Inspection on 11/11/08 for Redworth House

This inspection was carried out on 11th November 2008.

CSCI found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Redworth House 18/12/09

Similar services:

22 Sandown Road

The Highlands

Dilston College Of Further Education

West View House

Prince Bishop Court

Park View (15)

Craigmore House

1 Lanark Close

Extracts from inspection reports are licensed from CQC, this page was updated on 13/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Redworth House Beyerley Road Shildon County Durham DL4 1HQ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Elsie Allnutt     Date: 1 1 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: Redworth House Beyerley Road Shildon County Durham DL4 1HQ 01388777311 01388778811 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Southern Cross OPCO Ltd Type of registration: Number of places registered: care home 57 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia learning disability Additional conditions: The maximum number of service users who can be accommodated is: 57 The registered person may provide the following category of service only: Care Home with Nursing - Code N To service users of the following gender: Either Whose primary care needs on admission to the Home are within the following categories: Dementia Code DE, maximum number of places 57 Learning Disability - Code LD, maximum number of places 6 Date of last inspection Brief description of the care home Redworth House is a registered care home with nursing and it is built on the edge of an industrial estate in Shildon County Durham. The building includes a separate unit that delivers a service to 6 younger adults with learning disabilities, this service is separate from the main part of the home and it has its own entrance leading from the main entrance to the front of the building. This service offers permanent and respite places. The main part of the home provides permanent accomodation with personal care and Care Homes for Older People Page 4 of 29 Over 65 0 0 57 6 Brief description of the care home support for up to 51 older people some of who may have dementia needs. Accomodation covers 2 floors of the purpose built property, the first floor being served by a passenger lift. Each floor has lounge and dining areas, well equipped bathrooms, WCs and single en-suite bedrooms. The building is set within private grounds and the entrance is by level access, enclosed gardens are available to the rear of the building and to the front of the building there is a large car parking area. The area is well served by public transport and there are shops nearby. Care Homes for Older People Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: Before the visit we looked at, information we have received since the last visit, how the service dealt with any complaints and concerns since the last visit, any changes to how the home is run, the providers view of how well they care for people and the views of people who use the service, their relatives, staff and other professionals. An unannounced visit was made on 11th November 2009. During the visit we, talked to people who use the service, relatives, staff, the manager and visitors, looked at information about the people who use the service and how well their needs are met, looked at other records which must be kept, checked that staff had knowledge, skills and training to meet the needs of the people they care for, Care Homes for Older People Page 6 of 29 looked around parts of the building to make sure it was clean, safe and comfortable, checked what improvements had been made since the last visit. We told the manager what we found. What the care home does well: What has improved since the last inspection? The Statement of Purpose has been reviewed and now includes information about the Stephenson Unit stating its aims and objectives. This means that there is now more clarity to what sort of service is delivered in this unit. Service users care plans have been reviewed and revised. These are now more person centred and clearly guide staff to carry out tasks appropriately. So that tasks are carried out safely and so that service users are supported in a way that maximises their independence plans are put in place to reduce identified risks. The administration of medicines in the home has been reviewed and improved and all staff who are responsible for this task have received up to date training regarding the safe administration of medication. Staff therefore have a good understanding of, the reasons for certain medication and the Pharmaceutical Guidelines that must be followed. This means that service users receive their medication safely and in the right way. Staff have now received training regarding verbal and physical aggression which means that they know how to handle situations gently and safely when service users Care Homes for Older People Page 8 of 29 demonstrate challenging behaviours. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 29 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users are provided with good information about the home so that they can make an informed decision about using the service, however the people wishing to use the Stephenson Unit might not be able to understand the information due to the way the current information is presented. Preadmission assessments demonstrates service users needs and assists the home to make informed judgements as to whether they can meet these. Evidence: The home has developed a Statement of Purpose and Service User Guide that reflects the change in ownership and the homes aims and objectives. As the Stephenson Unit is a separate unit within the home and offers a service to younger adults with learning disabilities, a separate Service User Guide, that is developed in a format that can be understood by the service users, is needed. It was confirmed that this document is in Care Homes for Older People Page 11 of 29 Evidence: the process of being developed but has been delayed due to unforeseen circumstances. Although the homes terms and conditions are included in the Service User Guide and service users are aware of them, the home has not yet issued new contracts to reflect the change of ownership. However plans are in place for this to happen in near future. The home receives comprehensive information from referring agencies and other people involved in an individuals care, prior to making a decision that they can meet their needs. For example assessments from the care manager or information from a discharging hospital are received. In addition to this the home also carries a full needs assessment