Inspection on 15/08/06 for Old Farmhouse

This inspection was carried out on 15th August 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Old Farmhouse 17/06/08

Old Farmhouse 11/06/07

Old Farmhouse 28/02/06

Old Farmhouse 20/09/05

Old Farmhouse 28/02/05

Old Farmhouse 24/08/04

Old Farmhouse 18/03/04

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 Old Farmhouse Sundorne Grove Shrewsbury Shropshire SY1 4TP Lead Inspector Sue Woods Key Unannounced Inspection 15th August 2006 09:00 Old Farmhouse DS0000020666.V292557.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 Old Farmhouse DS0000020666.V292557.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. Old Farmhouse DS0000020666.V292557.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Old Farmhouse Address Sundorne Grove Shrewsbury Shropshire SY1 4TP 01743 440318 01743 440319 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) Vision Homes Association Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Old Farmhouse DS0000020666.V292557.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28th February 2006 Brief Description of the Service: The Old Farmhouse is a Care Home, registered with the Commission for Social Care Inspection to provide accommodation and personal care for up to six Adults with Learning Disabilities and associated complex behavioural needs. The Old Farmhouse is operated by Vision Homes Association. The organisation provides a block contract for the provision of this service to Shropshire County Council. Ms Sally Rumsey is the manager and she is currently in the process of registering with CSCI. The home is of a traditional detached cottage style and located in the Sundorne area of Shrewsbury town. It stands in its own spacious grounds, within a private housing estate. The Home seeks to provide a positive homely environment for service users affording the appropriate levels of support required to meet their needs. As the manager is new in post she has yet to develop and implement a formal process of quality assurance within the home however consultation with service users takes the form of regular observations and detailed care and support plans that identify and review likes and dislikes. Advocacy services are promoted. Current fees are charged on a block contract basis and amount to £96,607 per quarter Old Farmhouse DS0000020666.V292557.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection of The Old Farmhouse was carried out 15th August 2006 from 09.00 am until 4.00 pm. The inspection reviewed all 22 key standards and information to produce this report was gathered from the findings on the day and also by review of information received by CSCI prior to the inspection date. A quality rating based on each outcome area for service users has been identified. These ratings are described as excellent/good/adequate or poor based on findings of the inspection activity. As part of the fieldwork activity the inspector met four service users and spoke in private with one person. Due to the complex needs of the people living at the home the inspector used observations, discussions and review of care records to form judgements in relation to the quality of service provided at the home. Interactions were observed and these are reflected within the report. The inspector received three surveys from staff on duty at the time of the inspection and spoke all staff members, two in depth and in private. The inspector spoke with the manager of the home about her plans and priorities. Records reviewed included individual care plans, accident and incident forms, communication records and staff files for the last two staff to join the team. What the service does well: Service users are supported by a committed and enthusiastic staff team who receive good training opportunities. Staff have developed skills in order to safely support service users following person centred care and support plans. Staff have demonstrated over recent months that they respond competently and professionally to health care emergencies. Service users have opportunities to access community resources and maintain family links. The home works flexibly to support service users. Old Farmhouse DS0000020666.V292557.R01.S.doc Version 5.2 Page 6 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. Old Farmhouse DS0000020666.V292557.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 Old Farmhouse DS0000020666.V292557.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 at least once during a 12 month period. 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 information taken from a previous visit to this service. Appropriate procedures are in place that would enable the successful admission of new service users to the home however no admissions have taken place over the last six years. EVIDENCE: There were no care assessments seen on the files reviewed. It was noted that service users have lived at the home for a number of years. Therefore the judgement made at the time of the last inspection of the home will be carried forward. The manager said that the statement of purpose is in the process of being updated and the service user guide has not yet been developed for the home. Plans are in place to produce this document in a user-friendly format. These documents will be reviewed at a future inspection, as there are no plans to admit any new service users to the home. Old Farmhouse DS0000020666.V292557.