Inspection on 04/11/05 for Orchard House

This inspection was carried out on 4th November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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 but made no statutory requirements on the home.

Other inspections for this house

Orchard House 22/10/08

Orchard House 28/09/07

Orchard House 07/12/06

Orchard House 10/02/06

Orchard House 10/02/05

Orchard House 04/06/04

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

CARE HOME ADULTS 18-65 Orchard House 92 Brookfield Road Bedford Beds MK41 9LJ Lead Inspector Rachel Geary Unannounced 4 November 2005 th 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 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 Stationary 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. Orchard House I51 S33039 Orchard House V247087 041105 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Orchard House Address 92 Brookfield Road Bedford MK41 9LJ Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01234 349474 Bedfordshire County Council Care home 4 (4) Category(ies) of LD - Learning Disability registration, with number of places Orchard House I51 S33039 Orchard House V247087 041105 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Period of stay: Respite (max 6 weeks stay) Current respite service users who are over 65 years of age, may continue to receive a service from the home, as long as their needs are being met. No new service users over 65 years of age may be admitted to the home without prior consultation with the CSCI. Complete re-provision (subject to CSCI and other relevant authorities approval of the proposed plans) of the respite service by November 2005. Date of last inspection 10th February 2005. Brief Description of the Service: Orchard House is a respite service located in Bedford. The accommodation and grounds are owned and maintained by Aldwyck Housing Association, with Bedfordshire County Council providing the staffing and care support. It is a condition of registration that the service will have moved and been rebuilt by November 2005, as it does not currently meet the environmental requirements of the National Minimum Standards for Younger Adults. It is hoped that the service will remain in the local area, but at the time of this inspection, there were still no definite timescales for this to take place. The accommodation comprises of a bungalow, which is intended to provide respite care for up to 4 adults with learning disabilities at any one time. Stays are limited to a maximum of six weeks. There are four single bedrooms, a shared kitchen, bathroom (with shower facility only), separate toilet, laundry area and a living/dining area. The accommodation would not meet the needs of all individuals with a physical disability. Community facilities and shops are a short distance from the home, which is also in easy access of local transport routes. There is parking to the front of the property, and there is also a small garden area. Orchard House I51 S33039 Orchard House V247087 041105 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced, and took place from 16.35 to 19.45. A CSCI regulation manager accompanied the inspector. The inspectors were able to speak with a number of people including service users, staff on duty, and a parent of another service user. In addition, the inspectors observed practice, looked at records, and had a partial tour of the premises. After the inspection, feedback was provided to the resource manager for this service, who indicated that some of the information provided to the inspectors on the day, was not an accurate reflection of how the home actually operates. However, it was also discussed that as this information appeared to be held and given in good faith, it would be included within this report. What the service does well: What has improved since the last inspection? What they could do better: There are still a lot of things that the home could do to improve the service that is provided. One important task is making sure that any information given to service users and their families is clear and easy to use. Orchard House I51 S33039 Orchard House V247087 041105 Stage 4.doc Version 1.40 Page 6 Care plans need further work to provide sufficient information for staff to support the service users, and to meet their assessed needs and individual preferences. Finally, the service must continue to develop current paperwork and systems for staff and service users, to make sure that they are meeting legal requirements, and the Government’s standards for care homes such as Orchard House. 