CARE HOMES FOR OLDER PEOPLE
MERRIVALE 90 East Road Burnt Oak Middlesex HA8 0BT
Lead Inspector Rebecca Bauers Announced 25 April 2005 at 11.00am 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 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 Older People. 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. MERRIVALE Version 1.10 Page 3 SERVICE INFORMATION
Name of service Merrivale Address 90 East Road, Burnt Oak, Middlesex HA8 0BT Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 020 8952 7639 0208 951 5310 Carole Sawyers for Fremantle Trust Gillian Smith (new acting manager) Care Home 56 Category(ies) of Dementia - over 65years of age (56), mental registration, with number disorder, excluding learning disability or of places dementia - over 65 years of age (56), old age, not failing within any other category (56) MERRIVALE Version 1.10 Page 4 SERVICE INFORMATION
Conditions of registration: None Date of last inspection 9 November 2004 Brief Description of the Service: Merrivale Residential Home is registered to provide care to fifty-six service users over the age of 65, who have a mental health diagnosis or a diagnosis of dementia. The home has transferred from local authority responsibility to being run by Fremantle Trust. The home is divided into eight units and includes two dedicated respite units one of which is for people with dementia. The units accommodate between five and nine service users and have lounge, dining room and kitchenette. The units are staffed separately. The building has three floors. The ground floor has one respite unit and one mainstream unit. The second floor has one respite unit and two units for people with mental health needs. The third floor has one mainstream unit and two units for people with dementia. There are mature gardens to the front and rear of the premises. The overall aim of the home is: “To provide a high standard of care and support that is tailored to meet individual needs taking account of each service users right to exercise choice and self-determination in pursuing their own lifestyle.” MERRIVALE Version 1.10 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection took place on the 25th of April 2005 as part of the annual inspection programme to identify progress with previous requirements and to check standards of care against the core standard. The inspection took seven and three quarter hours to complete. A full tour of the home took place, twenty-three service users were spoken to in small groups and on and individual basis. No relatives requested to speak to the inspector. Care records, quality assurance audits and health and safety records were examined. Five staff were spoken to and the inspector was able to have discussions with the newly appointed manager, the assistant manager and the service manager. Further information was obtained from the pre-inspection questionnaire and comment cards. Twenty-four comment cards were received from service users, five from health care professionals including GPs and one from a relative. Positive comments were given with regard to the care received and the caring attitude of the staff team. There were mixed feelings expressed with regard to the food provided and access to activities with staff support. What the service does well:
The service users benefit from having detailed assessments of need in place, individual plans are comprehensive providing a holistic view of the individual so that staff are able to follow and provide continuity in care. This is supported by service users who said ‘the staff are very kind, caring and know what I like’. Risk management strategies are detailed ensuring the safety of service users. Social and personal health care needs are met fully by a variety of health care professionals. Service users know how to complain and have been given the relevant contact information to enable them to complain both internally and externally. Quality assurance audits ensure service users views are listened to and acted upon. Staff morale is good which promotes good positive team working. MERRIVALE Version 1.10 Page 6 The health, welfare and safety of service users are protected through regular health and safety checks. What has improved since the last inspection? What they could do better:
Twelve requirements and three recommendations were made at this inspection. One requirement was restated concerning the administration of medication and ensuring the records are completed appropriately this includes the controlled drug register. Further requirements were made for the record listing authorised trained staff members who administer medication to be updated. This is essential for the safe administration of medication to service users. In addition the returns book needs to be signed by the pharmacist.
