Inspection on 02/12/05 for REACH Bierton Road

This inspection was carried out on 2nd December 2005.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

REACH Bierton Road 07/07/08

REACH Bierton Road 13/07/07

REACH Bierton Road 20/12/06

REACH Bierton Road 23/05/06

REACH Bierton Road 07/07/05

REACH Bierton Road 05/01/05

REACH Bierton Road 15/07/04

REACH Bierton Road 20/02/04

Similar services:

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

Pinta

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

CARE HOME ADULTS 18-65 Bierton Road (20-22) Aylesbury Bucks HP20 1EJ Lead Inspector Mike Murphy Unannounced Inspection 2nd December 2005 09:30 Bierton Road (20-22) DS0000023044.V270574.R01.S.doc Version 5.0 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 Bierton Road (20-22) DS0000023044.V270574.R01.S.doc Version 5.0 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. Bierton Road (20-22) DS0000023044.V270574.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Bierton Road (20-22) Address Aylesbury Bucks HP20 1EJ 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) 01296 429586 REACH Limited Miss Amanda Follette Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Bierton Road (20-22) DS0000023044.V270574.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 12 September 2005 - existing service users are to be permitted to remain at 20 - 22 Bierton Road, beyond their 65th birthday. 7th July 2005 Date of last inspection Brief Description of the Service: 20-22 Bierton Road, Aylesbury, is a care home providing residential care to eight adults with learning disabilities. The home is a conversion of two midterraced house. The service is managed by Rehabilitation Education and Community Homes Limited (REACH), an organisation specialising in residential care for adults with learning disabilities. The home is located about half a mile from Aylesbury town centre, convenient for the facilities of the town, the specialist facilities of Manor House Hospital, which is across the road and public transport. All of the homes bedrooms are single. None have en-suite facilities. Bierton Road (20-22) DS0000023044.V270574.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was conducted by one inspector on a Friday morning in December 2005. The inspection consisted of discussions with staff and residents, reading documents, a walk around the home, measuring hot water temperatures and radiator surface temperatures (using electronic thermometers supplied by CSCI) and checking arrangements for the storage and administration of medicines. Three staff were on duty (including two who had recently been appointed) and six of eight residents were present in the home on the morning. One resident was at an employment project and one had recently been admitted to hospital. Some residents were watching television, others were colouring books and one was in her room. A calm atmosphere prevailed. The agenda for the inspection included following up progress on the requirements and recommendations of the July 2005 announced inspection, assessing performance in meeting the ‘Lifestyle’ and ‘Medication’ national minimum standards, obtaining a measure of resident’s well-being, and meeting newly appointed staff. Standards already assessed in the announced inspection were not examined in detail. Care planning is generally well organised and the home was developing person centred care plans (‘PCP’) at the time of this inspection. Due to staffing pressures throughout 2005 residents have experienced some limitation on the range of social and recreational activities pursued. It is hoped that the appointment of new staff will lead to increased opportunities for residents from the start of 2006 when the new staff have settled into their work. The home is maintaining good practice in the control and administration of medicines. The detail of this could be improved in some areas (fuller details are given in the relevant section of this report) and new staff will need to be trained to UK standards. The home is a conversion of two semi-detached houses and the environment will always present some challenges to managers. The temperature of some hot water outlets and uncovered radiators have been noted as a concern on successive inspections. This inspection is no exception and these matters again give cause for concern and pose a hazard to vulnerable residents. These concerns need to be seriously and effectively addressed by the registered manager and other managers in REACH. This small home provides good support to residents. The easing of staff pressures should enable it to improve on this from the start of 2006. The failure of managers to effectively address CSCI concerns about health and safety are a source of some disappointment and more importantly continue to pose a hazard to residents. The inspector would like to thank the residents and staff for their time and hospitality during the course of this inspection. Bierton Road (20-22) DS0000023044.V270574.R01.S.doc Version 5.0 Page 6 What the service does well: What has improved since the last inspection? What they could do better: Ensure higher compliance with health & safety issues in particular hot water and radiator surface temperatures. Please contact the provider for advice of actions taken in response to this Bierton Road (20-22) DS0000023044.V270574.R01.S.doc Version 5.0 Page 7 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Bierton Road (20-22) DS0000023044.V270574.R01.S.doc Version 5.0 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 Bierton Road (20-22) DS0000023044.V270574.R01.S.doc Version 5.0 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): Standards in this section were not assessed on this unannounced inspection, having been assessed in the announced inspection carried out five months earlier in July 2005 EVIDENCE: Bierton Road (20-22) DS0000023044.V270574.R01.S.doc Version 5.0 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): Standards in this section were not assessed on this unannounced inspection, having been assessed in the announced inspection carried out five months earlier in July 2005 EVIDENCE: Bierton Road (20-22) DS0000023044.V270574.R01.S.doc Version 5.0 