Inspection on 19/06/08 for Riverside Drive

This inspection was carried out on 19th June 2008.

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

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

Riverside Drive 11/05/09

Riverside Drive 24/04/07

Riverside Drive 09/06/06

Riverside Drive 01/02/06

Riverside Drive 08/08/05

Riverside Drive 14/10/04

Riverside Drive 18/05/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

Extracts from inspection reports are licensed from CQC, this page was updated on 28/09/2008.

CARE HOME ADULTS 18-65 Riverside Drive 112 Riverside Drive Mitcham Surrey CR4 4BW Lead Inspector Liz O`Reilly Unannounced Inspection 19th June 2008 09:30 Riverside Drive DS0000033994.V364769.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 Riverside Drive DS0000033994.V364769.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. Riverside Drive DS0000033994.V364769.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Riverside Drive Address 112 Riverside Drive Mitcham Surrey CR4 4BW 020 8640 8279 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) keniwenofu@merton.gov.uk www.merton.gov.uk/housingsupport London Borough of Merton Kenneth Nnamdi Iwenofu Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Riverside Drive DS0000033994.V364769.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care Home Only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: 2. Learning disability - Code LD The maximum number of service users who can be accommodated is: 8 24th April 2007 Date of last inspection Brief Description of the Service: 112 Riverside Drive is a care home providing personal care and accommodation for eight adults with learning disabilities, up to two of whom may have physical disabilities. The home is staffed and managed by the London Borough of Merton social services department. The premises are owned by a housing association. The home was purpose built and is located on a site set back from a residential road in Mitcham. All residents are provided with their own single bedroom. One bedroom is furnished with en suite facilities and tracking for a hoist. A lift provides access to the first floor. An enclosed garden is provided to the rear of the premises. Parking is available to the front of the home. The home is close to bus and tram links. Information about the service is available in the Statement of Purpose and Service User Guide. Fees are not applicable to this service as it is an in-house service funded by the London Borough of Merton. However, residents are expected to pay towards holidays. Riverside Drive DS0000033994.V364769.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is one star. This means the people who use this service experience adequate quality outcomes. This unannounced inspection was carried out by one regulation inspector over one day. We had the opportunity to speak with people who use the service, staff and one visitor. Completed surveys were received from the eight people who use the service, six members of staff and one other professional who visits the home. The manager completed an assessment of the service (AQAA) for the Commission. Staff files were provided after the visit to the service. Information received from all of these sources, along with the inspectors observations on the day of the visit, have been used to reach the judgements set out in this report. What the service does well: What has improved since the last inspection? Staff have been provided with additional training on dealing with complaints and safeguarding people. This has ensured that any complaint will be addressed in the appropriate manner. Staff have a clear understanding of when to process a complaint through the safeguarding process. Riverside Drive DS0000033994.V364769.R01.S.doc Version 5.2 Page 6 Care planning systems have been improved and staff are provided with some good information on the needs, likes and dislikes of people who use the service. Staff have improved the records of medication which assists in safeguarding people who use the service. Staff overtime has been reduced which assists in ensuring that people who use the service are not supported by an over tired staff group. 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. Riverside Drive DS0000033994.V364769.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 Riverside Drive DS0000033994.V364769.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 People who use this service experience adequate quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. People who use the service are provided with information to make a choice about where they live but the documents could be more accessible. Assessments are carried out before anyone moves into the service to make sure that this is the right place for them. EVIDENCE: Most of the people who use the service have lived in the home for many years. We found systems in place for carrying out an assessment of the needs and wishes of new people to the service. A copy of the care management assessment is also provided to the service before anyone moves in. This ensures that staff have some information on the individual before they arrive and that the service can meet their needs. We were shown a copy of the service user guide. Parts of this document have been produced in a more accessible format. The manager should review the information provided for people who use the service to make sure that it is suitable for the purpose of providing information on what people can expect Riverside Drive DS0000033994.V364769.R01.S.doc Version 5.2 Page 9 when they move in and are using the service. Consideration should be given to using a variety of formats for this information. Riverside Drive DS0000033994.V364769.