MERRIVALE Version 1.10 Page 7 Requirements have been made for the re-decoration of the home to make it more homely and comfortable for service users and for a maintenance plan to be sent to the Commission. The smell of urine in two of the units must be eradicated to ensure a pleasant environment for service users, visitors and staff. Service users views with regard to food ranged from ‘good to awful’ a review of the food provided in the home must be undertaken in order to meet the preferences of service users ensuring that the menus remain nutritionally balanced. Staff who handle food must have food hygiene training to ensure the safety of service users. Some service users stated that they felt lonely at times and would love to be able to have regular visitors who could chat with them and maybe go out for a coffee. A recommendation is made for efforts to be made to introduce befrienders or volunteers into the home following appropriate checks. Requirements are made for additional staff cover during specific times of the year when service users wish to go out and for the staff vacancy to be filled permanently to ensure service users are familiar with the staff that support them and feel safe. A recommendation has been made for rotas to be revised to promote clarity of designated roles of staff on duty; duty times and colour codes need an identification key. Staff training records must be reviewed to ensure that staff training needs are identified and that they are fully competent to support the service user group. Requirements have been made for specific mental health training in schizophrenia and anorexia. A recommendation is made for staff to receive IT training. Two references must be obtained for one member of staff. Until that time she must not work unsupervised. This is to ensure the safety of service users. Information must also be obtained to clarify her leave to remain in the UK. The newly appointed manager must apply to the CSCI to become registered. A recommendation is made for the filing system to be reviewed to make information more accessible to all staff. Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office.
MERRIVALE Version 1.10 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection MERRIVALE Version 1.10 Page 9 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,3 Service users are provided with the information that they need to make an informed decision about where they want to live. Full assessments of need are carried out prior to moving in to ensure that service users needs can be met by the home. EVIDENCE: There have been fourteen new admissions in the last twelve months. Service users are given information they need to make an informed decision about where to live. The homes statement of purpose is a document provided to all service users prior to admission. There was evidence in four of the new admissions files sampled that full assessments had taken place to ensure that service users needs are identified and that they can be met by the home. The initial assessments had been used to develop full individual plans for each service user identifying clear support needs. Following admission the service user is assessed over a number of
MERRIVALE Version 1.10 Page 10 days to enable staff to develop a thorough understanding of their abilities and needs. Reassessments are a feature of the home to ensure that service users needs are assessed on a regular basis. The home does not provide an intermediate care service. MERRIVALE Version 1.10 Page 11 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9,10 Service users health, personal and social care needs are clearly identified in their individual plans enabling staff to be consistent and caring in their approach when supporting service users. Service users are treated with respect and their rights to privacy are upheld. Medication policies and procedures are not being followed correctly to safeguard service users. EVIDENCE: Detailed individual plans of care are in place specifying service users personal, social and emotional care needs. These had been reviewed monthly with changes in need clearly documented to ensure all staff are aware of any changes to care. Annual reviews and in-house reviews involving the service users, key worker and the service user family are held every six months. Pen pictures and personal lifestyle summaries have enabled service users to be confident that staff have a good knowledge of their previous life and experiences including professions, likes, dislikes, family, interests and values. This information has proved to be essential for staff to be consistent and stimulating in their approach and conversation with service users. Service users preferred terms of address and the way in which they prefer to receive
