Inspection on 23/07/07 for Noire House

This inspection was carried out on 23rd July 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 no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Noire House 03/08/06

Noire House 01/02/06

Noire House 04/08/05

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

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

CARE HOME ADULTS 18-65 Noire House 31 Abbotts Road Erdington Birmingham West Midlands B24 8HE Lead Inspector Kulwant Ghuman Unannounced Inspection 23rd July 2007 09:30 Noire House DS0000064613.V342207.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 Noire House DS0000064613.V342207.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. Noire House DS0000064613.V342207.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Noire House Address 31 Abbotts Road Erdington Birmingham West Midlands B24 8HE 0121 382 0217 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) Robinia Care West Midlands Limited Nigel Alan Ward Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Noire House DS0000064613.V342207.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Residents must be aged under 65 The manager must obtain an NVQ Level 4 in Management or equivalent by July 2007. 3rd August 2006 Date of last inspection Brief Description of the Service: Noire House is a modern purpose built home at the end of Abbotts Road in Erdington. It provides accommodation for four people with learning disabilities. The house feels light and airy with a homely atmosphere. To the rear of the property is a large garden, which surrounds both sides of the premises and is laid to lawn. There is no off road parking. The ground floor of the premises consists of a large lounge, with a conservatory that is used as a dining room. There is also a large kitchen, which is occasionally used as a second dining room. A toilet, separate laundry area and office are also located on the ground floor. There are four single bedrooms on the first floor, all of which are a good size and a bathroom with a shower. The service is well situated for local amenities such as Erdington, Star City and The Fort retail park. It is also close to bus routes for Birmingham City Centre and Sutton Coldfield. The premises do not have access for people with mobility difficulties. The range of fees charged by the service range from £1036.80-£1447.94 There are currently no additional charges. Noire House DS0000064613.V342207.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. One inspector carried out this key inspection over two days during July and August 2007. The home did not know that the inspector was coming on the first day of the inspection but the manager was spoken to before coming on the second day to make sure that he would be there. During the inspection the inspector spoke with all the people who lived in the home, two people who worked there and the manager. The inspector also looked at the files of two people living in the home in detail and one where only some things were looked at. Other records that are kept in the home were also looked at. Before the inspection the manager had sent some information to the inspector about the home. The inspector watched and listened to things that were happening in the home as well. The inspector tried to speak to some of the families of the people living in the home but was only able to speak to one family. That family said they thought the people living in the home were well looked after. No complaints had been received by the service and none had been logged with the Commission. No issues of adult protection had arisen. What the service does well: The people who live in the home have a home that is clean and comfortable and tidy. The manager makes sure that the home is safe for them. The inspector heard lots of good conversations between the people who lived in the home and the people who worked there. The people who live in the home can talk to the manager whenever he is in the home. The people who live in the home were able to go and visit their families, go to college, go shopping for food for the home and often went out to have something to eat. The bedrooms in the home are usually kept locked but there is a key available to open them when the people who live in the home want to go into their rooms. There are both men and women who work in the home to help the people living in the home choose, whether to have a bath, what to eat and if they want to go out. The people living in the home are helped to buy things that they need. Noire House DS0000064613.V342207.R01.S.doc Version 5.2 Page 6 The family of one of the people who lived in the home said they thought people living in the home were being looked after well. Their relative was always happy to go back to the home and enjoyed going out with the other people who lived at the home. They said they were invited to celebrations that were taking place in the home and that the home was clean and tidy. What has improved since the last inspection? 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. Noire House DS0000064613.V342207.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 Noire House DS0000064613.V342207.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): 1, 2, 4 and 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people who were living in the home all had information available to them about what help they could expect to receive whilst living in the home and how much they needed to pay. EVIDENCE: The four people living in the home had lived there for several years so that the way in which people came to live in the home was not looked at. Information sent to the inspector before the inspection showed that the manager knew how important it was to give people who wanted to move into the home a chance to visit the home and meet the other people who lived there and worked there. There was a service user guide available for each of the people living in the home telling them what they were able to get from the home. It had pictures and some writing to explain things to them. The two files sampled showed that there was a contract and an agreement on the files. The agreement showed how much the people had to pay to live at the home. Noire House DS0000064613.V342207.R01.S.doc Version 5.2 Page 9 The assessments carried out before the people moved into the home were not checked as no new people had moved into the home. There was evidence on the files that the manager had been making efforts to obtain assessments carried out by social worker previously to ensure these were all in place. Noire House DS0000064613.V342207.