Inspection on 26/11/08 for New Redvers

This inspection was carried out on 26th November 2008.

CSCI found this care home to be providing an Poor service.

The inspector found no outstanding requirements from the previous inspection report, but made 9 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

New Redvers 21/04/09

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 30/01/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: New Redvers Bronshill Road Torquay Devon TQ1 3HA     The quality rating for this care home is:   zero star poor service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Stella Lindsay     Date: 2 7 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 30 Information about the care home Name of care home: Address: New Redvers Bronshill Road Torquay Devon TQ1 3HA 01803409174 Telephone number: Fax number: Email address: Provider web address: newredvers@yahoo.co.uk Name of registered provider(s): Name of registered manager (if applicable) Mrs Margaret King Type of registration: Number of places registered: Diamond Care (2000) Limited care home 19 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is 19. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: Learning disability (Code LD) Date of last inspection Brief description of the care home New Redvers is a large Victorian house in a residential area close to shopping and leisure facilities including a swimming pool. The home provides care and support for up to 19 people with learning disabilities some of whom may have physical disabilities. All bedrooms except one are single, and most have en-suite facilities. There is a lounge and a separate dining room. There is an area by the kitchen where residents may make hot drinks and snacks. Some residents attend day centres or work placements. The home has a vehicle for transporting residents. There is a level patio area, a good sized garden and a car parking area. Care Homes for Adults (18-65 years) Page 4 of 30 Over 65 0 19 Care Homes for Adults (18-65 years) Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: zero star poor service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 0 star. This means the people who use this service experience poor quality outcomes. This inspection was unannounced and took place on 26th and 27th November 2008. One inspector visited, but as we represent the Commission for Social Care Inspection we refer to ourself as we in this report. This was the first inspection since the service was registered under the name of Diamond Care (2000) Ltd. Before our visit we sent questionnaires to people who live at the home, and to people who work there. Nine residents and four staff completed and returned these. Care Homes for Adults (18-65 years) Page 6 of 30 The Registered Manager sent us their annual quality assurance assessment (AQAA) earlier in the year. It was clear and gave us all the information we asked for. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. During our visit we spoke to or observed twelve people who use the service and two regular visitors, the Acting Manager, the Company Administrator, and five other staff members. We case tracked four people who use the service. Case tracking means we looked in detail at the care four people receive. We spoke to staff about their care, looked at records that related to the residents, met with them and made observations if they were unable to speak to us. We also met other residents and their visitors, and shared a meal in the dining room. We looked at staff recruitment records, training records and policies and procedures. We did this because we wanted to understand how well the safeguarding systems work and what this means for people who use the service. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 30 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples care needs are assessed before a service is offered, and they are able to meet the people living in the home, to find whether the home will suit them. Evidence: One resident had been admitted recently. The Manager had been to visit the new resident in their former home, to assess their needs and the suitability of the home to meet them. Their social worker had provided a written summary of their assessed needs, visited several times and taken them to visit, and had been pleased with the attention given to them. She found that the social life within the home had been beneficial to them, to prevent them becoming isolated. Of the nine service users who returned surveys to the CSCI, eight said that thad been asked whether they been asked if they wanted to move into New Redvers. One said that the Manager had asked them, others that their parents had consulted them. Others said they could not remember being told much before they moved in, but that they were happy with the move. Care Homes for Adults (18-65 years) Page 10 of 30 Care Homes for Adults (18-65 years) Page 11 of 30 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care needs were not thoroughly monitored. The value of individual residents was not upheld by some staff responses to them. Evidence: Each person who lived at the home had a care plan, but we found that they were incomplete, and had not been kept up to date. It was not shown whether any 1:1 time was planned or provided, and we did not see any in progress during our visit. Staff said they did not normally have a briefing meeting in the mornings, to advise them of any health problems, or anything that had happened in the night, nor were they allocated duties to make sure that everybody was helped in the best way. Incident reports showed a poor value base, showing that people living at the home were not always treated with respect. Staff had recorded that cigarettes were denied as a removal of privileges. One had recorded that when they had found a person had not behaved as expected on a visit to a swimming pool, that they would never go again. There was no evidence that this was challenged by management, or that any Care Homes for Adults (18-65 years) Page 12 of 30 Evidence: attempt had been made to understand the cause for the unusual behaviour. We did not see evidence that the Specialist Support Team had been consulted when staff needed advice on understanding and addressing issues, or consultation with Speech and Language Therapists for help and advice with regards to communication. There had been treatment and advice from a physiotherapist, but we did not see records to show that an exercise programme they recommended was being maintained daily. A resident was told that they would not have a cigarette till 3pm because of aggressive behaviour, but there was no evidence that professional advice was sought on managing the behaviour. Care Homes for Adults (18-65 years) Page 13 of 30 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Although those people who were independent were able to have a fulfilling and interesting life, those who needed support had restricted opportunities. Evidence: We saw little evidence of individual activity programmes in peoples care plans. One persons chosen activities were described as walking up and down the corridor, and playing football. We saw that this person walked up and down the corridor alone with the football throughout most of our visit, not involved in any other activity apart from mealtimes. Two people who lived at New Redvers told us that they enjoyed cleaning the kitchen. One said, I like to keep it lovely and clean. The other told us they had been very upset over the past months because a Senior Carer had made them do this in a different way, which they did not like. Care Homes for Adults (18-65 years) Page 14 of 30 Evidence: Group activities were lead by staff with a video-based quiz in the lounge in the morning, and puzzles in the dining room during the afternoons. This meant that with the staff available on duty residents could be observed and kept safe, and was a sociable gathering. A staff member told us that during sunny days they had kicked a ball about in the garden, and some residents had enjoyed Round Robin trips, using local buses, boats and trains. A social worker told us that she considered that her client had made a good recovery at New Redvers because of the social activity. There was an album showing photos of successful activities and outings, but it was from spring/summer 2007. Fourteen residents had recently been on holiday to Portugal. We were told by a relative that this had been enjoyable, though none of the people who went mentioned it to us. There was no evidence that choices had been discussed. We did not see plans of activities which would ensure that everybody had an opportunity to be supported to engage in activities of their choice. There were records of occasions when people had been threatened or stopped by staff from engaging in their chosen activities as a punishment or consequence of their behaviour. There was no evidence that professional advice had been sought with regard to these interventions. We met two residents relatives. One told us they were satisfied that some staff were good at engaging with their family member. We saw that visitors were welcome to stay all day and share meals. Lunch was a choice of sandwiches and/or soup. The main meal was served around 5 or 5.30pm and residents may choose which sitting they join. Staff told us that people who need assistance mostly join the first sitting, then staff and residents eat together at the second sitting, but people could change their minds and were not expected to keep to the same time. We saw a good variety of food in the fridge and freezers, and also a good variety of fresh fruit and vegetables. Care Homes for Adults (18-65 years) Page 15 of 30 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples appearance and personal care were good but their health care was jeopardised by poor recording. Evidence: We saw that peoples appearance was cared for, with hair and nails in good order. The Acting Manager said she had found that toiletries were being bought in bulk for sale to the residents, so they had no choice, and she stopped that practice. Now each person has choice of toiletries, and the plan is that they should be supported to go to shops to buy and choose for themselves. We saw health care plans that were incomplete and unsigned, and had not been updated for over a year. Some people who live in the home had specific health care needs. Information was seen in their files but not highlighted to be brought to the attention of staff. Training in particular health care needs had yet to be obtained for the more recently appointed staff. We looked at the medication system. Medicines were securely stored, and we saw that they were administered with care. A monitored doseage system was in place, which makes it easy for staff to administer medication safely. We saw that the Medication Care Homes for Adults (18-65 years) Page 16 of 30 Evidence: Administration Records were being kept accurately. However, they showed that one persons pain killers ran out, and there was a gap of two days before the pharmacy could provide a new pack. When non-prescribed painkillers had been given, they had been recorded, but not with the reason. Care Homes for Adults (18-65 years) Page 17 of 30 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at New Redvers had been subjected to verbal abuse and deprivation of liberty. Procedures in place to protect them had not been followed, and their complaints had not been dealt with. Evidence: There was evidence that the Registered Manager had not responded to complaints from people living at New Redvers. We were told that a Senior carer had imposed their ways of cleaning and tidying on the home, in ways described by colleagues as obsessive, for example, particular ways of folding clothes, with no respect of the wishes of the people whose home it is. A resident told us that when they complained to the Registered Manager, she just told them to keep away from that staff member. This was a particularly unsuitable