CARE HOME ADULTS 18-65
Principle House 95 Ringwood Road Walkford Christchurch Dorset BH23 5RA Lead Inspector
Heidi Banks Unannounced Inspection 20 February 2006 11:20
th DS0000031699.V283456.R01.S.doc Version 5.1 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 DS0000031699.V283456.R01.S.doc Version 5.1 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. DS0000031699.V283456.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Principle House Address 95 Ringwood Road Walkford Christchurch Dorset BH23 5RA 01425 277707 01425 277026 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) Principle Care Ltd Mrs Lisa Trepka Rudkin Care Home 6 Category(ies) of Learning disability (6) registration, with number of places DS0000031699.V283456.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. Staffing levels must be calculated using the Residential Forum’s `Care Staffing` model (published 2002) The registered manager Mrs Lisa Trepka Rudkin must attain level 4 NVQ awards in management and care by December 2006. 15th November 2005 Date of last inspection Brief Description of the Service: Principle House opened in August 2002. It is registered to provide accommodation and support to six adults who have a learning disability. The home is situated in Walkford, Christchurch, on the main road through the town. It is a family style home and similar in appearance to the other houses in the road. All six bedrooms are single with en-suite facilities. There is a large lounge / dining room, separate kitchen and a garden to the rear of the house. There is an area for parking at the front of the house. Accommodation is on two floors. There is also an office and staff sleep-in room. Local shops are within walking distance and there is a bus route into the neighbouring town of Christchurch. DS0000031699.V283456.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place over the course of six hours on a weekday. The lead inspector was accompanied by another inspector for the duration of the inspection. The purpose of the inspection was to assess the home’s progress in meeting the three recommendations made at the last inspection and to assess outcomes for service users against some of the National Minimum Standards. The inspectors were assisted by the Registered Manager, Lisa Rudkin, throughout the visit. There are six residents living at Principle House at the present time. The age range of the residents is currently between 22 and 43. At the start of the inspection there were no service users present at the home as they were out doing their morning activities but the inspectors were able to meet some of the service users when they returned home for lunch and at the end of the day. During this inspection information was obtained from the Registered Manager, the Day Care Manager and some of the service users and staff present at the home. The inspectors were given a guided tour of the home. A sample of records was also inspected including service user files, staff training records and some records relating to medication, health and safety and complaints. The inspector received three completed comment cards from relatives of service users, two comment cards from Care Managers and four from health care professionals in contact with the home, information from which is reflected throughout the report. Fourteen standards out of the twenty-two key standards were assessed at this inspection. What the service does well:
In line with the home’s admissions policy, assessments of service users’ needs are carried out prior to admission to ensure that the home can make suitable arrangements to meet their needs. Service users are involved in making choices and decisions about the support they receive, the activities they wish to do and how they spend their leisure time so that they have some control over their daily lives and are able to do things that interest them. Risk assessments are in place to promote service users’ independence and ensure that their safety and welfare are safeguarded. Service user plans showed that their needs and wishes are central to the process meaning that service users’ requirements are met taking into account their preferences. Feedback from health and social care professionals and Care Managers indicated that staff have a good understanding of service users’ needs and work in partnership with other agencies to offer effective support. One health care professional reported that staff ‘respect privacy’ and there is ‘good
DS0000031699.V283456.R01.S.doc Version 5.1 Page 6 communication, good rapport with clients’. Another stated, ‘Very organised system, efficient but caring for service users and their needs’. Comments from relatives also indicated that they were satisfied with the overall care provided within the home and were kept informed of important matters affecting their relative. The home has a complaints procedure in place which provides a framework by which service users or their relatives / visitors can raise concerns with the manager. Records showed that complaints made had been responded to quickly and with positive outcomes for the service users concerned. The home appeared in good repair and comfortably furnished providing a pleasant environment for service users to live in and one that meets their needs. What has improved since the last inspection? What they could do better:
As a result of this inspection, three requirements and six recommendations have been made. The registered provider must ensure that a specific care plan is in place for a service user with epilepsy so that staff are able to recognise her seizures when they occur and are fully aware of what action to take. This will help ensure that the service user’s health care needs can be met by all staff on duty. The home’s quality assurance strategy must be fully implemented to ensure that the views of service users are sought on a regular basis and that their views are central to the home’s development. DS0000031699.V283456.R01.S.doc Version 5.1 Page 7 Inspection of fire training records indicated that not all staff had attended the required number of training sessions to ensure their effective response in the event of a fire. The home must ensure that all staff, including night staff, attend the required number of sessions. Inspection of service user records showed that in some cases it was not clear how information in care plans and reviews had been shared with service users and how the views of service users, their relatives and their Care Managers had been recorded. It is therefore recommended that service users, their relatives and representatives sign up to the plan to indicate their agreement and that any views expressed by them are included in the plan. Although systems and procedures are in place to safeguard service users when they are given medication, some recommendations have been made regarding the review and development of the system to further protect service users. More care staff need to complete NVQ training to enable them to be fully competent and qualified in their work with service users. In addition, staff need to be able to access training that will enable them to meet the individual needs of service users, for example, epilepsy, total communication and training around sexuality and personal relationships. Two recommendations regarding the individual supervision of staff have been repeated from the last inspection. This is to ensure that the Registered Manager has ample opportunity to implement the system fully and demonstrate that staff are receiving supervision at least six times each year that is recorded and from which their development and individual work with service users can be monitored. 