Inspection on 23/02/07 for Milton House

This inspection was carried out on 23rd February 2007.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Milton House 04/07/08

Milton House 20/07/07

Milton House 30/11/05

Milton House 14/06/05

Milton House 02/11/04

Milton House 05/07/04

Milton House 30/05/02

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Milton House 39/41 Spencer Road Bedford Bedfordshire MK40 2BE Lead Inspector Mrs Louise Trainor Unannounced Inspection 23rd February 2007 15:00 Milton House DS0000014937.V331677.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Milton House DS0000014937.V331677.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Milton House DS0000014937.V331677.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Milton House Address 39/41 Spencer Road Bedford Bedfordshire MK40 2BE 01234 216460 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) Mr Hurry Bhautoo Mrs Premila Bhautoo Mr Hurry Bhautoo Care Home 13 Category(ies) of Learning disability (13), Learning disability over registration, with number 65 years of age (13) of places Milton House DS0000014937.V331677.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Change to categories - LD (13), and LD (E) (13) No service users under the age of 35 will be admitted. The home is also to be registered to provide care to ONE (1) service user with a mental health disorder (MD) (1). This condition applies only to the service user who has been identified to the National Care Standards Commission. At such time as this identified service user ceases to live at the home, the NCSC must be informed immediately and this condition of Registration will be adjusted to reflect this fact. 30th November 2005 Date of last inspection Brief Description of the Service: Milton house is a residential care home, currently registered to provide support to 13 adults with learning disabilities. Community facilities and shops are a short distance from the home, which is also within walking distance of Bedford town centre, and the bus and train stations. The building consists of two attached houses linked by access doors on both ground and first floors. The accommodation is organised in three sections. One of the original houses was divided into flats, one on each floor, with three bedrooms each, a kitchen, bathroom and living room. The other house has seven bedrooms, distributed between the floors, with the lounge, dining room and kitchen on the ground floor, and bathroom on the first. There is a WC and shower on the ground floor. The office/sleeping in room and laundry are situated on the ground floor. There is a small enclosed garden and some off road parking. The fees for this service range from £309.66 - £665.60 per week. Milton House DS0000014937.V331677.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first Key Inspection for this service this year. It was carried out on the 23rd of February 2007, between 15:00 hours and 19:30 hours by Regulatory Inspector Mrs Louise Trainor. The home manager was not present when the inspector arrived at the home, but arrived shortly afterwards and was then present for the remainder of the inspection to assist. During this inspection the inspector met most of the service users, though some rather briefly, and spoke to three in more depth. These three particular service users were picked at random by the inspector for case tracking. This involved viewing all the documentation relating to their care, visiting them in their personal bedroom areas and chatting with them informally. Documentation relating to medication administration, service users’ finances, staff personal files (including supervision and training records), were also made available for inspection. This home has a small workforce of ten support workers, one senior support worker, a deputy manager, the manager and the owner. During this visit the inspector had the opportunity of interviewing three members of the team plus the manager. Pre inspection documentation and ten service user’s questionnaires were returned to the Commission for Social Care Inspection (CSCI) prior to this inspection and provided additional information that has been included in this report. The inspector would like to thank everyone involved for their assistance and support during this inspection. What the service does well: This home provides a comfortable environment for the service users that live there, and individual’s bedrooms are decorated in a way that reflects personal choices and preferences and elements of the individual’s life history. Service users and their representatives are encouraged to offer their views and opinions on all aspects of their life, and have access to a copy of the complaints policy that is produced in picture format to aid easy reading. Written information about the home is reproduced in a way that can be understood by many residents. These documents use fewer blocks of text, and include more picture illustrations. Milton House DS0000014937.V331677.R01.S.doc Version 5.2 Page 6 Discussions with service users and staff, and observations of staff and service user interactions indicate that service users are very happy with their lives in this home. They are treated in a way that reflects support, respect and companionship. The service users are very much the central focus in this home, and staff and service users all indicated that they feel well supported by the management team, and that their views are always taken into consideration. What has improved since the last inspection? What they could do better: The recruitment policy is not being closely adhered to. There were various documents that are required for recruitment, missing from the staff files. An Immediate Requirement was issued in respect of this matter. One member of staff had been employed without a CRB check and was removed from duty immediately until this documentation is obtained. Transactions where service users are taking money out and putting money into their ‘pocket money accounts’ are not being record when the transaction takes place. Consequently none of the individual accounts that were checked during this inspection corresponded with the funds available. The downstairs shower room and toilet were in