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. Orchard House I51 S33039 Orchard House V247087 041105 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Orchard House I51 S33039 Orchard House V247087 041105 Stage 4.doc Version 1.40 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 standard(s) 1 and 5. The information available to service users to help them to be clear about the services the home provides, is insufficient. EVIDENCE: A Statement of Purpose (SoP) and Service User Guide (SUG) were on display in the home. One service user said that he was not familiar with these documents. Similarly he was also not aware of the home’s complaints procedure, or his own care plan. A copy of the SUG had been sent previously to the CSCI. This document did not meet the requirements of the National Minimum Standards (NMS) for Younger Adults. It was also noted that the home had provided the fax number of the CSCI instead of the telephone number, within information written for service users and/or their representatives. Individual contracts for service users were still not in place at the time of this inspection. Orchard House I51 S33039 Orchard House V247087 041105 Stage 4.doc Version 1.40 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 standard(s) 6, 7 and 9. Care plans do not provide sufficient information for staff to be able to offer consistent support to service users. EVIDENCE: Orchard House I51 S33039 Orchard House V247087 041105 Stage 4.doc Version 1.40 Page 10 At the previous inspection, it was reported that there had been no care plans for the service users using the respite service during the inspection. On this occasion, care plans were in place for the two service users using the respite service. The plans contained basic information however, and one service user stated that he had not seen his own plan before. Plans were also not user friendly. Some information was found to be inaccurate or out of date, and there was little evidence that plans met the individual needs and preferences of the service users. For example, there was limited information describing the support needs and capabilities of service users, which meant that opportunities to build and develop independent living skills were restricted. One service user said that when he stays at the unit, staff support him to have a shower and manage his medication. He indicated that he was able to manage both these areas independently when at home. There was no information available within his plan to indicate the reasons for these apparent restrictions. On a positive note, staff provided appropriate responses to one service user who said that he wanted to be able to eat in his bedroom, and to go out to the pub during his stay. As reported previously, some information held on file was out of date or not dated; some was also missing i.e. service user photographs as required by Schedule 3 of the Care Homes Regulations 2001. In addition, copies of the most recent review minutes were not available. Examination of service user’s files indicated that limited risk assessments existed. Some files contained none. Assessments to cover independent living skills were also not in place. There was evidence that the responsible individual for this service, Kate Walker, had previously identified deficits regarding the care plans and risk assessments. It was proposed that this work would be completed by January 2006. Orchard House I51 S33039 Orchard House V247087 041105 Stage 4.doc Version 1.40 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 standard(s) 14 and 17. Some progress had been made with regard to enabling service users to access external activities. EVIDENCE: Orchard House I51 S33039 Orchard House V247087 041105 Stage 4.doc Version 1.40 Page 12 No activities had been planned during this inspection. Both service users spent time either talking with the inspectors, watching TV or wandering about the home. There was evidence that the recording of activities had improved since the last inspection, and that opportunities for service users to access external activities, had increased. One service user said that he would like to go out more when he stayed at the unit, and told staff that he would like to go to the cinema, and to a pub to watch football, during the course of his stay. A parent of one service user visited the unit briefly and spoke to one of the inspectors. Positive feedback was given regarding the service being provided to his daughter. Staff said that they planned to do some menu planning with service users after the inspection. This was therefore not observed on this occasion. Once again, service users did not help to prepare the meal (fish and chips) on the day of this inspection. Records indicated that this did happen, but on an irregular basis. It was said that the bulk of the weekly food shopping was still being organised through the adjacent domiciliary care service. Service users were therefore able to choose from the stock items provided, and a petty cash allowance enabled the purchase of additional items as requested. The fridge contained very little food on the day of this inspection. Staff explained that the fridge had been faulty, but it was not clear if it had yet been fixed. There was evidence that some items such as juice and crisps were being locked away. Since the last inspection of this service, a freezer had been provided. It was discussed that the current arrangements did not adequately promote independent living opportunities, and choice for service users. Orchard House I51 S33039 Orchard House V247087 041105 Stage 4.doc Version 1.40 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 