MERRIVALE Version 1.10 Page 12 personal care is documented fully ensuring that respect and their right to privacy is upheld. All service users confirmed that they are supported with all personal care in a respectful manner by the staff and confirmed that their privacy is maintained. Staff were seen knocking on individual service users bedroom doors prior to entering. Examinations by health professionals and discussions with other advisers are carried out in the service user’s own rooms. Comment cards received stated that service users felt ‘well cared for and that privacy is respected’. Relative comment cards state ‘ the care is excellent’. Appropriate detailed risk assessments for the prevention of falls and manual handling and lifting are in place to protect the health, welfare and safety of service users. These are reviewed monthly. Medication policy and procedures are still not being followed by staff to safeguard service users. This must be rectified. A requirement made for the administration of medication in the home to be accurately recorded and any refusal appropriately signed for had not been fully complied with. Gaps were found in four of the five records sampled for the administration of medication, Controlled drug records had not been signed by two staff following administration on several occasions. The list of staff trained and authorised to administer medication is dated 2001 and needs to be updated in accordance with recent medication training. Medication returned to the pharmacist is not be signed by the pharmacist to evidence receipt of medication. This must be rectified. Service users feel confident that their health care needs are well met. Service users receive input from health care professionals such as CPN’S, district nurses, psychiatrists, GP and psychologists. All interventions had been fully documented in the individual service user records in the health section. MERRIVALE Version 1.10 Page 13 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14,15 Service users lifestyle expectations and recreational needs are not being met fully to enable them to lead fulfilling stimulating lives. Service users do maintain good regular contact with family and friends although there are no representatives from the local community visiting individual service users. Food provided is wholesome and balanced but not always appealing to service users. The storage of frozen food is inappropriate and a risk to health and welfare to service users and staff members EVIDENCE: Service users were mixed in their views with regard to their lifestyles in the home. Some service users felt satisfied with the recreational activities provided in the home and the occasional visit to the pub or café. One service user does voluntary work. Others felt that they would like to get out of the unit more particularly during the summer months but were aware that there was not always enough staff on duty. This must be addressed to enable service users more flexibility. Service users maintain contact with family and friends on a regular basis, during the inspection day a number of relatives visited the home. Service users were seen participating in group activities for example, armchair exercises, listening to old time music, watching black and white films. Others were seen reading, listening to the radio and watching TV in their own
MERRIVALE Version 1.10 Page 14 bedrooms. Service users said they sometimes get lonely and could do with some company and someone to talk to, a befriender or volunteer would be ideal in some cases. Discussion with regard to the food provided was very mixed, some service users stated that they liked the food, others stated it was not very nice, one said the ‘liver is always too hard’ alternatives to the four week menu are offered and specialist dietary requirements such as low fat or reduced sugar for diabetic service users is provided. Mealtimes are flexible and are provided to meet individual service users preferences. It is clear also from the homes own quality audit questionnaire that food provided is a contentious issue and that further consultation and review of the menus is required. The home does not currently have a full time cook working in the home although they have appointed one and are waiting for the staff members CRB check. The storage of food in the freezer was not acceptable, frozen meat had been stored with pastries; this is a health and safety issue for service users and staff. All staff involved in handling food must have food hygiene training. MERRIVALE Version 1.10 Page 15 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16,18 Service users do feel confident that their concerns are listened to by staff and acted upon. Staff are adequately trained to protect service users from abuse. EVIDENCE: The home has a clear complaints procedure in place that is readily available to service users. Service users also had a copy of the commission address and telephone number in their rooms if they had issues they wished to discuss. Service users spoken to confirm that they felt at ease with staff to share any concerns, this had been borne out in the comment cards and the homes own quality assurance audit. The complaints record showed that there had been five complaints since the last inspection, one recent complaint was still being addressed by the service manager for Fremantle and the placing authority. A decision is yet to be made if a strategy meeting is to be held. The remaining four complaints had been investigated and outcomes had been fully documented. Service users are protected from abuse, staff spoken to had recently received adult protection training and are familiar with the reporting procedures in the event of an allegation of abuse. The home has robust adult protection procedures in place. MERRIVALE Version 1.10 Page 16 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,22,23,26 Service users live in a safe environment that is however in need of serious redecoration. Bedrooms are comfortable and personalised; aids and adaptations are available to meet service users mobility and safety needs. The home is clean but there is a problem in two units that smell of urine. EVIDENCE: Progress had been made following a requirement for the call bell system including all bleeps to be repaired or replaced. The call bell system is working effectively; service users were knowledgeable with regard to the safety reasons of the call bell system and confirmed that response times by staff were good. Each floor and the office have a bleeper in place. During a tour of the entire building including individual kitchens it was evident that the home had not been re-decorated for some time, paintwork was chipped, walls in the kitchens had been splattered with grease, and wall paper in some of the bedrooms was coming away from the walls. Some of the areas
