Inspection on 20/11/07 for Oakleigh House

This inspection was carried out on 20th November 2007.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 9 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Oakleigh House 13/09/06

Oakleigh House 28/09/05

Oakleigh House 18/05/05

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

CARE HOME ADULTS 18-65 Oakleigh House 8 Barn Park Road Teignmouth Devon TQ14 8PN Lead Inspector Judy Hill Unannounced Inspection 20 November 2007 9:30 th Oakleigh House DS0000062352.V349374.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 Oakleigh House DS0000062352.V349374.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. Oakleigh House DS0000062352.V349374.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Oakleigh House Address 8 Barn Park Road Teignmouth Devon TQ14 8PN 01626 870331 01626 776715 oakleigh@carepartnerships.com 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) Networking Care Partnerships (SW) Ltd Vacancy Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Oakleigh House DS0000062352.V349374.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13th September 2006 Brief Description of the Service: Oakleigh House is registered to provide accommodation and care for a maximum of six people who are Between eighteen and sixty-five years of age and who have learning disabilities. The home specialises in catering for people with a very high level of need and who may display challenging behaviour. The house is situated in a residential area of Teignmouth and is a short walk from the railway station, town centre and beach. Information about the service is available from the service provider in a Statement of Purpose and in a Service Users’ Guide. Copies of CSCI inspection reports are also available from the service provider and are on the CSCI website. The fees are calculated according to the individually assessed needs of the people living at the home. At the time of this inspection the weekly fees ranged from £815 to £3,155 a week. This covers accommodation, board and care. Additional charges are made for professional hairdressing, chiropody, toiletries, other items of a personal nature and some activities. Oakleigh House DS0000062352.V349374.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection unannounced and was carried out by one inspector on 20th November 2007. The information contained in this report was gained in conversation with the people who use the service, the operations manager, the prospective manager, the deputy manager and staff on duty. Additional information was gained from previous inspection reports, an Annual Quality Assurance Assessment, that had been completed by a former prospective manager, surveys completed for the Commission by staff and representatives of the people who use the service, the Statement of Purpose and Service Users Guide. Further information was gathered from an inspection of records, including service user assessments, care plans and reviews and staff recruitment records, training records and rotas. What the service does well: The individual needs of people considering using the service are assessed. The support workers write detailed daily reports after each shift. This helps provides continuity of service. House meetings are held to enable the people who use the service to contribute to discuss the service they receive and make suggestions for improvement. Good recording and auditing practices ensure any money handled by the management and support workers for the people who use the service is kept safely. Healthy eating is actively encouraged and the people who use the service are able to contribute to menu planning. The people who use the service are helped to maintain their personal hygiene. Trained support staff handle the medication of the people who use the service safely. Complaints are dealt with sensitively and recorded. Policies, procedures and staff training are provided to safeguard the people who use the service from the threat of abuse. The house is well maintained and kept very clean. The gardens are well maintained by the people who use the service and the support staff and this year came second in the Companies gardening competition. Oakleigh House DS0000062352.V349374.R01.S.doc Version 5.2 Page 6 Safe practices are used to recruit new staff. The staff are supported and encouraged to take National Vocational Qualifications and the provision of training is good. All of the required and recommended written policies and procedures are kept at the home and accessible to the support staff. What has improved since the last inspection? What they could do better: The Statement of Purpose needs to be reviewed and updated. The Service Users’ Guide needs to be re-written and copies need to be given to the people who use the service. The presentation of information about the people who use the service, including needs assessments, risk assessments, risk management strategies, care planning, and reviews needs to be better organised. This should ensure that the support staff have easy access to the information they need to meet the individual needs of the people who use the service. Better provision could be made to ensure that the people who use the service are able to engage in a wider range of social, occupational and recreational activities. This applies to the provision of active support in the home and outside activities. More seating needs to be provided in the lounge as there is not enough comfortable seating to accommodate the people who use the service and the staff. The small communal room on the first floor needs to be kept available for use by the people who use the service. The service is understaffed and the staff turnover is high. This means that the service relies heavily on bank and agency staff, who may not understand the complex needs of the people who use the service and how best to meet their needs. The home has had four changes of management since the last key inspection. This instability has had a negative impact on the quality of the service provided for the people living at the home. Oakleigh House DS0000062352.V349374.R01.S.doc Version 5.2 Page 7 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. Oakleigh House DS0000062352.V349374.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 Oakleigh House DS0000062352.V349374.