Inspection on 25/03/08 for Paddock House

This inspection was carried out on 25th March 2008.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 13 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Paddock House 28/11/07

Paddock House 06/07/06

Paddock House 27/01/06

Paddock House 01/07/05

Paddock House 27/01/05

Paddock House 08/09/04

Paddock House 20/03/04

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

CARE HOME ADULTS 18-65 Paddock House 13 Prospect Road Hythe Kent CT21 5NN Lead Inspector Mark Hemmings Unannounced Inspection 25th March 2008 09:00 Paddock House DS0000023503.V359402.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 Paddock House DS0000023503.V359402.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. Paddock House DS0000023503.V359402.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Paddock House Address 13 Prospect Road Hythe Kent CT21 5NN 01303 230067 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) Mr James Peter McCarthy Vacant Mr James Peter McCarthy Care Home 16 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (16) of places Paddock House DS0000023503.V359402.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28 November 2007 Brief Description of the Service: Paddock House (the Service) is registered to provide accommodation and personal care for 16 adults who have difficulties with managing aspects of their mental health. The property is a detached three-storey building. The ground and the first floor are used to provide accommodation for the people who use the Service. All of the people have their own bedroom. Each bedroom has a wash hand basin. One of the bedrooms also has a private toilet and shower. The Service is located in a residential street. It has ready access to local shops, pubs, clubs, library, swimming pool and public transport. The Registered Provider is in day to day control of the Service. He is assisted by the Manager. The current fee is £401.90 per week. This fee includes accommodation, personal care, meals and laundry. It does not include expenditure for things such as toiletries, clothes and transport. Paddock House DS0000023503.V359402.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this Service is One (1) Star. This means that the people who use this Service experience adequate quality outcomes. The commission since 1 April 2006, has developed the way it undertakes its inspection of care services. This inspection of the Service was an unannounced “Key Inspection”. We arrived at the Service at 09.00 and were in the Service for about six hours. It was a thorough look at how well the Service is doing. It took into account detailed information provided by the Registered Provider. Further, it considered any information that the commission has received about the Service since the last inspection. There are 12 Requirements at the end of this Report. What the service does well: What has improved since the last inspection? Paddock House DS0000023503.V359402.R01.S.doc Version 5.2 Page 6 Some items of new bed linen have been provided. Some new carpets have been laid. Some additional double glazing has been installed. Work has been completed to improve areas of the damp course. What they could do better: The pre-admission assessment system needs to collect more information. The system used to plan and to deliver personal care is not sufficiently detailed to ensure that people receive a consistent response to their needs. Some of the records relating to personal spending allowance managed on behalf of people are not adequate. The calendar of vocational and social activities is too limited. The record of food provided is not adequate. Some carpets are heavily stained. The heating system is not sufficient. The system for completing security checks for new members of staff is not robust. Some of the support workers do not have the basic knowledge they need to support their work. There are errors in the medication system. There are omissions in the health and safety arrangements. Paddock House DS0000023503.V359402.R01.S.doc Version 5.2 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Paddock House DS0000023503.V359402.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Paddock House DS0000023503.V359402.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 2. People who use the Service experience adequate outcomes. This judgement has been made using available evidence including a visit to the Service. There are gaps in the information that is collected about the assistance needed by people who move into the Service. EVIDENCE: The Manager and the Registered Provider complete an assessment of each prospective person’s needs for assistance. This is done before a decision is made about whether or not the Service is a suitable place for the person’s residence. The assessment is completed in consultation with the person concerned. As appropriate, members of their family are involved. When applicable, care managers (social workers) are also asked to make a contribution. One set of records relating to Person A was examined. There was information about the mental health diagnosis. However, there was no information about the particular approach support workers have to take to assist the person to undertake daily living tasks. Also, there was no information about the response to be given to occasions when the person conducts himself/herself inappropriately. There is a Requirement in relation to this matter at the end of this Report. Paddock House DS0000023503.V359402.R01.S.doc Version 5.2 Page 10 Paddock House DS0000023503.V359402.