standard(s) 20. The systems for the administration of medication are inadequate, and have the potential to restrict service users, or place them at risk. EVIDENCE: Orchard House I51 S33039 Orchard House V247087 041105 Stage 4.doc Version 1.40 Page 14 It was previously reported that staff from the adjacent supported living service, were required to support with the administration of medication within the respite unit. This was because the medication policy required two staff to be able to administer medication, and there were not always two staff on duty within the respite unit. This arrangement was still in place at the time of this inspection. In addition, agency staff had not been trained to administer medication, but were still providing a significant amount of support to the unit on a weekly basis. One service user said that he was not allowed to administer his own medication when staying at the unit, but that this was something that he could do independently when he was at home. There was no information available within his plan to indicate the reason for this apparent restriction. It was said that at times, service users needed to wait for their medication as staff from the supported living service, needed to administer medication to those service users first. It was not clear from records, if one service user currently required medication or not. Staff were also unsure. Orchard House I51 S33039 Orchard House V247087 041105 Stage 4.doc Version 1.40 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 standard(s) 22. The home has a satisfactory complaints procedure, but there is little evidence that this is really understood by service users. EVIDENCE: A complaints procedure was on display within the home. Although it contained the required information, the procedure was lengthy, and not particularly userfriendly. One service user said that he had not seen the procedure before, and did not know what it was about. Orchard House I51 S33039 Orchard House V247087 041105 Stage 4.doc Version 1.40 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24 and 30. The building does not meet the required environmental standards. EVIDENCE: It has previously been reported that the respite bungalow does not adequately meet the NMS environmental requirements. The accommodation would also not meet the needs of all individuals with a physical disability. To this end, the home has a condition of registration to reprovide the service by November 2005. At the time of this inspection, there were still no definite plans for this to take place. In the interim, the CSCI has agreed with the organisation, that until reprovision takes place, the home must at a minimum, be able to meet the assessed needs of the current service users. A number of temporary environmental improvements have been proposed as a result of this, including the installation of a specalist bath, a handbasin within the laundry room, fitting radiator covers, boxing in and making good pipework in the toilet, fitting new kitchen cupboards, redecorating the laundry room, and introducing some homely touches such as plants etc. It was not clear when these works would take place. At the last two inspections of this service, there had been concerns regarding Orchard House I51 S33039 Orchard House V247087 041105 Stage 4.doc Version 1.40 Page 17 the shower hot water pressure and temperature. There were no concerns regarding either of these matters on this occasion. The Fire Authority last inspected the building on 10th March 2005. A subsequent report stated that fire doors had been found to be wedged open, and that there had been no records of emergency lighting tests. During this visit, it was noted that the lounge door had been propped open, and records indicated that emergency lighting tests were not taking place as required. The home appeared to be clean, and free from offensive odours although the living room carpet was in need of a clean. Orchard House I51 S33039 Orchard House V247087 041105 Stage 4.doc Version 1.40 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33. Staff demonstrated a fair understanding regarding the needs of the service users. However, the high use of agency staff means that only the basic needs of individuals are being met. EVIDENCE: There were two agency staff on at the time of this inspection. Both had been working in the unit for approximately three months, and said that they had each achieved an NVQ 2 qualification. It became apparent through talking with staff, that they only had a limited knowledge of the day-to-day running of the service, and the holistic needs of the service users. It was noted that one service user did not appear to remember the name of one of the members of staff. He later said that he preferred coming to stay at the unit when there was permanent member of staff on duty. Despite this, staff on duty were observed to support service users in a respectful and appropriate manner. Orchard House I51 S33039 Orchard House V247087 041105 Stage 4.doc Version 1.40 Page 19 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) Limited progress has been made in a number of important