Inspection on 24/01/06 for Medihands Healthcare (149)

This inspection was carried out on 24th January 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 14 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Medihands Healthcare (149) 06/02/08

Medihands Healthcare (149) 18/10/06

Medihands Healthcare (149) 17/10/05

Medihands Healthcare (149) 23/02/05

Medihands Healthcare (149) 02/09/04

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

CARE HOME ADULTS 18-65 Medihands Healthcare (149) 149 - 153 Kingston Road New Malden Surrey KT3 3NS Lead Inspector David Pennells Unannounced Inspection 24th January 2006 1:00pm Medihands Healthcare (149) DS0000013394.V281564.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 Medihands Healthcare (149) DS0000013394.V281564.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. Medihands Healthcare (149) DS0000013394.V281564.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Medihands Healthcare (149) Address 149 - 153 Kingston Road New Malden Surrey KT3 3NS 020 8949 7860 020 8408 0767 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) Mrs Jayashree Sawmynaden Care Home 17 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (17) of places Medihands Healthcare (149) DS0000013394.V281564.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 17th October 2005 Brief Description of the Service: Medihands Healthcare is a care home for seventeen adults with varying degrees of mental health needs. The home has close links with the Community Mental Health Team that is based conveniently very close by the Roselands Resource Centre. Service users are enabled and supported to independently access all local community amenities and facilities. The accommodation consists of two adjacent houses; one (151-153) accommodating nine service users in single bedrooms, and the other (149) offering a service to eight - again in single bedrooms. The two ‘sides’ of the home are joined by a covered walkway (unfortunately) passing through the day-to-day office. The houses, owned by Mr Sawmynaden and Mrs respectively, are registered as one home in the name of Mrs Sawmynaden and are run as such - though such detail as the staffing rotas are ‘split’ between the two properties. The home is situated on the busy main road that leads from New Malden to Kingston. New Malden High Street / town centre is a short walk away. Public transport links are immediately accessible outside the home (busses), and a walk away (trains), the overground trains leading to Kingston, Surbiton, and into London Waterloo. There is limited parking at the front of the house, off the street. Medihands Healthcare (149) DS0000013394.V281564.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection visit was undertaken on an ordinary weekday afternoon, the inspector spending about three and a half hours at the home. During his visit, the inspector was able to engage with a number of service users, a significant number of staff (he was around to meet both morning and afternoon shifts), and to meet with Mr Sawmynaden - the acting manager of the house - who was able to assist the inspector. This was particularly fortuitous, as the proprietor, Mrs Sawmynaden was unwell that afternoon. The inspector was able to overview progress in meeting the requirements and recommendations set at the last visit to the home, and he was also able to assess standard 15 - the one core standard not assessed at the previous visit in mid-October 2005. The inspector is grateful to the service users, the staff and Mr Sawmynaden for their cooperation and hospitality given that afternoon. What the service does well: What has improved since the last inspection? A number of points have been furthered since the last inspection visit in midOctober 2005: some medication procedures have improved, health & safety issues such as water temperature checks have been enhanced and the major electrical auditing / servicing tests have been satisfactorily completed. Premises issues such as removing unnecessary locks on doors, improving bathing areas through redecoration is in process, with associated replacement of faulty extractors and provision of new safety equipment being completed. Medihands Healthcare (149) DS0000013394.V281564.R01.S.doc Version 5.1 Page 6 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. Medihands Healthcare (149) DS0000013394.V281564.R01.S.doc Version 5.1 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 Medihands Healthcare (149) DS0000013394.V281564.R01.S.doc Version 5.1 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): None inspected at this visit. The home provides service users & other interested parties with full details to enable them to make an informed choice about choosing to live at the home. Service user’s individual needs and aspirations are assessed, understood and implemented at the home – through the thorough and considered exploration of information provided, and fully including the service user’s views. Each service user can expect to have a statement of terms and conditions – clearly stating the ‘rules’ of the home and providing information about their rights in, and obligations to, the home. EVIDENCE: All key standards in this section were inspected at the visit in mid-October 2005. There had been no significant changes in the house since then. The above judgement statements are reiterated from the previous report, when standards 1,2 & 5 were inspected and found ‘met’. Medihands Healthcare (149) DS0000013394.V281564.R01.S.doc Version 5.1 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. The home creates and maintains care plans and assessment documents designed to ensure that the needs of individual service users are realistically met in a focused and individual way; the need to move towards regular sixmonthly reviews - previously required by the inspector - will ensure that