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,14,15.16,17 The home has a comprehensive care plan in place for each resident and at the time of this inspection was developing a person centred planning (PCP) approach to care planning. When PCP care planning is fully developed residents should benefit from an approach to organising care that is based on the resident’s perspective and which aims to meet his or her aspirations. Residents attend a variety of social, training and recreational activities (including an annual holiday), which aim to meet individual needs and improve the quality of residents lives. However, the range of such activities has been more limited than desired due to staffing pressures experienced throughout 2005 and the need for care staff to remain in the home. It is expected that with the recent appointment of new staff a fuller range can be utilised in 2006 and that residents will benefit from more out of hours activities with staff. EVIDENCE: A care plan is in place for each resident. The home is adopting ‘person centred care planning’ (PCP) and PCP care plans are being drawn up for each resident. Some sections of care plans examined were incomplete and the senior care worker in charge said that these sections are being completed over time with Bierton Road (20-22) DS0000023044.V270574.R01.S.doc Version 5.0 Page 12 the residents. One care plan had sections written by the resident herself – a very good practice where this is possible. All residents are supported by staff in carrying out daily activities and are encouraged to be as independent as possible. Residents share in house chores and help with shopping. All attend some activities outside of the home during the day. Two attend ‘Quest’, an employment project. Seven attend sessions in communication skills, IT and catering in colleges in Aylesbury. The home is in a good location for the amenities of Aylesbury town centre and has a car for travelling further where desired. However, residents have been unable to gain full benefit from this due to staffing pressures over the past year. It is hoped that once the new staff have settled down in their work in the New Year that residents will be able to get out more often with staff support. A trip to a Christmas pantomime was planned for the 18 December 2005 and to the REACH Christmas party in Stoke Poges in mid-December 2005. All residents are on the electoral register. Residents pursue a range of individual interests including knitting, football, painting, sewing, board games, TV & video and shopping. Residents have had holidays in Scarborough, Bognor Regis and Blackpool during 2005. This is at additional cost. On such occasions the residents pay for their own holiday and for staff accommodation while REACH pays staff salaries and some staff expenses. All residents have maintained contact with their families in varying degrees. Some residents attend social clubs in Aylesbury on a couple of nights a week. Attendance has also been affected by the staffing pressures referred to above and it is hoped that with the recent recruitment of new staff these will ease in the New Year. The home has an established routine, which appears to meet the needs of residents. Service users responsibilities for house chores are not consistently recorded in care plans but will be included in the diaries, which form part of the PCP plan. Residents are involved in menu planning. Breakfast consists of cereals and toast. Lunch, around 12.30 pm is a snack based meal such as hot dogs, sandwiches or salads. Supper, around 5.00 pm, is the main meal of the day and is usually based around a main course of meat or fish. Snacks are not offered to residents after supper with the exception of one resident who has diabetes and is on insulin. The care worker in charge said that residents are happy with the present arrangement. Fluids are offered with meals and at various times throughout the day. Residents are weighed monthly. Residents seemed comfortable pottering around the house for the morning and appeared well cared for. The inspector spoke to five of six residents present over the time of the inspection. Bierton Road (20-22) DS0000023044.V270574.R01.S.doc Version 5.0 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): 20 The home’s arrangements for the control and administration of medicines are generally satisfactory. This ensures that residents receive the medicines prescribed for them and that scope for error is minimised. The home does not receive periodic inspection of its arrangements by a pharmacist and is deprived of the potential benefits of this in terms of supporting good practice in the storage of medicines. EVIDENCE: The arrangements for the control and administration of medicines were examined. Medicines are stored in a large locked cupboard. One resident was on insulin at the time of this inspection. This is administered by district nurses and is stored in a domestic fridge in an annexe to the kitchen (although none was in stock at the time of this inspection). Arrangements for the storage of medicines appear satisfactory. The home has a contract with a local branch of Lloyds pharmacy. No residents were self-administering medication at the time of this inspection. Medicines administration records (‘MAR sheets’) were in good order with only one unexplained gap noted in the charts examined. The home has a homely remedies policy, which includes a short list of medicines, guidelines for their administration and a doctor’s signature. The guidelines include recording any Bierton Road (20-22) DS0000023044.V270574.R01.S.doc Version 5.0 Page 14 adverse effect of the administration of a homely remedy. It is recommended that staff also record in the care plan the effect of the medication administered since that is of equal importance. A number of MAR sheets had handwritten entries transcribed from labels on bottles supplied by the pharmacy. It is now considered good practice that in the absence of a typed label by a pharmacist that such handwritten entries are witnessed and recorded by two staff. Records of checks by a pharmacist were not available. Where the service is funded by the NHS it is considered good practice for the pharmacy supplying medicines