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. DS0000031699.V283456.R01.S.doc Version 5.1 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 DS0000031699.V283456.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 The home ensures that prospective service users’ needs are assessed so that suitable arrangements can be made to meet their needs and they avoid offering places to people whom they cannot adequately support. EVIDENCE: Principle House has an admissions policy which states that they strive to ensure that their admissions process is as thorough as possible in order to avoid offering places to people whom they cannot adequately support. A service user was admitted to the home in December 2005 and inspection of the service user’s file showed evidence of a single care management assessment provided by the service user’s Care Manager. There was also evidence on record to indicate that transitional visits had taken place to assess the service user’s suitability for admission and the home had met with the service user’s Speech and Language Therapist to discuss his communication needs. A pre-admission contact record was in place to detail all contacts made with the service user by staff. However, there were no signatures on the record to indicate who had made the entries. DS0000031699.V283456.R01.S.doc Version 5.1 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 the following standard(s): 6, 7 and 9 Although service users’ needs and goals are reviewed on a regular basis by the home it is not always clear from documentation how this information is shared with the service user concerned. Service users are given opportunities to make choices and decisions that give them control over aspects of their everyday life. Risk assessments are in place to promote service users’ independence with due regard for their safety and welfare. EVIDENCE: The individual plans for two service users were examined. This included the review documentation for one service user. There was evidence on records that service user plans are reviewed and updated as necessary to reflect their changing needs. There was also evidence on record that service users attend their reviews along with a member of their family, their key worker and the Registered Manager. Service users’ Care Managers, as representatives of the funding authority, are also invited to attend the review.
DS0000031699.V283456.R01.S.doc Version 5.1 Page 11 On the review documentation for one service user the sections corresponding to the service user’s views, parents’ views and Care Manager’s views were left blank and the review documentation had not been signed by the service user. On the service user profile and behaviour plan for another individual there was no evidence to demonstrate that the plan had been discussed with the service user concerned as the area for signature had been left blank. The home holds a weekly house meeting where service users are consulted about activities they want to do and any issues they wish to raise with each other or the staff. Key workers also support service users in making decisions and there was evidence on record of service users being involved in their individual reviews. The home offers opportunities for service users to be involved in making decisions about their lives on a daily basis, for example, their daily activities, the decoration and furnishing of their own room and which newspaper they wish to buy. It was also clear from a service user profile the areas in which the service user may need support in making decisions, for example, needing help to choose clothes. A sample of risk assessments for two service users was inspected. These demonstrated that risk assessments are carried out, both with regard to environmental risks in the home and risks associated with accessing the community and the individual service user. A specific risk assessment had been carried out for one service user, who due to changes in her health, was assessed as needing more support to promote her welfare. The risk assessment details the level of risk and the actions identified as necessary to minimise the risk. DS0000031699.V283456.R01.S.doc Version 5.1 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 the following standard(s): These standards were not assessed at this inspection. EVIDENCE: DS0000031699.V283456.R01.S.doc Version 5.1 Page 13 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Service users’ needs and wishes form the basis of their support with personal care to ensure their requirements are met in a way that they prefer. Service users are supported to access generic and specialist health care services as appropriate to maintain good health. Development of a care plan around one service user’s epilepsy and further staff training is required to ensure that staff respond to seizures in a timely and effective manner. Procedures are in place to promote safe systems for administering medication but some recommendations have been made in order for service users to be more fully protected EVIDENCE: A review of two service user plans showed that service users’ personal care needs have been identified and reviewed on a regular basis. It was evident from the plans that service user preferences are taken into account, for example, the fact that one service user prefers to bath or shower in the evening and likes to go to bed between 10 and 10.30pm. Inspection of service user records indicated that service users are supported to access their GPs and specialist health care services as appropriate to ensure that they maintain good health. The medical log sheet for one service user