areas. This has resulted in some significant shortfalls in service provision. EVIDENCE: Since the last inspection of this service, a part time manager, Angela Bradley, had been appointed to manage the respite unit. It was previously recorded that the inspector had advised that given the numbers of service users (approx 44), and the amount of work required to address ongoing service deficits, that the part time status of the manager should be kept under review. Findings from this inspection have not significantly reduced this concern. The manager had not yet submitted an application to register with the CSCI. Orchard House I51 S33039 Orchard House V247087 041105 Stage 4.doc Version 1.40 Page 20 Only two reports as required by regulation 26 of the Care Homes Regulations 2001, had been received by the Commission in respect of this home, since the last inspection. As previously reported, the bungalow’s fire alarm system was linked to the main system in the supported living service, and was likely to remain so until re-provision took place. A separate fire logbook had been set up to record tests carried out within the respite unit however, there was evidence that checks and alarm tests were not taking place at the required intervals. Previous concerns regarding the fridge temperature had been addressed. Previous concerns regarding the legibility and storage of accident records had also been addressed although, it was noted that there were reports dating as far back as June, that were not filed, and did not appear to have been acknowledged by a manager. Orchard House I51 S33039 Orchard House V247087 041105 Stage 4.doc Version 1.40 Page 21 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 x x x 1 Standard No 22 23 ENVIRONMENT Score 2 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 x x 1 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 1 x x x x x 3 Standard No 11 12 13 14 15 16 17 x x x 3 x x 2 Standard No 31 32 33 34 35 36 Score x x 2 x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Orchard House Score x x 1 x Standard No 37 38 39 40 41 42 43 Score 2 x 2 x x 2 x I51 S33039 Orchard House V247087 041105 Stage 4.doc Version 1.40 Page 22 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA24 Regulation 13 Requirement Ensure that radiators throughout the Home are covered to prevent risk of harm to service users (or risk assess this deficit). (Previous timescale of 30.4.05 not met). Please (ensure that) contracts/ terms and conditions (are in place that) include all elements of NMS 5. (Previous timescale of 30.6.05 not met). Ensure that information and documents in respect of person’s carrying on, managing or working in the home (see Schedule 2 of the Care Homes Regulations 2001), are kept in the home, and open to inspection at all times. *Please note that from 26/7/04 Schedule 2 has been updated within the amended Care Standards Act 2000 (Establishments and Agencies) (Miscellaneous Amendments) Regulations 2004. (Previous timescale of 30.4.05 given). Unable to assess on this occasion. Orchard House I51 S33039 Orchard House V247087 041105 Stage 4.doc Version 1.40 Page 23 Timescale for action 31/01/06 2. YA5 5 31/1/06 3. YA34 17 31/12/05 4. YA6 and 7 15 Ensure that care plans are completed for all service users that meet the requirements of NMS 6. Plans should also include any restrictions on choice and freedom, and identify clear goals with regard to the individual’s development of skills and abilities. Staff must be fully aware/trained on the purpose and completion of such plans. (Previous timescales of 30/11/03 and 30/6/05 not met). Ensure that individual and environmental risk assessments are updated and completed in line with the requirements of NMS 9. (Previous timescales of 30/11/03 and 30/6/05 not met). Ensure that there is a training and development programme, (for all staff) which incorporates induction, mandatory, specialisttraining and NVQ courses/qualifications. (Previous timescale of 30.4.05 given). Not assessed on this occasion. Evidence (regular) service user inclusion with regard to meal preparation. (Previous timescale of 30/4/05 not fully met). Ensure that the outstanding environmental matters referred to in sections 17, 24, 27 and 30 of the report dated 10/5/05 are in place. This must include regular fire alarm and emergency lighting testing, and regular planned fire drills (specifically for the respite bungalow). (Previous timescales of 23/7/04 31/1/06 5. YA9 13 31/1/06 6. YA35 18 31/12/05 7. YA17 16 31/12/05 8. YA 24 and 42 16 and 23 30/11/05 Orchard House I51 S33039 Orchard House V247087 041105 Stage 4.doc Version 1.40 Page 24 and 15.3.05 not fully met). (Also, ensure that the matters stated in the letter from the Fire Authority inspection 10/3/05, are fully adhered to). Ensure that an appropriate application form for a manager is received by the CSCI. (Previous timescales of 23/7/04 and 30.5.05 not met). Update the current Statement of Purpose (so that it meets the requirements of Schedule 1 and regulation 4 of the Care Homes Regulations 2001). Please forward a copy to the CSCI upon completion.