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6, 7 and 9. People who use the Service experience adequate outcomes. This judgement has been made using available evidence including a visit to the Service. There are gaps in the information that supports the delivery of personal care. Some of the records concerning the administration of personal spending monies are not accurate. The management of a personal risk has not been well planned. EVIDENCE: People say that the support workers offer them all the assistance they need. There is a written individual plan of care for each person. These are important documents. This is because they form one of the means by which people can be informed about and can agree to the assistance they will receive. Also, the plans are a source of information for staff. This then helps them to provide support in a consistent manner. Three sets of these plans were examined. In Paddock House DS0000023503.V359402.R01.S.doc Version 5.2 Page 12 relation to Person B, there were two omissions. These concerned information that should have been present about an Order under the Mental Health Act that is in place. The other involved the need to have more information about how support workers should respond to instances of distressed conduct. Support Workers A and B gave partly different accounts about how they respond to this issue. In relation to Person C, there was a gap again in relation to the Order that applied. In relation to Person D, there was insufficient information about the person’s needs to be encouraged to do things when demotivated. Again, Support Workers A and B gave partly different accounts about how they respond to this matter. There is a Requirement in relation to these points at the end of this Report. The Registered Provider holds some people’s personal spending monies in order to help them budget. Two sets of records relating to this were examined. In relation to Person B there were errors. These involved the fact that some of the entries for the various transactions were not signed. Also, the tally did not match the cash balance. There is a Requirement in relation to this matter at the end of this Report. The Registered Provider is aware of his duty to help people not take unreasonable risks. In relation to Person D, there is a shortfall in these arrangements. There is not enough information about how support workers should respond to occasions when it is best for him/her not to go out on his/her own. Support Workers A and B were not sure about how to respond to these situations. There is a Requirement in relation to this matter at the end of this Report. Paddock House DS0000023503.V359402.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 15, 16 and 17. People who use the Service experience adequate outcomes. This judgement has been made using available evidence including a visit to the Service. The calendar of occupational and social activities is not well organised. People can spend their days as they wish. Good quality meals are served, but there are gaps in the catering records. EVIDENCE: People are free to do things that interest them. For example, some people go along to a local drop-in centre. Other everyday things include going to the shops and meeting up with friends. There is an activities coordinator. Her role is to work with each person to develop the range of occupational and social Paddock House DS0000023503.V359402.R01.S.doc Version 5.2 Page 14 opportunities open to them. This arrangement is not well developed. There is no clear account of who is doing what. For some people it seems that they are not doing very much other than being around the house and popping out to the shops. One person said, “it can be boring here because I don’t have much to do. It’s partly my own fault. But I would probably do more if someone helped me get myself together so that I could try new things”. There is a Requirement in relation to this matter at the end of this Report. People say that the pace of daily life in the Service is relaxed and unhurried. While they have considerable choice about how to spend their day, there are broad expectations about some of the things they will do. For example, they are expected to adopt reasonable personal practices such as not going to bed too late. People are assisted to keep in touch with members of their families, if this is necessary and if it is their wish. Family members and friends are welcome to call to the Service at any reasonable time. The Registered Provider and the Manager in consultation with the person concerned, keeps in touch with family members so that they know how things are going. People say that they receive good quality meals and that they have enough to eat. They consider meal times to be a relaxed and pleasant experience. There is a choice of dish available at each meal time. The record of the food actually served was examined. There were gaps in that on some days not all the meals were recorded. On other days none of the meals served had been recorded. The Registered Provider is going to set up a more comprehensive record by 1 May 2008. Paddock House DS0000023503.V359402.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18, 19 and 20. People who use the Service experience adequate outcomes. This judgement has been made using available evidence including a visit to the Service. People are helped to support themselves. This includes using health care services. There are errors in the arrangements used to dispense some medicines. EVIDENCE: People are assisted in ways that are right for them. Support workers are courteous in their manner and they respect each person’s individuality. People say that they think that they can rely upon support workers to be there when they are needed and to be approachable. People are assisted to maintain their health. Support workers are alert to the need to identify occasions when someone is becoming unwell. This is so that medical assistance can be sought promptly. Since the last inspection, one person has been assisted to attend a hospital appointment. The Registered Paddock House DS0000023503.V359402.R01.S.doc Version 5.2 Page 16 Provider is now helping him/her to consult further with his/her doctor