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1&2 Quality in this outcome area is adequate. People considering using the service and their representatives do not have access to the information they need to make an informed decision about whether the service will meet their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Both the Statement of Purpose and Service Users Guide were requested prior to the inspection and reviewed. The Statement of Purpose was found to contain most of the required and recommended information, however sections of the Statement do not relate to Oakleigh House and/or are misleading or out of date. The Service Users Guide was found to duplicate the information contained in the Statement of Purpose. It did not contain most of the required and recommended information and was not presented in a format that would be accessible to the service users. The people who use the service have not been given copies of this document. Oakleigh House DS0000062352.V349374.R01.S.doc Version 5.2 Page 10 In their Annual Quality Assurance Assessment the service providers acknowledge that the pre-admission assessment documentation for three of the service users needs to be reviewed. An inspection of pre and post admission assessment documents was carried out and although most of the relevant information had been collected, the presentation of the information could be improved. This would ensure that the information kept in the files of the people who use the service is easily accessible. Oakleigh House DS0000062352.V349374.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Quality in this outcome area is adequate. Individual care plans, including risk management plans, are poorly presented and the support staff may not have access to the information they need to meet the individual needs of the people who use the service. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The support staff complete daily records about the work they have done with each of the people using the service and these were seen to detailed and relevant. At the last key inspection, which was carried out on 13th September 2006, the quality of the individual care planning was assessed as good. A random inspection was carried out on 31st May 2007 and the care planning and risk assessments were found to be in disarray because the service users files were Oakleigh House DS0000062352.V349374.R01.S.doc Version 5.2 Page 12 in the process of being re-organised. During this inspection the care plans were identified in the service providers Annual Quality Assurance Assessment as areas for improvement through the implementation of Person Centred Planning practises. In their current format the information contained in the individual care plans and risk management plans made available to the support staff and kept in the office was found to be poorly presented and difficult to access. This was discussed with the prospective manager (who has been in post for less than two weeks) and she is aware that the quality of the care planning and risk assessment needs to be improved. She is also aware that the presentation of care plans and behavioural guidelines/risk management plans need to be worked on to ensure that the information that the support staff need is readily accessible to them. Minutes of regular House meeting, which include the people who use the service, were seen. These provide evidence that the people who use the service are involved in making decisions about their lives. With better care planning the independence and autonomy of the service users could be further developed. One of the people who use the service manages his own bank account, although all of the service users are given the help they need to manage their personal spending money. Records of the financial transactions that the staff had assisted the service users with were inspected. They were found to be clearly written and regularly audited. Oakleigh House DS0000062352.V349374.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16, & 17 Quality in this outcome area is adequate. More could be done to ensure that the social, occupational and recreational needs of the people who use the service are met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Three of the four service users have very limited communication skills and were unable to respond to direct questioning. The fourth chose not to speak to the Commission. Because of this most of the information gathered about the service users lifestyles was taken from records and from the prospective manager and deputy. Evidence was seen of a limited use of outside day care services. This was discussed and acknowledged by management, who said that they were Oakleigh House DS0000062352.V349374.R01.S.doc Version 5.2 Page 14 working towards improving this situation by exploring the availability of organised activities, which may suit their individual abilities and interests. The people who use the service are taken out both individually and as a group by the support staff. Recent group outings have included a visit to Living Coasts and a visit to Longlete. The people who use the service are involved in the day-to-day running of their home but it is anticipated that with the planned introduction of Person Centred Planning more active support will be provided to improve their input and to provide more focussed social, occupational and recreational support. The Statement of Purpose states that visitors are welcome at all reasonable times and that the people who use the service will also be helped to keep in touch with their families and friends by letter of phone. The minutes of house meetings provided evidence that the people who use the service are encouraged to contribute to menu planning and that they are encouraged to eat healthy meals, which include plenty of fruit and vegetables. Oakleigh House DS0000062352.V349374.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this outcome area is adequate. The personal hygiene needs of the people who use the service are being met, however the people who use the service may have unmet emotional needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All four of the people using the service require some help with their personal care. Although none of the people could provide verbal feedback on the quality of the care provided they were all seen to be clean and well dressed. Although structured routines are in place to ensure the smooth running of the home, a level of flexibility is used to enable the people who use the service to make decisions about when they want to go to bed and get up and whether or not they wish to use the communal rooms or remain in the privacy of their bedrooms. Oakleigh House DS0000062352.V349374.R01.S.doc Version 5.2 Page 16 The healthcare of the people who use the service is monitored on a daily basis by the staff and timely