MERRIVALE Version 1.10 Page 17 of the home were quite dark and had a cold feeling not a warm inviting feeling; service users felt that each of their units needed freshening up. The following areas need to be addressed and re-decorated: 1. In one particular kitchen the cooker was old and tired looking and needed replacing. 2. Communal areas are tired and in some places dark, these must be redecorated, including woodwork. 3. In some cases service users wallpaper in their bedrooms was coming away from the walls this must be replaced. 4. Two of the units smelt of urine, this smell must be eradicated 5. In one of the units on the ground floor the assisted bath is not used by service users because they prefer a hoist assisted bath and so are currently using the bath in another unit. Consideration must be taken to replace the bath with one that suits the preferences and need of the service users. The service manager for Fremantle explained that they had identified that a great deal of maintenance is work needed to make the home more comfortable and homely. A maintenance plan must be developed and submitted to the Commission. Service users individual bedrooms had been personalised with their own possessions and were safe. The home was generally clean and hygienic with the exception of the two units that smelt of urine. MERRIVALE Version 1.10 Page 18 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,29,30 Service users needs are not being fully met by the numbers and skill mix of staff. Recruitment procedures are thorough although there has been one omission in one staff file. Staff training records are incomplete. EVIDENCE: The staffing levels in the units are based on the level of need of the service user group; there is an additional ‘floating’ member of staff on duty that acts as extra cover as and when needed. This additional ‘floater’ has proven to be insufficient in some instances according to service users and staff. The feeling is that in order for service users to gain a level of independence and flexibility with regard to accessing the community even for short period of time, there is not enough staff on duty to achieve this. The floater is usually being used for additional personal care support. This issue must be addressed to enable service users at least during the summer months to access the community and to provide more flexibility across the home. The staff rota does not provide clarity with regard to staff roles, start times and colour codes this must be rectified to ensure that all staff can understand the rota. Service users spoke very positively about the staff stating that they were ‘great, don’t know what we would do without them’, ‘ staff are very caring and helpful I can’t fault them’. Staff were seen interacting positively with service users and some staff had been working in the home for five or more years. There was evidence of a recent recruitment drive to reduce the use of agency to try to promote continuity of care for service users. The level of agency staff
MERRIVALE Version 1.10 Page 19 must be further reduced and the 30-40 hour a week vacancy must be recruited to. Six staff files were seen for newly recruited staff all contained POVA and CRB checks. All but one contained two references. The one file that does not contain two references means that the staff member must not work alone; in addition documentation from the home office stated that her leave to remain in the UK expired on the 9/2/05. These issues must be rectified so that appropriate information is held on file and to safe guard the service users. Staff training files were incomplete and must be reviewed to identify current training needs to ensure that staff are competent to support the service user group. Training must be provided to reflect the current service users mental health issues such as schizophrenia and anorexia. As mentioned previously food hygiene training is essential for all staff that handle food. Staff stated that IT training would benefit them in the development and revision of service users individual plans. Staff acknowledged that they had received training in dementia care; medication, vulnerable adults and some staff are undertaking NVQ assessors training. MERRIVALE Version 1.10 Page 20 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,33,3638 The home has a newly appointed manager who has not yet registered with the CSCI. Staff morale is good and staff are well supported and receive regular supervision. Service users views are listened to, to ensure that their best interests are accounted for. The health welfare and safety of service users are promoted and protected. EVIDENCE: Progress has been made following a requirement made for all staff to receive supervision at least six times a year. Staff records and staff spoken to confirmed that they now have regular supervision. Staff said that supervision had been of benefit because it has enabled current work practice and training needs to be addressed and monitored which promotes continuity of care to service users. Staff morale is good; staff described positive team working which helps to create a happy relaxed atmosphere for service users. The management of the home is open and inclusive.
