Inspection on 06/06/07 for Priory Close (3)

This inspection was carried out on 6th June 2007.

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 no outstanding requirements from the previous inspection report, but made 12 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Priory Close (3) 11/08/08

Priory Close (3) 29/06/06

Priory Close (3) 19/12/05

Priory Close (3) 01/07/05

Priory Close (3) 20/01/05

Priory Close (3) 07/07/04

Priory Close (3) 04/02/04

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

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

CARE HOME ADULTS 18-65 Priory Close (3) 3 Priory Close Aigburth Liverpool Merseyside L17 7EG Lead Inspector Helen Carton Key Unannounced Inspection 6th June 2007 09:30 Priory Close (3) DS0000025316.V331987.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 Priory Close (3) DS0000025316.V331987.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. Priory Close (3) DS0000025316.V331987.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Priory Close (3) Address 3 Priory Close Aigburth Liverpool Merseyside L17 7EG 0151 727 1886 F/P 0151 727 1886 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) www.c-i-c.co.uk. Community Integrated Care Alan Morris Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Priory Close (3) DS0000025316.V331987.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 29th June 2006 Brief Description of the Service: 3 Priory Close is registered to provide care for three adults with a learning disability. The home is a detached bungalow; there are three single bedrooms, a large lounge, kitchen and an office. Laundry facilities are situated in the garage. There is a garden to the rear of the home with a patio and grass areas. There is wheelchair access to the property. Bathing aids are provided. The home is situated in a quiet cul-de-sac in the Riverside district of Liverpool. Local shops and amenities can be found a mile or so from the home. Otterspool Promenade and local parkland are within walking distance. The home’s fees are £60:45p per week. Priory Close (3) DS0000025316.V331987.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. As part of the inspection process the Commission sent the home a pre inspection questionnaire to be completed prior to the site visit. This information is helpful in allowing the inspector to decide what areas are most likely to need to be looked at. An inspector made a site visit to examine records and written information and to discuss how the service supports residents in all areas of their lives. Part of this process involved speaking with the manager, members of the staff team and spending time and talking with residents to find out their views about living at the home. Approximately 4 hours were spent at the home. What the service does well: What has improved since the last inspection? The manager ensures fire safety checks and training takes place at regular intervals. The manager and the staff team have supported residents to access educational activities. Priory Close (3) DS0000025316.V331987.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Priory Close (3) DS0000025316.V331987.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Priory Close (3) DS0000025316.V331987.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2 & 5 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home’s statement of purpose does not clearly reflect the services provided by the organisation and those that are the responsibility of the residents living at the home. This lack of clarity restricts the ability of people to make an informed decision about whether the home can meet their needs, aspirations and lifestyle choices. EVIDENCE: There have been no admissions to the home over the last twelve months. Examination of the statement of purpose indicates prospective residents are provided with fairly detailed information about the type and level of services the home can provide. However there appears to be discrepancies regarding who provides the transport used by residents living at the home. The statement of purpose states, “There is an accessible vehicle which is adapted to carry wheelchairs”. Residents contracts of terms and conditions of residency states “ fees do not cover transport. Examination of residents files indicate residents have entered into consumer hire agreements for the minibus and pay £23.71 per week. The registered persons are advised the statement of purpose Priory Close (3) DS0000025316.V331987.R01.S.doc Version 5.2 Page 9 must not be ambiguous with regard to services the organisation is providing and those that are to be provided by residents themselves. Priory Close (3) DS0000025316.V331987.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8 & 9 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Care planning and risk management records do not accurately reflect the care needs and support of residents. Resulting in some residents not receiving the level of support and care they need to live their daily lives as they wish. EVIDENCE: Care plans risk assessments and essential lifestyle plans for the three people who live at the home were examined the following issues were discussed with the manager: Overall the information held in the care plans is detailed and provides good information about how residents like to be supported with their personal care needs and daily routines. The plans also include information regarding the need for residents to receive gender appropriate personal care and specific support and personal items that are important to individuals. However discussion with the manager and examination of daily records indicate sensory Priory Close (3) DS0000025316.V331987.R01.S.doc Version 5.2 Page 11 impairment conditions, which would have an impact on residents’ daily lives are not clearly identified. Resulting in residents being reliant on the verbal information the staff team hold to ensure their safety and wellbeing. It is acknowledged the home does not currently use temporary or agency staff however the manager is advised this information must be incorporated