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 & 9 People who use this service experience adequate quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. Each person using the service has an individual plan but the practice of involving people who use the service, or their representatives, in the development and review of the plan is not evidenced. Risk assessments are in place but not up to date. EVIDENCE: We looked at a sample of two care plans and found that these included opportunities to gather good information to support people according to their individual needs and wishes. Staff have included some of the likes and dislikes of individuals, good information on communicating with people and useful indicators of when individuals are showing signs of being happy or distressed. Riverside Drive DS0000033994.V364769.R01.S.doc Version 5.2 Page 11 At the last key inspection of this service the inspector stated that goals must be made more specific and meaningful to individuals who use the service with timescales for reviews. We found goal plans had been set up with timescales, however in one instance the timescale for action was six months but the review date was at twelve months, six months after this should have been achieved. Action plans had not been completed and we could find no evidence of a review of the goals. In one instance strengths and weaknesses were written from the point of view of staff, for example, a strength was noted as ‘cooperative’. The list of priorities and goals were headed with health care issues in both files we looked at. It is not clear if these priorities are of the staff or the person using the service. In one instance church attendance was described as a medium priority when previous care planning had stated this person did not attend church. Information on likes and dislikes should be expanded. In one file it was noted that the person liked music but there was no further information on the type of music or where they liked to listen. The music section was not completed in this file and under recreation and relaxation music was not noted. Care plans need to contain more person centred goals and priorities with timescales and appropriately timed reviews. All care documentation must be signed and dated. Information on who was involved in compiling and reviewing care planning must be on file. We found files containing previous care planning documentation. Out of date information must be kept separate from current files to ensure that staff have clear up to date information on the support needs and wishes of individuals. At the time of the last inspection a requirement for staff to develop alternative forms of communication to enable people who use the service more opportunity to make choices about their lives was set. The manager via the AQAA stated that this work was still to be carried out. Staff informed us that this work had not been completed. Therefore this requirement is re set. Risk assessments are in place. However we found the general risk assessment and fire risk assessment for one person was dated 2006 and the personal care risk assessment was dated 2007. In order to ensure the health and safety of people who use the service risk assessments must be reviewed and if necessary updated on a regular basis. Riverside Drive DS0000033994.V364769.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): 12, 13, 15, 16 & 17 People who use this service experience good quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. People who use this service are given opportunities to take part in a variety of activities both within the home and in the community. EVIDENCE: People who use the service told us that they made their own choices about whether they took part in activities or not. The majority of people who use the service attend day centres four days a week. One person attends a day centre five days a week. On days when they are not attending a centre people are supported to carry out their own domestic tasks, shopping and go out to places of their own choosing. Riverside Drive DS0000033994.V364769.R01.S.doc Version 5.2 Page 13 Individuals told us they enjoyed attending evening clubs, a disco and going out for meals. One person told us that they had enjoyed a trip to the coast recently. We were told that a BBQ and another trip to the coast was being planned for the near future. People who use the service are supported to attend religious services of their own choosing. Care should be taken to make sure that where individuals have expressed a wish to take part in an activity that this is arranged. In one instance we found the strengths of one person included swimming. When we asked staff if this person was supported to go swimming were told they were not. One person has taken a long distance holiday abroad with staff support. Main meals are taken together in the evening. The food provided is of a good quality and people who use the service told us they ‘always’ have plenty to eat. One person told us that the staff were “very good cooks”. A menu is produced with alternatives available at each meal time. Mealtimes were seen to be a social event with staff and people who use the service sitting down together. Staff were observed to support people who needed assistance with eating in a sensitive manner going at the pace of the person. The kitchen is open to people who use the service who can make their own drinks and snacks. The manager informed us through his own assessment that staff plan to encourage individuals to become more involved in preparing meals over the next twelve months. Riverside Drive DS0000033994.V364769.