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): 6,7,8 and 9 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The people living in the home were involved in making decisions about their lives and in the daily activities of the home. Personal service plans were detailed but not always fully completed and progress on the aims and objectives for the people living in the home were not fully monitored. EVIDENCE: The people living in the home had a personal service plan which included some good details about the needs of the people who lived in the home and what they could do themselves and what they needed to have help with. The plans covered areas including housing, medication, personal hygiene, activities, mobility, communication and making relationships. The file sampled in depth showed that some of these plans had been updated in February this year but many had not been updated since July 2006. Noire House DS0000064613.V342207.R01.S.doc Version 5.2 Page 11 Some aims and objectives had been identified for the individual. These had been completed in July 2006 but others had not been completed at all. The manager needed to ensure that these documents were either completed or removed from the files if they were not required. The sections that had been completed did not evidence what progress had been achieved over the past year. It was advised that progress on these aims and objectives was monitored so that any difficulties in achieving them were identified and addressed as soon as possible. A timetable of activities for the people living in the home was available however, this only indicated the times the individual was to attend college. Activities other than these were decided on a weekly or daily basis and recorded on a separate timetable. The people living in the home met on a weekly basis to discuss what they wanted to eat during the week and any particular activities they wanted to do. The last review of their care had been carried out a year ago and it was signed by the person living in the home indicating that they were being consulted about the care being provided. There was an individual risk assessment in place that had some good details about what the staff needed to do when escorting them outside, going swimming, bathing and so on. The home looked after the some of the monies for the people living in the home. There was an appointee for them who was employed by the organisation but was not employed in the home. Purchases were made on behalf of the people living in the home. There was not always a clear rationale for the reasoning about why the money was being spent in this way. A system needed to be set up to ensure that this was clearly recorded. Noire House DS0000064613.V342207.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): 12,13,14,15,16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people living in the home were enabled to live fulfilling lives and take part in appropriate activities according to their needs and wishes. They all seemed to like the food that was provided in the home. EVIDENCE: There was evidence on the three files sampled that the individuals were involved in activities that helped them to develop their daily living skills. For example, one was attending college to build on life skills and communication through art as well as developing domestic skills such as helping staff to prepare vegetables for the evening meals in the home. Another person enjoyed clearing the tables, vacuuming and dusting around the home. Others were assisted to make drinks for themselves. Noire House DS0000064613.V342207.R01.S.doc Version 5.2 Page 13 Observations during this inspection indicated the people living in the home were receiving appropriate support from the staff and being included in everyday tasks. One person was observed going into the kitchen to make a drink and others went shopping with the staff on a regular basis. Another person used Makaton to show that he had been out for a drive and his facial expressions and body language showed that he was comfortable in the presence of the staff. He asked for a cup of tea several times during the day and the staff gave this to him. The people living in the home were enabled to be independent in self-care tasks as far as possible whilst steps were taken to keep them safe. One individual whose seizures were well controlled was able to have a bath without staff assistance but had been asked to let the staff know when they were going for a bath so that they could be checked regularly while in the bathroom for their own safety. The people living in the home were being encouraged to be part of the community by attending college, places of worship, visiting friends and families and going to the cinema, pub or local shops. The religious and cultural needs of the people living in the home were being met. There was evidence on the files that showed that two of the people living in the home had been taken to or given information about places of worship however the cultural and religious needs of one of the individuals was met mainly by the family. The service user plans needed to show how the home would meet these especially now as the individual was spending less time with the family. There was evidence of the people living in the home having contact with their relatives and families wherever possible. It was possible for the families to visit them at the home and in some cases the individuals went for overnight stays with the family. One of the people living in the home had been on holiday to Portugal. The other people had not been on holiday this year and no decisions had been made about where they would be going. The manager said that this was currently being looked into. The home had acquired a car to help with taking the people who lived in the home out to college, day centre, shopping or for a drive. The amount of money that had to be paid by each person for use of the car had not yet been decided. There was a four weekly rolling menu in place in the home however, each week the people living in the home met together to