Inspection on 29/11/07 for Newton Lodge

This inspection was carried out on 29th November 2007.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Newton Lodge 19/09/06

Newton Lodge 01/02/06

Newton Lodge 01/09/05

Newton Lodge 09/03/05

Newton Lodge 11/11/04

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 Newton Lodge 50 Olive Road New Costessey Norwich Norfolk NR5 0AS Lead Inspector Mrs Judith Last Unannounced Inspection 29th November 2007 03:40 Newton Lodge DS0000027627.V355922.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 Newton Lodge DS0000027627.V355922.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. Newton Lodge DS0000027627.V355922.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Newton Lodge Address 50 Olive Road New Costessey Norwich Norfolk NR5 0AS 01603 740282 NO FAX # 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) www.caremanagementgroup.com Care Management Group Ltd (trading as CMG Homes Ltd) Mr Martin Edward Rendle Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Newton Lodge DS0000027627.V355922.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th September 2006 Brief Description of the Service: Newton Lodge is a care home providing personal care and accommodation for up to 3 younger adults with a learning disability. The service users may also have a physical disability. Care Management Group Limited, (whose registered office is located in London), owns Newton Lodge which is located in a residential area of New Costessey and a bus ride to the city of Norwich. Local amenities, shops and pubs are close by. The home consists of an adapted bungalow. All bedrooms are single rooms and one is below 10 square metres. None of the bedrooms have en-suite facilities. There is large lounge diner and kitchen nearby that it of an appropriate size for the number of people living at the home. People cannot get safely or easily into their own garden at the rear of the home and the service has not remedied this. On-road parking is available in a nearby side street. The home is staffed at all times including a waking member of staff at night. The fee level for the service is dependent on the care needs of the individual and ranges from £806.00 - £2698.70 per week. Newton Lodge DS0000027627.V355922.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. We visited the home unannounced and spent about three hours there. While we were there we spoke to the manager, team manager and the two staff on duty. We also spoke to all three people who lived there, but only one was really able and willing to tell us anything. We had received written comment cards from everyone living at the home. Staff helped to complete these. We also had comments from four staff and a relative. We got other information from the form the manager filled in before we went and we also looked and listened to what was going on and looked at things that were written down. We used this information to judge the home against outcome groups and see how well the service meets the needs of people living there. We have rules that tell us how to do this. What the service does well: What has improved since the last inspection? There has been work done to improve the home, with new carpets and decoration as well as some furniture. The way the quality of the service is looked at has improved. The new manager has completed the registration process and has tried to make some of the improvements we required last time. This included looking at the checks that were made on people who applied to come and work at the home. There is better supervision for staff, but more work is still needed. Newton Lodge DS0000027627.V355922.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Newton Lodge DS0000027627.V355922.R01.S.doc Version 5.2 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 Newton Lodge DS0000027627.V355922.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who are thinking of moving into the home, could be confident that their needs would be assessed. EVIDENCE: There are no vacancies at the moment. There are systems in place to ensure people’s needs would be assessed should one arise. Newton Lodge DS0000027627.V355922.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People’s care needs are set down and there are efforts to involve them in decision making. There is a need to look at risk assessments and see how well these help staff to protect people from harm. EVIDENCE: Comment cards show two people feel that they are involved in making decisions. A relative expresses the view that the staff team are generally “person centred” in their approach and now carry out what is described as an “ace review”. People’s support needs are set down in their care plans and these are kept under review. However, the dating and signing of these could be improved. A recommendation has been made. Discussion with staff showed that they worked to help people make progress with goals and this was borne out in records, (for example increasing abilities for one person to clean their own teeth, and progress of another person in Newton Lodge DS0000027627.V355922.R01.S.doc Version 5.2 Page 10 learning additional signs to help with communication and making choices). Discussion shows that staff understand frustration that might result from someone not being able to make their needs understood, but say that they can often get to the bottom of this by the use of closed, (yes/no), questions about the things they know the person likes to do or are important to them. Information is not presented in a simplified form or pictures/symbols, and does not clearly show how service users were involved. Objects of reference are not used at present and could help someone make decisions where they might not learnt the relevant signs. However, we did see and hear people being encouraged to participate in activities such as preparing meals and drinks, subject to their abilities and risks. We heard staff talking to residents about what they had done and what they wanted to do and also what kind of drinks or food they would like. There is guidance for people about how to manage behaviour that might result in self-harm. In common with other homes in the group, risk assessments are added to without consideration of how they could be made more meaningful and looking at