need of attention regarding both cleanliness and repair. It was also noticed that none of the toilets had toilet rolls in them. This was because one service user has a tendency to block the toilets with it. The inspector recognises the problems this may cause, however the home should look at alternative ways of managing this individual service users behaviour in a way that does not impact on the rest of the home. Documentation regarding pre admission assessments and care planning were insufficient to ensure that all service users needs are being fully met with continuity and in a way that they would choose. There were two sets of step- ladders being stored against the upstairs landing wall. These could be easily accessed by any of the service users and thus presented a safety risk. Throughout this inspection there have been several areas of record keeping and documentation where it appears there have been serious oversights by Milton House DS0000014937.V331677.R01.S.doc Version 5.2 Page 7 management, which may leave service users at risk and open to abuse, in particular service users financial records and the recruitment processes. These issues require urgent attention in order to meet the minimum standards. 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. The summary of this inspection report can be made available in other formats on request. Milton House DS0000014937.V331677.R01.S.doc Version 5.2 Page 8 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 Milton House DS0000014937.V331677.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4, Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Lack of documentation indicates that not all service users are fully assessed prior to being offered a permanent place in this home. Therefore there is no assurance that their needs will be appropriately met. EVIDENCE: The inspector examined three service users files. All of these three service users had lived in this home for several years, but none of them had any evidence of pre admission assessments. The manager stated that service users do have a pre admission assessment completed, and that this includes ‘tea visits’ to assess the compatibility with other service users. It was recommended, by the deputy manager, that the inspector view a more recent admission. The most recent admissions’ file was examined. There was no evidence of a pre admission assessment. During the inspection three service users were interviewed informally as part of the ‘case tracking’ process, and two of these service users confirmed that they had not visited the home prior to coming to live there permanently. The third was unable to confirm either way. Milton House DS0000014937.V331677.R01.S.doc Version 5.2 Page 10 All the service users’ files that were viewed contained a Statement of Purpose and a Service User Guide. These were presented in picture format so that all service users could easily understand the content. All had been dated and signed by the individual service users to indicate that they had seen these documents. Milton House DS0000014937.V331677.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9, Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There are individual care plans in each service user file, however these lack ‘care instructions’ and personal choices and preferences so that service users needs may not be met with any continuity or in a way that they would choose. EVIDENCE: All service users had care plans in place that identified areas of care that they required assistance in. Unfortunately these plans contained very limited instructions to indicate the level of care required and how it should be delivered, and they did not contain any details relating to personal goals, choices and preferences. One service user had a care plan for: oral hygiene, personal hygiene, using the microwave and washing machine and ironing. These contained very little information about the level of assistance required, and the service user indicated that the washing and ironing is all done for them. Whilst talking to Milton House DS0000014937.V331677.R01.S.doc Version 5.2 Page 12 this service user, a member of staff brought in a pile of freshly washed and ironed clothing, indicating that this had been done for him, not with him. Another service users plan indicated that she had needs related to: hygiene, clothes storage, shoe polishing and hair cutting. However there was very limited information documented, and no specific instructions regarding the level of assistance required or how these needs could be met. The inspector was informed that the home is in the process of introducing a new care plan format, which would include all the components presently missing. The file of the most recent admission was inspected and the new care plan documentation was in place. This is a positive move but requires a lot of work to ensure that all service users have an efficient and effective care plan in place. Service User meetings are held every month, and service users are encouraged to voice their own opinions and listen to those of others. They are also encouraged through these meetings to discuss menus, outings and holidays. One service user told the inspector that she had been on holiday to Yarmouth last year and there were plans for a week in Weymouth in the summer this year. Milton House DS0000014937.V331677.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 15, 16, 17. