Inspection on 14/08/06 for Meadow Lodge

This inspection was carried out on 14th August 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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 no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Meadow Lodge 19/03/09

Meadow Lodge 04/02/08

Meadow Lodge 13/12/05

Meadow Lodge 02/08/05

Meadow Lodge 01/12/04

Meadow Lodge 26/07/04

Meadow Lodge 30/03/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Meadow Lodge Sadlers Mead Monkton Park Chippenham Wiltshire SN15 3PE Lead Inspector Alyson Fairweather Key Inspection 14 August 2006 12:15 th Meadow Lodge DS0000032434.V296347.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 Meadow Lodge DS0000032434.V296347.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. Meadow Lodge DS0000032434.V296347.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Meadow Lodge Address Sadlers Mead Monkton Park Chippenham Wiltshire SN15 3PE 01249 656136 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) Wiltshire County Council Vacant Care Home 4 Category(ies) of Learning disability (4), Learning disability over registration, with number 65 years of age (4) of places Meadow Lodge DS0000032434.V296347.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13th December 2005 Brief Description of the Service: Meadow Lodge is situated in a quiet residential area on the outskirts of Chippenham. The home provides respite care for up to four service users who have learning disabilities, and service users continue to take part in activities and training sessions which they would when they are at home. The home is owned and managed by Wiltshire County Council. The staff team also provide care for service users in Derriads, which is part of the Chippenham Respite Service. There is 24 hour staff cover to provide support for service users. Meadow Lodge is an attractive home, with a lounge, dining room and a domestic style kitchen. It is light and airy, with comfortable furnishings. There are four single bedrooms, one with ensuite facilities. To the rear of the house is a large, secluded garden which is accessible to the service users, with attractive features and a paved patio area. There is ample parking to the front of the building. Meadow Lodge DS0000032434.V296347.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over one afternoon in August. Two service users responded to our questionnaires with help from their families, and one service user and two staff members, including the deputy manager, were spoken to. Various documents and files were examined, including care plans, the service user guide, risk assessments, staff files and medication records. Fees range from £50.40 - £94.45 per week. The judgements contained in this report have 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: Residents are encouraged to maintain their independence, and supported in this by a dedicated staff group. People are encouraged to take responsibility for themselves, and to do as much as possible for themselves, subject to their abilities. One family remarked; “Respite is a great help to our lives and the service provided is excellent”. Another said: “It has been beneficial for X to stay at Meadow Lodge: the benefits of added stimulation are marked”. The food provided in the home is of a good quality, and residents can help with preparing meals, if they wish. There is ready access to the kitchen, and people can help themselves to snacks if they want to. A good supply of fruit and vegetables is available and healthy eating options are on offer. Service users decide what they wanted to eat when they come back from day services. The home’s complaints procedures were seen to operating well. Several concerns identified by families had been addressed appropriately by the deputy manager and staff. Both service users who replied to our questionnaire said that they knew who to speak to if they were not happy, and both said they knew how to make a complaint if they had to. Meadow Lodge DS0000032434.V296347.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. Meadow Lodge DS0000032434.V296347.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 Meadow Lodge DS0000032434.V296347.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): 2 All service users have their individual needs assessed before they arrive, although more up to date information would help to provide the support needed. Quality in this outcome area is judged to be adequate. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Much of the information about new service users is gathered from the community care assessment which accompanies a referral, but staff also visit prospective service users’ homes or day services in order to get as much information as possible so that they know best how to support people. The assessment includes such information as mobility, specific health needs and family circumstances. Details of any medication support needed is written down and agreed with the service user or a relative. Whilst examining the records for one emergency respite service user, it was noted that some of the information was out of date, and did not reflect the needs of the service users accurately. Another service user’s assessment spoke of health needs which care staff said were not known to them. The deputy manager was therefore asked to ensure that a review of their needs was urgently carried out, and advice sought from the multidisciplinary team involved. Meadow Lodge DS0000032434.V296347.