into care plans. This is to ensure that newly appointed staff or agency staff are able to access vital information to enable them to support residents appropriately and safely. Examination of reviews of care plans indicates significant changes in residents’ behaviour were not identified and did not reflect the changes in the type and level of support provided. The home has carried out multiple environmental risk assessments however they do not include information about residents’ sensory impairments. By not including this information all risk factors have not been identified and therefore risky behaviours or actions cannot be responded to effectively. At the time of the site visit the staff team at the home were supporting residents presenting with challenging behaviour. Discussion with members of the staff team, the manager and examination of documentation indicates they are attempting to support residents appropriately and safely. However they are not documenting the impact these behaviours are having on the individuals presenting with the behaviour and the other people living at the home. Particularly with regard to their quality of life, emotional wellbeing and ability to access community and leisure facilities. The registered provider must look at the impact these behaviours are having and look at ways to improve outcomes for all residents living at the home. Priory Close (3) DS0000025316.V331987.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,15,16,17 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Residents’ lifestyles and ability to be involved in decision making about their daily routines are limited by care practices and staffing levels operating at the home. EVIDENCE: The home has worked hard to provide education and personal development opportunities for some residents. However due to high levels of inappropriate behaviour occurring daily and over a significant period of time the quality of daily living and the ability to access community and leisure facilities has reduced. Examination of records, direct observations and discussion with members of the staff team indicates the inappropriate behaviour is having a detrimental impact on residents’ emotional, social and mental wellbeing. Records indicate Priory Close (3) DS0000025316.V331987.R01.S.doc Version 5.2 Page 13 there has not been a review of all residents needs and the issue of the impact of the inappropriate behaviour on the other residents has not been raised. Staffing level currently in place at the home do not recognise the significant impact the inappropriate behaviour is having on the ability of the staff team to support residents to access community facilities regularly and safely. Resulting in residents’ ability on a daily basis to access the community being dependent on the severity of the behaviour. The registered persons must review the care packages of the people living at the home to ensure they can meet all care needs safely and proactively and that in supporting one individual others needs are not being ignored or marginalised. Records indicate the home supports residents to maintain positive relation ships with family members and friends. The home does not have a dining room table and chairs with residents eating their meals in the lounge. The kitchen area including equipment such as the cooker, cutlery and drawers were dirty. The inspector discussed this issue with the manager who said he would ensure the kitchen and all cupboards and equipment were thoroughly cleaned. Priory Close (3) DS0000025316.V331987.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 & 20 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Not all residents physical and emotional health needs are being met due to the lack of structure to the planning of the care and support provided. EVIDENCE: Care plans provide good information about how residents like to be supported with their personal care needs and guidance on personal items that residents need to have with them to maintain their emotional wellbeing. As detailed earlier in the report the manager and staff team are supporting residents who are presenting with a high level of challenging behaviour in a sensitive and caring manner. However record keeping regarding the impact these behaviours have on other residents and staff is poor. Resulting in no formal strategies applied to reduce their impact on the health and mental well being of residents, particularly with regard to the impact of sleep deprivation and high noise levels on individuals. Priory Close (3) DS0000025316.V331987.R01.S.doc Version 5.2 Page 15 The registered persons must carryout formal reviews of all residents holistic needs to ensure the home can meet them also as part of the reviews the compatibility of the residents living at the home should be looked at. This is to ensure the needs of one resident are not having a negative impact on another. Care plans and risk assessments do not identify where residents have a sensory impairment. Resulting in the staff team relying on verbal information passed between them. This lack of written information reduces the ability of review processes being a proactive tool in developing appropriate care and support strategies for residents living at the home. There is some documentary evidence that health care professionals are contacted and their advice sought. A sample of residents medication and the accompanying Medication Administration Record (MAR) sheets were examined they corresponded and indicate medication is being stored, recorded and administered safely. Priory Close (3) DS0000025316.V331987.