to a care home to carry out periodic checks on the home’s arrangements for the control of medicines and to record the outcome of such visits. The home was holding a significant number of Diazepam tablets (42 tablets) 5 mg which had been prescribed for a resident on an ‘as required’ (‘PRN’) basis about a month earlier. The home had only administered two doses of 2.5 mg (with an interval of about a fortnight between each administration) since the drug had been prescribed. This is evidence of good practice in relation to the administration of such ‘as required’ medicines. It indicates that the home is responsible in exercising the freedom which ‘as required’ prescriptions permit. This raises three points: (1) what arrangements exist for reviewing such a prescription so that the home does not have to retain such quantities when a drug may no longer be required? (2) how are the 5mg tablets broken in half? (3) how is the unused half disposed of? The home is advised to obtain a tablet splitter if it is required to administer medicines to a variable dose prescription but which are supplied in the higher dose (assuming the medicine is suitable for splitting in half). This is more hygienic and a little more accurate than breaking tablets by hand. The registered manager should ensure that staff have clear instruction on how to dispose of the unused half of the tablet (it should be dealt with in accordance with REACH policy and practice with regard to returns to pharmacy). The registered manager should seek the advice of the pharmacist with regard to the need to retain such quantities of such an ‘as required’ drug given the relative infrequency of administration. Bottles of liquid homely remedies medicine did not have the date opened and given the relative infrequency in which such medicines are administered it is recommended that the registered manager seek the advice of a pharmacist on the shelf life of such medicines once opened. New staff will require training in REACH policy and in good practice in the administration of medicines. Bierton Road (20-22) DS0000023044.V270574.R01.S.doc Version 5.0 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards in this section were not assessed on this unannounced inspection, having been assessed in the announced inspection carried out five months earlier in July 2005 EVIDENCE: Bierton Road (20-22) DS0000023044.V270574.R01.S.doc Version 5.0 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards in this section were not assessed in detail on this unannounced inspection, having been assessed in the announced inspection carried out five months earlier in July 2005. The home is failing to maintain a safe environment by not effectively addressing within a reasonable timescale its failure to meet the national minimum standards for hot water temperatures and the surface temperatures of radiators in areas to which residents have access. This exposes residents to risk and injury. EVIDENCE: Although these standards were not assessed in detail, the inspection did provide an opportunity to check progress on health and safety issues raised at earlier inspections. The temperature in the hot water outlet in the kitchen was found to be 61.9 degrees Celsius. At the announced inspection in July 2005 this was tested at 75 degrees Celsius. In January 2005 it was found to be 59 degrees Celsius. A requirement for immediate corrective action was made in the July 2005 inspection. Progress was reviewed with the registered manager, the operations manager and the Care Services Manager, in November 2005. No action had Bierton Road (20-22) DS0000023044.V270574.R01.S.doc Version 5.0 Page 17 been taken by REACH because of a need to fit a new sink in the kitchen. This had not yet been installed by the time of this inspection in December 05. At the November meeting REACH managers said that the risk to residents was being controlled by restricting access to the kitchen in the absence of staff supervision. The surface temperature of radiators was checked. This was found to be 61 degrees Celsius in the office, 62.4 degrees in a bathroom, 63 degrees in a corridor and 54 degrees in a resident’s bedroom. These temperatures are well in excess of that recommended in the standards (‘temperatures close to 430C’ (standard 42.3 iv)). Reference to uncovered radiators was noted in inspection reports in December 2003, February 2004, July 2004 and January 2005. The home was clean and tidy. Bierton Road (20-22) DS0000023044.V270574.R01.S.doc Version 5.0 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): Standards in this section were not assessed in detail on this unannounced inspection, having been assessed in the announced inspection carried out five months earlier in July 2005. The home has recently appointed new staff. This should relieve the staffing pressures, which have existed throughout 2005. Once the new staff have settled in to their jobs residents should benefit by experiencing more consistency in staffing and by having more opportunities to participate in social and recreational activities with staff support in Aylesbury. EVIDENCE: Although these standards were not assessed in detail the inspection did provide an opportunity to review progress since the July 2005 inspection. Since the registered manager was not on duty, staff files were not available. Four new care staff have been appointed since July 2005. These staff were appointed in Bulgaria. Two were on duty at the time of the inspection. Both had worked in the home for just under two months. Both were registered nurses in Bulgaria and therefore were experienced in care. Both were settling down well in the home and felt that their induction, orientation and familiarisation with the home, local services and the area would be complete at three months. Language can be a problem on occasions but the new staff were Bierton Road (20-22) DS0000023044.V270574.R01.S.doc Version 5.0 Page 19 taking action to improve their English and their understanding of the range of accents they meet in the UK. Staff files were not accessible so records of recruitment, appointment and induction procedures were not examined. The new staff said that supervision had taken place monthly. Details of training to date