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Inspection on 05/10/05 for Mill House

Also see our care home review for Mill House for more information

This inspection was carried out on 5th October 2005.

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

The inspector 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 4 statutory requirements (actions the home must comply with) as a result of this inspection.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

When asked what the service does well, Mrs Revelle said that she felt Broad Horizons Limited, in their three care homes, were able to offer a homely environment. Service users are involved in the daily domestic duties, as they are able, and this was evidenced from record keeping and observation. The one service user able to communicate verbally confirmed that they were happy living at Mill House. They spoke of the support and assistance given in their care. The other two service users were not able to express their views of the care they received, but from observation and body language they appeared to be contented and settled in the home. Within the service Broad Horizons Limited has a small, established staff group. Relationships between service users and care staff were seen to be sensitive and caring and established friendships have developed within the service user group.

What has improved since the last inspection?

Mrs Revelle said that Broad Horizons Limited had undertaken a review of their policies and procedures and some revision and amendment had been necessary. Within Broad Horizons Limited, nine staff have completed three modules of the Learning and Disability Framework (LDAF) training entitled Safe Practitioner, Communication and Adult Abuse Awareness. National Vocational Qualification (NVQ) level 2 training has been progressed and the majority of staff have completed or are working towards completing this training. Two care staff are awaiting a final module/assessment visit to complete NVQ level 3 training in care.

What the care home could do better:

Mrs Revelle said that Broad Horizons Limited recognises the need to continually review and update training for care staff. It was acknowledged that this was a way to help ensure that `staff are equipped for the job.` The need to continually decorate and maintain the care home, inside and out, was highlighted by Mrs Revelle. Ongoing work in all three properties is planned with kitchen renovations and garden hard landscaping planned in each home. Whilst it is acknowledged that great strides have been made in the presentation of the Statement of Purpose and the Service Users` Guide, the need to develop a Service Users` Guide in a format easily readable by the service users is highlighted once again in this report. Quality assurance and quality monitoring systems need to be developed and established and continued review and updating of policies and procedures still require attention.