response, as the member of staff concerned was that persons keyworker at the time. There was evidence that the Registered Manager had not followed procedures which were in place to protect residents from harm. We were told that a carer had had a general habit of using bad language and mimicking residents. We saw inappropriate language they had used in reporting incidents. It showed a lack of understanding of the value base expected in this service, and undermining of the dignity of the people who live here. The Registered Manager had not challenged this behaviour, and it was seen as part of the culture of the home. There had been a concern in February 2008 that one person who lives at the home Care Homes for Adults (18-65 years) Page 18 of 30 Evidence: would go into a toilet while another person was using it, and urinate on them. The Registered Manager recorded three possibilities on the care plan to address this, one of which was to lock the door. A bolt was fitted to the outside of the door, high up. There is evidence that this was used, and a person with serious health issues locked inside. This situation continued until 14th October, but no longer occurs. The bolt has been disabled and staff attention is made available to assure the persons safety. Care Homes for Adults (18-65 years) Page 19 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The house is comfortable, and mostly bright. Some issues of good hygiene needed addressing. The office does not protect confidentiality. Evidence: There was evidence that redecoration and maintenance had continued through the year. New carpets had been fitted in the entrance hall and stairways, and an extractor fan had been fitted in the residents smoking room. We saw that residents bedrooms were personalised, and most looked attractive, though we visited one bedroom which was in need of decoration and the furniture looked shabby. The lounge was comfortable, with sofas and a large television. The tables and chairs in the dining room are suitable for activities as well as mealtimes. The area of the lounge and dining room together do not provide enough communal space to meet the National Minimum Standards. There are in addition a residents smoking room - a lean-to outside the kitchen, and a lobby by the front door where some residents like to sit. The office is well suited for the safe administration of medications, but another venue is needed for confidential discussions. All door locks were seen to be safe, in that they could be opened by staff in an emergency, except for a toilet on the first floor, which had a bolt on the inside which could not be opened in an emergency. Care Homes for Adults (18-65 years) Page 20 of 30 Evidence: The garden is spacious, and not overlooked. There is potential for development for outdoor activities such as growing flowers. Two people have shared a bedroom for many years. They should be supported to consider whether this remains their choice when a room becomes vacant. There were some outstanding issues with regard to control of infection. Shampoos and other products had been left out in bathrooms,, and the bath in the first floor bathroom had a poor surface. We saw a notice on the laundry door, telling staff that they did not need to use new gloves each time they dealt with dirty laundry - as we have no infections in the home. This notice was removed promptly by the Acting Manager, and the company secretary told us that the purchase of disposable gloves was not restricted. Understanding of the underlying principles needs to be confirmed for staff in training. Care Homes for Adults (18-65 years) Page 21 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The staff team needs to built, trained and supported, in order to provide good care for the people who live at New Redvers. Evidence: At the time of this inspection management needed to cover for staff absences and managed this by bringing some carers from a neighbouring Diamond Care home. In this way the team were maintaining a safe level of care, but were not able to provide individual attention or enable people to go out if they needed support. It was not clear that the number of staff would be sufficient to meet individual needs even without absences. We did not see evidence of 1;1 time being allocated to residents. All the residents who completed surveys said that staff treat them well. One said, they are always nice to me. One relative told us they were pleased that staff had the ability to engage with their family member, who was able to speak for themself. However, none of the staff on duty at this time had long experience of working with these residents, or of developing communication skills with people who had little or no language. We saw that night staff come on duty at 8pm, and were concerned that residents who Care Homes for Adults (18-65 years) Page 22 of 30 Evidence: needed support to go out would have to be home by then. The company secretary told us that day staff are authorised to stay out later than this if a resident needs support for an evening activity. There was not evidence that this had happened recently. Recruitment was continuing. We saw that references and CRB checks were requested routinely during recruitment. Job descriptions had been produced which required the delivery of care sensitive to the individual needs of Clients, and empowering Clients to achieve independence and self-advocacy, amongst the responsibilities. Candidates would visit the home, but residents were not formally involved in the recruitment process. Staff said they had received a brief induction training when first recruited, which had been boosted recently by a more detailed programme. Staff had all received fire safety training, and other training provided for some staff included epilepsy training, food safety, and diet and nutrition. Training in epilepsy had been booked for more staff, as had training in the protection of vulnerable adults. We found there was need for a range of staff training, to include Total