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users are encouraged to participate in appropriate activities through day centres, clubs and colleges to enhance their personal and social development. However evidence indicates that new skills are not always actively supported in the home. EVIDENCE: All the service users attend some form of development programme at local day centres and colleges. One service user told the inspector that he was learning the computer at college, but did not have access to one in the home. Another service user talked about how much she enjoyed her cooking lessons at college. This skill could be enhanced further with more involvement cooking the meals in the home. Although generally service users prepare their own packed lunches and snacks, the staff cook the main meals for the service users. Milton House DS0000014937.V331677.R01.S.doc Version 5.2 Page 14 At approximately five o’clock on the evening of the inspection, a group of service users arrived home from their day centres placements accompanied by staff. They all seemed very enthusiastic about their days activities and dispersed in all directions of the home until teatime. The inspector met one service user in the lounge, he was very busy with his diary and kept confirming with the inspector that it was Friday evening, he knew it was ‘pocket money day’ and he was clearly very excited by this. In the evenings and at the weekends, service users are encouraged to pursue various activities of their own choice, including shopping trips to the town, evening visits to the ‘sparkle club’, visits to the cinema and to families and friends. One service user told the inspector that she visited her auntie regularly on Sundays and special days. During the inspection, staff were preparing supper and although service users kept coming into the kitchen area to talk to the staff, they did not appear to be involved in the meal preparations. They had however been offered a choice of egg and chips or pie and chips, earlier in the evening. A three- week ‘rolling menu’ was submitted to CSCI as part of the pre inspection paperwork. This identified the wide variety of meals offered within this home. Milton House DS0000014937.V331677.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20, Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Observations of care practices indicate that service users receive personal support appropriate to the individual to ensure that their physical and emotional health needs are fully met. However supporting documentation was very limited. EVIDENCE: Discussions with service users and staff, and observations of staff and service user interactions indicate that service users are very happy with their lives in this home. They are treated in a way that reflects support, respect and companionship. The service users in this home require varying levels of support. One service user talked to the inspector about the day centre she visits two days a week and also about her weekly visits to college where she is learning to cook. She said. “I enjoy cooking, but I only do my breakfast and snacks here, I prefer the staff to cook the main meals, they look after us so well and I Milton House DS0000014937.V331677.R01.S.doc Version 5.2 Page 16 can always talk to them if I have a problem. I do all my own hoovering, polishing and laundry”. None of the service users in this home manage their own medication at present. They are all administered by staff. The Medication Administration Record (MAR) sheets for all service users were inspected. There were no missing signatures on any of the charts and they reconciled correctly with the stocks remaining in the home. Milton House DS0000014937.V331677.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. All service users have a copy of the complaints procedure so that they are confident their concerns will be listened to, taken seriously and acted upon. But unfortunately service users protection and safety is compromised by failure in other areas of this report. EVIDENCE: All service users’ files that were inspected had a copy of the complaints policy in them. These were presented in a picture format to make understanding easier, and all had been signed and dated by the individual service users. All the service users that were interviewed were very satisfied with the service and said they had never needed to complain, but would know who to speak should they need to. The ‘staff training file’ was inspected and identified that all staff attend Protection of Vulnerable Adult training. This is amongst the mandatory subjects for all staff and is also included in a module of the NVQ 2 that many staff have completed. Ten ‘Have you say about…’ questionnaires were returned to CSCI prior to the inspections. These all indicated that service users are satisfied and happy in this home, and feel their views are considered by the staff. Milton House DS0000014937.V331677.R01.S.doc Version 5.2 Page 18 Evidence sited elsewhere in the body of this report, relating to service user’s money records and the recruitment of staff, dictates that service users are not fully protected from harm and abuse in this home. Milton House DS0000014937.V331677.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28, 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. This home provides a comfortable environment for the service users, however some areas require some attention regarding safety and cleanliness. EVIDENCE: As this was this inspectors first visit to this particular home a full tour of the premises was undertaken. Two individual bedrooms were visited with the service users that occupied them. These were comfortable and individually decorated. Each service user had family photographs around them and items that reflected their personal interests and life history. All service users have the facility to lock their rooms if they so wish. One service user told the inspector that she enjoys doing art work and showed the inspector a range of pictures that she had done over the course of the last Milton House DS0000014937.V331677.R01.S.doc Version 5.2 Page 20 two years since she had come to live at the home. She also had an assortment of pot plants and ornaments that were meaningful to her. In general the communal living areas were tidy and comfortable, however the downstairs shower room was both dirty and in need of some repair. The manager stated that this were due for a refurbishment. None of the toilets had any toilet paper in them. A support worker told the inspector this was because one of the service users has a tendency to overfill the toilet with paper, and so all service users have their own roll in their room. The inspector recognises the problems this may cause, however the home should look at alternative ways of managing this individual service users behaviour in a way that does not impact on the rest of the home. There were two sets of step- ladders being stored against the upstairs landing wall. These could be easily accessed by any of the service users and thus presented a safety risk. Milton House DS0000014937.V331677.