Inspection on 11/12/06 for Noble Lodge

This inspection was carried out on 11th December 2006.

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

Other inspections for this house

Noble Lodge 17/12/08

Noble Lodge 14/06/07

Noble Lodge 05/09/05

Noble Lodge 03/05/05

Noble Lodge 09/09/04

Noble Lodge 10/05/04

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

CARE HOME ADULTS 18-65 Noble Lodge 143 Bounds Green Road London N11 2ED Lead Inspector Mr Brian Bowie Key Unannounced Inspection 11th December 2006 09:30 Noble Lodge DS0000010705.V320178.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 Noble Lodge DS0000010705.V320178.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. Noble Lodge DS0000010705.V320178.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Noble Lodge Address 143 Bounds Green Road London N11 2ED 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) 020 8245 7560 Mr Shaukatally Hossenally Ms Ellen McKinnon Care Home 6 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (6) of places Noble Lodge DS0000010705.V320178.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. One specified service user who is over 65 years of age may remain accommodated in the home. The home must advise the registering authority at such times as the specified service user vacates the home. 5th September 2005 Date of last inspection Brief Description of the Service: Noble Lodge is a care home providing personal care for 6 adults who have mental health needs. It is a private care home owned by Mr Shaukatally Hossenally. The home, which opened in 1990, is in Bounds Green close to the underground station and local shops and services. There are six single bedrooms on the ground, first and second floor. There is a dining room and lounge as well as a garden to the rear. The home is not accessible for wheelchair users. The aim of the home is to provide a quality service for people who have mental health needs and to promote their independence. Noble Lodge aims to achieve this by providing support to help residents maximise their potential, physically, intellectually, emotionally and socially, within a homely atmosphere. One of the current residents is over the age of sixty-five. The home therefore has a condition on the registration certificate for one named person over sixty-five. In 2006 the fees charged ranged from £500-£700/week. Noble Lodge intends to make inspection reports and other important information about the home available to residents, their families and professionals. Noble Lodge DS0000010705.V320178.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 1 day and lasted 8 hours. The registered manager was present throughout the inspection and the owner was interviewed towards the end of the visit. The inspector looked round the home and spoke to 5 of the 6 residents living in the home at the time of the inspection. The residents are able to communicate how they feel about living at the home. Throughout the inspection the way in which staff communicated with and supported residents was observed. In addition one member of care staff and the manager were interviewed. A variety of records, including care plans, staff files and health & safety documents were looked at. The overall impression is that the experienced staff team at Noble Lodge is providing an adequate standard of care to residents. What the service does well: Feedback from the 5 residents interviewed was positive about how they found living at Noble Lodge. One relative had written: ‘Brilliant home that has looked after my relative very well.’ The home has a homely and relaxed atmosphere. Members of staff have got to know the residents very well and understand their individual needs and preferences. As a result residents are able to communicate confidently with staff. Each resident is seen and treated as an individual in their own right. This approach is giving residents the opportunity to build and develop for themselves a more positive lifestyle than they have had previously. In several cases residents have been through a number of living situations that have not been able to meet their needs. They are now benefiting from being well supported by staff so that in general their mental heath is relatively stable. There is an experienced team of staff at Noble Lodge who have attended a range of training courses in working with adults with mental health needs. Consequently the residents get the benefit of living in a home where they feel understood and supported. Noble Lodge DS0000010705.V320178.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? Areas that have improved since the previous inspection include: • • • • Storage of medication Recruitment procedures First Aid training Health & safety documentation As a result 6 of the 8 areas that needed sorting out from the previous inspection had been sorted out. In addition residents are continuing to get out and about in the community more than previously. 2 community mental health nurses who visit the home regularly wrote that they were satisfied with the care being given to the residents they were responsible for. What they could do better: At this inspection 16 areas to be improved are identified, including 2 that have previously been highlighted. It is important that all requirements made, especially for the second time, are complied with. In order that the needs of residents are properly met at all times the home needs to achieve the following: • • • • • • • • Care plans that detail each resident’s needs Care plans that include each resident’s cultural and religious needs Toilet seat in downstairs toilet secured or renewed Toilet seat and toilet roll holder in first floor toilet renewed Old dining room chairs replaced with new ones Stool in first floor bathroom renewed Front and rear areas of the premises tidied, with leaves, litter and general rubbish removed The laundry area to be cleaned thoroughly to ensure it is hygienic and fit for purpose Noble Lodge DS0000010705.V320178.R01.S.doc Version 5.2 Page 7 • • • • • • • • Communal areas inside the home to be cleaned properly to remove cobwebs and dust One member of staff on duty at all times (urgent) An induction record to be completed for all new members of staff at the home The manager and staff to undertake training in person-centred planning All staff to have a minimum of 6 recorded supervision meetings each year Findings from quality assurance surveys to be recorded and made available to those parties involved with the home Residents’ meetings and staff meetings to be held at least 4 times each year All the home’s policies and procedures to be kept under review and regularly updated The management team at the home emphasised that they are keen to work closely with CSCI in order that the home improves from ‘adequate’ to ‘good’. 