about an operation that he/she might need. This is an example of good practice. People are free to manage their own medicines when this is appropriate. None of them have chosen to do this at present. Five sets of records relating to medicines dispensed by support workers were reviewed. There were errors in three of them. In relation to Person E, there was a medicine in store that had not been entered on the medication record. The Registered Provider said that it was intended to be used on a discretionary basis, but this did not tally with the written instructions on the container. There was no evidence that the medicine was actually being dispensed. In relation to Person F, there was a medicine in store that was written up on the container to be used on a discretionary basis. However, the medicine had not been entered onto the medication record. There was no evidence that it had been used and the Registered Provider was not sure about how it would be used in the future. In relation to Person D, there was insufficient information available about how best to use a medicine that can be used now and then. This is important because clear instructions are needed to help ensure that it is given in the right way. There is a Requirement in relation to these matters at the end of this Report. Paddock House DS0000023503.V359402.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22 and 23. People who use the Service experience adequate outcomes. This judgement has been made using available evidence including a visit to the Service. There is an error in the information contained in the complaints procedure. The wellbeing of the people in residence is safeguarded. EVIDENCE: There is a written complaints procedure. This explains how the people who live in the Service and other interested parties can go about raising a concern. As a first step it is often best for people to try to sort out concerns informally with the Registered Provider. However, as an alternative they can directly contact us. The procedure does not explain this alternative. The Registered Provider said that he will correct this omission by 1 May 2008. Since the last inspection, we have received an expression of concern from someone in the local mental health service. This related to concerns about the state of the accommodation. Also, there were worries about the suitability of some of the care practices in the Service. The matters raised were examined during the course of the present inspection. We share some of the concerns. They are addressed in some of the Requirements. Paddock House DS0000023503.V359402.R01.S.doc Version 5.2 Page 18 There is a written statement of the Registered Provider’s commitment to promote the wellbeing of the people in residence. The support workers are aware of how to go about making sure that people who live in the Service are protected from abuse. This includes being alert to indirect signs that someone is not being treated well. The people who live in the Service say that they feel safe living in Paddock House. Paddock House DS0000023503.V359402.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24, 29 and 30. People who use the Service experience adequate outcomes. This judgement has been made using available evidence including a visit to the Service. People live in a generally comfortable setting. Some of the carpets are heavily stained. Parts of the accommodation are rather cool. The kitchen is clean. The laundry is well equipped. EVIDENCE: Most areas of the accommodation are decorated and furnished to a normal homely standard. The carpets in one stairwell and along the first floor corridor are heavily stained. There is a Requirement in relation to this matter at the end of this Report. There are night storage heaters. These are not that effective. On the day of the inspection the weather was cold. One of the stairwells, the television Paddock House DS0000023503.V359402.R01.S.doc Version 5.2 Page 20 lounge, the smokers’ lounge and the first floor landing were too cool for comfort. The Registered Provider is hoping to install new gas-fired central heating before next winter. The premises are fitted with an automated fire detection system. This provides a high level of fire safety protection. The Registered Provider has prepared a fire risk assessment. This has been done to ensure that the fire safety system works as intended. The kitchen is clean and well organised. The local Department of Environmental Health has not identified the need for any improvements to be made to the food handling arrangements used in the Service. Some people need extra help in the bathroom because they have difficulties with their mobility. Support workers know what assistance they have to provide. There is suitable equipment in place to enable them to do this safely and reliably. The laundry is equipped with a washing machine and dryer. People are encouraged to do their own laundry, but in practice most rely upon support workers to organise this for them. The arrangements used work well. Each person has a sufficient supply of clean and presentable clothes from which to choose. There are new regulations that have been introduced to ensure that used water does not leak back into the main pipe-work. The Registered Provider is going to check with the local water supply company to make sure that he complies with these provisions. He will do this by 1 June 2008. Paddock House DS0000023503.V359402.