Inspection on 10/10/05 for Overton House

This inspection was carried out on 10th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Overton House 13/02/07

Overton House 27/02/06

Overton House 02/03/05

Overton House 20/09/04

Overton House 10/02/04

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

CARE HOME ADULTS 18-65 Overton House Overton Road Cheltenham Glos GL50 6BL Lead Inspector Caroline Jones Announced 10 October 2005 18:15 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. Overton House D51_D03_S16529_OvertonHouse_V202991_111005_Stage4_A.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Overton House Address OVerton Road Cheltenham Glos GL50 6BL 01242 234635 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) National Star College Care Home 31 Category(ies) of Physical Disability (31) registration, with number of places Overton House D51_D03_S16529_OvertonHouse_V202991_111005_Stage4_A.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 02/03/05 Brief Description of the Service: Overton House is one of two homes providing off site accommodation for students attending the National Star College. The building is owned by Barnwood Trust and is leased to the college. Overton House is a large Georgian property, which has been adapted and extended to provide residential accommodation for up to 31 students who have physical disabilities. The house is situated in a residential area very close to the centre of Cheltenham. Student accommodation is provided on three floors, accessed by shaft lifts. This consists of a mixture of single and double rooms and a flat. A recent garage conversion creates an additional two independent living flats. Overseas volunteers who work at Overton are housed on the top floor. Students have access to a range of communal spaces, including a large recreation room, a quiet lounge and a dining room. A domestic size kitchen is also provided in addition to the main kitchen. An enclosed inner garden is accessable to all students. During the day time parts of the building such as the computer room and recreation room are used by local people with disabilities for adult education courses. Overton House D51_D03_S16529_OvertonHouse_V202991_111005_Stage4_A.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection, which took place over two days. The lead inspector and a colleague visited the home on the evening of Monday 10th October to meet with individuals or groups of students for them to comment about Overton House and their experiences of living there. The lead inspector returned the next day and met with the manager and most of the staff on duty, toured the building and tracked the records for some students. In addition to the comments made during meetings with students a further 14 student questionnaires were completed and returned. Additional inspection of staff recruitment, staff training and quality assurance systems was carried out during the inspection of The Star College main campus in mid November. What the service does well: What has improved since the last inspection? Since the last inspection students said that the house meetings have now improved. They said that their views were listened to and actions had been taken. For example the meeting includes only the manager and not all staff. Overton House D51_D03_S16529_OvertonHouse_V202991_111005_Stage4_A.doc Version 1.40 Page 6 At the time of the last inspection there were problems with the hot water and heating at Overton. This has now been resolved with an additional electricity supply added. Many of the maintenance issues noted at the last inspection have been dealt with although there are continual maintenance needs around the building. 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. Overton House D51_D03_S16529_OvertonHouse_V202991_111005_Stage4_A.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 Overton House D51_D03_S16529_OvertonHouse_V202991_111005_Stage4_A.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) 2 & 3 Overton House identifies students’ needs and goals with a thorough assessment on admission and during the first half term. This can be a time consuming and repetitive process, which could be modified, as the college already knows all students. Students, who have made a positive choice to move to Overton, receive the individual care they need from competent staff and with additional support available from specialists on the main campus. EVIDENCE: Students moving to Overton House have generally spent at least one year at the college staying in the on site accommodation. Whilst the staggered admissions at the beginning of term assist the staff team in completing new care assessments the potential for more pre-admission assessment does not appear to have been fully exploited. Responses from the students confirmed that they have made a positive choice to move to Overton House and were aware of the advantages and disadvantages of moving. College managers confirm that students would be supported to move to another residential unit of the college if their move to any of their residential units proved unsatisfactory. Comments such as ‘I can access town and gain my independence’ summarises statements from many students from Overton House. Overton House D51_D03_S16529_OvertonHouse_V202991_111005_Stage4_A.doc Version 1.40 Page 9 The acting manager and nursing staff employed to work at Overton confirmed that they are able to meet the needs of a wide range of students. However remaining at the accommodation on the main campus may be necessary for some students if they have care needs that cannot be managed at Overton. Nursing staff reported that they have access to specialist advice from colleagues on the main campus - such as occupational therapist, speech and language therapist, psychologist and physiotherapist - and have attended specific training and updating. Overton House D51_D03_S16529_OvertonHouse_V202991_111005_Stage4_A.doc Version 1.40 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7 & 9 Overton House staff gain a clear picture of students’ assessed needs and their aspirations by expecting active participation in the process from students themselves. Greater use of existing records and sharing of information