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 People who use this service experience adequate quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. People who use the service have access to healthcare services. Health care planning needs further work. Staff respect the privacy and dignity of individuals. Medication is appropriately managed. EVIDENCE: Records show that people who use the service are supported and encouraged to have health care checks. Referrals are made to specialists where necessary. Everyone is registered with a local GP surgery. Individuals are supported to attend health care appointments in the community where possible. In order to make sure that people who use the service receive the support they need in the way they choose care planning must show evidence that people who use the service and or their representatives have been consulted and agreed the plan. All staff who administer medication have been provided with training on the management of medication. We found medication administration records to be Riverside Drive DS0000033994.V364769.R01.S.doc Version 5.2 Page 15 up to date and accurate. Medication is appropriately stored. Staff should make sure that when medication is received into the service any medication still in stock carried forward on the figures. This will allow for a full audit of medication in the home to be carried out and make sure that checks can be carried out on the amount of medication in the home at any one time. We found health care plans were in place but in one instance no health care questionnaire was on file and other questionnaires had not been completed. Records indicated that staff were using the health care plan as a record of checks carried out rather than a planning tool. This issue should be addressed. As noted previously, out of date care planning information and medical information needs to be separated from the current information. In one instance we found conflicting information which could impact on the health of the individual. Out of date hospital discharge sheets should also be filed to avoid any confusion in up to date instructions on medication. Riverside Drive DS0000033994.V364769.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 People who use this service experience good quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. The organisation has a comprehensive complaints system which is on display in the service. Staff understand the procedures to be followed for Safeguarding Adults. EVIDENCE: People who use the service told us they knew how to make a complaint. One person showed us a poster for reporting any concerns they may have which was on display in the entrance hall. Since the last key inspection all senior staff have received training in dealing with complaints. This will assist in ensuring that all complaints are dealt with appropriately. Systems are in place for the recording of any complaint along with the actions taken and outcomes. All staff have been provided with training on safeguarding people. This will ensure that staff can recognise and report abusive behaviour and understand when complaints need to be referred to the safeguarding officer. Staff are aware of their roles and responsibilities in reporting any allegations or suspicions of abuse. Riverside Drive DS0000033994.V364769.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25 & 30 People who use this service experience good quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. People who use this service live in a clean, comfortable and homely environment. EVIDENCE: People who use this service told us they were “very happy” with their own rooms. We saw that individuals had personalised their bedrooms which reflected their own interests and taste. Staff have negotiated and reached agreement with individuals on issues such as keeping food and drinks in their bedrooms. Communal areas are comfortably furnished and mostly meet the needs of people using the service. A well maintained enclosed garden is easily accessible from the house. Riverside Drive DS0000033994.V364769.R01.S.doc Version 5.2 Page 18 Furnishings are of a good quality and all areas of the service seen were clean and free from odour. The building is well maintained and the manager reported new windows had been installed and a number of areas had been decorated over the last twelve months. Riverside Drive DS0000033994.V364769.R01.S.doc Version 5.2 Page 19 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 People who use this service experience adequate quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. Staff have the skills and experience to meet the needs of people who use the service. Good training opportunities ensure that staff are provided with information on current good practice. Staffing levels need to be monitored to ensure that sufficient staff are available to meet the needs of individuals. EVIDENCE: People who use the service told us that they felt they were well treated by staff. Four people told us staff ‘always’ listened to them and acted on what they said. Two people felt that staff ‘sometimes’ listened to them. Individuals made positive comments about staff. They told us staff were ‘great’. Staff told us they had good opportunities for training. Training records showed individuals taking part in a number of training sessions over the last twelve Riverside Drive DS0000033994.V364769.R01.S.doc Version 5.2 Page 20 months. Recent training has included Safeguarding Adults, Food