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 32, 33, 34 and 35. People who use the Service experience adequate outcomes. This judgement has been made using available evidence including a visit to the Service. The Service is adequately staffed. There is a gap in one set of the security checks. Some of the support workers do not have enough knowledge about mental health conditions. EVIDENCE: There are at least two support workers on duty during the day and the evening. At night time, there are two support workers present. On weekdays there is a housekeeper and the activities coordinator. There is no cook. This means that support workers need to spend some of their time in the kitchen. There is an on-call system. This means that someone senior can be contacted for advice out of office hours. The Registered Provider completes a number of security checks in relation to new support workers. This is done to ensure that they are trustworthy people who are suitable to have unsupervised access to the people in residence. The Paddock House DS0000023503.V359402.R01.S.doc Version 5.2 Page 22 records relating to Support Worker C were examined. Most of the checks were recorded as having been completed. These included the receipt of a disclosure from the Criminal Records Bureau. Also, there were two references. Due to his/her employment history an additional check should have been completed with a previous employer. This had not been done. There is a Requirement in relation to this matter at the end of this Report. New support workers receive introductory training before they work without direct supervision. After that, they are provided with ongoing training. This is designed to develop further their ability to provide a high quality residential care experience. We looked at the adequacy of some of the skills and knowledge of Support Workers A and B. There were gaps in their knowledge. This included uncertainty about the nature of the main mental health diagnoses, about the symptoms related to each and about some of the resultant assistance likely to be needed. Both were not sure about the reason for administering some special mental health medicines. There is a Requirement in relation to this matter at the end of this Report. Paddock House DS0000023503.V359402.R01.S.doc Version 5.2 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 37, 39 and 42. People who use the Service experience adequate outcomes. This judgement has been made using available evidence including a visit to the Service. The Registered Provider does not hold the relevant qualifications. The quality assurance system does not collect enough information. There are gaps in some of the health and safety arrangements. EVIDENCE: Although he is assisted by the Manager, the Registered Provider is in day to day charge of the Service. This means that he has to hold certain qualifications in health and personal care and also in management. He does not have these qualifications and is not currently studying to acquire them. The qualifications Paddock House DS0000023503.V359402.R01.S.doc Version 5.2 Page 24 are designed to guide managers in setting up the necessary systems to provide high quality residential care. These are important given that we have noted a number of problems in the running of the Service that should have been picked up and corrected before we raised them. There is a Requirement in relation to this matter at the end of this Report. There are various systems used to promote good team-work. These include handover meetings at the beginning and end of each shift. Also, there are staff meetings. Several things are done to consult with the people in residence about how well the Service is running. These include informal discussions and the completion of more organised questionnaires. The information collected by these means shows that the people who live in the Service generally are very happy with how things are going. The consultation system does not include members of staff. Also, there is no organised system to tell contributors what is going to be done to respond to any suggested improvements. The Registered Provider is going to address these omissions. This will be done in time for the results to be notified to us in 2009, when the Registered Provider submits his next Annual Quality Assurance Audit. Regular checks are completed to ensure that the Service’s fire safety equipment remains in good working order. This includes a weekly test of the fire alarm bells and periodic more detailed checks completed by a contractor. There are unannounced fire drills. The records do not clearly show that each member of staff has been assessed as knowing how to operate reliably the Service’s fire safety procedure. There is a Requirement in relation to this matter at the end of this Report. The electrical wiring system has been certified as being in a safe-worthy condition. The annual check of gas appliances is overdue. There is a Requirement in relation to this matter at the end of this Report. There have not been any significant accidents or other unwelcome events in the Service since the last Key Inspection. The Registered Provider checks the premises and the accommodation to ensure that there are no hazards that might cause someone to have an accident. He says that no such problems have been identified. We did not identify any particular hazards. Paddock House DS0000023503.V359402.R01.S.doc Version 5.2 Page 25 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 2 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 2 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 3 30 2 STAFFING Standard No Score 31 X 32 X 33 3 34 2 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 2 X 2 X LIFESTYLES Standard No Score 11 X 12 2 13 3 14 2 15 3 16 3 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 1 X 2 X X 2 X Paddock House DS0000023503.V359402.