and recording between care and nursing staff would benefit students. The college supports students to prepare for adult life within a risk assessment approach that safeguards individuals. EVIDENCE: The inspection took place within the first half term of the new college year and whilst basic care assessments were completed for students, personal development profiles and Target Action plans had not been fully completed in the files tracked. Some discrepancies between parts of the records seen were pointed out. The college integrated care and education assessment and plan format gives a full picture of students’ needs, aspirations and goals. Ongoing monitoring and evaluation of this new process should identify any shortcomings and lead to ongoing improvement of the system. Some of the nursing records included information that would have been useful to a wider audience. Overton House D51_D03_S16529_OvertonHouse_V202991_111005_Stage4_A.doc Version 1.40 Page 11 Rapid archiving of information from previous years has lead to some gaps in current records and could impact on current action. College documentation emphasises student rights and responsibilities for making decisions about and for themselves. Student comments confirm support through the education tutorial system and care key working arrangements. Students described the programme of assessment used for increasing level of independence and responsibility in the community. It was described as ‘fair’ and designed to ensure adequate protection and encourage staged independence. Students confirmed that they are involved in making choices about financial and medicine management although some people were not clear about arrangements to have keys to their rooms or lockable storage. Records examined as part of case tracking included a range of Risk Assessments. Copies of Manual Handling Assessments are kept in students’ rooms. Some instances were noted where Risk Assessments relating to self management of medicines had been previously completed on main campus but had not been transferred to current files. Students talked about comprehensive citizenship and personal development programmes where they have information and training to improve their personal safety. Overton House D51_D03_S16529_OvertonHouse_V202991_111005_Stage4_A.doc Version 1.40 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 15, Students at Overton are generally able to access activities in the local community. There is a range of activities available to them, some of which they have been involved in organising. Students are able to maintain contact with family and friends, usually returning home during normal college breaks. EVIDENCE: Of the fourteen students who completed a questionnaire half responded ‘Yes’ to the question ‘Do you have lots of things to do?’ The remainder responded ‘sometimes’. Discussion with students indicated that they felt there was more to do while living at Overton House compared with living on main campus and that they have been consulted about organising different groups. Activities outside the house need to be planned in advance and take into account risk assessments and staffing ratios. Students recognise that living at Overton House gives them ready access to activities in Cheltenham. Some instances were reported by students and Overton House D51_D03_S16529_OvertonHouse_V202991_111005_Stage4_A.doc Version 1.40 Page 13 confirmed by staff where staffing ratios and levels had prevented students taking part in events in the local community. The comment from a student that Overton House is ‘close to town and they are able to go shopping’ summarises many of the student comments. One young person did note that they wanted to attend a local church but there was insufficient staff to allow this. Responses from student questionnaires confirmed that ‘family and friends’ could visit. Students confirmed that with prior arrangement friends from other parts of the college might visit them at Overton House. Whilst there is a payphone students generally have their own mobile phones and email address and are able to keep in touch with friends both inside the college and beyond and family. Students generally return home during college holidays; members of staff are familiar with the arrangements for their key students. Overton House D51_D03_S16529_OvertonHouse_V202991_111005_Stage4_A.doc Version 1.40 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19, 20 Students’ personal care is discussed with them and some students direct care staff so that they receive the help they require. Students’ physical and emotional health needs are met by the nursing and care staff at Overton House and when necessary by accessing specialists at the main campus or in the community. Arrangements for the administration of medicine, including students managing their own medicines, are designed to protect and safeguard students. EVIDENCE: The students confirmed that they are involved in designing their care routines and if they wish are actively involved in directing support staff to the exact care and attention they need. Students were familiar with and understood the written consent forms, which the college uses in a number of areas, including self-management of medicines and use of specific pieces of equipment. Students confirm that the college Physiotherapists, Occupational Therapist and Speech & Language therapists work with them and support staff to identify equipment and techniques to maximise their independence. Discussions confirmed that privacy and dignity is respected when intimate care is undertaken and routines have flexibility, in particular at weekends. Several students commented that their key workers were not on duty for ‘Personal Overton House D51_D03_S16529_OvertonHouse_V202991_111005_Stage4_A.doc Version 1.40 Page 15 development’ sessions. Students would appreciate easier access to the rota to identify when they could speak to their key worker. The manager agreed that this could be easily arranged. Students living at Overton House remain registered with the college GP who they can visit at college during surgery hours or attend his local surgery. Overton House nurses described how they liaise with their nursing colleagues