decide whether they Noire House DS0000064613.V342207.R01.S.doc Version 5.2 Page 14 wanted the meals identified on the menus or something different. There were a variety meals available that had been prepared in the home or that were eaten in the pub or restaurant. However, examination of the food records for one person living in the home showed that over a two week period the individual had had chips with their main meal seven times. The staff needed to be mindful of this and encourage more variety in the meals for the individual especially as the person had diabetes and an increase in weight would not be desirable. The people living in the home were provided with support as needed at mealtimes. Staff said that they needed to prompt some of them to eat more slowly and ensure that their food was cut up so that they were not sick because they had not chewed their food enough. Some efforts were made to ensure that the cultural needs of the people living in the home were being met. For one of the one many of his cultural needs were met through regular contact with his family. The home needed to gather further evidence about what was exactly required and how the home could also facilitate this. Noire House DS0000064613.V342207.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people living in the home were able to choose how support was provided and independence was encouraged wherever possible. EVIDENCE: The people living in the home were given support as they wanted it. Their personal service plans indicated what help they required to maintain their personal hygiene and what tasks they could undertake themselves. There was a choice available for them to have a bath or shower, when they wanted these and whether they wanted male or female assistance. It was clear from the records seen that the people living in the home had regular contact with the doctors, nurses, dentist, psychologists and physiotherapists as they needed. All the people living in the home appeared to be in good physical and emotional health. Noire House DS0000064613.V342207.R01.S.doc Version 5.2 Page 16 Some very good interactions between the staff and the people living in the home were seen. Interactions were not just about what people had to do but also included some very funny conversations. For example, one person living in the home asked a member of staff how old they would be at their next birthday and when the member of staff told them the individual laughed and said that that was really old and there was a lot of laughing going on. There were no people living in the home that were able to manage their own medicines. The medicines were kept in a cupboard in the office and the people living in the home were asked to come to the office to take their medicines. Only if they were ill was their medication taken to them. The home used a blister pack system for managing the medicines and there were some medicines that were in boxes. There were copies of recent prescriptions available with the medication administration records and there were no medicines in the fridge. The management of medicines was good. There was an issue of rectal diazepam being available for the use of one of the people living in the home however none of the staff in the home at the time of the inspection had been trained in its use. The inspector was told that the staff would have to make a call to the on-call person for advice. This medication had not been needed for use for some time as the individual’s epilepsy was well controlled. It was recommended that the manager discussed with the medical staff the need for this medication to be kept in the home. If this is to be kept in the home staff needed to be provided with the appropriate training. Noire House DS0000064613.V342207.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people living in the home were made aware of the complaints procedure and were protected by the policies and procedures in the home. EVIDENCE: No complaints or adult protection issues had been raised with the Commission about the service. No complaints had been logged in the complaints book in the home. There was an appropriate easy read complaint procedure available in the home and there were multi-agency guidelines available for the management of any adult protection issues if they arose. The recruitment procedures were robust and safeguarded the people living in the home. Noire House DS0000064613.V342207.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26,27,28 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is situated in a residential area of Birmingham and appears to be an ordinary family home from the outside. Internally the home provides a comfortable environment for the people in the home to live in. EVIDENCE: The home is situated in a residential area of Birmingham and appears to be an ordinary family home from the outside. Internally the home was well decorated, clean, comfortable and homely. Three of the people living in the home showed the inspector their bedrooms and all the bedrooms appeared to be comfortable and suited their needs. The bedrooms were locked and the people living in the home knew where the key was kept. Noire House DS0000064613.V342207.R01.S.doc Version 5.2 Page 19 All the bedrooms were situated on the first floor of the building. All bedrooms were singly occupied and furnished to the individual needs of the people occupying them. On the ground floor was a communal lounge, conservatory, kitchen, bathroom, laundry and office. There was a pleasant garden to the side of the housewith a swing and trampoline in it for the use of the people living there. These belonged to two of the people living in the home. There was also a greenhouse that was used by some of the people living in the home to grow plants. There were suitable toilet and bathing facilities in the home. Noire House DS0000064613.V342207.