the risks associated with a single activity. For example, someone’s risk of hurting themselves was broken down into the various ways they might do this together with individual instructions about managing each aspect even though the response required by staff to the behaviour was the same. This creates a lot of paperwork for staff to look at and could be made less complicated. A recommendation has been made. We were concerned that one person has guidance about checking the temperature of hot drinks before these are given because they will put their mouth/nose to them when they are too hot and may be scalded. There were three records on body charts about blisters or redness to mouth and nose, one of these saying that the cause was the person’s “drinks are too hot”. Two of these incidents occurred less than three weeks apart. The balance of probability is that not all staff are consistently aware of - or following - the risk assessment in place. There is some concern that this might be due to the use of agency staff. A requirement has been made. Daily records and handover information did not cross-reference with body charts on each occasion. A recommendation has been made. People are helped with their finances by staff and these are checked regularly by staff and by the person who carries out monthly visits on behalf of the registered providers. This is good practice Newton Lodge DS0000027627.V355922.R01.S.doc Version 5.2 Page 11 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): 12, 13, 15, 16 and 17 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Recruitment to vacancies should help to increase the opportunities open to one person for their day care. People have access to a variety of opportunities to contribute to a fulfilling lifestyle. EVIDENCE: Written comments from all three people, (made with support from the staff), show they feel they have lots of things to do, and also that they like the food. One person told us about what they were doing at college. Two people are supported with structured day care outside the home and staff from the home support another person each day. At present, one person, whom staff support for day care rather than using the activities centre, is involved a lot in transporting other service users where they need to go rather than having the full allocated time to access opportunities. The recruitment of staff to fill vacancies will help this. Newton Lodge DS0000027627.V355922.R01.S.doc Version 5.2 Page 12 Records show people making use of their rooms and of the communal areas, for music, television or videos. Arrangements are also made for massage and swimming and to go out for meals. Records and discussion show that people are able to keep in contact with families and arrangements had been made for one person to make regular visits. Comments from a relative indicate that there is room for improvement in supporting someone to make contact spontaneously with family, rather than just when there is a particular issue. However, they also say that the communication when there are important matters affecting the person is very good. We saw people who were able to go to their kitchen for drinks and to help with some meal preparation and there was encouragement to do this. Meals are taken at the dining table in the lounge. The evening meal was a cooked meal and smelled appetising, with fresh vegetables being used. Records show that people are able to join in with shopping. The person who was able to tell us, said they liked their food and all three people completing comment cards with staff support, confirm this. Newton Lodge DS0000027627.V355922.R01.S.doc Version 5.2 Page 13 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 and 20 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People’s personal and health care needs are met in the way they need, and medicines are managed in a way that generally promotes people’s safety. EVIDENCE: Records show the attention the staff pay to personal care and the assistance that people need to maintain their personal hygiene. A care plan showed someone was making progress towards cleaning their own teeth and that this was reviewed regularly. Daily records also show a range of times that people go to bed or get up which shows some flexibility of routine, depending on daytime activities. One person needs a bath seat to get in and out of the bath safely for personal care tasks and this is provided. There is clear guidance drawn up with a relevant health professional, about how to safely support one person with mobility and staff have signed to say they are aware of this. We saw that the handling belt necessary had been in use. However, the risk assessment has not been reviewed to cross reference Newton Lodge DS0000027627.V355922.R01.S.doc Version 5.2 Page 14 with or include the guidance that was developed in October 2007. A recommendation has been made. All three people completing comment cards say that they feel their privacy is respected, that staff treat them well and they feel well cared for. Records show that people are referred for advice about their health as appropriate and care plans list the health professionals who are involved with each person. There are health action plans that have recently been introduced but have not yet been completed. A recommendation has been made about this. The process for medication administration and staff training includes booking people on a formal course, followed by in house training and shadowing until people feel confident. There is also a questionnaire to assess competence. We looked at medication administration records in use, which were complete. An audit of one medication not supplied in a monitored dosage system showed no anomalies. Medicines were stored in a locked cupboard. The person in charge retains the key, although there is a spare available for emergencies. One prescribed medication is recorded in a controlled drugs register in order to provide an additional method of preventing misuse. There were no other medicines in the home needing additional precautions like this. Newton Lodge DS0000027627.V355922.R01.S.doc Version 5.2 Page 15 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 and 23 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People, or most likely their representatives, would