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 and 9 Service users’ needs and goals are reflected in their support plans, and they are encouraged and assisted to make their own decisions. They are supported to take risks as part of an independent lifestyle. Quality in this outcome area is good. This judgement has been made from evidence gathered both before and during the visit to the service. EVIDENCE: Each service user has a support plan in place. These plans include information on communication, finances, literary skills and health and social activities. Staff have introduced a section called “All about me” and this records the individual’s likes and dislikes, as well as information about their family, any pets and what they like to do. Support plans are reviewed regularly every six months, but are also done so when the situation has changed. Staff also record on a daily basis the activities service users undertake as well as their general wellbeing. Manual handling assessments were in place for those service users who need them, and behavioural guidelines were also in place. One service user had been seen by staff to have some unexplained bruising. This had been marked on a body chart but no records had been made in the daily notes, and Meadow Lodge DS0000032434.V296347.R01.S.doc Version 5.2 Page 10 no mention was made of any action taken. No date had been recorded, making it difficult to trace back. Some support plans had not been completed, and the deputy manager has been asked to ensure that this is done, and that information contained in them is accurate and up to date. Wiltshire County Council is in the process of introducing new formats for support plans, and these are likely to be introduced within the next few months. Service users are supported to make decisions about their own lives with guidance from the staff. The interaction observed between staff and the service user at home showed clearly that staff were aware of her wishes. People are encouraged to manage their own finances wherever possible. Where restrictions are in place, for example to limit self harm or harm to others, this is clearly recorded and guidelines are drawn up for staff to follow. No formal advocacy is in place, but families have formed a “Friends of Meadow Lodge & Derriads” and help staff look at how they can improve the service. Risk assessments had been done for each service user and these included things such as mobility and travelling, and ways of minimising risks were identified. These risk assessments are reviewed annually, unless there is a need to do otherwise. Staff place great emphasis on encouraging service users to be as independent as possible, while trying to minimise any risk to their safety. One service user had a risk assessment on file which said that because of various problems two staff members should work overnight. Staff reported that this was now not the case, and that the risk assessment was simply out of date. The deputy manager has been asked to ensure that all risk assessments are current and changed as necessary. Meadow Lodge DS0000032434.V296347.R01.S.doc Version 5.2 Page 11 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 and 17 Social and leisure activities are varied and tailored to individual need, with service users choosing what they wish to do. People have as much or as little contact with family and friends as they wish, and are encouraged and supported by staff. Service users’ rights are respected and responsibilities recognised in their daily lives. They are offered a healthy diet and enjoy their meals and mealtimes. Quality in this outcome area is good. This judgement has been made from evidence gathered both before and during the visit to the service. EVIDENCE: Staff at Meadow Lodge try to ensure that those who enjoy regular daytime activities when they are at home can continue to do so whilst having respite care. Some people attend clubs, college and day centres, some like swimming, going to church, trampoline and volleyball. Others like to do crafts, basic cookery or simply socialising with friends. One resident was said to like going to the gym, swimming and computers. One lady who has recently been referred has no day care, and was seen to be taken out for lunch. Staff are Meadow Lodge DS0000032434.V296347.R01.S.doc Version 5.2 Page 12 working with her in deciding what structured activities she would enjoy. On weekdays, many service users prefer to stay at home in the evening, as they are busy during the day. On weekends there are occasional daytrips, to the seaside in the summer for example. When at home service users watch videos, play board games and do jigsaws. They also enjoy trips out to the pub, out for meals and go swimming. One family remarked; “It has been beneficial for E to stay at Meadow Lodge: the benefits of added stimulation are marked”. As Meadow Lodge caters for respite service users, most already have strong links with their families. However, staff encourage and support these links, and families can visit during the respite period if they wish. Staff also visit the families to carry out regular reviews. Service users can choose when to be alone or in company, and when not to join in an activity. Staff enter service users’ bedrooms only with the individual’s permission. Daily routines are flexible, with people choosing what they want to do when they return from day services. Service users have unrestricted access to the home and grounds, and can come and go as they please. The food provided in the home is of a good quality, and residents can help with preparing meals, if they wish. There is ready access to the kitchen, and people can help themselves to snacks if they want to. A good supply of fruit and vegetables was available and healthy eating options were on offer. Once all service users returned from their day services, they all decide what they wanted to eat. The dining room is adjacent to the kitchen, and is a large, bright room. The menu supplied in the home is varied and nutritious, and is centred round the likes of the people staying in the home on a daily basis. Breakfast usually consists of cereal and toast, and lunch can be a cooked meal for those who wish, or a packed lunch for those who go out during the day. The main meal of the day is at supper-time, and is usually cooked