CARE HOME ADULTS 18-65 Mill House 102 Mill Road Mile End Colchester, Essex C04 5LJ Lead Inspector Pauline Dean Final Announced Inspection 09:30 5 - 6th October th Mill House DS0000017887.V255930.R01.S.doc Version 5.0 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 Mill House DS0000017887.V255930.R01.S.doc Version 5.0 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. Mill House DS0000017887.V255930.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Mill House Address 102 Mill Road Mile End Colchester, Essex C04 5LJ 01206 845378 01206 843367 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) Broad Horizons Limited Miss Sarah Walsh-McKechnie Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Mill House DS0000017887.V255930.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Persons of either sex, under the age of 65 years, who require care by reason of a learning disability (not to exceed 3 persons) 14th December 2004 Date of last inspection Brief Description of the Service: Mill House is an established, small care home for three younger adults with learning disabilities. The registered provider is Broad Horizons Ltd. The responsible person is Mrs Jean Revelle. The registered manager is Miss Sarah Walsh-McKechnie. Mill House is one of a group of three small care homes located in Mill Road, Colchester. The three homes work in close co-operation with each other. The home is found in a residential area of Colchester, located close to Colchester General Hospital. There are local shops and facilities nearby, with the main town centre offering shopping and leisure facilities a short bus ride away. Accommodation for the three service users is on the ground and first floor; each having a single room with a wash hand basin. There is a bathroom with bathing and shower facilities, and a toilet. An office/staff bedroom is also found on the first floor. On the ground floor there is a lounge/dining room and kitchen. The property is semi-detached and has gardens to the front and rear. There is some off the road parking. The rear garden is enclosed with a decking patio area, flowerbeds and lawns. Mill House DS0000017887.V255930.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection, which took place over two days in October 2005. This was the first inspection of the inspection year 2005 to 2006. Throughout the two day inspection there was discussion with the responsible individual, Mrs Jean Revelle. Miss Sarah Walsh-McKechnie, the registered manager was not present during this inspection. A senior care officer assisted the inspector during the inspection. The three small care homes of Broad Horizons Limited were inspected over the two day period of the 5th & 6th October 2005, with the inspector moving from one home to the other during the inspection. A total of 15½ hours was spent on the inspection in the three care homes. Three members of the care staff were interviewed and all service users were met and spoken with during this inspection. No visitors or relatives were interviewed during this inspection. Tours of the premises were conducted during the inspection and both care and staff records were sampled. In addition, some of the policies and procedures were sampled and inspected. Twenty-six of the forty-three standards were inspected; of these twenty-one were met, with five standards nearly met. One standard was not inspected and was carried over as a requirement from the last inspection. There is a marked improvement in meeting requirements since the last inspection. The shortfalls noted relate to the production of a Service Users’ Guide in a format that would be readily understood by Service Users; the management of medication and self-medication; staff supervision; quality assurance and quality monitoring processes; and the need to review and revise policies and procedures. What the service does well: When asked what the service does well, Mrs Revelle said that she felt Broad Horizons Limited, in their three care homes, were able to offer a homely environment. Service users are involved in the daily domestic duties, as they are able, and this was evidenced from record keeping and observation. The one service user able to communicate verbally confirmed that they were happy living at Mill House. They spoke of the support and assistance given in their care. The other two service users were not able to express their views of the care they received, but from observation and body language they appeared to be contented and settled in the home. Within the service Broad Horizons Limited has a small, established staff group. Relationships between service users and care staff were seen to be sensitive and caring and established friendships have developed within the service user group. Mill House DS0000017887.V255930.R01.S.doc Version 5.0 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. Mill House DS0000017887.V255930.R01.S.doc Version 5.0 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 Mill House DS0000017887.V255930.R01.S.doc Version 5.0 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): 1 & 2. Clear detailed information, by the way of the Statement of Purpose and the Service Users’ Guide, is provided to placing authorities, prospective service users and their families to enable them to make a choice of whether they wish to be admitted to the home. Prospective service users’ individual needs and aspirations are assessed prior to admission to ensure that the home is able to meet their needs. EVIDENCE: The home’s Statement of Purpose and Service Users’ Guide have been reviewed and revised, in terms of content, to meet requirements. There is, however, still a need for Broad Horizons Limited to further develop the Service Users’ Guide into a briefer and more accessible format for the current service user group. Mill House DS0000017887.V255930.R01.S.doc Version 5.0 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 & 9. Service users’ assessed and changing needs and personal goals are detailed in their individual care plans to help ensure that their personal needs are met. Care planning records detail service users’ right to make decisions about what they wish to do. Overall, staff enable service users to take responsible risks with both risk assessments and risk management strategies in place. EVIDENCE: Individual plans of care are in place for all service users. All aspects of health, personal and social care needs are identified and planned for within nine aims and a personal needs section. Within this documentation there was evidence of service user involvement in the management of their care needs. Records detailed choices made and acted upon. Risk assessments and risk management strategies have been developed and are detailed within the care planning documentation. Mill House DS0000017887.V255930.R01.S.doc Version 5.0 Page 10 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 & 17. Service users are supported and enabled to have opportunities for personal development through the provision and promotion of appropriate leisure and training activities in the community. Family contact and visiting arrangements