(Previous timescales of 6/8/04 and 30/4/05 not met). Ensure that all records as set out in Schedule 3 of the Care Homes Regulations 2001, are maintained in respect of all service users. (Previous timescales of 6/8/04 and 30/6/05 not met). Revise the current medication policy with regard to administration, and the reduced numbers of staff on duty within the respite unit. In addition, accredited training for staff with regard to basic knowledge of how medicines are used, how to recognise and deal with problems in use, and the principles behind the home’s policy on medicines handling and records must be arranged. (Previous timescales of 31/8/04 and 30/4/05 not met). Ensure that job descriptions specific to the needs of the respite service are in place for all staff. (Previous timescales of 31/8/04 and 30/4/05 given). I51 S33039 Orchard House V247087 041105 Stage 4.doc 9. YA37 8 15/12/05 10. YA 1 4 31/12/05 11. YA6 and 41 15 and 17 31/1/06 12. YA20 13 31/12/05 13. YA31 19 30/11/05 Orchard House Version 1.40 Page 25 Not assessed on this occasion. 14. YA32 18 Include details in the staff 31/12/05 training and development plan to ensure that 50 of care staff (including agency and relief staff) in the home achieve a care NVQ 2 by 2005, and that the manager will have achieved qualifications at level 4 NVQ in both management and care by 2005. (Previous timescale of 30/4/05 given). Not assessed on this occasion. Ensure that the home’s written policies and procedures are specific to the respite service, and cover all the topics as set out in Appendix 2 of the NMS for Younger Adults. Please also ensure that the death of a service user policy is updated to include the additions listed in the previous report. (Previous timescale of 30/4/05 given). 16. YA6 15 Not assessed on this occasion. Develop care plans with the involvement of the service users, to ensure that plans include measurable goals, aimed at supporting individuals to maximise their independent living skills (inc personal hygiene, medication administration, and food preparation). (Previous timescales of 30/9/04 and 30/6/05 not met). Ensure that a quality assurance and monitoring system is in place for the home, which meets the requirements as set out in standard 39 of the National Minimum Standards for Younger Adults. (Previous timescale of I51 S33039 Orchard House V247087 041105 Stage 4.doc 15. YA40 17 31/1/06 31/1/06 17. YA39 24 31/1/06 Orchard House Version 1.40 Page 26 30/4/05 given). 18. YA43 25 Not assessed on this occasion. Produce a business and financial plan for the home and the service, which is open to inspection and reviewed annually. (Previous timescale of 30/4/05 given). Not assessed on this occasion. The registered person must demonstrate the home’s capacity to meet the assessed needs (including specialist needs) of individuals using the service. This must include obtaining up to date information relating to the person, i.e. annual review minutes. (Previous timescale of 30/4/05 not met). Ensure that the stained carpet in the lounge is cleaned or replaced. Previous timescale of 15/4/05 not met). Update the Service User Guide so that it meets the requirements of NMS 1 for Younger Adults, and regulation 5 of the Care Homes Regulations 2001. Please forward a copy to the CSCI on completion. Ensure that service users retain, administer and control their own medication where appropriate, and are protected by the homes policies and procedures for dealing with medicines. Ensure that monthly unannounced visits are carried out in accordance with regulation 26 of the Care Homes Regulations 2001, and that subsequent reports are sent to the CSCI on a regular basis. 31/1/06 19. YA3 18 31/1/06 20. YA24 and 30 YA1 23 15/12/05 21. 5 31/12/05 22. YA20 13 15/12/05 23. YA39 26 31/12/05 Orchard House I51 S33039 Orchard House V247087 041105 Stage 4.doc Version 1.40 Page 27 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 YA1, YA3, YA5, YA6, YA22 YA3 and 8 Good Practice Recommendations Produce information for service users, i.e. complaints procedure, care plans, contracts, menus, Service User Guide etc, in a more user-friendly format. (This is a recommendation from the 4/6/04 and 10/2/05 reports). Introduce a user-friendly system in the home so that service users know in advance which staff are planned to work with them. (This is a recommendation from the 4/6/04 and 10/2/05 reports). Increase the proposed management hours (specifically dedicated to the respite service), to reflect the needs of this diverse and expanding service. (This is a recommendation from the 10/2/05 report). Ensure that where agency staff are used, that there is a small core team who know the service users, and understand the homes way of working. 2. 3. YA33 and 37 YA33 4. Orchard House I51 S33039 Orchard House V247087 041105 Stage 4.doc Version 1.40 Page 28 Commission for Social Care Inspection Clifton House 4a Goldington Road Bedford MK40 3NF 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 Orchard House I51 S33039 Orchard House V247087 041105 Stage 4.doc Version 1.40 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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