have their concerns taken seriously. There are measures in place to help protect people from abuse. EVIDENCE: There is a complaints procedure for people to follow. Feedback from someone living at the home was that they knew who to speak to if they had concerns. The three comment cards from people living at the home also confirm that they know who to speak to if they have concerns. Written comments from four staff show that they know what to do if anyone expresses concern about the home. A relative said they know what the complaints procedure is should they need to raise concerns on someone’s behalf. They express the personal view that the way concerns are addressed within the home is generally constructive but if concerns need to be taken further, the response can be slow and sometimes defensive. Staff confirm training in the protection of vulnerable adults and this is shown on the training matrix. We saw that people were comfortable in the company of staff and that there were generally good interactions. Written comments from residents, completed with staff support, show that people feel safe in the home. Financial records are checked regularly by staff, including the management team, and again when monthly visits are made on behalf of the registered providers. Newton Lodge DS0000027627.V355922.R01.S.doc Version 5.2 Page 16 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 and 30 People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There has been investment in improving the quality of the décor and furnishings in parts of the home and this programme continues. People live in a comfortable and clean environment. However, people living at the home have not had the opportunity to safely access the garden since moving in. There has been an unacceptable delay in complying with requirements we have previously made about this. Dependent on the statement of purpose and service users guide, as well as terms and conditions of residence, the organisation may be misrepresenting its services. EVIDENCE: The home is furnished appropriately for the needs of service users. One person requires an aid to access the bath and this is provided. There has been some redecoration to improve the appearance, and carpets have been replaced. There are plans to replace others and continue with the programme. Newton Lodge DS0000027627.V355922.R01.S.doc Version 5.2 Page 17 People’s rooms reflect their interests and are homely. One person chose to use theirs regularly during our visit and we saw from records that others did so too. The kitchen door was propped open during the first part of our visit. The door wedge was later removed. A requirement has been made. There are concerns that shortfalls in terms of people’s ability to access their garden safely, were identified at the inspection in September 2005. This work has not been progressed despite the manager obtaining quotes and recognising the importance of this facility to people, especially in the summer. He has not been able to meet the requirements that were made following that inspection and repeated since. As plans to extend the home have now been abandoned the organisation must now undertake this work for the benefit and safety of the people living at the home. See outstanding requirements. The areas of the home seen were clean and there were no unpleasant odours. There is guidance about infection control for staff. Newton Lodge DS0000027627.V355922.R01.S.doc Version 5.2 Page 18 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, 33, 34, 35 and 36 People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported by staff who understand their needs. Action has been taken to address staff shortages and progress is being made towards achieving the standard for National Vocational Qualifications (NVQ) although more work is needed in this area. Minor improvements are needed in supervision. EVIDENCE: A relative considers staff are usually able to meet people’s needs and that, although there are “occasional lapses” that the established staff team usually have the skills and abilities to support people properly. There are vacancies on the staff team at the moment, (although people have been appointed, subject to checks, to fill these). This means that the service has needed to use agency staff and that permanent staff also work overtime. Predominantly the overtime is used to cover daytime activities for someone who does not attend the company’s activities centre or other “formal” day care resources. Staff comments show concern about staffing levels at present. We have highlighted concerns about consistency, particularly in relation to following risk assessment, elsewhere in this report. Newton Lodge DS0000027627.V355922.R01.S.doc Version 5.2 Page 19 Someone living at the home told us that they liked the staff and comment cards from all of them shows that a person feels well cared for and well treated by staff. There have been no staff recruited since the last inspection. At that point a requirement was made because proper checks were not completed before a staff member started work. The current manager was not in post and therefore was not responsible at this time. Although there has been no recruitment, the manager told us two people are now going through the process and they are awaiting checks and references. He was able to give us a good account of what happens and how the process is managed, together with the issues he would follow up if there were concerns. We therefore conclude that the requirement has been met and that full and complete information will be obtained in future. Feedback from staff is that training is generally good, and the training matrix shows efforts are made to book updates when these are needed. We know from elsewhere in the company that there is an appropriate induction programme in place. Two staff feel their induction covered everything they needed very well. There are mixed feelings from two others who felt that relevant information was covered in part. Information from the manager shows that three of the six staff currently employed are working towards NVQ qualifications. However, two permanent staff members are due to fill vacancies in the near future. This means that (unless they already have NVQs), the standard will not be met in the immediate