all care plans are kept ‘live’ throughout a service user’s stay. Currently the acting manager is seeking to collate the dates of the previous Care Programme Approach (CPA) reviews for all service users in order to collate a matrix of projected dates for the implementation of such half-yearly focuses. Service users can be assured that their rights to individuality and selfexpression are protected, whilst acknowledging the community aspect of living at the home. Consultation and sharing of information will involve, and take into account, the wishes and aspirations of the single service user – as an individual and also as a member of the home’s community. Service users can generally be assured that risk-taking will be an integral part of the support / protection plans put in place by the home. Service users and staff can be assured that information kept personally relating to them will be kept appropriately safely in line with legislative requirements. Medihands Healthcare (149) DS0000013394.V281564.R01.S.doc Version 5.1 Page 10 EVIDENCE: All five of the above standards were inspected at the last inspection visit and all but standard 6 were found ‘met’. The first judgement statement continues to state that the home must move towards the process of reviewing each care plan thoroughly each six months - as a maximum time lapse between reviews. The remaining judgement statements - covering standards 7 - 10 are brought forward from the previous report and reiterated here for the information of the interested reader. Medihands Healthcare (149) DS0000013394.V281564.R01.S.doc Version 5.1 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): 15. Service users can be assured that the service provides opportunities for them to engage in activities both within and outside the home, and to adopt a lifestyle suited to their individual needs and preferences. Relatives / friends can expect a positive welcome from the home, within the context of respect for a service user’s own choice and decision-making. Service users can expect to be positively supported in forming and maintaining relationships with friends, family and those of an intimate personal nature. Service users can expect to be provided with a good standard of nutritious and wholesome food, whilst acknowledging the right to their own stated choice and ensuring that mealtimes are a pleasant and enjoyable time. EVIDENCE: The previous inspection visit covered all key standards except standard 15 that was discussed at this visit with care staff, service users and the acting manager. On this occasion the inspector assessed that the standard was ‘met’ - reflected by the third judgement statement above. Medihands Healthcare (149) DS0000013394.V281564.R01.S.doc Version 5.1 Page 12 The first two and last judgement statements above cover the outcomes of the previous inspection, which covered standards 12 - 17, excluding standard 15. Standard 15 covers support for family links and friendship support, and also covers the needs of service users to have intimate relationships too. The home has a clear policy - stated within the Statement of Purpose - with regard to service users’ families and friends, who are positively welcomed to the house. A policy also exists covering sexuality and relationships - which the inspector read and felt covered the salient points that should be included. Day-to-day notes on service users reflected the number who engaged with family and friends - by going out visiting, as much as them actually visiting the house. During the inspection visit the acting manager was observed supporting one service user who was in need of reassurance concerning family relationships direct contact being arranged to allay fears of abandonment. Medihands Healthcare (149) DS0000013394.V281564.R01.S.doc Version 5.1 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): 20. Service users can be assured that their personal, health care and emotional needs will be recognised and met by the home’s daily service input and through longer-term monitoring, assessment and care plan programming. The systems adopted by the home regarding medication – once advice from the advising Pharmacist has been adopted – will ensure the safety and consistent treatment and support for each service user. EVIDENCE: All four standards above were inspected at the last inspection, and all but standard 20 was found ‘met’. The inspector revisited the requirement set at the last inspection and found that two of the five points had been met and therefore the standard remains with a ‘almost met’ scoring. The two judgement statements above - from the previous report - are reiterated as they accurately reflected the situation at the time of the inspection visit. The remaining requirements cover aspects of advice given by the visiting Consultant Pharmacist at her visit to the home in October 2005. The outstanding issues raised are ‘blocked together’ as one requirement stated below. Of particular concern was the continuing absence of clear criteria for the administration of ‘prn’ (‘when required’) medication. A checklist must be in place for any service user who has such ‘discretionary’ medication prescribed. Medihands Healthcare (149) DS0000013394.V281564.R01.S.doc Version 5.1 Page 14 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): None inspected at this visit. Service users can be confident that their comments and complaints are responded to, with appropriate action being taken in a timely fashion. The home provides support to service users to ensure that they are protected from harm and any form of abuse. EVIDENCE: Both standards above were found ‘met’ at the last inspection visit and nothing was in evidence to suggest that anything had significantly changed since the last visit in mid-October. The two previous judgement statements are therefore reiterated for the reader’s