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 Quality in this outcome area is good. This judgement has been made using available evidence including information taken from a previous visit to this service. Person centred care and support plans enable staff to offer service users choice and assist with decision making as well as delivering care in a way that they prefer. EVIDENCE: The inspector case tracked two service users during the fieldwork activity. Care files contained all essential information relating to individual care and support needs. All files had last been reviewed in September 2005. The manager was currently updating one file to reflect the service users increased support needs due to recent ill health. Communication records seen on both files reflected individual likes, dislikes and information to support offering choice and decision making processes. Support guidelines were seen on both files reviewed although some had not been formally reviewed for a number of years. It was positive to note that the manager has already prioritised the review and updating of risk assessments Old Farmhouse DS0000020666.V292557.R01.S.doc Version 5.2 Page 10 and is organising care reviews for all service users. This will be particularly valuable for revisiting the reasons for restrictions placed on one particular service user. The manager is involving input from health care professionals to do support this review. Sensitivity issues in relation to being supported by male and females staff are documented on individual files. The home employs a mix of male and female support staff. Old Farmhouse DS0000020666.V292557.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. 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 information taken from a previous visit to this service. Service users enjoy a good quality of life as support systems enable them to access community resources and maintain family links. The well-balanced menu enables service users to eat a nutritious diet that reflects individual preferences and dietary requirements. EVIDENCE: Daily activity records reflected the likes and dislikes recorded in individual files. Support plans and risk assessments to access activities were seen in place. The deputy manager informed the inspector of how the staff team work together to identify new activities and opportunities for service users by discussing events that they have enjoyed or when they have shown a particular interest in something. Each service user has two key workers who lead this process but the whole staff team are committed to making things happen. From observations and discussions complex needs and identified Old Farmhouse DS0000020666.V292557.R01.S.doc Version 5.2 Page 12 challenging behaviours do not stop activities from happening but risk assessments enable them to take place with appropriate support. The manager has the flexibility to increase staffing in evenings to support activities. Service users enjoy local walks and car rides, take part in shopping activities and two service users like to visit the local pub on a Tuesday evening. It was agreed that as the person centred planning process develops, and in particular the life story work, that additional activities would be introduced. Family contact is supported and encouraged with the manager who gave examples of how they have offered flexible support for one service user and his family to spend time together. The menu on the wall reflected a healthy and well balanced diet with choice available each day. One service user told the inspector that he was looking forward to having an egg sandwich for his dinner. On the day of the inspection one service user went out for lunch and from review of records this is a regular occurrence. The special dietary needs of two service users were discussed and the manager and deputy manager demonstrated that they were knowledgeable about individual requirements. Interactions between service users and staff were seen by the inspector to be empowering and supportive. One service user was supported to make himself a pot of tea. Other service users were seen to sit and relax with staff. Service users moved freely around the house. One service user likes a ‘lie in’ in the mornings and this is supported and recorded in her care plan. Old Farmhouse DS0000020666.V292557.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 Quality in this outcome area is adequate. This judgement has been made using available evidence including information taken from a previous visit to this service. Service users benefit from a staff team that is knowledgeable about individual health care needs and are competent in their support role. However service users will benefit further from the introduction of health action plans, as current records relating to health and medication are out of date. Service users may be at risk of PRN protocols are not in place to support the use of such medication. EVIDENCE: Personal care and support needs are detailed in individual care plans. Individual likes and dislikes are recorded and preferred routines identified. When service users are admitted to hospital 24-hour support is provided by staff from the home. Notes from family members reflect that support to service users during times of ill health are valued. Staff support at these times reflects their commitment for providing continuity to the people they support. Old Farmhouse DS0000020666.V292557.R01.S.doc Version 5.2 Page 14 A recent incident with one service user demonstrated that staff were competent to administer first aid and their conduct during the incident should be commended. The deputy manager stated that the previous manager had completed health action plans however they were not available on service users’ files. The manager intends to start this process again but in consultation with appropriate health care professionals, family members and staff. This whole team approach reflects on the style of management that the home currently benefits from. Arrangements for the storage, administration and recording of medication were reviewed by the inspector. Records were generally well maintained and the manager committed to discuss a gap in recording with the staff on duty. Medication is administered from blister packs however the administration of medicines as and when required (PRN) needs review. Service users requiring PRN medication do not have guidelines available for its use and a bottle of such medication needs to be monitored to account for the number of tablets on site. It was noted that such medication is rarely used. Some medication profiles on file and lists of medicines taken by service users seen on service user files no longer reflected the current MAR sheets so to avoid confusion need to be updated. Old Farmhouse DS0000020666.V292557.