DS0000031699.V283456.R01.S.doc Version 5.1 Page 14 indicated that appointments had been made as required with her GP, Community Nurses, the dentist, Neurology and the optician to ensure that her changing needs are being assessed by appropriate professionals. There was evidence on file to show that preventative health screening had been considered and discussed with the service user’s GP. Feedback from health and social care professionals received through comment cards indicate that staff demonstrate a good understanding of the needs of service users and communicate well with them; ‘I am always made welcome by staff and clients. Information is readily available and imparted accurately. My client is very happy and settled, behaviour issues from two years ago are greatly reduced as his emotional, social and personal needs are met with empathy to his personality’; ‘I have found Principle House staff very welcoming. I feel that all questions I have asked have been answered fully and the staff have helped me to join the resident concerned in activities he enjoys’. Relatives of service users expressed satisfaction about the support received ‘My son…has settled in very well. He is well looked after…’; ‘I am very pleased with the progress my son has made since being at Principle Care and he is happy living there’. The staff response to a seizure of one service user was discussed with the Registered Manager. The Registered Manager reported that the home is working with the Community Learning Disability Nursing team to produce a specific care plan relating to the service user’s seizures. However, there was no interim care plan in place to give guidance to staff about how they should respond to the service user’s seizures and at what point emergency services should be called. In addition, not all staff have accessed training in epilepsy. Monitoring records around the service user’s epileptic seizures were seen to be in place and gave a good amount of information about the seizures observed. Medication procedures were reviewed. Medication is kept in a secure cupboard in the office of the home. There is a medication policy in place which covers safe administration, administration of over the counter medication, disposal of medication and refused / missed medication. The Registered Manager confirmed that procedures for taking verbal messages regarding medication and obtaining written confirmation had not been included in the policy. At present medication is delivered by the pharmacy to Principle House. The Day Care Manager has the responsibility of re-dispensing medication from its original boxes into a weekly dosette box for administration by staff. Redispensing is not considered good practice because of the potential risk of error. DS0000031699.V283456.R01.S.doc Version 5.1 Page 15 The home has a list of non-prescribed medicines used. Supplies of nonprescribed medicines were checked against this list and were found to be correct. The home prints a weekly Medicine Administration Record (MAR) chart for each service user. Separate charts are used to record the administration of short courses of medicines and non-prescribed household medicines. Two members of staff sign the MAR chart to confirm that medication has been administered. A sample of dosette boxes and MAR charts were checked and no inconsistencies were found. There was evidence of a good use of service user photographs on MAR charts and medication trays as a safeguard for identifying service users when administering medication. The PRN medication care plan for one service user was examined. This contained very clear information about what medication should be administered when and by whom and had been authorised by the service user’s medical practitioner. The Registered Manager reported that only staff who have been in employment for more than one month are permitted to administer medication. Administration of medication is covered in the home’s induction process and covers safe storage, respecting dignity, reporting errors, refusal of medication, aspects of administration and recording. The Day Care Manager reported that staff receive in-house training which includes observation and giving medication with supervision before they are able to administer medication independently. Training records showed that approximately one third of all staff have completed a safe handling of medicines course with a local college. DS0000031699.V283456.R01.S.doc Version 5.1 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 the following standard(s): 22 Systems are in place to ensure that service users are given opportunities to raise issues about the support they receive with the Registered Manager and the complaints procedure is followed to respond to concerns. EVIDENCE: The home has a complaints policy in place. House meetings are held on a weekly basis and minutes of the meeting show that the agenda allows for service users to raise concerns or complaints as part of the meeting. The home’s complaints record showed that there have been three complaints made in the past year by service users. The nature of the complaint and the action taken by the Registered Manager in response to the complaint had been clearly recorded. Three relatives of service users indicated via comment cards that they were aware of the home’s complaints procedure. DS0000031699.V283456.R01.S.doc Version 5.1 Page 17 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 Service users live in a comfortable home which meets their needs and allows them to exercise their personal choice with regards to the decoration and furnishing of their own rooms. EVIDENCE: The home is in keeping with properties in the neighbourhood and service users are supported to access their local community by using the home’s vehicle or by public transport. The home presents as clean, comfortable and airy with environmental risk assessments being carried out for each service user to ensure that their safety in the home is safeguarded. Furnishings and fittings are domestic and unobtrusive. Bedrooms of service users have been decorated to meet their own personal tastes. DS0000031699.V283456.R01.S.doc Version 5.1 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 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 35 and 36 Further development of the home’s training programme for staff will ensure that all staff have training in areas specific to the service user group and access to NVQ training. The Registered Manager is developing a system of recorded individual supervision of staff to ensure that all staff receive the support and guidance they need to work with individuals. EVIDENCE: The home’s training programme for staff was discussed with the Registered Manager and Day Care Manager. There is an in-house induction programme in place and it was reported that all new staff are now undertaking Learning Disability Awards Framework (LDAF) modules as part of their induction. The staff training record showed that staff undertake Emergency First Aid training every three years and that staff have also attended Non-Clinical Manual Handling training. Some staff have undertaken Basic Food Hygiene training. Staff receive training in Non-Violent Crisis Intervention. The Registered Manager reported that training is mainly ‘on-the-job’ and bimonthly staff meetings have been used to watch videos on issues relevant to the service user group. The Registered Manager stated that the home has recently identified a training provider to support them with the delivery of