by staff, as the level of need of the service users means that cooking can be difficult for them. Suggestions made by families or service users for what they would like in their lunch box are recorded so that staff know what people like. There was a good supply of fresh fruit and vegetables in the home, and juices and yoghurts were also available. Staff have records of the food likes and dislikes of all service users. Meadow Lodge DS0000032434.V296347.R01.S.doc Version 5.2 Page 13 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 and 20 Personal care needs of service users are written in care plans so that they can receive support in the way they need and prefer. Their physical and emotional health needs are met. The home’s medication policies and staff good practice in administration and recording ensure that service users are safe when their medication needs are being met. Quality in this outcome area is good. This judgement has been made from evidence gathered both before and during the visit to the service EVIDENCE: All service users have support plans for any personal care required. The information contained in them is gathered from the initial community care assessment, the home’s own assessment and staff knowledge of the service users. People have guidelines in place which say how they like to be helped to get washed and dressed, assisted with food and helped to and from bed. One family member commented that “Respite is a great help to our lives and the service provided is excellent”. All service users have health care plans on file. if a service user becomes unwell, and their family lives locally, the person’s own GP is used, although local GPs are used for those who live further afield. Medical professionals are seen as and when required. This varies according to the needs of individuals Meadow Lodge DS0000032434.V296347.R01.S.doc Version 5.2 Page 14 and the situations arising while having respite care. The home has good links with the local learning disability teams, which enables an effective response to any crisis periods that may arise. As previously stated, the deputy manager has been asked to review the healthcare needs of two service users whose community care assessments contain information different to that known about them by staff at Meadow Lodge. Some people who stay at Meadow Lodge are able to look after some medication that they can buy over the counter, for example some creams. For other service users, responsibility for medication is taken by staff, and all staff have medication training when they first start work. One service user was noted to be allergic to penicillin, and this was recorded on the medication administration record and highlighted in red. Staff also keep a running total of all medication in the home, and a check on the medication stock showed that all was in order. The home’s medication policy has been amended to allow for the times when there is only one staff member on duty, and a risk assessment regarding this practice is in place. Meadow Lodge DS0000032434.V296347.R01.S.doc Version 5.2 Page 15 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 and 23 Service users’ views are listened to and acted on. The policies and procedures the home has in place, and the regular updates in staff training in Protection of Vulnerable Adults, ensure that residents are safeguarded from abuse and harm. Quality in this outcome area is good. This judgement has been made from evidence gathered both before and during the visit to the service. EVIDENCE: There is a complaints procedure which outlines the steps to take if there are any complaints, and all service users get a copy of this. It also gives details of how service users and families can contact the Commission for Social Care Inspection (CSCI).A complaints book is kept in the office, and any complaint would be recorded there. Several concerns identified by families had been addressed appropriately. Both service users who replied to our questionnaire said that they knew who to speak to if they were not happy, and both said they knew how to make a complaint if they had to. The home has copies of the Wiltshire & Swindon booklet “No Secrets”, as well as the organisational policies and procedures on responding to allegations of abuse. A “Whistle Blowing” procedure is also available for all staff. All staff should have regular updates on vulnerable adults training, although this has proved difficult to obtain. Two referrals have been appropriately made by staff to the vulnerable adults’ team. Meadow Lodge DS0000032434.V296347.R01.S.doc Version 5.2 Page 16 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): Service users have a homely, comfortable and safe environment, which is clean and hygienic. Quality in this outcome area is good. This judgement has been made from evidence gathered both before and during the visit to the service. EVIDENCE: Meadow Lodge is an attractive home, with a lounge, dining room and a domestic style kitchen. It is light and airy, with comfortable furnishings. A new carpet is planned for the dining room and lounge. There are four single bedrooms, one with ensuite facilities. Service user’s bedrooms were homely and each contained individual personal items. To the rear of the house is a large, secluded garden which is accessible to the service users, with attractive features and a paved patio area. The house was clean and hygienic, with policies and procedures in place for the maintenance of the premises. Meadow Lodge DS0000032434.V296347.R01.S.doc Version 5.2 Page 17 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 and 35 Service users are supported by competent and qualified staff, although some training needs have been neglected and must be addressed. It was not possible to verify that service users are protected by the recruitment procedures used by the home. Quality in this outcome area is adequate. This judgement