referrals are made to the primary healthcare services as and when necessary. A high number of incidents have been reported to the Commission since the last key inspection. These include attacks on staff and people who use the service by people who use the service. Professional help is being provided by the NHS/Social Service specialist team for people with learning disabilities, however the increased frequency of these incidents over the past year places the people who use the service and the staff at risk. These incidents could indicate that the health and/or emotional needs of the people who use the service are not being met. None of the people who use the service are able to handle their own medication and records were seen to provide evidence that assistance is provided by trained staff. The storage cupboards provided for the medicines and the records of administration were seen and were satisfactory, although the location of the storage facilities were inappropriately and should be moved out of a room that, at the time of registration, was identified as a communal room (see Premises). Oakleigh House DS0000062352.V349374.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. Complaints are handled appropriately and policies, procedures and staff training are in place to safeguard the people who use the service from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A complaints procedure is included in the Statement of Purpose but this needs to be amended as it relates to another home. The complaints procedure is available at the home in picture format to make it more accessible to the people who use the service. The homes record of complaints was inspected. Most of the recent entries related to an on-going complaints from or on behalf of neighbours about noise. These complaints were discussed with the management of the home and, despite their best efforts, are likely to remain unresolved for the foreseeable future. Policies are procedures are in place to safeguard the people who use the service from abuse. The deputy manager has been trained to provide training for staff on the Protection of Vulnerable Adults. The two most recently appointed support staff have not had received this training and arrangements are in place to provide this for them and to update the training with the remaining staff. Oakleigh House DS0000062352.V349374.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 & 30 Quality in this outcome area is adequate. The people who use the service benefit from living in a clean and wellmaintained home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Oakleigh House is situated in a residential area of Teignmouth and is within easy walking distance of the town centre, railway station and beach. Although there is a flight of steps to the front door, level access can be gained from the back of the house. Bedrooms, all of which have en-suite bathrooms or shower rooms are situated on the ground floor, the first floor and the second floor. The bedroom on the second floor is currently being used as a staff sleeping in room. Some of the Oakleigh House DS0000062352.V349374.R01.S.doc Version 5.2 Page 19 bedrooms were seen during the inspection and found to be clean and suitably furnished. There is a large communal lounge/dining room on the ground floor. It was observed that are not enough easy chairs and/or settees in this room to accommodate all of the people who use the service and the staff on duty. Although this room is a little bare, pictures (some of which had been painted by the people who use the service) cushions and books had been used to give it a more homely feel. A second communal room, which has in the past been used as a sensory room and as a quiet lounge has been converted into a second office and is being used to store the medication and some records. This is not appropriate or necessary as there is ample space for storage in the office on the second floor. This was discussed with the prospective manager and deputy manager who have agreed to reinstate this room as a communal room for the use of the people who use the service. There is a communal bathroom, although this is little used as the people who use the service have their own private facilities. There is a communal toilet in the laundry room. The laundry room was seen to be clean and appropriate for the needs of the home. The kitchen is clean and to have sufficient storage and workspace to meet the needs of the home. There is a large decked patio to the front of the house. The main garden is at the back of the house, it has been tended by the staff and by the people who live at the house and came second in the Companies best garden in the region competition this year. Oakleigh House DS0000062352.V349374.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 & 35 Quality in this outcome area is adequate. The permanent staff are recruited safely and well trained, however service is short staffed and relies heavily on agency and bank staff. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The records of staff recruitment were seen and provide clear evidence that safe recruitment practices are being used and that new staff do not work with the people who use the service until references, Criminal Bureau Record checks and POVA checks have been received. The service has an Induction training programme that meets the required guidelines. A record is in place, which is used to identify the staffs collective and individual training needs and achievements. This record provides evidence that the service providers are committed to ensuring that the staff have access to the training they need. Oakleigh House DS0000062352.V349374.R01.S.doc Version 5.2 Page 21 The support staff are encouraged to gain National Vocational Qualifications. Both the prospective manager and the deputy manager said that they have National Vocational Qualifications in Care at Level 4 and have gained their Registered Managers Awards. Two of the support workers have gained an NVQ in Care at Level 3 and three are working towards gaining this qualification. One support worker has gained her NVQ at Level 2. Over the past year the staff turnover has been high and the staff rota shows that the service has had to rely heavily on agency and bank staff. The proposed manager said that there are currently vacancies for senior support workers and support workers. The information provided on the staff rota shows that most of the support staff work twelve and a half hour shifts. This was discussed with management and the commission was told that the staff prefer to work their hours in long shifts. Although this is accepted, primary consideration when drawing up rotas must be given to the assessed needs of the service users and the ability of the staff to provide as good a service at the end of their shift as they can at the beginning. The rota shows that the staffing levels fluctuate from day to day. However, as one of the contracting authorities are paying for one of the people who use the service to receive twenty-four hour a day one to one support, this does leave the service short staffed at times. Other indications that the home may be short staffed are the incidents, which have been reported about the challenging behaviour of which have placed the people who use the service and staff at risk. Oakleigh House DS0000062352.V349374.