information. Medihands Healthcare (149) DS0000013394.V281564.R01.S.doc Version 5.1 Page 15 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): 26, 27, 28, & 30. Service users can expect to live in a clean, warm and comfortable environment designed to meet their individual needs and providing adequate services and domestic facilities. Service users can be assured that, generally, the home is maintained as a safe environment in which to live without unnecessary risk. EVIDENCE: Seven requirements related to premises issues at the last inspection visit, the majority of these have been resolved, at least in part - just two remain. Outstanding issues relate to completing the ongoing refurbishment of bathrooms, and the need to provide more than the current four lockers to ensure that staff members have a secure (but not necessarily huge) space in to which to individually lock their possessions whilst on duty. Improvements of note include the removal of unnecessary locks on bedroom doors, the cleaning up of the patio area, the replacement of faulty extractor fans throughout, and the provision of new non-slip mats for bathroom and shower areas. Medihands Healthcare (149) DS0000013394.V281564.R01.S.doc Version 5.1 Page 16 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): 35. Service users can be assured that they will be supported at all times by staff who are trained and competent in their work, staff being provided in sufficient numbers to meet service user’s identified needs. Service users can expect to be provided a service that ensures their safety and protection from abuse through thorough recruitment processes, and ongoing staff support arrangements. EVIDENCE: All key standards were inspected at the last visit (standards 32 to 35 covered only standard 35 ‘almost met’) - and the above judgement statements cover these outcomes - reiterated here for information. Standard 35 was revisited at this inspection and the acting manager admitted that the training profiles were still being compiled, but were not in place as yet - and did not comprise an effective planning tool - which is the goal for such a recording system. The requirement therefore is reiterated. The acting manager also assured the inspector that sufficient staff were now enrolled onto the NVQ in care (or ‘health & social care’) - at level 2 or 3 - to attain the minimum ratio of at least 50 of care staff in the home being qualified to this level. Medihands Healthcare (149) DS0000013394.V281564.R01.S.doc Version 5.1 Page 17 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, 38, 41, 42 & 43. The home operates systems that ensure that service users benefit from a reasonably well-run and managed, and generally safe environment, however the need to recruit to the management position is urgent, and clarification of the role of the registered provider and support services manager the would benefit all at the home. Service users can be assured that generally their rights and interests are well served and protected through the home’s approach to record keeping, policies & procedures, and through the day-to-day conduct of the home. Service users can be assured that their welfare and health & safety is, in general, safeguarded through the home’s adherence to appropriate guidance and regulations concerning best safety practice. EVIDENCE: The overriding issue arising at this inspection is that of the need to urgently appoint a manager to take over the day-to-day running of the home - the previous incumbent of this post had only recently left the home, after a time of Medihands Healthcare (149) DS0000013394.V281564.R01.S.doc Version 5.1 Page 18 great uncertainty regarding his post at the home. Almost to the point of his leaving the post, the possibility of his completing his registration with the Commission was also ‘on the cards’ - so it is important for the proprietor, Mrs Sawmynaden to seek a replacement in the earliest possible timescale. In the interim, Mr Sawmynaden - the proprietor’s husband - is temporarily acting into the role as manager. The proprietor is required to keep the commission informed of any appointments being made in respect of managing the home and the inspector will be keeping a keen interest in this process. The inspector includes (in italics) directly below a (slightly edited) statement from the last inspection report - which is an area that needs close attention to ensure a clear future for the management of the home: Clarification of the role of the day-to-day (registered) manager - and this relationship to the proprietor and her husband both of whom are significantly ‘on site’ – is essential to the smooth long-term running of the establishment. Once registered, it is the case that the manager has the overarching responsibility to run the home - and should therefore be ‘left to it’ – to evolve / develop their own management style and influence. A clearer designation of management roles and responsibilities must be evolved and agreed; it is essential that such clarity be introduced. This will then leave the proprietor (or a nominated representative) – as the ‘registered responsible person’ – to undertake the required monthly statutory Regulation 26 visits (which are currently not undertaken and remain outstanding) - checking that the manager is undertaking the day-to-day job competently. The registered provider is also required to ensure that all policies and procedures are dated and countersigned by herself or a senior representative or the new registered manager, that health and safety issues relating to window safety, risk assessments, fire alarm checks and fire drills are completed. Attention to creating a business and financial plan for the home is also required, to inform the long-term development of the home - leading to a formal development plan. Health & safety issues such as the inspector