Inspection on 30/01/06 for Miller Farm

This inspection was carried out on 30th January 2006.

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 no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Miller Farm 13/12/06

Miller Farm 03/11/05

Miller Farm 10/03/05

Miller Farm 23/06/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Miller Farm 66 High Street Worle Weston Super Mare North Somerset BS22 6EJ Lead Inspector Catherine Hill Announced Inspection 30th January 2006 09:30 Miller Farm DS0000043599.V270830.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 Miller Farm DS0000043599.V270830.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. Miller Farm DS0000043599.V270830.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Miller Farm Address 66 High Street Worle Weston Super Mare North Somerset BS22 6EJ 01934 521288 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) Freeways Trust Ltd Mrs Deon Davis Care Home 10 Category(ies) of Learning disability (10) registration, with number of places Miller Farm DS0000043599.V270830.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3rd November 2005 Brief Description of the Service: Miller Farm is a small community home for younger adults with learning disabilities. Some of the residents display behaviour which challenges carers or have severe communication difficulties. The home is on the main street of a suburban area, with easy access to the local shops and services. This is a main bus route for the local town and for Bristol, but the home also has its own minibus. Miller Farm DS0000043599.V270830.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection was conducted during the course of one day. The inspector spent the earlier part of the day looking at records, and the later part of the day talking with staff and residents. The inspection particularly focused on contractual and financial records, care planning and health care plans. The inspector also looked at how well staff practice tallies with planned care, and on how residents and their representatives view the care they are given. Staff had supported six of the residents to complete and return CSCI comment cards before this inspection, all of which were generally very positive but which also reflected areas of particular concern to residents. One comment card had also been returned by a healthcare practitioner associated with the home, and this indicated overall satisfaction with the service being provided in the home. There was a much stronger sense of the team pulling together and working in a structured way towards clear goals. Work systems are better defined, and people are clearer about their roles and are working more effectively. It was evident that residents are being supported to make progress towards meeting their personal goals. There is still some work to be done on improving the residents care recording systems and on ensuring staff can relate to their dayto-day work back to the underpinning aims for each person. Care records also need to more fully reflect the work that is actually being done. The environment has greatly improved over the past year and is much better suited to the people who live in it but some areas still look bare. What the service does well: What has improved since the last inspection? The home’s Statement of Purpose has been updated and now gives accurate and useful information. Fire extinguishers are now being checked on a monthly basis. Miller Farm DS0000043599.V270830.R01.S.doc Version 5.0 Page 6 What they could do better: Four • • • • requirements were made. These concerned: Residents’ contracts Residents’ health care plans Medications reviews Complaints procedures Three recommendations were made. These concerned: • The admissions procedure • Residents’ contracts • Residents’ care records These will help the home to meet legal requirements and to improve already good systems. 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. Miller Farm DS0000043599.V270830.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 Miller Farm DS0000043599.V270830.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): 1-5 Prospective residents or their representatives are enabled to make an informed choice about moving to the home. EVIDENCE: The homes Statement of Purpose has been reviewed since the last inspection, and now provides a good depth of accurate information about the service and the people providing it. It also gives much clearer information on the range of needs that the home can cater for. Some abbreviations have been used in the Statement of Purpose that may not be familiar to all readers, so it is suggested that these are written in full the first time each is mentioned. The admission procedures described in the homes Statement of Purpose describe the Trusts chief executive as having final say in who moves into the home. It is the homes manager who must be responsible for this decision, because they hold the responsibility under the Care Standards Act 2000 as the person registered in day-to-day control of the home. The admission procedures should be amended. The two newest residents files were sampled. Neither of these contained a Freeways Trust contract. One contained a local authority contract with Freeways Trust to which the resident themselves was not party. The other contained no contract at all, only a letter from the placing authority regarding who should pay what towards the fees. It is a requirement of the Care Miller Farm DS0000043599.V270830.R01.S.doc Version 5.0 Page 9 Standards Act 2000 that each resident must have a contract, so the inspector advised that the two new residents are supplied with a copy of Freeways Trusts own pictorial contract. None of the other files sampled contained a contract. It looks like residents contracts were not transferred to the new files when their old information