that includes addressing risks. Following this, with all the information at hand, individual care plans are developed. When the home is happy that the persons needs can be addressed appropriately, a letter is sent out to the person to confirm this. This home does not provide intermediate care. Care Homes for Older People Page 12 of 29 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Suitable and effective arrangements are in place to meet service users healthcare needs and good procedures are in place for the safe administration of medicines. However more detail and improved recording during illness could further promote the health and welfare of service users in a more consistent way. Evidence: A care plan document that reflects the corporate image of the company is in place and staff have received training in its use. It is used with the assessment document to ensure that the identified care needs and any identified risks are addressed. For one service user a care plan was in place to reflect the assessed risks identified relating to the possible lack of nutrition and details regarding the individuals food preferences, the way they preferred to have their food served and guidelines for staff to follow regarding support needed, was in place. The care plans are comprehensive and cover all aspects of service users health and social care needs, they are person centred and are generally written in good detail, Care Homes for Older People Page 13 of 29 Evidence: recording good information about service users needs and how they need to be supported to maintain independence. When service users experience ill health individual care charts are put in place to ensure that good care is given, for example one person had a nutrition chart in place to ensure that good levels of food and drink were taken. However records were inconsistent and there were some gaps where the fluid intake was not recorded at all or in enough detail. This inconsistent recording did not support a comment in the daily notes that said food and fluid intake was pushed. Furthermore on another occasion guidelines regarding promoting continence were in place and although the care plan stated that the person needs to be taken to the toilet on a regular basis it did not state the times this support should be given. If a positive toiletting programme that records the outcomes is put in place with accurate detail an individuals pattern/routine could be established. Healthcare professionals are approached for further professional advice about service users care and the guidance given is recorded as part of the care plan. For example for one person there are clear guidelines in place regarding diabetese and the risks related to not eating properly are identified. It is also recorded that the chiropodist must cut the persons toe nails and records are held of this. However for one person there were no alternative arrangements put in place when they refused to see the chiropodist. Bedrails are only used if the need is assessed by a healthcare professional and the assessment and risks involved are recorded in the care plan. Although these documents were in place for one service user, there was no evidence that the service user or their representative had agreed with the risk assessment. This was discussed with the manager who agreed to address it. Service users are supported to attend healthcare appointments, GPs are contacted if requested or needed and arrangements are made for service users to receive support at outpatient appointments. Any appointment or visit from a healthcare professional is recorded with the outcome. Staff interact with service users in a sensitive and competent way and communicate reflecting the individual service users needs. Staff working on the Stephenson Unit know the service users well and their communication methods. Staff were able to respond to service users who communicated in Makaton sign language even though the sign at times had been adapted by the individual. However although one care plan recorded that the individual can only communicate through facial expression, it did not include the interpretations of the different expressions used. This information could further inform staff and result in a more consistent response. Care Homes for Older People Page 14 of 29 Evidence: The care plans are monitored monthly or as needs dictate and reviewed six monthly with the service user and their families/representative. Care Homes for Older People Page 15 of 29 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. So that service users do not become bored and socially isolated they are encouraged to make choices and to take control over their lives by being offered a range of activities and stimulation, while also maintaining contact with family and friends. Their individual dietary needs are met by being offered food that is appropriate, healthy and nutritious. Evidence: An activities coordinator is employed to organise the activity programme throughout the home and the programme is advertised on the homes notice board. The programme is regularly reviewed to ensure that individual service users interests are accomodated and the activity coordinator attends meetings with other coordinators within the company so that ideas and plans can be shared. As part of the assessment process service users are involved in completing an activity questionnaire prior to admission. This includes gathering important information about activities they enjoy and also information about the way they prefer to live, some stated: X loves conversation, X loves classical music and X would love to have a pale blue door. The questionnaires are kept in the care files, where service users Care Homes for Older People Page 16 of 29 Evidence: daily activity is also recorded, so that they can be monitored and reviewed with the care plans. For one service user the preference to have free access to the garden is recorded and although the persons independence is encouraged staff are alerted to gently prompt where needed and to ensure that the persons orientation is promoted positively. One of the activities planned for the day took place in one of the lounges where many service users enjoyed a well attended singalong. Following this service users and staff talked about a series of entertainers who have attended the home over recent months and of recent trips out including a trip to the railway and lorry museum at nearby Shildon and to the Hobbycraft store at Team Valley where materials were bought to use in craft making. Service users in the Stephenson Unit were busy making Christmas decorations. The people who live on