Communication and Person Centred care, as well as specific health issues of residents including behaviour management and the development and ageing of people with Downs Syndrome. Individual training needs and the value base of the team as a whole need to be reviewed in order to build a sound team who will be able to promote the rights and well being of the residents. Individual supervision sessions had been recorded. Discussion between the Manager and staff had included training needs and any concerns that staff had. One Support Worker said that these meetings were not, to their knowledge, planned, but happened when time allowed. These sessions had not been adequate to ensure that good practice was implemented in the home, as we saw that poor practice had gone unchallenged. (See Individual Needs and Choices and Complaints and Protection.) Care Homes for Adults (18-65 years) Page 23 of 30 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Although action was taken promptly when problems were brought to light, the company had failed to see problems developing or protect residents from harm. Evidence: The Registered Manager was suspended at the time of this inspection, pending an investigation. The Responsible Individual for Diamond Care, Karen Barnes, was Acting Manager. Along with the Manager and the Company Administrator, she had drawn up an Immediate Action Plan to address some of the problems that had become apparent. This included recruitment and training, review of all the care plans, and a review of the duties of the staff including how breaks are taken. The observation of company policies and legal requirements was to be observed. The Registered Manager, Maggie King, had achieved the Registered Managers Award and National Vocational Qualifications Assessors award. She had developed good relationships with the residents, and previously had worked well with outside professionals, to promote a team approach to managing behaviours in the home. We did not see evidence of consultation during 2008, but we did see and hear evidence Care Homes for Adults (18-65 years) Page 24 of 30 Evidence: that she was not managing her staff effectively. The Company Secretary visited the home monthly, in accordance with regulation 26, and provided reports which show that she consulted residents and staff. Managers will need to consider how to make their systems of monitoring more robust. One of the staff told us that the Registered Manager gives everyone a voice. We found that not everyones words had been heard. Staff meetings had been held. We were told that these were held in the dining room. This is not appropriate, as residents would have to be excluded from their own space. Also this room is not suitable for confidential discussions. The health, safety and welfare of staff were otherwise well protected by the homes policies and procedures. Fire-safe hold open devices had been fitted to fire doors. Care Homes for Adults (18-65 years) Page 25 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 26 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 6 12 You must ensure that care plans are up to date and clearly presented so that staff are provided with clear instructions on how to meet the health and welfare needs of people who live at the home. 30/01/2009 2 9 12 You must refer to relevant health and social care professionals so that people receive specialist care and staff are given advice on how to provide good and consistent care. 30/01/2009 3 19 12 You must ensure that health care information on residents files is complete and up to date. To make sure that service users receive treatment that makes proper provision for their health and welfare needs. 30/01/2009 Care Homes for Adults (18-65 years) Page 27 of 30 4 22 22 The complaints procedure shall be appropriate to the needs of service users so that action is taken to address problems raised by residents in a timely way. 30/01/2009 5 23 13 You will ensure that no service user is subject to physical restraint unless professional advice confirms that this is the only practicable means of securing the persons welfare So that their lawful freedom and welfare is respected. 19/12/2008 6 23 13 You must make arrangements to prevent service users being harmed or suffering abuse so that they will be safe and respected in their home. 30/01/2009 7 33 18 The numbers of staff on duty needs to be increased at certain times. This is so that peoples individual needs can be met. 30/03/2009 8 35 18 You must provide training for the staff. This is so that they have the skills and knowledge base to deliver a competent and person-centred service. 30/06/2009 9 37 10 You must have a Manager who keeps up to date with good practice 30/03/2009 Care Homes for Adults (18-65 years) Page 28 of 30 so that residents can be offered a good quality of life. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 7 You should consult with people who live at the home and help them develop their preferences and record these in their care plan, to enable them to make decisions about their own lives. Following assessment of residents individual needs and aspirations, a programme of activities should be drawn up, so that it can be seen that all residents are offered regular opportunities for fulfilling activities. Daily routines and house rules should be revised to promote individual choice, independence, and freedom of movement for residents, subject to risk assessment. Reasons should be recorded on the MAR sheets when homely remedies are given to residents. A suitable place for confidential discussions, including staff hand-over meetings, should be identified. Laundry procedures should be reviewed to ensure that good practice is maintained in the control of infection. You should consider how to develop and improve quality monitoring at New Redvers. 2 12 3 16 4 5 6 7 20 24 30 39 Care Homes for Adults (18-65 years) Page 29 of 30 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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