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There is a comprehensive complaints procedure in place, which is being adapted to meet the individual communication needs of residents. However the registered persons do not proactively manage risky or challenging behaviour that has a negative impact on the resident group. EVIDENCE: The home has a detailed complaints procedure with timescales for action and responses to concerns raised. There is also a shorter version that is made available to service users and their family/advocates. Since the last site visit the manager and staff team have started to work with one resident with a sensory impairment and other supporting agencies to produce an individualised communication system. Part of this is to produce a complaints communication prompter in a pictorial format. The home has an adult protection procedure and a copy of the Liverpool City Council’s adult protection procedures is also available. A whistle blowing policy is available. Staff spoken with had received training in the adult protection procedure and recognised the different forma of abuse and neglectful practice. As detailed earlier an issue regarding the ability of the manager and staff team to ensure all residents receive the care and support they require and to protect them from the negative impact of challenging behaviour is raised. Priory Close (3) DS0000025316.V331987.R01.S.doc Version 5.2 Page 17 Members of the staff team spoken to raised issues regarding the level of challenging behaviour and the impact it was having on other residents. Priory Close (3) DS0000025316.V331987.R01.S.doc Version 5.2 Page 18 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): 24,25,26,27,28,29 & 30 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Residents do not live in a clean comfortable and safe environment that meets their holistic needs. EVIDENCE: A tour of the home identified the following issues of concern: The lounge The lounge furniture is very low and deep with the seating being hard and uncomfortable resulting in two residents spending much of their time in their wheelchairs. The furniture was dirty with stains visible on the fabric covering the sofas and chairs. The carpet was worn and stained. Priory Close (3) DS0000025316.V331987.R01.S.doc Version 5.2 Page 19 There is one lounge which is also where residents eat their meals there is no other area in the home other than bedrooms for residents to spend time alone. The lounge environment does not provide residents with a pleasant, comfortable and needs appropriate environment in which to relax. The shower room The shower cubicle sealant and grout were badly discoloured with what appeared to be black mould. The tiles round the shower cubicle were damaged with some missing. The radiator cover was water damaged and badly stained. All areas of the shower room were dirty with stains being present on the toilet, floor, shower cubicle floor, walls and woodwork. Resulting in residents being supported with their personal care in an unhygienic and unpleasant environment. Carpets Carpets in the hall and lounge areas are badly worn and stained and do not provide residents with a pleasant and clean environment. Kitchen area This area was dirty with food debris and staining being found in drawers, the oven and microwave. Work surfaces and cooking utensils were dirty the flooring was stained and in parts damaged. Resulting in residents’ food being prepared in an unhygienic environment. The rear garden area The patio area is uneven and poorly maintained. The raised garden area, which has a significant number of trees and shrubs is overgrown and does not provide a pleasant environment for residents to spend time in. Decoration Decoration in all communal areas of the home is worn and in parts damaged and does not provide a pleasant environment for residents to live. The manager told the inspector the home is due to be redecorated and some refurbishment, which will include sofas and chairs. A requirement will be made in this report to require the registered persons to provide CSCI with a schedule of works with timescales detailing when work will be carried out to improve the environment of the home. This is to ensure a Priory Close (3) DS0000025316.V331987.R01.S.doc Version 5.2 Page 20 safe and homely environment that meets residents’ holistic needs is maintained at all times. Priory Close (3) DS0000025316.V331987.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): 32,33,34 & 35 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There are polices and procedures in place to ensure that staff are safely recruited and vetted. However there are insufficient numbers of staff to meet the changing needs of residents. EVIDENCE: The rota for the week of the site visit was examined and indicated there are two staff on duty from 8.00am until 8.00pm. At night there is a waking member of staff. Examination of daily records and discussion with members of the team and direct observations indicates due to the continuing effect of challenging behaviour two members of staff on duty does not meet the holistic needs of residents. The ability of two residents to access community and leisure facilities is being restricted due to the current staffing levels also being needed to support residents presenting with challenging behaviour. The registered providers are required to review the current staffing levels to ensure they are able to meet the changing needs of residents. Priory Close (3) DS0000025316.V331987.R01.S.doc Version 5.2 Page 22 On the day of the site visit the manager did not have access to the staff files. It has been previously reported that all staff have a POVA (Protection of Vulnerable Adults) and CRB (Criminal Records Bureau) clearance check, one member of staff commenced employment since the last site visit. The inspector has spoken to the manager during the writing of this report and he confirmed that all staff files have all the information required under legislation. The inspector observed members of the staff team supporting residents in a supportive and respectful manner. Priory Close (3) DS0000025316.V331987.