems, the current service users could access all parts of the premises. New flooring in the conservatory was appreciated by service users. New washing machine with sluice programme improved facilities for infection control and general hygiene. There was no systematic plan for maintenance, but the owner stated that “his men could come when he calls them” and added that he expected them for refurbishing the bathroom when the service users go on holiday. The manager felt that the home would benefit from having a maintenance man permanently employed. Individual bedrooms were furnished with good quality furniture and contained users’ individual possessions. Toilets and bathrooms were appropriately located and met users’ needs. There was a plan to convert a bathroom into a wet room with a shower, but this needed to be discussed with service users. Marlin Lodge DS0000060196.V291734.R01.S.doc Version 5.1 Page 18 The premises were clean and bright and the laundry facilities were improved by the new washing machine. Marlin Lodge DS0000060196.V291734.R01.S.doc Version 5.1 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35,36 Although direct care for service users was good due to the commitment and devotion of staff, the staffing issues, standards, knowledge and training were matters that were not of satisfactory standard and presented a potential risk for the smooth operation of the home. EVIDENCE: With a temporary arrangement for the management of the home by the consultant, the staff were much clearer about their roles, tasks and expectations. Delegated tasks were clearly and precisely explained to staff. A staff member stated: “I know what is expected of me. The manager gives us clear instructions.” Practical care observed during the inspection confirmed this statement. However, the break during the long shift was not set and the staff were not sure of what the arrangement was. The manager commented and staff confirmed that staff cover during weekends was minimal and limited staff in meeting all service users’ needs. The home introduced a waking night position based on the increased needs assessment, although the care plans did not indicate or provide evidence to support this newly identified need. Staff competence in meeting the users’ needs was limited by the lack of knowledge, such as in the area of medication, communications and dealing with challenging behaviour. The home exceeded expectations in having the percentage of NVQ trained staff on duty. Marlin Lodge DS0000060196.V291734.R01.S.doc Version 5.1 Page 20 The staff team responded to the needs of service users by their dedication rather than contracted hours. They were prepared to extend their shifts to respond to the needs of service users, but there was no system in place to ensure the same response if staff’s motivation and dedication were not so high. The staffing structure did not balance or reflect the users’ cultural and ethnic background. Recruitment procedure did not give the expected outcomes. The home did not manage to attract and employ a permanent manager. The contracts did not specify the hours in number that staff were employed to work. However, the files checked confirmed that all checks, such as POVA first, CRB and references were obtained prior to the offer of employment. Training records did not accurately present the current situation. Staff files contained certificates, but the training record was not updated. Recent staff survey did not provide accurate training records either, as individuals did not enter recent training on the form. Staff spoken to confirmed that the supervision process was now regular since the appointment of the temporary manager. Supervision notes demonstrated that the content of these sessions was appropriate. All staff were issued with written warnings as a result of the investigation carried out locally after irregularities in medication procedural practice was identified. Marlin Lodge DS0000060196.V291734.R01.S.doc Version 5.1 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): 37,39,40,41,42,43 Although the home was managed well by a temporary manager, the uncertainty of the future, ineffective recruitment and lack of permanent management capacity represented a threat not only to staff, but to service users too and determined a high risk level that was not appropriately addressed. EVIDENCE: The home unsuccessfully tried to find a permanent manager. The current temporary arrangement minimised the risk to service users, but historically unsuccessful recruitment could not provide sustainable development of the home. The home carried out a survey of service users, staff and visitors/relatives. The manager was analysing results and planned to produce an action plan. A development plan was in hand written form, awaiting results of these surveys to incorporate them into the plan. The manager was reviewing and updating home’s policies. The effectiveness of the policies varied. Some were prepared in picture format, such as the complaints procedure or infection control. Marlin Lodge DS0000060196.V291734.R01.S.doc Version 5.1 Page 22 Staff understanding of the policies was not evident and their involvement occurred once the policies were set, to provide their comments. Records and service users’ files were not yet consolidated and needed updating. The health safety and welfare of service users were partly protected by the safe working practices. Recent mishandling of medication demonstrated how vulnerable service users were when staff lacked the knowledge despite the training attended. Some risk assessments were not updated. Fire risk assessment was not updated when a change in environment, the flooring in the conservatory, required new risk assessment. There was no system in place for auditing accidents/incidents, as the manager was not informed of the latest two accidents. The budget figures showed financial viability, but the staffing budget, for example, could not be connected to staff contracts without specified hours. Accountability of the manager and staff in relation to budgeting and expenditure was evident and the manager and staff’s involvement in budgeting was not specified and was unclear. Marlin Lodge DS0000060196.V291734.R01.S.doc Version 5.1 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 4 2 3 3 3 4 X 5 4 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 3 27 3 28 X 29 X 30 3 STAFFING Standard No Score 31 2 32 2 33 1 34 1 35 1 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 2 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 2 1 3 1 X 3 2 2 1 1 Marlin Lodge DS0000060196.V291734.R01.S.doc Version 5.1 Page 24 yes 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 YA6 Regulation 14,15 Requirement Care plans must contain a working summary that would allow staff to obtain necessary information on service users’ needs with suggested actions on how to meet these needs. The plan must contain evidence of reviews when new needs are identified, such as night care needs. The plans must be signed to demonstrate that they were discussed with service users or their representatives, if they were unable to comprehend the content. All inapplicable documents and charts must be removed from the files to prevent potential confusion. The registered persons must ensure that all risk assessments are comprehensive and are reviewed regularly. (This was a requirement from the previous inspection) Now, having the risk assessments in place, regular reviews must be carried out and recorded.