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, 39 & 42 Quality in this outcome area is adequate. Frequent changes of management in the past year have had a negative impact on the quality of the service provided for the people who live at the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The last registered manager for the service left her post in October 2006 and since this time four prospective managers have been appointed and three have left. The changes of leadership in the past year have had a negative impact on the quality of the service provided. For example, the staff turnover has been very high, the number of reported incidents of aggressive behaviour towards Oakleigh House DS0000062352.V349374.R01.S.doc Version 5.2 Page 23 staff and between the people who use the service has increased and the quality of care planning has deteriorated. The most recently appointed prospective manager had been in post for a little over one week at the time of the inspection and she demonstrated a clear understanding of the work that needs to be done to bring the home up to a good standard again. Part of the manager job is to complete monthly audits to enable the registered service provider to keep a check on the quality of the service provided. Regular monthly visits are carried out by the operations manager on behalf of the Company and copies of reports of these visits were seen. Staff and House meetings are held and minutes taken. The house meeting include the people who use the service and minutes were seen to provide evidence of input from them. Relatives surveys are used to gain feedback from them about the service provided. The Annual Quality Assurance Assessment completed for the commission identified that all of the required and recommended policies and procedures are kept at the home and are accessible to the staff. Regular servicing and maintenance is carried out to ensure that the heating, fire detection and safety appliances and electrical appliances are safe. Staff training is provided in health and safety related topics. Oakleigh House DS0000062352.V349374.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 1 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 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 1 3 X 2 X LIFESTYLES Standard No Score 11 X 12 2 13 2 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 3 X 1 X 3 X X 3 X Oakleigh House DS0000062352.V349374.R01.S.doc Version 5.2 Page 25 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 YA1 Regulation 4, 5 & Schedule 1 Requirement The registered persons must ensure that the information provided in the Statement of Purpose is kept up to date, accurate and service specific. The registered providers must ensure that the Service Users’ Guide revised. This document must contain all of the required information and should contain the recommended information. Where practical the information should be presented in a format that is accessible to the people who use the service. Service Users Guides must be given to each of the people who use the service (Previous requirement, timescale 30/06/07 – not met). Copies of the revised Statement of Purpose and Service Users Guide must be sent to the Commission. 2. YA6 12 The registered providers must ensure that the support staff DS0000062352.V349374.R01.S.doc Timescale for action 20/02/08 20/02/08 Oakleigh House Version 5.2 Page 26 3. YA9 13 have access to clearly presented individual care plans. The registered providers must ensure that the support staff have access to individual behavioural guidelines/risk management plans. The registered providers must make provision for the people who use the service to engage in a range of suitable social, occupational and recreational activities within their home and in the community. The registered providers must make provision for the people who use the service to engage in a range of suitable social, occupational and recreational activities within their home and in the community. The registered providers must ensure that the service is conducted so as to make proper provision for the health and welfare of the people who use the service and that the people who use the service are protected from harm. The registered providers must ensure that the second communal room is reverted back to its proper use and not used as an office. The registered providers must ensure that sufficient care staff are employed at all times to ensure that the needs of the service users are met and that the people who use the service are adequately supervised and protected from harm. 20/02/08 4. YA12 16 20/01/08 5. YA13 16 20/01/08 6. YA19 12 & 13 20/01/08 7. YA24 23 20/12/07 8. YA33 18 20/02/08 Oakleigh House DS0000062352.V349374.R01.S.doc Version 5.2 Page 27 Previous requirement, timescale 31/06/07 – not met. 9. YA37 8 The registered providers must ensure that a manager is registered for this service. 20/01/08 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 YA20 Good Practice Recommendations Information about what each of the service users medication is used for and possible side effects should be kept with the medication administration sheets to enable the staff to monitor the condition of service users on medication. A sufficient number of comfortable chairs or settees should be provided in the lounge to accommodate the people who use the service and the staff. Consideration should be given to reviewing the way that the staff rotas drawn up with a view to reducing or eradicating excessively long shifts, which could have a negative impact on the performance of support workers. 2. YA24 3. YA33 Oakleigh House DS0000062352.V349374.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Oakleigh House DS0000062352.V349374.R01.S.doc Version 5.2 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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