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): 37,38,39 & 42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There are shortfalls in the management systems which impact on the level and quality of care offered and provided to residents living at the home. EVIDENCE: Issues regarding the information held in residents care plans and risk management support plans are detailed earlier in the report. As are concerns about the frequent incidents of challenging behaviour occurring and the impact they are having on residents abilities to access community facilities and enjoy time in their home. Issues regarding the poor decoration, furnishings and maintenance of the home are raised earlier in the report as were concerns regarding the general cleanliness of the building. Priory Close (3) DS0000025316.V331987.R01.S.doc Version 5.2 Page 24 Members of the staff team spoken to told the inspector they felt supported and valued by the manager. Financial records for two residents were examined and were well maintained. A service manager from CIC carries out a monthly audit of the home and provides formal supervision to the manager. Issues regarding the effectiveness of the current auditing system are raised due to the number of issues of concern highlighted during the site visit. There are policies and procedures to promote safe working practices. A sample of safety check records in relation to the gas, electric, portable appliances, fire alarm and emergency lighting tests and maintenance checks were examined and found to be in order. There was evidence that all staff had received fire safety training. Fire safety training is being provided at frequencies recommended by the fire service of 6 monthly for day staff and 3 monthly for night staff, with all fire equipment being tested and maintained regularly. However issues regarding environmental risk assessments not including information about residents’ sensory impairment are raised as in the body of the report. Priory Close (3) DS0000025316.V331987.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 2 2 2 3 X 4 X 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 1 25 2 26 2 27 1 28 1 29 1 30 1 STAFFING Standard No Score 31 X 32 3 33 1 34 3 35 3 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 2 2 2 X LIFESTYLES Standard No Score 11 3 12 3 13 2 14 X 15 3 16 2 17 1 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 2 3 X 2 2 2 X X 3 X Priory Close (3) DS0000025316.V331987.R01.S.doc Version 5.2 Page 26 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. 1. Standard YA1 Regulation 4 Requirement Timescale for action 30/08/07 2. YA2 14 3. YA5 5 The statement of purpose must provide accurate information regarding the services and facilities that are the responsibility of the registered persons and those, which are the responsibility of residents. With particular regard to arrangements for use of the home’s minibus. Full assessments must be 30/08/07 undertaken for residents’ to determine whether the home can continue to meet their holistic needs. This is to ensure residents’ care need requirements and lifestyle aspirations are compatible with the home’s ability to meet these needs. Terms and conditions of 30/08/07 residency must provide the same information regarding facilities and services to be provided by the registered persons as detailed in the statement of purpose. With particular regard to arrangements for use of the home’s minibus. DS0000025316.V331987.R01.S.doc Version 5.2 Priory Close (3) Page 27 4. YA6 15 5. YA7 12 6. YA9 13 7. YA13 16 8. YA19 12 9. YA23 13 10. YA24 23 Care plans and daily records must provide detailed information regarding the holistic needs of residents. This is to ensure medical, personal care, emotional, mental wellbeing and social needs are met and enable resident to live the lifestyles of their choice. The registered persons must support the rights of residents to make and be directly involved in decision-making processes. With particular regard to having the impact of challenging behaviour on their daily lives proactively managed. Risk assessments and accompanying support plans must be drawn up for those residents presenting with challenging behaviour and those who are being affected by it. Residents’ ability to access community facilities must not be restricted because of challenging behaviour presented by fellow residents. Healthcare needs of residents must be assessed, monitored and reviewed regularly. To ensure the registered persons seek advice and support from health care professionals at the earliest opportunity. The staff team must receive support to ensure they have a good understanding of protection of vulnerable adults procedures and protocols including their roles and responsibilities. This is to ensure the staff team supporting residents’ are able to recognise abusive situations and act appropriately to safeguard them. The registered persons must provide a detailed schedule of DS0000025316.V331987.R01.S.doc 30/08/07 30/08/07 30/08/07 30/08/07 30/08/07 30/08/07 30/08/07 Priory Close (3) Version 5.2 Page 28 11. YA30 16 12. YA33 18 works, which provides information and timescales regarding the refurbishment and maintenance of the home to CSCI. Particularly regarding the issues raised in the report. This is to ensure residents live in a well-maintained, comfortable and safe environment that meets the assessed needs of residents. All areas of the home must be 30/08/07 kept clean to ensure residents live in a pleasant safe environment at all times. Sufficient support worker hours 30/08/07 must be provided to ensure all residents receive the appropriate levels of support to enable them to live their chosen lifestyles. With particular regard to ensuring the behaviour of an individual presenting with challenging behaviour does not restrict the ability of others to access community facilities and enjoy time in their home. 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 YA5 Good Practice Recommendations The registered person should consider the introduction of an independent advocate for clients who do not have family members to act on their behalf. Priory Close (3) DS0000025316.V331987.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Liverpool Satellite Office 3rd Floor Campbell Square 10 Duke Street Liverpool L1 5AS 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 Priory Close (3) DS0000025316.V331987.R01.S.doc Version 5.2 Page 30 - 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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