are open and relaxed, with family links promoted and encouraged. The home offered a healthy, varied, planned menu, with consideration given to preferences and dietary requirements. EVIDENCE: Service users are enabled and supported to participate in local community activities. One service user recently admitted to the home is able to visit friends and access leisure activities and courses in the Colchester area as they wish. The only current restriction is finances to support these outings. They have the services of an Occupational Therapist and a Community Pyschiatric Nurse. The remaining two service users are supported and escorted to access local community activities. Care planning records detailed outings to Colchester town, socialising with other service users in the two other Broad Horizons Mill House DS0000017887.V255930.R01.S.doc Version 5.0 Page 11 Limited care homes and visiting the holiday caravan at St Osyth. Unfortunately a social club attended by the service users has recently closed. It is hoped that this is only temporary. All of the current service user group are unable to engage in employment as their skills are limited and outside this attainment. Links with families and friends are supported and encouraged. All of the service users at Mill House have links with relatives, with day and overnight visits encouraged. Contact is also maintained through telephone conversations if service users are able. Records were seen to support service users’ rights and responsibilities. This was with regard to the provision of a bedroom key and a front door key. Of the three service users resident, none of them currently hold any keys, although this maybe reviewed with regard to the most recent admission. An on going review of care planning records, with detailed risk assessments, will need to be completed. During the inspection, service users were seen to choose and select their lunchtime menu. Detailed records are kept of how this selection is made. Service users are encouraged in assisting with the preparation of food and drinks, as they are able, and service users were seen to lay the table and clear away after the meal. As part of their care, one service user shopped for and prepared a roast dinner for all three service users. They were assisted by the Occupational Therapist. All enjoyed the meal. Mill House DS0000017887.V255930.R01.S.doc Version 5.0 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 & 21. Service users’ personal and healthcare needs are met within the home and records evidenced that service users are supported to access healthcare professionals as needed. The administration of medication for service users was found to be detailed and recorded to help ensure that service users’ health needs are met. Self-medication practices and requirements need attention to help safeguard service users. The management of ageing, illness and death of a service user needs to be further considered to help ensure that staff and management deal with these matters with sensitivity and respect. EVIDENCE: Care staff spoke of ways in which they support and provide personal care to the service users. They detailed action they would take to ensure that these tasks are managed in a sensitive manner respecting privacy and dignity. One service user told the inspector that they were able to get up and go to bed as they wished, requiring only support in managing their personal care needs. Care planning documentation further evidenced this. All three service users use the service of a local GP surgery located across the road. Service users are escorted to GPs visits as needed and are supported in decisions made about healthcare/medical treatment. Other healthcare services are used as required. Records on care planning files evidenced this. Mill House DS0000017887.V255930.R01.S.doc Version 5.0 Page 13 Medication storage, administration and medicines entering and leaving the home were sampled and inspected for two service users. The records were found to be in good order, with adequate secure storage. On the first day of the inspection the management and storage of medication held by a service user, for self-medication, was not meeting requirements. Broad Horizons Limited took immediate action. Management and the service user completed a risk assessment around the storage of this medication. Lockable storage space was to be provided by the end of the day and medication was to be dispensed in suitable packaging to enable dispensing and secure storage. As with all other medication held in the home records are to be kept of this medication, with care staff and management continually monitoring the management of these medications. Further risk assessments on the ability of the service user to self-medicate need to be implemented, monitored and reviewed. Mill House DS0000017887.V255930.R01.S.doc Version 5.0 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): 22 & 23. Appropriate practices were in place to help ensure that service users’ views are listened to, acted upon and their protection is promoted. Staff training, the awareness of management and staff, policies and procedures and staff recruitment practices help to safeguard this. EVIDENCE: The home’s complaints procedure was seen to be in place and is to be found with the Service Users’ Guide and in care planning documentation. A simple pictorial complaints procedure has been drafted for service users. A member care staff interviewed was aware of this procedure and said that should they have any concerns they would take them to the registered manager. Equally they had a good understanding of the Adult Protection Procedure and again they would raise any concerns with the registered manager. Recent Adult Abuse Awareness training under LDAF training had further enforced this procedure. Mill House DS0000017887.V255930.R01.S.doc Version 5.0 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): 24 & 30. Mill House provides a safe, homely and pleasant environment, which was clean and comfortable. EVIDENCE: Mill House offers accommodation in a domestic type dwelling. It was light, bright and airy and is in keeping with the local community in a residential area. Decoration and maintenance is ongoing. Mrs Revelle said that the home plans to re-decorate the bedroom of the service user most recently admitted to their liking. This was confirmed by the service user in conversation with the inspector. The remaining two bedrooms and the lounge/dining room have been decorated to the liking of the service user group and new work surfaces, cupboards, kickboards and a sink unit are planned for the kitchen. Mrs Revelle said that these changes are to be completed by Christmas 2005. Some landscaping and changes to the front and rear gardens are planned for Spring 2006. A domestic washing machine is located in the kitchen, with a dryer fitted in the garden shed. They were found to meet requirements. Mill House DS0000017887.V255930.R01.S.doc Version 5.0 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): 32, 33, 34 & 35. Staffing levels and skills are appropriate to the needs of service users. There