checking temperature-monitoring checks, fire alarm testing and other associated records were all found to be in order. Medihands Healthcare (149) DS0000013394.V281564.R01.S.doc Version 5.1 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 X 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 X 23 X ENVIRONMENT Standard No Score 24 X 25 X 26 3 27 2 28 2 29 X 30 3 STAFFING Standard No Score 31 X 32 X 33 X 34 X 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 X X X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 3 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X 2 X 2 2 X X 2 1 2 Medihands Healthcare (149) DS0000013394.V281564.R01.S.doc Version 5.1 Page 20 Are there any outstanding requirements from the last inspection? YES 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 Requirement Timescale for action 31/03/06 15(1) & The Registered Provider must 15(2)(b) (c) ensure that each Service User Care Plan is reviewed at least every six months, with the involvement of the service user, and updated to reflect changing needs. Timescales of 01/05/05 & 24/12/05 not met. 13(2) In regard to the handling of medication and following the advice of the visiting Consultant Pharmacist: [a] A training matrix must be established to show dates and types of training undertaken by staff in regard to this discipline. [b] Service users must be asked to sign to indicate their consent to medication being administered and also to agree that any additional medication obtained by them is notified to the home. 2. YA20 31/03/06 Medihands Healthcare (149) DS0000013394.V281564.R01.S.doc Version 5.1 Page 21 [c] ‘PRN’ criteria / profiles must be established for any service user on medicines which may be give ‘when required’ clearly stating the criteria under which they may be administered. Timescale of 24/12/05 for the three above elements not met (two elements were ‘met’). 3. YA27 23(2)(b) Bathrooms - especially in 31/03/06 house no 151 - need refurbishment as discussed with the proprietors at the time of the inspection visit. Timescale of 24/12/05 not met. Staff lockers must be provided in sufficient quantity that all staff members be able to individually lock away their possessions when on duty in the home. Timescale of 24/12/05 not met. The Registered Provider must ensure that individual staff’s training profiles are developed. Timescales of 01/05/05 & 24/12/05 not met. A clear job description, stating the lines of responsibility and governance in the home must be evolved - clearly stating the respective roles of senior members of the organisation. The registered provider must urgently seek out and appoint a new suitably qualified and competent manager for the home and subsequently DS0000013394.V281564.R01.S.doc 4. YA28 23(3) 31/03/06 5. YA35 18(1)(c) 31/03/06 6. YA37 9 24/03/06 7. YA37 8&9 31/03/06 Medihands Healthcare (149) Version 5.1 Page 22 propose them for registration to the Commission. 8. YA38 26 The Registered Provider must implement unannounced monthly visits (under Regulation 26’) to the home. The purpose of these being to monitor and to inspect the quality of the facilities and service provided (the ‘conduct’ of the home). A written report must be prepared following these visits, and copied to the Commission. Timescale of 24/12/05 not met. The Registered Provider must ensure that all policies and procedures developed are signed - and dated in order to maintain their regular review. Timescale of 24/12/05 not met. All risk assessments must be fully completed, signed and dated to ensure that the document is fully understood by all and therefore effective. Timescale of 24/12/05 not met. 31/03/06 9. YA41 24(1) 31/03/06 10. YA42 13(4) 31/03/06 11. YA42 13(4) One window on a landing 31/03/06 staircase in 149 (pointed out to the support services manager) must be protected / restricted - as with other similar window areas - to avoid accident risks in this communal space. Timescale of 24/12/05 not met. The fire alarm ‘fault’ in 151 noticed by the inspector - was to be investigated and rectified immediately that day by DS0000013394.V281564.R01.S.doc 12. YA42 23(4) 24/01/06 Medihands Healthcare (149) Version 5.1 Page 23 professional intervention. 13. YA42 23(4) All staff must undertake fire drills on an annual basis. Fire drills must be increased to ensure all staff, including night staff members are drilled. The registered provider must ensure that a business and financial plan for the home is available, to inform the longterm development of the home. Timescale of 24/12/05 not met. 31/03/06 14. YA43 24 & 25 31/03/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA6 Good Practice Recommendations That documentation relating to service users should be rationalised - to avoid recording in so many different ‘types’ of record books. Ideally all records should be centralised in one continuous document or location - the existence of special report book / daily progress report book / night report book / review book adds to confusion and an apparent lack of cohesive recording and joined-up work with individuals. That at least 50 of care staff employed at the home should be qualified to NVQ level 2. That the Registered Provider should develop an annual development plan for the home (39). That the Registered Provider should ensure that meetings involving service users are facilitated on a more regular basis in order to allow service user’s views to be taken into account in the development of the home (39). 2. 3. 4. YA32 YA39 YA39 Medihands Healthcare (149) DS0000013394.V281564.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Croydon, Sutton & Kingston Office 8th Floor Grosvenor House 125 High Street Croydon CR0 9XP 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 Medihands Healthcare (149) DS0000013394.V281564.R01.S.doc Version 5.1 Page 25 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!