MERRIVALE Version 1.10 Page 21 The home has recently recruited a new manager who is currently on induction and who was present throughout the inspection. She must apply to the CSCI to become registered. Quality assurance audits that involve service users demonstrate that the home is working toward running the home in the best interest of the service users. Action plans have been developed to address the issues raised by service users including food provided. Service users have regular meetings where they are able to express any issues or make suggestions. The health, safety and welfare of service users are promoted and protected; all relevant records and certificates were in place. The requirement made for the bin in the kitchen to have an appropriate cover had been achieved. Office files needed were not always easily identifiable for the assistant manger and new manager who were assisting the inspector, it is recommended that the filing system is reviewed to make information more accessible for all staff. MERRIVALE Version 1.10 Page 22 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. Where there is no score against a standard it has not been looked at during this inspection. 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 1 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2
COMPLAINTS AND PROTECTION 1 x x 3 3 x x 1 STAFFING Standard No Score 27 2 28 x 29 1 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 x 2 x 3 x x 3 x 3 MERRIVALE Version 1.10 Page 23 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 9 Regulation 13(2) Requirement The registered provider must ensure that the administration of medication in the home is accurately recorded and any refusal is appropriately signed for. This requirement is restated from the last inspection. Timescale for action was 1/1/05 The registered person must ensure that when controlled drugs are administered two staff sign the controlled drugs book. The registered person must ensure that medication returned to the pharmacist is signed by the pharmacist acknowledging the returns. The list of trained authorised staff to administer medication must be reviewed and updated in each medication file. The registered person must review the menus in consultation with the service users on a regular basis in order to meet their dietary and food preferences. The registered person must provide a maintnenance plan to address the re-decoration of the home including the replacement
Version 1.10 Timescale for action 30/5/05 2. 9 13(2) 30/5/05 3. 9 13(2) 30/6/05 4. 15 16(2)(i) 30/6/05 5. 19 23(2)(d) 31/7/05 MERRIVALE Page 24 6. 7. 26 27 16(2)(k) 18(1)(a) 8. 29 17(2) Schedule 4 (6) (c )(f) 9. 30 17(2)(3) 10. 30 18(1) (c )(i) 18(1)(c ) (i) 11. 30 12. 31 9 (1)(2) of some of the cooking facilities in individual units. A copy of the maintenance plan must be sent to the CSCI. The registered person must eradicate the smell of urine in two of the units. The registered person must supply an extra member of staff as a floater during the months of May and August to promote service users independence and to give them more freedom as per their request to leave the units with staff support. The 30-40 hour a week staff vacancy must be filled by employing permanent staff. The registered person must ensure that the new member of staff who currently does not have two references on her file does not work alone. In additon confirmation is needed from the Home Office with regard to her leave to remain in the UK. Copies of the documentation must be sent to the CSCI. The registered person must ensure that the staff training files are reviewed and updated to include all training received including induction and foundation. The registered person must ensure that staff who prepare and handle food receive food hygiene training. The registered person must ensure that staff receive regular training in areas of mental health that reflect the current service user groups needs. For example schizophrenia and anorexia. The registered person must ensure that the newly appointed manager applies to the CSCI to become registered.
Version 1.10 30/6/05 26/5/05 1/5/05 31/7/05 30/6/05 31/7/05 30/6/05 MERRIVALE Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 13 Good Practice Recommendations It is recommended that the registered person research and identify suitable befrienders or volunteers to visit service users on a regular basis. This would promote independence and promote the development of friendships for some service users who sometimes feel lonely. It is recommended that the rota is revised to show clearly the designation of each member of staff and the times shift start and finish particularl for night staff. A clear key should be provided on the rota so that all staff understnd what diiferent colour codes and symbols mean on the rota. It is recommended that the registered person consider providing IT skills training to enable support staff to update and review individual plans and other documentation related to service users effectively and efficiently. It is recommended that office files are reviewed and organised in such a way to make information more readily availble and accessible to all staff. 2. 27 3. 30 4. 33 MERRIVALE Version 1.10 Page 26 Commission for Social Care Inspection Solar House 1st Floor, 282 Chase Road Southgate London N14 6HA 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 MERRIVALE Version 1.10 Page 27 - 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!