are appropriate recruitment procedures in place. An induction and basic staff training programme helps to ensure that training and skills requirements are identified and met. EVIDENCE: Broad Horizons Limited have introduced Learning and Disabilities Framework (LADF) Training for all care staff. A total of nine staff have completed three courses – Safe Practitioner, Communication and Abuse Awareness training. In addition, National Vocational Qualifications (NVQ) training is encouraged. One senior care staff member at Mill House said that they are about to commence NVQ level 2 in care. The majority of care staff at Broad Horizons have completed or are completing NVQ level 2 in care. Mrs Revelle said that she hopes to meet the requirement of having 50 of care staff in each home achieving a care NVQ level 2 by the end of 2005. Within the staff group of Broad Horizons Limited there is a worker who is aged under 18. They are on a BTEC Business Management course and undertake domestic duties only. Mrs Revelle said that this worker works under the direct supervision of qualified staff and does not undertake personal care tasks. Mill House DS0000017887.V255930.R01.S.doc Version 5.0 Page 17 At this inspection clarification and confirmation of staffing levels, being determined with consideration to the Department of Health Residential Forum Guidance, was requested. An immediate requirement was left with the registered manager and subsequently calculations and staffing levels have been sent to the Commission. Current staffing care hours at Mill House are calculated to be 133.83 hours, with the provision of 168 hours detailed in an action plan. The need to regularly review staffing levels with regard to service users’ changing needs is highlighted. The file of one care staff member was sampled and inspected. This contained evidence that all the required checks, including references, Criminal Record Bureau (CRB) and Protection of Vulnerable Adults (POVA) checks, had been satisfactory carried out and copies of relevant identification documents had been obtained e.g. birth certificate, passport and photograph. A copy of Terms and Conditions were seen. The General Social Care Council (GSCC) code of conduct and practice was not considered at this inspection. Standard 36 – relating to staff supervision and support was not considered at this inspection. As this was statutory requirement at the last inspection, this is carried over in the requirements of this inspection and will be reviewed at future inspections with the registered manager. Mill House DS0000017887.V255930.R01.S.doc Version 5.0 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 40 & 42. Staff and service users are well supported by the home’s manager, who is hands-on and part of the care team in the home. An effective quality assurance and quality monitoring system is still required. The home needs to monitor, review and revise their policies and procedures to help safeguard service users’ rights and best interests. The health, safety and welfare of service users is promoted and protected by the registered manager helping to ensure safe working practices through the implementation of safety certifications, basic training opportunities and knowledge of relevant legislation. EVIDENCE: The inspector was informed that Miss Sarah Walsh-McKechnie, the registered manager has completed the National Vocational Qualification Assessor’s course and is looking to working with her staff on their NVQ training courses. Miss Walsh-McKechnie is currently working on her NVQ level 4 in care and management. One senior care staff member working at Mill House over the Mill House DS0000017887.V255930.R01.S.doc Version 5.0 Page 19 inspection period said that they found the manager to be readily available and supportive. Whilst a quality assurance survey had been completed in the past, Mrs Revelle acknowledged that there is a need to consider undertaking a new survey and to develop an annual development plan. Policies and procedures were sampled and reviewed. In addition to policies and procedures already referred to in this report, the Fire Procedure and Policy was reviewed and was found to meet requirements. It became clear from viewing policies and procedures in each of the three homes that senior care staff were unclear as to the current and old policies and procedures on file. Mrs Revelle was made aware of this and copies of policies and procedures are to be reviewed, revised, amended and dated. Broad Horizons Limited has employed a business consultant to complete an internal audit of the care homes. Some recommendations were made and these were found to be completed. Basic training courses, videos and workbooks help ensure that safe working practices are kept to. Examples of these courses and training are detailed earlier in this report. Mill House DS0000017887.V255930.R01.S.doc Version 5.0 Page 20 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 3 X X X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 X 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X X X X 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X 3 3 3 3 2 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Mill House Score 3 3 2 X Standard No 37 38 39 40 41 42 43 Score 3 X 2 2 X 3 X DS0000017887.V255930.R01.S.doc Version 5.0 Page 21 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 YA20 Timescale for action 12, 13, 14 The registered manager and staff 28/10/05 & 16 must ensure that they encourage and support service users to retain, administer and control their own medication, within a risk management framework, and comply with the home’s policy and procedure for the receipt, recording, storage, handling, administration and disposal of medication. 17, 18 The registered person must 25/11/05 ensure that staff receive support and supervision to carry out the job as detailed in the National Minimum Standards for Care Homes for Adults (18 – 65). (This a repeat requirement. This standard was not inspected at this inspection.) 24(1) The registered person must 25/11/05 ensure that there is an annual development plan for the home, based on a systematic cycle of planning-action-review, reflecting aims and outcomes for service users. (This a repeat requirement. Previous timescale of 07/02/05 not met.) Regulation Requirement 2 YA36 3 YA39 Mill House DS0000017887.V255930.R01.S.doc Version 5.0 Page 22 4 YA40 12-13,1619, 23-24 The registered person must ensure that all policies and procedures are signed by the registered manager and are dated, monitored, reviewed and amended. 25/11/05 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 YA1 Good Practice Recommendations The Service Users’ Guide should be summarised in a clear and accessible format and addressed directly to service users in terms, which can be easily understood by them. Mill House DS0000017887.V255930.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ 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 Mill House DS0000017887.V255930.R01.S.doc Version 5.0 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. 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!