was archived. These contracts are likely to be very out of date by now as key workers and room numbers may have changed, so the inspector recommended that contracts are re-issued to each person. Going through these with residents will be a really useful exercise for reminding people about residents rights and what they can expect from the service. Residents benefit books are still kept at Freeways Trust headquarters. At the time of the last inspection, the Chief Executive was exploring ways of handing this area of control over to residents where practicable. Residents assessments cover their ability to manage their finances, but none of the care plans seen addressed this issue. Ways of enabling individual residents to take more control of their cash were discussed. For example, key workers could remind the person to make use of the cash boxes in their bedrooms, and a note of this strategy could be added to the care plan. Freeways Trust operates a very thorough system for managing residents money. But the records sampled were extremely clear and well maintained. The format of the monthly unannounced visits by the provider is about to be changed so that representatives with different areas of expertise regularly visit the home. One of these representatives will be from the Trust’s accounting department and will carry out a financial audit visit. Miller Farm DS0000043599.V270830.R01.S.doc Version 5.0 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6-10 Residents’ needs are being well met. They are generally well documented but records need to be more thoroughly cross-referenced and be sufficiently detailed. EVIDENCE: The care plans sampled generally gave a good depth of information on each persons particular needs and preferences. The home is moving towards person-centred planning, putting the resident at the centre and giving them as much control over the process as possible. Residents invite the people they would like to participate to review meetings of their care plans, and are involved in service planning. Some of the information on files looked really useful, but it was not obvious whether or not it was current. The inspector recommended that documents like current daily routine are signed and dated. One of the staff has started to draw up a personal profile on a resident. This gives a brief picture of the whole person in a very positive way, with clear Miller Farm DS0000043599.V270830.R01.S.doc Version 5.0 Page 11 indications of how staff can best support them. This could be cross-referenced to other relevant documents - for example, the mention of occasional serious aggression could be cross-referenced to the reactive strategy for this. This document is such a useful summary, particularly for new or agency staff, that it is recommended similar profiles are drawn up with- and for- all the other residents. The inspector also recommended that a front sheet is drawn up for each resident’s file that consists of a brief summary of all the essential information that staff may need to access in a hurry. This could be cross-referenced to other more detailed guidance elsewhere in the file. At present, many documents are not cross-referenced sufficiently. For example, one persons person-centred plan mentions music as a non-negotiable but to no further mention of this was found anywhere in this persons file. Residents’ files are very heavy and cumbersome at the moment due to the volume of old information. Having to manhandle such heavy objects must be very off-putting for staff and is likely to discourage them from using the files. If vital and rarely changing information - such as allergies or key behaviour triggers - is kept on a front sheet, it should be possible to regularly weed out non-current information for archiving, so that it is only up-to-date information on the file. The manager is already looking at setting up new smaller files that key workers can take away from the office to work on. Staff are working much more consistently with individual residents, and the inspector noted that some people have been able to make good progress towards their goals. Addressing the issues outlined above should help to ensure that the day-to-day work staff do with residents directly relates back to their longer-term plans. Each new resident works through an informative introduction book with a key worker to make sure they are given all the information they need in order to be able to settle into the home quickly. This is an excellent idea but the newest residents information on who their key worker, homes manager, line manager, and the home’s inspector are was blank: there were only two staff photos in this information, one of which was a picture of a group of staff, many of whom no longer work at the home. Staff are now starting to ask new residents about their wishes in the event of their death, so that this can be recorded and that their wishes are known in good time. A good range of risk assessments is in place for those people who may be at particular risk. These are designed to protect the person and others around them with a minimum of restriction, but any unavoidable restrictions are negotiated with the person themselves. Miller Farm DS0000043599.V270830.R01.S.doc Version 5.0 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11-17 Each person is offered a good range of interesting activities and opportunities for development. EVIDENCE: The conservatory has now been set up as an arts and crafts area, and the manager has been trying to set up a programme of regular crafts sessions. The team are working towards providing regular scheduled leisure activities for the residents while they are at home. Many residents attend the Freeways Day Centre or use the hydrotherapy pool there. Some attend the local Gateway club. With staff support, residents use community facilities in their