has been made from evidence gathered both before and during the visit to the service. EVIDENCE: All new staff receive induction training, and have also started using the Learning Disability Award Framework (LDAF) to assist their training, which means that the needs of service users with learning disabilities will be more fully understood. There are currently seven staff who have completed NVQ Level 3 and three waiting to start. Two staff members have completed NVQ Level 2. One has also completed the Work Place Assessor award. The two service users who responded to our questionnaire both said that staff treat them well. Staff training has included Valuing People, epilepsy awareness, and positive response training. Staff should have mandatory training updates, which include administration of medication, manual handling, first aid, food hygiene, basic health and safety and risk assessment. The staff training files examined Meadow Lodge DS0000032434.V296347.R01.S.doc Version 5.2 Page 18 showed that there had been no food hygiene or first aid training. One recent member of staff had not been able to access medication training, although the deputy manager had conducted some in-house training for her. Staff reported difficulty accessing training from Wiltshire County Council, as courses would fill up quite quickly. Several staff had been unable to have updates on manual handling training. The home must ensure that all staff receive their induction training as well as any updates needed. Wiltshire County Council’s employment checks usually include Criminal Records Bureau (CRB) and Protection of Vulnerable Adults (POVA) checks, two written references and a medical declaration. However, one staff file examined was seen to contain a CRB from another employer, and no references. The deputy manager explained that these may have been held at County Hall by the HR department. Another staff file examined showed that all these documents were present. The deputy manager has therefore been asked to ensure that all staff files contain appropriate information. Meadow Lodge DS0000032434.V296347.R01.S.doc Version 5.2 Page 19 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 and 42 Service users benefit from a well run home, although this would be improved by the appointment of a manager. They know that their views underpin the monitoring and review of care practice. The home’s policies and procedures, and the health and safety checks carried out, mean that residents live in a safe environment. Quality in this outcome area is good. This judgement has been made from evidence gathered both before and during the visit to the service. EVIDENCE: The post of team manager has been vacant for some time. No new manager been appointed yet, although interviews were being held. The acting manager has a number of years experience of working with people with learning disabilities, and all the service users who use Meadow Lodge know her. She is currently responsible for the day to day running of both Chippenham respite services, and is supported by senior staff in both homes. The staff team work well together, but would benefit from a permanent manager. Meadow Lodge DS0000032434.V296347.R01.S.doc Version 5.2 Page 20 The home has good quality assurance mechanisms in place. All families are visited on an annual basis, and other contact is made by telephone and letter. A “Friends of Meadow Lodge” group has been set up, and family and friends of service users regularly meet to give feedback on the running of the home. A questionnaire has been sent out to service users and families to ask their views, and to ask if there is anything which could be done to improve service users’ stay. One of Wiltshire County Council’s senior managers makes a regular monthly visit to the home, and writes a report of her findings. There were good health & safety records in place. The fire log was examined, and it was seen that fire alarms are checked weekly by staff, emergency lighting is checked monthly, as is fire-fighting equipment. The home’s fire extinguishers are serviced on a contractual basis, and this was done in February 2006. One staff member has been assigned the role of fire officer for the home, and fire drills are done quarterly, with details recorded of how long evacuation takes. The fridge and freezer temperatures are recorded daily, as well as the food prepared for residents. As mentioned previously, some staff have not had food hygiene training, and the home has been asked to make sure that this takes place. Meadow Lodge DS0000032434.V296347.R01.S.doc Version 5.2 Page 21 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 2 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 2 34 X 35 2 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 X 2 x 3 x x 3 x Meadow Lodge DS0000032434.V296347.R01.S.doc Version 5.2 Page 22 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. 2. 3. 4. 5. Standard YA2 YA6 YA9 YA33 YA35 Regulation 14 (2) (a) (b) 15 (2) (b) 15 (2) (b) 17 Schedule 2 18 (1) (c) (i) Timescale for action An urgent review must be sought 28/08/06 for the service users identified during the inspection. All care plans must be completed 14/10/06 and contain accurate, up to date information. All risk assessments must be 14/10/06 kept up to date and changed as necessary. All staff files must contain two 14/10/06 references and evidence of a CRB & POVA check. Staff training updates must take 14/10/06 place, and records kept of this. Requirement 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 Meadow Lodge DS0000032434.V296347.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Chippenham Area Office Avonbridge House Bath Road Chippenham SN15 2BB 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 Meadow Lodge DS0000032434.V296347.R01.S.doc Version 5.2 Page 24 - 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. 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