were not available and it was not possible to check what training had taken place to date. In answer to a question on the subject the new staff did have a reporting system in mind should they suspect that abuse had taken place. These appointments should lead to a reduction in the use of bank or agency staff, more continuity in care for residents and increased opportunities for social and leisure activities. The home is now fully staffed and it is expected that the benefits of this recruitment round will be felt from the start of 2006. Staff files were not accessible on this unannounced inspection, therefore compliance with requirements made at the previous inspection on POVA or CRB checks and a supervision policy governing staff appointed under POVA could not be checked. There is no reason to believe that REACH is not complying with the requirements but evidence needs to be seen for confirmation of this. Bierton Road (20-22) DS0000023044.V270574.R01.S.doc Version 5.0 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): 42 Standards in this section were not assessed in detail on this unannounced inspection, having been assessed in the announced inspection carried out five months earlier in July 2005. The home has to date failed to effectively address concerns about the temperature of hot water and of radiator surface temperatures expressed at successive inspections. This raises the risk of injury to residents and some restriction on unsupervised freedom of movement as a result of the imposition of control measures. EVIDENCE: Although standards in this section were not assessed in detail, progress on matters raised at the July 2005 announced inspection was followed up. One of the requirements of the announced inspection was that cleaning chemicals (mainly in the kitchen and laundry), which might pose a hazard to residents, should be locked away when not is use. REACH managers argued Bierton Road (20-22) DS0000023044.V270574.R01.S.doc Version 5.0 Page 21 that this was in conflict with the home’s philosophy of encouraging residents to be as independent as possible. This was discussed at a meeting in November 2005 and the inspector agreed to withdraw the requirement providing a risk assessment was drawn up for each resident. This was subsequently confirmed by the inspector in writing. Progress on this seemed unclear at the time of this unannounced inspection but the control measure of locking cleaning materials away after use was still in place. The temperature of the hot water in the kitchen has been referred to earlier (under standard 24 above) and no progress had been made due to the decision to delay the fitting of temperature regulating valves in the kitchen and laundry until a new sink had been fitted in the kitchen. The risk to residents was being controlled by restriction of resident access to the kitchen and laundry without staff supervision. On this occasion, on a cool day in December 2005, the surface temperature of radiators was found to be well in excess of the recommended level of close to 43 degrees Celsius. This poses a risk to residents, which could be eliminated by installation of radiator covers. This matter has been referred to on earlier inspection reports. Bierton Road (20-22) DS0000023044.V270574.R01.S.doc Version 5.0 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x x x x Standard No 22 23 Score x x ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score x x x x x Standard No 24 25 26 27 28 29 30 STAFFING Score 1 x x x x x x LIFESTYLES Standard No Score 11 3 12 3 13 2 14 2 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score x x x x x x CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Bierton Road (20-22) Score x x 2 x Standard No 37 38 39 40 41 42 43 Score x x x x x 1 x DS0000023044.V270574.R01.S.doc Version 5.0 Page 23 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA42 Regulation 13(4)(a) Requirement Timescale for action 31/12/05 2. YA34 3. YA34 4. YA43 5 YA42.3 The registered manager is required to ensure that the temperature of the hot water in areas to which service users have access does not pose a hazard (previous timescale of 15 July 2005 not met) 19 The registered manager is required to ensure that staff are not appointed before a POVA first check has been carried out in advance of an enhanced criminal record certificate 19 The registered manager is required to ensure that staff appointed following a successful POVA first check are effectively supervised until an enhanced criminal records certificate is received 13(4)(a) The registered manager is required to ensure that individual risk assessments are in place for cleaning and other materials, which pose a potential hazard to vulnerable residents. 13(4)(a)(c) The registered must ensure that the surface temperature of radiators in areas to which DS0000023044.V270574.R01.S.doc 15/07/05 15/07/05 31/12/05 28/02/06 Bierton Road (20-22) Version 5.0 Page 24 residents have access are close to 43 degrees Celsius. Radiator covers should be fitted where necessary 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 YA22 Good Practice Recommendations It is recommended that the registered manager in liaison with the responsible individual review and update the homes documentation relating to the protection of vulnerable adults It is recommended that the registered manager seek the advice of a pharmacist on ensuring that the shelf life of liquid medicines is not exceeded once opened. It is recommended that the registered manager obtain a device for splitting tablets where the home is required to do so by the prescription and dosage of the medicine supplied It is recommended that the registered manager ensure that there is an effective system for disposing of surplus medicines (including portions of tablets which have been split and which are to be disposed of). 2 3 YA20 YA20 4 YA20 Bierton Road (20-22) DS0000023044.V270574.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection Aylesbury Area Office Cambridge House 8 Bell Business Park Smeaton Close Aylesbury HP19 8JR National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Bierton Road (20-22) DS0000023044.V270574.R01.S.doc Version 5.0 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!