on the main campus providing a complimentary service of treatment, monitoring, health education and support. Students understood that they should be arranging routine dental appointments during the holidays and only be accessing local dentists for urgent or emergency dental treatment. The nurse team demonstrated a good knowledge of students’ specific medical needs and within the smaller size of the home are integrated with and compliment the care support staff. The nurses who take responsibility for medicines described the system for the safe administration of medicines and a sample of records and storage arrangements were checked. Student citizenship and personal development programmes support students taking responsibility for their own medicines; the process described is staged with proper safeguards and reviews in place. As noted earlier, where students are already managing their own medicines when they move to Overton House, it is recommended that a copy of the risk assessment to support this in kept in the students’ current file. Nursing staff were clear and conscientious in following proper procedures for administering and recording medicines. A limited list of household medicines, agreed by the college medical officer who is also the General Practioner for Overton House students, is available for minor and short-term use. Whilst student medical records are used to record the giving of any of such items, and the reason, good practice guidance recommends maintaining a general record so that stocks held at any time can be easily checked. Overton House D51_D03_S16529_OvertonHouse_V202991_111005_Stage4_A.doc Version 1.40 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 & 23 Students are able to express their views both at Overton and at college and can be confident that what they say will be listened to and acted on. The college follows clear procedures when they receive a formal complaint. Students can be confident that staff at Overton will protect them from abuse and neglect. EVIDENCE: Student responses in the questionnaires confirm that they feel confident to speak with members of staff, often their ‘keyworker,’ if they have any worries. Discussion with students indicated that issues raised in house meetings are followed up. A change of practice to exclude all but the acting manager from these meetings was cited as an example of views being acted on. Notes from a complaint made about the care of a student at Overton House in February 2005 confirm that complaint investigation procedures are followed and senior staff involved in investigation and responding to complainants. Complaints relating to care at Overton House are recorded in the college record, which is held on the main campus. All but one student confirmed that they felt safe living at Overton House. The worry of one student who did not feel safe did not relate to Overton House. Discussion with members of staff confirmed that they have received training about protecting students form abuse and neglect and are aware of related college policies and procedures. The college has taken steps to safeguard students from financial abuse following an incident of misuse of a student bank PIN number. The acting manager confirmed that the college is aware of its responsibility to report members of staff who may be unsuitable to work with students. Overton House D51_D03_S16529_OvertonHouse_V202991_111005_Stage4_A.doc Version 1.40 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 standard(s) 24 & 30 Within its design limitations, Overton House provides students with adequate, clean accommodation, which is subject to ongoing maintenance and upgrading. The home has systems and operates to maintain the cleanliness of the building and avoid infection control. Sluicing arrangements would benefit from upgrading. EVIDENCE: Overton House is subject to high and heavy use by students and their equipment and college maintenance staff are regularly working at Overton House. It was noted that the standard tiling and flooring in the bathrooms varied and some remedial work was in progress at the time of the inspection. The acting manager identified that one bathroom was not used because of its poor standard. There was damage noted to the part-doors of five rooms, which compromise their fire safety. A damaged lock on a first floor bedroom raised concerns for the inspector about the safety and security of these students’ belongings, particularly as this room was on the route used by nonstudents accessing the computer room. Comments from students indicated a need to remind them about arrangements for having keys to lock their bedroom or safe storage. Overton House D51_D03_S16529_OvertonHouse_V202991_111005_Stage4_A.doc Version 1.40 Page 18 Whilst staff identified that the accommodation at Overton is limited, in particular with regard to the number of shared rooms and lack of en-suite facilities, none of the students commented about these shortcomings. The building was found to be clean and odour free at the time of inspection. Hazardous products are locked securely and COSHH data sheets are in place. Colour coded mops and buckets are used. Some of the washing machines in the laundry room have sluice cycles. Nursing staff were clear about infection control procedures and implement a system of limiting the number of staff to care for students when they are unwell. Hand washing signs were noted throughout the building. There are sluice facilities on the ground and first floors, which appear to offer an adequate level of cleaning for low to medium level of risk items. The manager reported that there are plans to upgrade the sluice facilities. To meet NMS 30.6 a sluicing disinfector should be provided, which is described as ‘the most effective cleaning method’ by the Health Protection Agency. The current method has limitations in the consistency and standard of washing and disinfecting which is a particular issue where items may be shared. Overton House D51_D03_S16529_OvertonHouse_V202991_111005_Stage4_A.doc Version 1.40 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 34, 35 There appears to be sufficient staff deployed at Overton House to care for the students. This needs to be monitored, however, in