(This was a requirement set on two previous DS0000060196.V291734.R01.S.doc Timescale for action 30/06/06 2. YA9 13(4)(c), 14 30/06/06 Marlin Lodge Version 5.1 Page 25 inspections, but although the hand written assessments were ready for typing, some still did not fully address risks, such as risks associated with night care needs and self medicating risk assessments for service users that were self medicating. New time-scale is now set and the potential enforcement action, if not met, will be implemented. 3. YA20 13 This was an immediate requirement served during the inspection. The home must introduce safe practical procedures for handling medication that must include among other elements, training, risk assessments and record keeping. The pharmacist must be involved in this process. The home must ensure that staff working in the home are competent for providing appropriate care to all service users and are clear of their duties and rights, including time off, their limits, and must understand the home’s policies and procedures. The home must ensure that the staff ratio corresponds to the service users needs identified in care plans and employ a sufficient number of workers to meet these needs, especially at weekends. The home must ensure that it has the skills and knowledge to respond to service users’ needs, including communication skills, knowledge of specific service users’ conditions, understanding and being able to appropriately deal with aggression, challenging behaviour, understanding of the cultural heritage of service users DS0000060196.V291734.R01.S.doc 04/06/06 4. YA31 18 30/07/06 5. YA32 18 30/07/06 6. YA32 18,19 30/07/06 Marlin Lodge Version 5.1 Page 26 7. YA33 18,19 8. YA34 18 9. YA35 18,19 10. YA37 8 11. YA40 12 and be familiar with techniques of rehabilitation. The staff team must be effective in meeting service users’ needs. The home must be able to identify and respond to changes in service users’ needs and respond to these needs by adjusting staff number, cultural composition, staff’s communication skills and knowledge, as well as the staff roles and duties. All staff must be clear of their roles and must be given a clear statement-contract- of their terms and conditions. Service users must be involved in the recruitment process and the manager must be involved in all stages of this process. All staff working in the home must be suitably trained and knowledgeable and training records must demonstrate staff competence. Staff must be able to practically implement knowledge gained through training to ensure the safety of service users. LDAF, the accredited training must be used to provide staff with underpinning knowledge necessary for safe and effective care. The home must employ a permanent manager that is suitably qualified, experienced and has the skills necessary for management of the scheme. The home must aim to employ a manager even during the period of cover provided by appointing the consultant temporarily, but not later than specified in the time scale stated here. The manager must ensure that staff and service users are DS0000060196.V291734.R01.S.doc 30/07/06 30/07/06 30/07/06 30/09/06 30/07/06 Marlin Lodge Version 5.1 Page 27 12. YA41 17 13. YA42 12,13 14. YA42 12,13, 15. YA43 25 involved in the process of reviewing and setting the home’s policies and procedures and that staff are fully aware of and understand policies and procedures. The manager must ensure that records kept in respect of each individual service user are accurate and up to date. The manager must ensure that safe working practices are in place at all times by ensuring that competent staff are present in the home all the time, and that staff are appropriately trained to provide safe care and protect service users. Generic risk assessments, accidents/incidents records and other measures to ensure the safety and protection of service users must be kept up to date and there is a system for effective auditing of these protective measures in the home’s aims to protect service users. The home’s budget must respond to real operational practices and demonstrate the financial viability of the home. Lines of accountability and responsibility must also be clearly presented and known within the home by staff and service users. 30/07/06 30/07/06 30/07/06 30/08/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Marlin Lodge DS0000060196.V291734.R01.S.doc Version 5.1 Page 28 1. YA18 2. 3. YA18 YA24 The home should improve its recruitment procedure to attract staff from a similar cultural and ethnic background as service users and to balance the composition of the staff team to the service users composition. The home should ensure that staff have the skills to communicate with all service users, including those without verbal communication ability. The home should aim to establish a stable and continuous maintenance system and consider deployment of a maintenance man. The present system that ensured the maintenance issues are dealt with when several items accumulate does not guarantee a sustainable safe environment. Marlin Lodge DS0000060196.V291734.R01.S.doc Version 5.1 Page 29 Commission for Social Care Inspection Bedfordshire & Luton Area Office Clifton House 4a Goldington Road Bedford MK40 3NF 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. Extracts may not be used or reproduced without the express permission of CSCI Marlin Lodge DS0000060196.V291734.R01.S.doc Version 5.1 Page 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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