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. Noble Lodge DS0000010705.V320178.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 Noble Lodge DS0000010705.V320178.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): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. • People moving into the home can be confident that their needs will be assessed and an appropriate plan for meeting these needs will be drawn up. EVIDENCE: The files for 3 of the residents were looked at and indicated that before they moved in a full mental health assessment had been received by the home. A care plan had then been drawn up by the home showing how the resident’s needs were to be met. Residents said, or indicated, that they enjoyed living at the home. Reviews with mental health professionals indicated that residents are appropriately placed and their needs are being met. Observation throughout the inspection showed that residents are appropriately placed at Noble Lodge. This indicates that the home is careful to ensure that it is able to meet the needs of new residents and does not admit people whose needs it is unable to meet. Noble Lodge DS0000010705.V320178.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. • • • Care plans need more detailed information on how the needs of residents are met, including their cultural and religious needs. Noble Lodge is good at finding ways for residents to make as many decisions for themselves as possible. Residents are protected by risk assessments that are comprehensive and indicate clearly how risks to the safety of residents are reduced. EVIDENCE: Feedback from the residents interviewed was positive about how they found living at Noble Lodge. One social worker had said at a review meeting: ‘My client appeared content and well cared for, and told me that they are happy at Noble Lodge DS0000010705.V320178.R01.S.doc Version 5.2 Page 11 the home.’ Residents thought their needs were being met and that they were getting on well. The records for 3 residents were looked at and indicated that for each one there was a current plan of care. These set out the needs of the resident and how they are to be met by the home. However they still do not contain sufficient detail to indicate how the needs of residents are to be fully met. In addition care plans looked at did not clearly identify the cultural and religious needs of residents. The manager must ensure that care plans drawn up by the home are detailed and include cultural and religious needs. ‘Support staff at the home encourage residents to be as independent as possible.’ This was the comment of a social worker at a placement review. Throughout the inspection members of staff offered choices to residents. People made choices about when they got up in the morning and when they went out. Residents said they could choose what they had to eat and what outings they went on. All care plans recognise potential risks to residents and the risks that they may pose to others. The plans outline how these risks can be minimised, for example detailing action to be taken by staff if a resident became aggressive or violent within the home. Staff interviews indicated that members of staff understand how to support residents. They do this in line with training they have had on how best to meet the mental health issues presented by the residents. Noble Lodge DS0000010705.V320178.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. • • • • • Residents have a good quality of life because they take part in a range of stimulating activities. Residents are helped to be part of their local community. Residents are helped to keep in touch with their families and relatives. The residents benefit by having staff who allow them to make choices for themselves and to have as much control over their life as possible. Residents have a choice about what they eat and enjoy the food provided. EVIDENCE: Noble Lodge DS0000010705.V320178.R01.S.doc Version 5.2 Page 13 Residents are relatively independent at choosing their own activities and preferred lifestyles. Staff have generally been able to provide individual opportunities relevant to residents’ needs and wishes on a daily basis. One resident said she enjoyed going to her local club for older people where she played bingo. Another resident was having some additional 1-to-1 support from an individual from the same ethnic background as the resident. On the day of the inspection plans were being made to celebrate in the home the birthday of one of the residents. Some residents attend day centres during the week, others visiting their family regularly. Residents make use of local facilities, including shops and cafes, and make use of public transport to get out and about in the local community. On the day of the inspection a hairdresser came in to do the hair of a resident. Staff and residents confirmed that residents are encouraged to maintain contact with family and friends. There was positive written feedback from relatives that confirmed they are consulted about the care given to their family member and that they are kept informed about key developments. All residents spoken to were satisfied with the selection of food provided to them within the home. Menus indicated that a varied and nutritious diet is provided to service users. One resident told the inspector “the food here is very good.” Noble Lodge DS0000010705.V320178.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. • • • Staff are good at supporting residents in a way which the residents are happy with. Residents benefit by having their physical and emotional health needs met. The residents are protected by effective medication in the home. arrangements regarding EVIDENCE: ‘I like the staff- they help me.’ This was the comment of one resident and reflected the general feeling of the residents at Noble Lodge. The care plans set out clearly how to respond to the needs and wishes of residents, with guidelines about dealing with any areas of risk. As a result the residents feel Noble Lodge DS0000010705.V320178.R01.S.doc Version 5.2 Page 15 more relaxed which in turn enables them to have improved relationships both with other residents and with staff. All residents have detailed healthcare records and have access to local health centre facilities as and when required. Attendance of health care appointments is recorded appropriately for each service user so that these can be tracked easily. Records are maintained of all medicines brought into the home or disposed of, and a system is in place for recording medicines given to residents for overnight stays. The manager indicated she has overall responsibility for the recording of medicines, so that any problems can be resolved straight away. Changes in medication arrangements are followed up and recorded by staff. Care staff have had training on how to administer medication safely and correctly. Noble Lodge DS0000010705.V320178.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. • • Residents and relatives feel confident their complaints and concerns will be listened to and acted on. The residents are protected by adult protection procedures that make sure that they are safe and secure whilst at Noble Lodge. EVIDENCE: There have been no complaints made to the home since the previous inspection. ‘It’s ok here. Staff are fine. I don’t have any problems, I’ve no complaints about the home.’ This was the comment of one resident. Residents spoken to said they felt able to raise their concerns or complaints with staff and managers. Written feedback from 2 community mental health nurses who visit the home indicated that they had not received any complaints about the home. The home has policies and procedures in place in relation to reporting and investigating complaints. Staff have attended training courses on how to protect vulnerable adults from abuse and know what to do if they think a resident has been the victim of any form of abuse. The home has procedures and policies on protecting residents from abuse. There have been no allegations of abuse in the past year. Noble Lodge DS0000010705.V320178.R01.S.doc Version 5.2 Page 17 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): 24,30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. • Residents at Noble Lodge enjoy a homely, comfortable and safe living environment. However maintenance and refurbishment standards in the home need improvement. Residents do not have the benefit of a home that is kept clean and tidy at all times, both inside and outside of the building. • EVIDENCE: A homely living environment is provided for residents. Residents have personalised their own rooms to reflect their own individual tastes and wishes. However a number of items needed attention: Noble Lodge DS0000010705.V320178.R01.S.doc Version 5.2 Page 18 • • • • Toilet seat in downstairs toilet to be secured or renewed Toilet seat and toilet roll holder in first floor toilet to be renewed Old dining room chairs to be replaced with new ones Stool in first floor bathroom to be renewed On the day of the inspection the home did not present an attractive and tidy appearance. A number of areas required attention: • • • Front and rear areas of the premises needed tidying up to remove leaves, litter and general rubbish The laundry area needed cleaning thoroughly to ensure it is hygienic and fit for purpose Communal areas inside needed proper cleaning to remove cobwebs and dust Noble Lodge DS0000010705.V320178.R01.S.doc Version 5.2 Page 19 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 adequate. This judgement has been made using available evidence including a visit to this service. • The residents have the benefit of a committed and experienced team of staff. However staffing levels do not always ensure residents’ needs are met at all times. Residents are protected by the home’s recruitment procedures for new staff. Residents get better support because staff have the relevant training and skills. However residents do not have the benefit of being supported by staff using person-centred planning principles. Residents benefit by being supported by staff who are supervised on their care practice. However staff need to have more frequent supervision meetings with the manager. • • • Noble Lodge DS0000010705.V320178.R01.S.doc Version 5.2 Page 20 EVIDENCE: The registered manager has worked in the home for a number of years and is supported by the owner who is at the home on most days and works in the home at weekends. In general staffing levels are sufficient to meet the needs of the current group of residents. However on the day of the inspection the late arrival of one member of staff meant that for a short period of time a member of staff was not on the premises. This is unsafe practice and an immediate requirement was made to ensure that there is always one member of staff on duty at all times. Subsequent to the inspection the owner put in writing that he would ensure that at all times there was one member of staff on duty on the premises. Most members of staff have achieved the NVQ Level 2 in care, and have considerable experience in working with people with mental health needs. As a result residents are being supported well which is contributing to their improving mental health. Staff files were looked at and contained the information needed to make sure that all new staff in the home have had the appropriate checks made, including obtaining written references and satisfactory CRB disclosures. As a result residents are protected by the arrangements Noble Lodge has in place when recruiting staff to work at the home. New members of staff have a planned induction into the roles and responsibilities of being a care worker. However this had not been recorded on a new member of staff’s file. The manager must ensure that an induction record is completed for all new members of staff at the home. The staff team has attended a range of relevant courses, including fire safety, food hygiene, administration of medication, and first aid. As a result staff are more effective in how they support residents. However