line with students’ increasing care needs and comments from students that activities, particularly at weekends, are being refused because of lack of staff. The processes for the recruitment of staff will be safe when some sequencing and recording issues are attended to. Students can be confident that staff caring for them receive training appropriate to their role and level of experience and knowledge. EVIDENCE: Overton House staff team has a wide mix of skill and experience and students spoke positively about them as individuals and as a team. A new post of Lead Nurse/ Deputy has been created since September 2005, which has helped to clarify the role and responsibilities of nurses at Overton House. Comments from students suggest that insufficient staffing levels at Overton House, in particular at weekends, leads to limitations on students accessing activities in the community. Not being able to go to church and repeated cancellation of a cinema trip were cited as examples. The acting manager and nursing staff acknowledged that there had been a slight increase in students’ care needs Overton House D51_D03_S16529_OvertonHouse_V202991_111005_Stage4_A.doc Version 1.40 Page 20 from previous years. Evidence from current staff rotas and the inspection report from September 2004 do not indicate any reduction of staff numbers, however staffing levels need to be monitored and discussed with students, in particular with regard to planning of weekend activities. Staff recruitment arrangements were examined during the inspection of the main campus. A sample of recruitment records was examined. The CSCI are happy for the personnel records to be maintained centrally on the main campus. Overall the college has very efficient recruitment systems and procedures, although some of the records examined did not have two references on file obtained before an appointment is made. The college report that three references are taken up on preferred candidates, as well as checks made with previous employers involving children or vulnerable people. Where there were gaps in employment records there was no evidence that these had been satisfactorily explored. Whilst it was noted that students might not be involved in the recruitment of all staff, they do participate in the selection of senior positions. Detail of the training and development programme for all college staff was examined during the inspection of the main campus where the Continuing Professional Development Department is located. Both new and existing staff are provided with induction, refresher and ongoing training. Staff commented positively that they receive appropriate updating and are being supported to gain Vocational Qualifications. There are regular training events for all staff, for core subjects such as manual handling, first aid and fire safety. Overton House D51_D03_S16529_OvertonHouse_V202991_111005_Stage4_A.doc Version 1.40 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 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) 39 Students can be confident that their views and opinions will be sought as part of the college’s comprehensive quality assurance process and their views will effect goals developed for the service. EVIDENCE: Information about this standard was gained during the inspection of the main campus. The college undertakes regular comprehensive self-assessment, which includes consultation with service users. A copy of the draft summary report supplies included a good range of student comments. Students confirmed that they are consulted about matters affecting Overton House and that their observations had resulted in change. Overton House D51_D03_S16529_OvertonHouse_V202991_111005_Stage4_A.doc Version 1.40 Page 22 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 x 2 3 x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score x 4 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x x x Standard No 11 12 13 14 15 16 17 x 4 4 x 3 x x Standard No 31 32 33 34 35 36 Score x x 3 2 4 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Overton House Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score x x 4 x x x x D51_D03_S16529_OvertonHouse_V202991_111005_Stage4_A.doc Version 1.40 Page 23 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 Regulation Requirement Timescale for action 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. 5. 6. 7. 8. Refer to Standard YA 2 YA 6 YA 20 YA 20 YA 24 YA 24 YA 30 YA 33 Good Practice Recommendations It is recommended that greater use be made of existing assessments and goal setting when students move in to Overton House to avoid unnecessary duplications Greater co-ordination and sharing of information is recommended between care and nursing records. It is recommended that copies of existing Risk Assessments for students self medicating are transferred to their current files. It is recommended that an auditable system is established for supplies of homely medicines held and administered. It is recommended that students are reminded of the arrangements for their having keys to their rooms or lockable storage boxes. It is recommended that attention is paid to the ongoing maintenance of the building in particular the standards of bathrooms. It is recommended that the sluice facilities are upgraded in line with Health Protection Agency guidance. It is recommended that staffing levels are monitored and careful planning of weekend shifts is undertaken so that D51_D03_S16529_OvertonHouse_V202991_111005_Stage4_A.doc Version 1.40 Page 24 Overton House 9. YA 34 students are able to participate in activities of their choosing. It is recommended that recruitment system is tightened to ensure that references are on file prior to a person’s appointment being confirmed and there is evidence that any gaps in employment have been explored. Overton House D51_D03_S16529_OvertonHouse_V202991_111005_Stage4_A.doc Version 1.40 Page 25 Commission for Social Care Inspection 1210 Lansdowne Court Gloucester Business Park Brockworth Gloucester GL3 4AB 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 Overton House D51_D03_S16529_OvertonHouse_V202991_111005_Stage4_A.doc Version 1.40 Page 26 - 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!