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35, 36 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The recruitment policy and practices are not being sufficiently adhered to so that service users may not be fully supported and protected EVIDENCE: The files of three members of staff were inspected. The manager keeps these files at her home and went to collect them during the inspection. The following documentation was missing from the files on the day of the inspection: One file inspected was for a member of staff that had been employed at the home since 2002, had no references present. Another member of staff that started work at the home in 2005 had no evidence that a CRB or POVA first check been carried out. The CRB from her previous employment was present and the manager thought this was sufficient. Milton House DS0000014937.V331677.R01.S.doc Version 5.2 Page 22 Another file that was that of a member of staff from overseas lacked detail from the Home Office indicating that permission to work in this country had been granted. The manager agreed to fax these documents to the Commission for Social Care Inspection (CSCI) local office when she had located them, the next working day, Monday 26th February 2007. Unfortunately the references and the CRB were not submitted. Consequently an Immediate Requirement was issued with regards to this matter. The manager informed the inspector that the member of staff who was working without a CRB check had been removed from duty until the appropriate documentation has been received. Staff in this home have a wide variety of training available to them, both mandatory and more specialist subjects. Two staff training files were inspected and certificates indicated that fire training, moving and handling, POVA and food hygiene are being up dated appropriately. Some staff is doing other subjects such as Epilepsy, first aid, medication administration and mental health awareness. Both of the files examined contained certificates for NVQ 2, and two staff that were interviewed are presently studying for their NVQ 3 certificates. Staff files indicate that all staff do receive supervision from the manager or the deputy, however this needs to be delivered on a more regular basis. Milton House DS0000014937.V331677.R01.S.doc Version 5.2 Page 23 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Some of the records for service users within the home are insufficient to ensure that service users are protected. EVIDENCE: This home has been owned and run by a husband and wife team since 1986, however there is some confusion as to which member of this team is the registered manager for this home. Confirmation of this is being addressed with Mr and Mrs Bhautoo as a separate matter. The service users are very much the central focus in this home, and staff and service users all indicated that they feel well supported by the management team, and that their views are always taken into consideration. Milton House DS0000014937.V331677.R01.S.doc Version 5.2 Page 24 Throughout this inspection there have been several areas of record keeping and documentation where it appears there have been serious oversights by management, which may leave service users at risk and open to abuse, in particular service users financial records and the recruitment processes. These issues require urgent attention in order to meet the minimum standards. Milton House DS0000014937.V331677.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 2 3 2 4 2 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 1 ENVIRONMENT Standard No Score 24 2 25 3 26 3 27 2 28 3 29 X 30 2 STAFFING Standard No Score 31 X 32 2 33 X 34 1 35 2 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 3 X LIFESTYLES Standard No Score 11 2 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 3 3 X 2 X 2 X 1 X X Milton House DS0000014937.V331677.R01.S.doc Version 5.2 Page 26 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 YA2 Regulation 14(1) Requirement The registered person must ensure that there is appropriate documentation to evidence that service users have been fully assessed prior to moving into the home. The registered person shall ensure that all service users have a care plan that contains personal goals and preferences and has clear instructions regarding the level of care required. These care plans must be regularly reviewed to reflect any changes in service users needs. The registered person shall make arrangements by what ever measures necessary to prevent service users being placed at risk of harm or abuse. The registered person shall ensure that all parts of the home which service users have access to are free from hazards to their safety, and where identified these risks must be eliminated wherever possible. The registered person must ensure all parts of the home are DS0000014937.V331677.R01.S.doc Timescale for action 31/03/07 2. YA6 15(2) 31/03/07 3. YA23 13(6) 05/03/07 4. YA24 13(4)(a)(c) 06/03/07 5. YA30 23(2)(d) 31/03/07 Milton House Version 5.2 Page 27 6. YA34 19(1)(b) kept clean and reasonably decorated. The registered person shall not employ a person to work in the care home until he has obtained, in respect of that person, all the information and documents specified in paragraphs 1 to 7 of schedule 2. 03/03/07 7. 8. YA36 YA41 An Immediate requirement was issued 26/02/07 18(2) The registered person shall ensure that all staff are appropriately supervised. 17(2)sch4.9 One clear system for the recording of resident’s monies must be used and adhered to by all staff. Previous requirement 05/01/06 unmet. 31/03/07 05/03/07 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 YA11 Good Practice Recommendations The home should consider ways that they can actively support service users developing skills in the home, such as computer skills and cookery. Milton House DS0000014937.V331677.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Bedfordshire & Luton Area Office Clifton House 4a Goldington Road Bedford MK40 3NF National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Milton House DS0000014937.V331677.R01.S.doc Version 5.2 Page 29 - 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!