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Quality in this outcome area is good. This judgement has been made using available evidence including information taken from a previous visit to this service. Service users are protected by appropriate procedures in place for adult protection and by staffs’ knowledge of how to make a complaint or raise concerns of poor practice. Compliments received by the home reflect that service users and their representatives value the service they receive. EVIDENCE: There have been no complaints made about the service on offer at The Old Farmhouse since the time of the last inspection of the home when processes were examined and found to be appropriate. The new manager has begun recording compliments received and these were seen by the inspector both in a file in the office and also in the staff handover/ communication book. These compliments were valued by staff and reflect positively on the staff team and the support they offer to service users. All staff who spoke with the inspector were aware of the organisations complaints and whistle blowing procedure. Old Farmhouse DS0000020666.V292557.R01.S.doc Version 5.2 Page 16 The manager is aware of the adult protection procedures and at the time of the last inspection of the home it was noted that ‘Robust procedures are in place to protect service users from abuse and are included in all aspects of staff training’. Staff have recently completed refresher training for adult protection procedures. Advocacy services are actively used within the home. Old Farmhouse DS0000020666.V292557.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 30 Quality in this outcome area is poor. This judgement has been made using available evidence including information taken from a previous visit to this service. Recent improvements and interim works have improved the standards of accommodation for service users however the majority of communal areas are in need of major refurbishment to make the Old Farm House a homely and safe place to live and address issues of cleanliness. EVIDENCE: Since the time of the last inspection of the home a new kitchen has been installed. The room looked modern and well designed although a few small jobs remain outstanding to complete it. Through discussion with the staff team and the manager it was evident that the whole process had been very well planned to ensure minimum disruption and continued service user safety. The downstairs shower room has also received remedial work, including new tiling and repairing the flooring. The overgrown trees have been pruned and the gardens were looking attractive and well maintained at the time of the inspection. The raised flowerbeds are to be planted out with ‘safe’ flowers. Old Farmhouse DS0000020666.V292557.R01.S.doc Version 5.2 Page 18 The full refurbishment of the building has still not taken place and discussion is ongoing as to whether service users will need to move out during renovations. The manager reported increased input from BVT over recent weeks and it is hoped that a date will be set soon. An action plan for the works to be done together with timescales is required to demonstrate that the requirements made during previous inspections are to be met. Despite the need for renovation it was apparent that staff work hard to keep the home clean. This proves difficult when new flooring is required to eliminate unpleasant odours. The carpet on the landing is not part of the agreed improvements but is badly stained. The manger said that a regular programme of professional cleaning is in place but has not removed the stains. The deputy manager checked the fire alarms as per her weekly programme at the time of the inspection, demonstrating the process in place. Some locks on bedroom doors were inappropriate. One lock required a key to open or lock it on each side and two locks had a locking mechanism for use without a key however the keys to the doors were missing potentially meaning that service users could lock themselves in their room and staff not be able to gain access in an emergency. Another such lock had had the mechanism removed. Water temperatures in all outlets are recorded daily and records were seen. Staff had made efforts to ensure that bedrooms were personalised and suitable to meet the needs of the individual. Old Farmhouse DS0000020666.V292557.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 Quality in this outcome area is good. This judgement has been made using available evidence including information taken from a previous visit to this service. Service users are supported by a well trained and committed staff group who are doing all they can to meet the needs of each individual in a sensitive and professional manner EVIDENCE: Since requirements made at the time of the last inspection of the home one service user, who had increased support needs, has moved out and there are no plans to admit anyone else. The staffing levels in place to support five service users are adequate in that essential care and access to the community are all maintained. Staffing levels are reduced in the evenings although additional staffing is available on the evenings that service users go to the pub. The manager is currently monitoring these staffing levels. Starting from next week the home will have one waking night member of staff and one sleeping member of staff. This arrangement also reflects the reduction in numbers and will also be monitored closely by the manager. Staff feel well supported by the manager and spoke positively of improvements that she has made since her arrival. Staff said they received formal supervision and the manager and deputy spend time working alongside them. Old Farmhouse DS0000020666.V292557.R01.S.doc Version 5.2 Page 20 Staff files were reviewed and found to contain all required information although, as per the organisations policy, only the disclosure number for CRB is stored on files. Details of one staff member’s induction were seen on file and records of supervision were stored in a sealed envelope. Discussions with the manager agreed that she should be aware of the content of all supervisions even the ones she didn’t personally conduct therefore this practice will be reviewed. Staff all spoke positively about training opportunities offered by Vision Homes. Certificates were seen to support staffs’ recent appointed person first aid training. Old Farmhouse DS0000020666.V292557.