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,33,34 and 35 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The staffing levels and training undertaken by the staff appeared to meet the needs of the people living in the home. EVIDENCE: Staff in the home carried out a multi-tasking role that included cooking, cleaning, laundry and supporting the people living in the home. Examination of the rota showed that there were generally two support staff on duty during the day and one waking night staff during the night. Staff were generally working a twelve-hour shift. There was only one vacancy at the home at the time of the inspection. There were times during the shifts where staffing levels were falling below these levels. On some of these occasions there was only one member of staff on duty with the four people living in the home between 8 and 9am. This does not safeguard the people living in the home or the staff themselves. For example, if there were an accident and one of the people living in the home needed to go into hospital the sole member of staff would be in a difficult Noire House DS0000064613.V342207.R01.S.doc Version 5.2 Page 21 position as to what to do. This could mean a delay in getting help whilst the on call person came to the home to cover the shift or the individuals being left alone for a period of time or the individual needing help would have to go to hospital unescorted. None of these scenarios would be satisfactory. Two staff files were sampled during the inspection. The appropriate employment checks had been undertaken before the individuals had started work at the home. One of individuals had been working within the organisation as a bank staff and their details of induction were not available at the home. The manager stated that this had been undertaken. An induction programme in line with the Skills for Care guidelines had been arranged for the other person however for personal reasons was unable to continue to work at the home. There was evidence that other staff had or were undertaking their induction training. The staff team comprises of individuals who reflect the cultures and backgrounds of the people living in the home in respect of gender and languages. Examination of the training records showed that training in the protection of vulnerable adults, fire prevention, induction and Makaton was being provided. Noire House DS0000064613.V342207.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,38,39,42,43 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are policies and procedures in place and there is an open and friendly atmosphere in the home. The people living in the home are involved in making decisions about the home where possible. EVIDENCE: The manager had completed the Registered Managers award and spoke knowledgeably about the needs of the people living in the home. The home was well organised and the staff team were found to be fully able to manage the home on a day to day basis in the absence of the manager indicating that the manager shared tasks and skills with the staff team. A manager from another home had been visiting the home to carry out the provider’s monthly visits to the home. Noire House DS0000064613.V342207.R01.S.doc Version 5.2 Page 23 Throughout the inspection it was evident that the manager had an open door policy and the people living in the home regularly came into the office to talk to the staff if they were in the office and that they were easy in their presence. There had not been any recent surveys completed by the people living in the home and these should be undertaken again to ensure that they were still satisfied with the service provided by the organisation. The records were well managed and easily accessed. Health and safety in the home was well managed. The manager was spending some time of the shifts as a support worker and this was having some impact on the development of records in the home. The provider needed to ensure that sufficient amount of time was allowed for the manager to develop the health care action plans and ensure that the care plans and objectives were completed and monitored. Noire House DS0000064613.V342207.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 3 4 3 5 3 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 3 25 3 26 3 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 2 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 3 2 X x 3 3 Noire House DS0000064613.V342207.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? No 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)(2) Requirement Aims and objectives must be set and monitored on a regular basis. This will ensure that the people living in the home receive person centred care that is tailored to their development. The manager must discuss the need for rectal diazepam to be kept on the premises with the medical staff concerned and ensure that if needed the support staff are trained in its use. This will ensure that the staff are trained to meet the needs of the people living in the home. There must be two staff on duty at all times during the day. This will ensure that there are always enough staff on duty to meet the needs of the people living in the home safely. Timescale for action 01/10/07 2. YA20 13(2) 01/10/07 3. YA33 18(1)(a) 01/10/07 Noire House DS0000064613.V342207.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. 1. Refer to Standard YA6 Good Practice Recommendations All service user plans must be reviewed and updated on at least a six monthly basis so that the needs of the people living in the home continue to be met. A record should be kept to show how the home would ensure that the cultural and religious needs of the people living in the home would be met if the families were unable to do so. A clear rationale for the spending of money on behalf of the people living in the home should be recorded. This will ensure that the people living in the home are safeguarded. The home needed to encourage the individual identified in the home to have more variety in their meals. This will ensure that a varied diet is eaten and their health is safeguarded. The provider should ensure that the manager maintains sufficient management hours enabling him to ensure that records are updated and developed as required in the home. The manager should ensure that the views of the people living in the home and other visitors are sought to enable the service to be developed taking into consideration the views being expressed by them. 2. 3. YA7 YA15 4. YA33 Noire House DS0000064613.V342207.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Birmingham Office 1st Floor Ladywood House 45-46 Stephenson Street Birmingham B2 4UZ 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 Noire House DS0000064613.V342207.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!