leisure time, either individually or in small groups. There are many activities that are shared by several residents, but each person has their own individual timetable that is based on their particular interests and needs. Miller Farm DS0000043599.V270830.R01.S.doc Version 5.0 Page 13 Key workers spend a regular daily working one-to-one with each person doing life skills. This involves basic self-care such as changing bedlinen and doing laundry, but can also be used for one-to-one social and leisure activities. House meetings are held, and staff use a variety of communication methods in an effort to ensure that each persons views are taken into account. Menus are based on residents known preferences, and provide a good balance of nutritious meals that are likely to suit the tastes of this age group. Miller Farm DS0000043599.V270830.R01.S.doc Version 5.0 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18-21 Support is tailored to suit individual needs and preferences. Further development of health care plans is needed. EVIDENCE: Care planning records included information on each person’s preferred means of having support. The senior Freeways Trust manager with line management responsibility for this home has been liaising with the Action for Health Co-ordinator from the local Community Learning Disability Team regarding drawing up health care plans. At present, health care needs are addressed as part of care plans and key worker reviews, but these tend to focus on health problems that are particular to the person, and on routine dental and optician checks. A healthcare plan needs to be drawn up in respect of each person that incorporates all routine health care checks, with the emphasis on early detection of any new ailments as well as the regular treatment of existing ones. This plan should include prompts for the home to request input from other healthcare professionals, such as regular blood tests if necessary, breast screening, and medications reviews. This is particularly important as some residents are on medications that may require regular blood testing. Miller Farm DS0000043599.V270830.R01.S.doc Version 5.0 Page 15 Every so often, staff and observe each other giving out medications to ensure that practice conforms to the home’s written procedure and to highlight any inconsistencies. The medications file has a list of each persons medications with notes on the reverse about their preferences and habits regarding taking the medicines. This helps to ensure that all staff are able to offer the right support to each person. There have been a significant number of medications errors in recent months, and the manager is taking appropriate action to address this. Miller Farm DS0000043599.V270830.R01.S.doc Version 5.0 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Residents evidently feel comfortable to express negative opinions about the staff and the service, and staff respond to this positively. There are effective arrangements in place for protecting residents from abuse. EVIDENCE: Freeways Trust operates a straightforward complaints procedure. However, the complaints procedure outlined in the statement of purpose is slightly different from the one in the complaints file. A symbol-supported format is available for residents use, but much of the information on this about who residents can complain to is out of date. Staff remind residents in house meetings and individually of how they can complain and who to. None of the complaints procedures included CSCIs contact details, as required by the Care Standards Act 2000. The complaints procedure needs to be updated and reissued to residents. No complaints have been received by either the home or the CSCI since the last inspection. Freeways Trust operates a clear and thorough abuse procedure, and all staff have been trained in abuse awareness. Refresher training has been arranged for later this month. Senior management staff are currently drafting a policy on sexuality and relationships. A PoVA (Protection of Vulnerable Adults) issue arose recently. Staff took prompt and appropriate action. The manager was quick to take up additional recommendations made by the CSCI. Further training on the protection of Miller Farm DS0000043599.V270830.R01.S.doc Version 5.0 Page 17 vulnerable adults is planned for all staff, using this incident as a basis for discussion. Miller Farm DS0000043599.V270830.R01.S.doc Version 5.0 Page 18 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 The environment is well suited to the needs of the residents. EVIDENCE: The home was completely refurbished over the past year to provide a better range of facilities that are better suited to the needs of this resident group. Work was started last summer on making the back garden a more accessible space for residents to use. All the bedrooms are single and three have ensuite facilities. There are five communal toilets around the home, three of which are in bathrooms. There is a wet room with a shower in one wing of the building, and a Parker bath in the nearby bathroom. Toilets and bathrooms are well spaced throughout the home so that all bedrooms are within easy reach of one. A ramp leads from the dining room up to the corridor leading to some of the bedrooms. The conservatory is now being used as a craft area. The front lounge has been redecorated and has new furniture that is much better suited to the residents needs. However, the inspector commented that this room is Miller Farm DS0000043599.V270830.R01.S.doc Version 5.0 Page 19 quite bare. The manager is in the process of identifying ornamentation that will make the room more homely without putting the people using it at undue risk. The office is now at the top of the stairs, and the attic has been fitted out for use as a study space for staff. The kitchen was completely refitted, and the