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 41, 42 Quality in this outcome area adequate. This judgement has been made using available evidence including information taken from a previous visit to this service. Service users are benefiting from the current management style of involving them, the staff team and family and advocates in all decision-making processes. Smoking arrangements may make service users and staff vulnerable. Effective record keeping and monitoring processes mean that service users needs are noted, monitored and reviewed. The health and safety of service users and staff is promoted and protected EVIDENCE: The current manager of the home has been in post since May 2006. Staff have reflected positively on the improvements made since her appointment. She has Old Farmhouse DS0000020666.V292557.R01.S.doc Version 5.2 Page 22 involved staff in decision-making processes enabling them to promote the needs and wishes of service users. The inspector reviewed completed accident and incident reports at the time of the inspection. It is recommended that these records are stored on individual files and that incidents that involve staff injury should also be recorded. A potential issue in relation to smoking arrangements with staff leaving the premises to smoke was discussed and the manager agreed to carry out risk assessments on the implications of this practice on the home and the staff members. Other issues discussed demonstrated the manager’s ‘team approach’ although issues of professional boundaries should be explored further in relation to service user/staff relationships. Notifications are made appropriately to CSCI following significant events and the latest report of a visit carried out by a senior manager for the home was very detailed, service user focussed and identified issues that will lead to service improvement and compliance with the national minimum standards for care of younger adults. On the day of the inspection the manager was reconciling the homes budget prior to sending it off to head office. The manager explained the process to the inspector and detailed how cross checks are made. The manager was happy that the process was straightforward and detailed expenditure at a glace. Old Farmhouse DS0000020666.V292557.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 1 25 X 26 X 27 2 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 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 2 2 X 3 X 3 X 3 2 X Old Farmhouse DS0000020666.V292557.R01.S.doc Version 5.2 Page 24 NO 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 2 3 Standard YA19 YA20 Regulation 14 (1) (2) 13 (2) 15 (2) (b) Requirement Service users health care needs must be reassessed and plans updated to reflect any changes PRN protocols must be in place to support the administering and monitoring of such medication Information relating to medication and health support needs of service users must be updated to ensure it accurately reflects current arrangements That the bathroom on the first floor and the shower room on the ground floor be refurbished. This requirement was made at the time of the last inspection the timescale for action being 31/12/05 and 31/05/06. An action plan identifying dates for work to be completed must now be sent to CSCI (timescale given on this occasion is for the production of an action plan) Refurbishments identified by the home and BVT must be carried out without any further delay An action plan identifying dates for work to be completed must now be sent DS0000020666.V292557.R01.S.doc Timescale for action 22/09/06 08/09/06 22/09/06 YA20 4 YA27 23(2) (b) 08/09/06 5 YA24 23 (2) (b) 08/09/06 Old Farmhouse Version 5.2 Page 25 to CSCI 6 YA24 23 (2) (b) Locks on service users bedroom doors must ensure the safety of service users and be fit for the purpose Carpets and other flooring must be replaced to eliminate offensive odours and stains The manager must review the current ‘smoking practices’ and carry out risk assessments to ensure the protection and safety of service users and staff 31/08/06 7 8 YA30 YA42 23 (2) (b) 13 (4) 22/09/06 08/09/06 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. 2 3 4 Refer to Standard YA32 YA36 YA41 YA38 Good Practice Recommendations That 50 of care staff be trained to level 2NVQ. The manager should review arrangements for monitoring supervisions carried out by other staff to ensure she is aware of all issues identified. Incident and accident records should be stored on individual files and not collectively. Injuries to staff following incidents should also be recorded. Issues of professional boundaries should be explored further in relation to service user/staff relationships. Old Farmhouse DS0000020666.V292557.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Shrewsbury Local Office 1st Floor, Chapter House South Abbey Lawn Abbey Foregate SHREWSBURY SY2 5DE National Enquiry Line: 0845 015 0120 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 Old Farmhouse DS0000020666.V292557.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!