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? Yes. STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA2 Regulation 14 (1) (a) Requirement The registered person shall not provide accommodation to a service user at the care home unless so far as it shall have been practicable to do so the needs of the service user have been assessed by a suitably qualified or suitably trained person in that, the Registered Provider must in relation to Person A collect and share with support workers the specified information. Timescale for action 01/05/08 2. YA6 15 (1) Unless it is impracticable to carry 01/05/08 out such consultation, the registered person shall after consultation with the service user or a representative of his prepare a written plan as to how the service user’s needs in respect of his health and welfare are to be met in that, the Registered Provider must in relation to Persons B, C and D enter the specified information in the written plans of care and must ensure that all support workers are familiar with its provisions. DS0000023503.V359402.R01.S.doc Version 5.2 Page 27 Paddock House 3. YA7 17 (2) Schedule 4 (9) The registered person shall maintain in the care home the records specified in Schedule 4 a record of all money or other valuables deposited by a service user for safekeeping or received on the service user’s behalf in that, the Registered Provider must in relation to Person B ensure that a suitable record is maintained of each transaction involving the use of his/her personal spending allowance and must ensure that the account tallies with the cash balance. The registered person shall ensure that any activities in which service users participate are so far as reasonably practicable free from avoidable risks in that, the Registered Provider must in relation to Person D enter the specified information in the written assessment of risk and must ensure that all support workers are familiar with its provisions. The registered person shall having regard to the size of the care home and the number and needs of service users consult service users about their social interests and make arrangements to enable them to engage in local social and community activities … and provide facilities for recreation including having regard to the needs of service users, activities in relation to recreation, fitness and training in that, the Registered Provider in relation to each person must establish what social and vocational activities are undertaken and must assess their adequacy. DS0000023503.V359402.R01.S.doc 01/05/08 4. YA9 13 (4) (b) 01/05/08 5. YA12 YA14 16 (2) (m) (n) 01/08/08 Paddock House Version 5.2 Page 28 6. YA20 13 (2) The registered person shall make 01/04/08 arrangements for the recording, handling, safe keeping, safe administration and disposal of medicines received into the care home in that the Registered Provider must in relation to Persons D, E and F ensure that there are clear arrangements with respect to the administration of all medicines held in the Service for each of them. The registered person shall not 01/05/08 use premises for the purposes of a residential care home unless all parts of the home are kept clean and reasonably decorated in that, the Registered Provider must arrange for the carpets in the stairwell and in the first floor corridor to be returned to a normal domestic standard. The registered person shall not employ a person to work at a care home unless … he has obtained in respect to that person the information and documents specified in paragraphs 1-9 of Schedule 2 where a person has previously worked in a position which involved contact with children or vulnerable adults written verification of why he ceased to work in that position unless it is not reasonably practicable to obtain such verification in that, the Registered Provider must in relation to Support Worker C secure the specified verification (this matter is outstanding from the previous inspection report and should have been addressed from 30/01/08). 01/05/08 7. YA24 23 (2) (d) 8. YA34 19 (1) (b) Schedule 2 (4) Paddock House DS0000023503.V359402.R01.S.doc Version 5.2 Page 29 9. YA35 18 (1) (a) The registered person shall having regard to the size of the care home, the statement of purpose and the number and needs of service users ensure that at all times suitably qualified, competent and experienced persons are working at the care home in such numbers as are appropriate for the health and welfare of the service users in that, the Registered Provider must ensure that Support Workers A and B have an adequate knowledge of the primary mental health diagnoses and of the specialist medication dispensed in the Service. 01/06/08 10. YA37 10 (2) (a) If the registered provider is an 01/08/08 individual he shall undertake from time to time such training as is appropriate to ensure that he has the experience and skills necessary for carrying on the care home in that, the Registered Provider must begin a course of study that will enable him to acquire the specified Awards by the end of 2009. The registered person shall after consultation with the fire and rescue authority ensure by means of fire drills and practices that the persons working at the care home and so far as practicable service users, are aware of the procedure to be followed in the case of fire including the procedure for saving life in that, the Registered Provider must ensure that all members of staff at least once in every period of six months are validated as being competent to operate the fire safety DS0000023503.V359402.R01.S.doc 11. YA42 23 (4) (e) 01/05/08 Paddock House Version 5.2 Page 30 procedure. 12. YA42 23 (2) (c) The registered person shall not use premises for the purposes of a care home unless the equipment provided at the care home for use by service users or person who work at the care home is maintained in good working order in that, the Registered Provider must ensure that the all gas fired appliances are inspected and certified as being safe-worthy by a competent person. 01/05/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Paddock House DS0000023503.V359402.R01.S.doc Version 5.2 Page 31 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Paddock House DS0000023503.V359402.R01.S.doc Version 5.2 Page 32 - 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. 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