future. See outstanding requirement. In written comments, two staff expressed the view that they regularly had meetings with their manager to discuss their work. Two others felt that this happened sometimes, but did identify support was available from the team manager rather than the home’s manager who oversees other small homes in the group. Records show there are shortfalls in the supervision of night staff. Although improvements have been made we cannot conclude the requirement made at the last inspection is wholly met. See requirements. Newton Lodge DS0000027627.V355922.R01.S.doc Version 5.2 Page 20 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 and 42 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is managed in the best interests of service users and to promote their safety. EVIDENCE: The manager is now registered and has shown our registration officers that he is fit to run the home. He is working towards completion of the relevant qualifications. He has worked with the organisation for some time and so is familiar with company structures and procedures. There is a process for monitoring the quality of the service. The manager says questionnaires have gone out recently for staff, and the results of service user surveys are back, awaiting analysis. The analysis does not always reflect the progress needed in individually registered units in the Newton Lodge DS0000027627.V355922.R01.S.doc Version 5.2 Page 21 group. However, there are periodic audits of the way services are being run carried out by staff from HQ and not connected with the local functioning of the organisation. We saw a report from one of these together with the manager’s action plan to improve awaiting completion. Regulation 26 visit reports have improved and look at specific areas of the service as well as general matters. The manager’s attention to the national minimum standards, regulations and previous requirements when completing the quality assurance assessment we send, would improve the process. This is so outcome groups reflect the relevance of standards and any requirements for improvement made at previous inspections because regulations are not being adhered to. At present it does not properly do this. There are systems in place for monitoring and checking safety aspects. This includes testing of equipment and risk assessments for hazards within the home. The practice of wedging the kitchen door is commented upon elsewhere in this report. Newton Lodge DS0000027627.V355922.R01.S.doc Version 5.2 Page 22 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 x 2 3 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 2 33 2 34 3 35 3 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 2 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 2 x 3 x x 3 x Newton Lodge DS0000027627.V355922.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? YES 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 YA9 Regulation 13(4) Requirement The management team must take further steps to ensure all staff, including agency staff follow the instructions given for keeping risks to a minimum. If they do not, then people living at the home may be exposed to unnecessary or avoidable risk. Outstanding requirement The garden must be safe and accessible for service users, and properly maintained. This is so people can fully make use of the facilities and benefit from easy and safe access. This was first identified over two years ago and timescales of 31/10/05, 30/04/06 and 30/04/07 have not been met. 3. YA24 23(4)c The kitchen door must not be wedged open, especially when the cooker is in use. If it is wedged, then people living at the home are at risk from any fire breaking out not being properly contained so that they can get out in time. DS0000027627.V355922.R01.S.doc Timescale for action 31/12/07 2. YA24 23(2)(o) 30/04/08 31/12/07 Newton Lodge Version 5.2 Page 24 4. YA35 18(1) Outstanding requirement There must be increased effort to ensure the standard for 50 of staff achieving (or at least working towards) NVQ qualifications is met. This to show people’s needs are met by people with the right training and underpinning knowledge of how to support people with learning disabilities. Timescale of 31/12/06 has not been met. 30/06/08 5. YA36 18(2) Outstanding requirement All staff must have supervision with the nature and frequency set out in national minimum standards. This is to address their training needs or performance issues and so staff are supported in their work with people living in the home Timescale of 31/10/06 has not been met. 31/01/08 Newton Lodge DS0000027627.V355922.R01.S.doc Version 5.2 Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA6 Good Practice Recommendations Records should be dated and signed in all cases. This is so the management team can be confident information is up to date, regularly reviewed and shows who is accountable for accuracy. There should be a review of all documentation associated with risks to avoid repetition or duplication and increase how comprehensive these are. If there are lots of separate pieces of paper that are not linked, crossreferenced or otherwise clear, staff may not be able to remember all the concerns they set out and may inadvertently place people at risk. Daily records should provide additional supporting detail about any physical injury noted on body charts. This is so there is clear detail about when difficulties were noted and whether any treatment was needed or given. Where a specific moving and handling programme has been devised by other health professionals, this should be incorporated into risk assessment information and care plan goals. This is so there is an integrated approach to care and people are not at risk of error or having their needs overlooked in any way. Work should continue to ensure that health action plans recently introduced, are fully and thoroughly completed. This is to increase the accessibility of information and comprehensively and easily show how people’s health needs are to be successfully met. 2. YA9 3. YA9 4. YA18 5. YA19 Newton Lodge DS0000027627.V355922.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF 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 Newton Lodge DS0000027627.V355922.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!