this unit mainly attend day centres where they take part in various activities appropriate to their age and interests. One service user was keen to share their interest of music and another was keen to discuss what they had cooked at the weekend. Service users in this unit are encouraged to cook their own meals at weekends which assists in the development of their domestic skills and independence. Visitors are welcomed to visit the home and are given a friendly greeting on arrival. Good information about what is going on in the home is displayed on the walls of the entrance hall along with recent photographs of acitivities enjoyed. This informs service users, their families and friends of what is going on for example activities planned, meetings to be held and of the managers surgeries that are frequently held to discuss various issues inlcuding concerns and complaints and the development of the home. The cook leads a competent kitchen staff team and is aware of the diverse dietary needs of service users and the training needs of staff to address them. Staff are allocated to the dining rooms at mealtimes in numbers that reflect service users needs. There was sufficent staff in the dementia care units dining room to appropriately support and encourage service users to eat a healthy diet. Where it has been identified that a service user may have a risk of not eating or drinking effectively a care plan is in place to monitor food and liquid intake and also their weight. Care Homes for Older People Page 17 of 29 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Effective procedures are in place to help protect service users from abuse and to address concerns and complaints about the home seriously. Evidence: The home has a comprehensive complaints procedure of which service users and their representatives are aware. Any concerns that are brought to the homes attention are addressed directly and this often avoids them escalating to complaints. The homes complaints file demonstrates that complaints have been taken seriously and addressed appropriately, the outcomes demonstrating changes made to improve the service delivered. One complaint is in the process of being addressed by the company. The care records related to this were examined and the improvements made by the home to address the anomalies were discussed. It was clear that the service had looked at the issues raised seriously and was reviewing their procedures in relation to them so that the practice and service could be improved. Staff receive training regarding the local authoritys safeguarding adults policies and procedures and they are aware of the action they would take if abusive practice was observed or if abuse was reported to them. A copy of the procedures is available in the home to which the staff can refer. Care Homes for Older People Page 18 of 29 Evidence: Service users are encouraged to look after their own finances when appropriate and when support is needed with this comprehensive procedures are followed. The records are kept by the homes administrator and monitored by the manager and a monthly reconciliation report is carried out and submitted to the head office. Care Homes for Older People Page 19 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users live in an environment that is safe attractive and comfortable and that encourages their independence and autonomy. Evidence: There is easy access to the home both from outside and within and the first floor can be accessed by a passenger lift or stairs. The home is modern, bright and easy to get around and gives a welcoming feel on entrance. There are mobility aids in place where needed and grab rails around the walls and in bathrooms encourage service users independence. An ongoing refurbishment plan has resulted in the home maintaining a good standard of decor and furnishings throughout and a redecoration programme is underway, however work still needs to be addressed in some areas particularly on the first floor where signs of wear and tear are evident. For example a room that is used as a smoking room does not project a positive image of the people that use it. It is sparse and cold looking and the furniture is damaged and stained. The manager immediately addressed some of the issues raised. The Stephenson Unit is a separate unit to the main building that has its own entrance and stairwell leading from the main entrance. There have been many changes made to Care Homes for Older People Page 20 of 29 Evidence: the environment of this unit since the last inspection to make the environment more homely and comfortable. All areas have been decorated enhancing the look of the rooms and meeting the prefences of the service users. Service users look at home and take ownership of their environment. Small furnishings add to the ambience of the unit and the kitchen is organised and used by service users to develop their daily living domestic skills. Much work has been focussed on making the environment throughout the main part of the building more accessible and stimulating for people with dementia, this has been achieved by using different textures and colours in the decorating programme. Creative and stimulating pieces of artwork decorate the walls in the corridors that invite service users to be motivated when touched and observed and that act as a prompt to service users when attempting to orientate themselves. Pegs with hats, coats and bags, that some service users are stimulated to try on and return as part of their daily routines, decorate one part of a corridor. All provides alternative activity to people who prefer to be physically active during the day as well as providing a diversion to boredom, anxiety and agitation. The dining areas can be located by following colourful signs and pictures related to eating and drinking and inside the rooms more colourful pictures relating to food and drink decorate the walls. This is a good start to providing an environment that meets the needs of the people who live here, however these innovative ideas are currently mainly focussed on the ground floor of the building and when they are included on the first floor, will provide all service users living at Redworth House with a stimulating and motivating environment. The home is clean, pleasant and hygienic and reflects effective domestic routines. Care Homes for Older People Page 21 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Robust recruitment and selection procedures and developing training opportunities ensure that service users are appropriately supported and protected by a competent and qualified staff team. Evidence: The home employs