DS0000031699.V283456.R01.S.doc Version 5.1 Page 19 accredited training and that these options are currently being explored. This will be necessary to ensure that all staff have the necessary knowledge and skills to meet the individual needs of service users, for example, training in epilepsy, dementia / memory loss, sexuality and total communication. Two members of care staff stated that they had received adequate training from the home to support them in their role, one reporting that this had helped her feel confident in working with the service user group. According to the training records, ten staff out of thirty-four have either achieved or are working towards an NVQ qualification. Following a recommendation made at the last inspection the Registered Manager confirmed that she is implementing a system to ensure that all staff receive regular planned and recorded supervision. DS0000031699.V283456.R01.S.doc Version 5.1 Page 20 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 39 and 42 The home’s quality assurance process requires full implementation to demonstrate how service users’ views underpin the review and development of the home. Systems and procedures are in place to ensure that the health and safety of residents is protected. However, there was not enough evidence to show that all staff had attended an adequate number of training sessions in order to ensure their effective response in the event of a fire. EVIDENCE: The quality assurance strategy for the home is still in the process of being developed. Fire records were checked and indicated that appropriate checks were in place to test the alarm system, emergency lighting and fire equipment within the home. Records showed that there have been six announced fire drills in the past year. These were clearly documented to show when the drill occurred, who was present and the time taken for the evacuation to occur. Fire training
DS0000031699.V283456.R01.S.doc Version 5.1 Page 21 records for staff showed that for one member of night staff had only received one training session in the past six months. There was no training record for a member of staff who had returned to work recently following a period of leave. The Registered Manager confirmed that thermostatic valves are on radiators and some radiators have covers. A sample of service user records showed that risk assessments on water temperatures and windows had been completed. Systems and procedures around infection control are in place. Hand sanitising gel is in place in the laundry and kitchen areas for use by staff and service users. Body fluid kits are also available for staff to use in the event of a spillage of body fluids. Gloves are available for staff when supporting service users in their personal care and the manager confirmed that soiled bed linen or clothing is washed separately and at an appropriate temperature. DS0000031699.V283456.R01.S.doc Version 5.1 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 Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 X ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 2 33 X 34 X 35 2 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 2 X X X 2 X X 2 X DS0000031699.V283456.R01.S.doc Version 5.1 Page 23 Are there any outstanding requirements from the last inspection? No 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. Standard Regulation Requirement The registered person must ensure that a specific care plan is in place for a service user who has epilepsy so that staff are aware of the procedure to follow in the event of a seizure and at what point they should contact the emergency services. The registered person must ensure that the quality assurance strategy within the home is fully implemented. The registered person must ensure that all staff, including night staff, attend the appropriate number of formal fire training sessions each year. Timescale for action 1 YA19 12 30/04/06 2 YA39 24 30/05/06 3 YA42 23 30/04/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA6 Good Practice Recommendations The views of service users, their family, friends and / or advocate as appropriate and relevant agencies should be
DS0000031699.V283456.R01.S.doc Version 5.1 Page 24 indicated on review documentation. Service users should be encouraged to ‘sign up’ to their individual plans to indicate that the information has been shared with them and that they are in agreement. Guidance from the Royal Pharmaceutical Society should be followed with regards to the receipt, recording, storage, handling, administration and disposal of medicines. It is recommended that the home’s procedure for redispensing medicines be reviewed and risk assessed. Medicines should be given directly from the container in which the pharmacy supplied them labelled with the doctor’s prescription directions. 2. YA20 When MAR charts are printed in the home or handwritten, a second competent person should sign to confirm that all the details of prescribed medicines are correct. Records should be kept to identify staff responsible for filling and checking dosette boxes. Procedures for taking verbal messages regarding medication and obtaining written confirmation should be added to the medicines policy. 50 of all care staff in the home should obtain a care NVQ Level 2 or above. The home’s training and development programme should be reviewed to ensure that all staff receive training that is linked to the home’s service aims, service users’ needs and individual plans. This should include, for example, training in epilepsy, total communication, autism, sexuality and personal relationships and challenging behaviour. The manager should ensure that all staff receive at least six supervision sessions each year which are clearly recorded. This recommendation is carried forward from the last inspection. The manager should ensure that an accurate record is kept of all discussions, which relate to the care and support of residents and the individual work and development agreed. This recommendation is carried forward from the last inspection. 3. YA32 4. YA35 5. YA36 6. YA36 DS0000031699.V283456.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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