the staff team needs to develop a more person-centred approach to the support of residents so that the home practises current best practice in the support of people with mental health needs. The manager and staff therefore must undertake training in person-centred planning. Staff records showed that members of staff have had a supervision session so that their care practice can be developed and any training needs identified. However these meetings were not taking place regularly enough. The manager must ensure that all staff have a minimum of 6 recorded supervision meetings each year. Noble Lodge DS0000010705.V320178.R01.S.doc Version 5.2 Page 21 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): 37,39,40,42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. • • Residents benefit from living at Noble Lodge because the home is run in the best interests of the residents. The home is good at consulting with residents and relatives about the quality of care provided. However findings from quality assurance surveys need to be recorded and available for interested parties to look at, with more frequent residents’ and staff meetings being held. The home’s policies and procedures need updating. The home is good at making sure the residents are kept safe and secure. • • Noble Lodge DS0000010705.V320178.R01.S.doc Version 5.2 Page 22 EVIDENCE: The running of the home was seen to be of an adequate standard with priority given to meeting the needs of residents. The manager and staff had a good understanding of the needs and wishes of each resident. Residents were seen to be relaxed in the presence of staff and confident about interacting with them. One resident commented: ‘The staff team are very helpful- you can talk to staff.’ The home uses feedback forms and questionnaires to get the comments and views of residents, families and professionals about the service provided by Noble Lodge. Findings from these surveys need to be recorded and made available to those parties involved with the home. Meetings are held to enable residents to contribute their ideas and suggestions on the running of the home. However these need to be held more regularly, as do staff meetings, so that key parties have plenty of opportunity to comment on the care provided and suggest improvements. The home has a comprehensive set of policies and procedures relating to the running of the home. However these had not been updated, as previously required, in order to ensure that they reflect current legislation and best practice. The manager must ensure that all the home’s policies and procedures and kept under review and regularly updated. A range of records was looked at, including health and safety and fire safety. These records were detailed, up-to-date and accurate and confirmed that the home is being run responsibly with essential checks being made and acted on. Noble Lodge DS0000010705.V320178.R01.S.doc Version 5.2 Page 23 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 2 STAFFING Standard No Score 31 X 32 2 33 X 34 3 35 2 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 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 3 X 2 1 X 3 X Noble Lodge DS0000010705.V320178.R01.S.doc Version 5.2 Page 24 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 YA6 Regulation 15 (1) Timescale for action The registered persons must 31/01/07 ensure that care plans are updated to include a greater level of detail regarding the exact nature of support needed by residents. (Previous timescale of 28/10/05 not met). The registered persons must 31/01/07 ensure that care plans describe how the cultural and religious needs of residents are to be met. The registered persons must 31/12/06 ensure that the toilet seat in the downstairs toilet is secured or renewed. The registered persons must ensure that the toilet seat and toilet roll holder in the first floor toilet is renewed. The registered persons must ensure that old dining room chairs are replaced with new ones. The registered persons must ensure that the stool in the first floor bathroom is renewed. The registered persons must DS0000010705.V320178.R01.S.doc Requirement 2. YA6 15 (1) 3. YA24 23 (2) (c) 4. YA24 23 (2) (c) 31/12/06 5. YA24 23 (2) (c) 31/01/07 6. 7. YA24 YA24 23 (2) (c) 23 (2) (d) 31/01/07 31/12/06 Page 25 Noble Lodge Version 5.2 8. YA30 23 9. YA30 23 10. YA33 18 11. YA35 18 12. YA35 18 13. YA36 18 14. YA39 24 15. YA39 24 16. YA40 17 ensure that the front and rear areas of the premises are tidied up to remove leaves, litter and general rubbish. (2) (d) The registered persons must ensure that the laundry area is cleaned thoroughly to ensure it is hygienic and fit for purpose. (2) (d) The registered persons must ensure that the communal areas inside are cleaned properly to remove cobwebs and dust. (1) (a) The registered persons must ensure that there is always one member of staff on duty at all times. (An immediate requirement is made to ensure prompt compliance) (1) (c ) The registered persons must ensure that an induction record is completed for all new members of staff at the home. ( c) (i) The registered person must ensure the manager and staff undertake training in personcentred planning. (2) The registered persons must ensure all staff have a minimum of 6 recorded supervision meetings each year. (1) The registered persons must ensure that findings from quality assurance surveys are recorded and made available to those parties involved with the home. (3) The registered persons must ensure residents’ meetings and staff meetings are held at least 4 times each year. (4) The registered persons must ensure all the home’s policies and procedures and kept under review and regularly updated. (Previous timescale of 14/10/05 not met). 31/12/06 31/12/06 13/12/06 31/12/06 31/03/07 31/01/07 31/01/07 31/01/07 28/02/07 Noble Lodge DS0000010705.V320178.R01.S.doc Version 5.2 Page 26 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Noble Lodge DS0000010705.V320178.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Southgate Area Office Solar House, 1st Floor 282 Chase Road Southgate London N14 6HA 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 Noble Lodge DS0000010705.V320178.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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!