kitchen door has a keypad as well as a magnetic hold-open device. Residents are able to use this room to prepare drinks and snacks with staff support. All areas were clean, tidy and fresh smelling, but the inspector commented that the backs of many door handles feel sticky. Miller Farm DS0000043599.V270830.R01.S.doc Version 5.0 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31-36 Residents are protected by safe staffing practices. EVIDENCE: Detailed job descriptions are available for each role within the staff team. All new staff are required to do the LDAF (Learning Disabilities Award Framework) training programme in addition to their basic induction training. Some of the residents have very high needs and it is written into the contracts that they will have set amounts of one-to-one support from staff. Each persons one-to-one time is clearly marked on the rota, and staff are supplied additional to basic staffing levels. Despite two of the full-time staff being on long-term leave, normal staffing levels for this home have been maintained with a minimum reliance on agency staff. This is thanks to the willingness of the permanent staff team to work flexibly and support each other. There is usually a minimum of three staff on duty throughout the day, and two waking night staff. Daytime staffing levels are supplemented by the manager, administrator and driver. One staff member is employed part-time as a driver for the homes minibus. The home also employs a part-time administrator to help with paperwork that is not directly related to residents care. Miller Farm DS0000043599.V270830.R01.S.doc Version 5.0 Page 21 Two newer staff members recruitment records were checked. Copies of their references and evidence of a satisfactory Criminal Records Bureau check were on file. Evidence of ID checks is kept at Freeways Trust headquarters, in agreement with CSCI. Eight of the twenty care staff hold NVQs, and the deputy manager has started NVQ 4. As mentioned earlier, it is planned to give all staff update training on the protection of vulnerable adults. Training on diabetes is also planned for the near future, and support workers will be attending a training session to improve their practice and develop their skills in one-to-one work with residents on life skills. Miller Farm DS0000043599.V270830.R01.S.doc Version 5.0 Page 22 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): 37-43 The home is well managed and has an inclusive ethos. EVIDENCE: Deon Davies, the manager, holds the Registered Managers Award, NVQ 4, the NVQ Assessors Award, City and Guilds Advanced Management of Care, the NVQ Training and Development Award, and is currently training as a Studio 3 trainer in the management of challenging behaviour. Mrs Davies has prioritized her work since taking over as manager of the home. She began by working on building a sense of team spirit and improving staff morale, and has continued this work during all the changes to the environment. Her current priority is organising the system of residents care records to be a clearer, more usable framework for informing staffs day-today work with clients. Miller Farm DS0000043599.V270830.R01.S.doc Version 5.0 Page 23 The staff the inspector spoke with described a really supportive working atmosphere. Individual staff have their own delegated areas of particular responsibility, and there is room within these to be creative. Checklists for each shift are now in use, and staff initial each task on the list when they have completed it. This helps to ensure that all essential tasks are carried out. Staff records included evidence that each person has a formal supervision session at least every two months. All staff hold an Appointed Persons first aid certificate. This is a longer and more in-depth first aid course, in excess of basic requirements, and all staff have a yearly update. All staff also have a yearly manual handling refresher training. Miller Farm DS0000043599.V270830.R01.S.doc Version 5.0 Page 24 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 3 3 3 3 2 Standard No 22 23 Score 2 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 3 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Miller Farm Score 3 2 3 3 Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 3 3 DS0000043599.V270830.R01.S.doc Version 5.0 Page 25 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. 3. 4. Standard YA5 YA19 YA19 YA22 Regulation 5 15 15 22 Requirement Each resident must have a contract. Each person must have a health care plan that addresses all their health care needs. GPs must be asked to carry out the necessary medications reviews. The residents complaints procedure must be updated and a copy given to each person. Complaints procedures must include CSCIs contact details. Timescale for action 30/04/06 30/04/06 30/01/06 30/04/06 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. 2. Refer to Standard YA2 YA5 Good Practice Recommendations The admission procedures should be amended to show that it is the decision of the homes manager whether to admit a resident. Each resident should be given an updated copy of the contract. DS0000043599.V270830.R01.S.doc Version 5.0 Page 26 Miller Farm 3. YA6 Documents should be signed and dated to show which are current. Old, no longer current information should be archived. A personal profile should be drawn up on each resident. Each resident’s file should have a front sheet with all essential information so that it can be accessed quickly. Residents’ care records should be clearly cross-referenced to other related documentation. Miller Farm DS0000043599.V270830.R01.S.doc Version 5.0 Page 27 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 Miller Farm DS0000043599.V270830.R01.S.doc Version 5.0 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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