a team of staff with diverse experience and qualifications, almost 60 per cent have qualified in NVQ and others are working towards it. The staffing levels are continually reviewed to ensure that there are sufficient staff on duty to address the needs of the service users. The staff on duty included 8 care staff, 1 senior carer, a qualified nurse, the manager and a deputy and in addition various domestic and kitchen staff. Staff were allocated to different areas of the home in numbers that addressed service users needs effectively. Staff work competently, interacting with service users in a sensitive and skilful way and this reflects the effective guidance and training received. A training programme that reflects the homes and individual staffs needs is now beginning to be established and a training matrix demonstrates the various training programmes arranged and the dates training needs to be updated. Care Homes for Older People Page 22 of 29 Evidence: Training recently delivered to staff includes, managing challenging behaviour, fire safety, the safe handling of medication, food awareness, COSHH, the safeguarding of adults and the safe use of bedrails. In addition to this staff have also received training related to the use of the homes documentation and all are working through the Skills for Care induction programme to up date them with the basic skills and knowledge needed to carry out their roles effectively. Although some staff have received training relating to dementia care in the past, the home is in the process of organising a new up to date training programme called Yesterday Today and Tomorrow (YTT). It plans to train two members of staff in this programme who will then return and cascade the training to all staff in the home. It is important that all staff receive this training as it will equip them with the understanding of issues surrounding dementia illnesses and equip them with the skills and knowledge to effectively address related behaviours demonstrated. Staff are recruited following robust recruitment procedures and staff files include, a completed application form clearly demonstrating the individuals work history, two relevant references and Criminal Record Checks (CRB). Care Homes for Older People Page 23 of 29 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager is supported by a competent administrator and a qualified senior staff team to develop and maintain good management routines that deliver a service in the best interests of the service users. Evidence: A permanent manager has recently been employed to manage this home, she is fully qualified and has had many years experience managing services, her previous position was in a home also owned by this company. She is therefore known and valued by the company. Although she was the registered manager in her previous position, currently she is going through the application process again to be the registered manager for this home. The manager has a clear vision regarding the development needs of the home and is Care Homes for Older People Page 24 of 29 Evidence: working hard with staff and service users in order to review the homes policies and procedures. It is her aim to bring these to everyones attention and to make staff aware of their individual responsibilities to them. This will ensure that good care practices are followed and the standards set by the home met. It will also empower staff to take responsibility and in turn empower service users to live a valued, healthy lifestyle. An effective quality assurance system is in place. Monthly audits are carried out and validated bi-monthly by the operations manager, they are then sent to the main office where they are collated and a service development plan is produced. A development plan is currently in place and this clearly demonstrates the companys aims and objectives relating to how they plan to develop and improve the service, many of the aims in the plan have already been achieved. All staff have received supervision from the manager since she was employed and records are in place. Staff generally feel that they are receiving good support and agree with the changes that are being put in place. Clear notices in the entrance hall invite service users and their families and friends to approach the manager to discuss their issues about the home including concerns and complaints. Dates of meetings and individual managers surgeries are advertised and this has had good response. This is a good way of informing people of changes taking place and a way that encourages people to be involved and feel empowered. The home has good health and safety records in place and appropriate up to date certificates prove good maintenance procedures. Good arrangements are in place to safeguard service users monies held in the home and comprehensive procedures, managed by the administrator and monitored by senior management, are followed and recorded appropriately. Care Homes for Older People Page 25 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 26 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 1 The registered provider should ensure that the people living in the Stephenson Unit have access to a Service User Guide that is in a format that they can understand. When service users have no or limited speech, the ways used to communicate and the interpretation of the communication used, should be clearly recorded in the care plan. Service users and/or their representatives should be made aware of any identified risks relating to their care and they should be given the opportunity to sign the risk assessments carried out and the risk manangement plans that are put in place, so that they understand them and agree with the steps taken to reduce the risk. It is strongly recommended that more thought is given to providing more detail regarding individuals patterns/routines, as part of the care plan process, when working to promote continence; ie the development of individual toiletting programmes. This might establish an individual routine for a service user and in so doing promote the individuals dignity and wellbeing. Also when a person is ill any care chart put in place, for example a nutrition chart, should be recorded accurately and consistently. 2 7 3 8 4 8 Care Homes for Older People Page 27 of 29 5 31 The manager should submit completed application forms and other information needed to the CSCI Registration Team as soon as possible so that she can be considered for registration. Care Homes for Older People Page 28 of 29 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 29 of 29 - 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!