Hygiene, Infection Control and First Aid. Staff are encouraged to take part in NVQ training. Eleven staff have achieved NVQ level two or above with four staff in the process of achieving this qualification. Discussions with staff and responses from staff surveys indicated high levels of staff satisfaction. However the number of staff on duty at any one time was the one area staff had concerns about. Where staff are off sick they are not replaced unless staffing numbers fall below three people on shift. Staff informed us that the result of this is that people who use the service cannot always participate in community activities that they would like. This practice of not always covering staff sickness is understandable where staff are sick in the short term however where staff may be away for a long period this should be reviewed. We saw that changes had been made to the staff rota which will result in more staff being available at peak times. We looked at a sample of staff files and found Criminal Records Bureau checks and references had been sought before staff started work in the service. These checks assist in safeguarding people who use the service. We noted that a full employment history was not available on file and that confirmation from the staff members previous employer as to why they left, where they had worked with vulnerable adults or children, was not recorded. Evidence that these additional checks have been carried out must be in place. Riverside Drive DS0000033994.V364769.R01.S.doc Version 5.2 Page 21 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, 39 & 42 People who use this service experience good quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. People who use the service can have their say about how the service is run through regular meetings. Regular checks are made to ensure the health and safety of people who use the service, staff and visitors. EVIDENCE: The manager has the relevant qualifications and experience to run the service. Senior staff need to monitor the systems used in the home to make sure that care planning, risk assessments and health care plans are reviewed and kept up to date. Riverside Drive DS0000033994.V364769.R01.S.doc Version 5.2 Page 22 People who use the service told us that they can let people know what they feel about things either through talking with individual staff or at residents meetings. Records showed that residents meetings are held on a regular basis. The manager told us through his own assessment that these meetings offer a formal way in which people who use the service can influence the service provision. An annual review of the support provided needs to be carried out taking into account the views of people who use the service and other stakeholders. This review should be used to produce an annual development plan for the service. Regular checks are carried out on the building and equipment which assist in ensuring the health and safety of people who use the service, staff and visitors. Riverside Drive DS0000033994.V364769.R01.S.doc Version 5.2 Page 23 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 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 2 34 2 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 2 X 2 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 2 3 X 3 X 2 X X 3 X Riverside Drive DS0000033994.V364769.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA6 Regulation 15 Requirement To ensure that people who use the service have their needs met, a Care Plan must be in place which includes individual, person centred goals. Timescale of 15/07/07 not met Reviews with information on the progress made or goals achieved must be evidenced to show that the wishes of individuals are being met. 2. YA6 15 To ensure that individuals 01/11/08 receive the support they need in the way they wish evidence of consultation with people who use the service and or their representatives must be in place. 12(2)(3)(4) So that people who use the 01/01/09 service can make decisions about their lives, staff must develop alternative forms of communication. Timescale of 15/07/07 not met. Staff must make sure that risk assessments are reviewed and DS0000033994.V364769.R01.S.doc Timescale for action 01/11/08 2. YA7 3. YA9 13(4) 01/08/08 Riverside Drive Version 5.2 Page 25 4. YA34 19 Schedule 2 (4)(6) Amended up dated if necessary to ensure the health and welfare of individuals and support people to take informed risks. To safeguard people who use the service the following checks must be carried out before any staff member commences work in the service:• A full employment history, together with a satisfactory written explanation of any gaps in employment. Where a person has previously worked in a position which involved contact with children or vulnerable adults, written verification of the reason why they ceased to work in that position unless it is not reasonably practicable to obtain such verification. 01/08/08 • RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA1 Good Practice Recommendations The information provided to people who use the service, about what they can expect from the service, should be reviewed. Consideration should be given to providing this information in formats suitable for individuals using the service. To ensure that staff are provided with clear up to date information on the support required by people who use the service out of date information should be held separately from current information. To make sure that people who use the service receive the health care they require health care plans should be DS0000033994.V364769.R01.S.doc Version 5.2 Page 26 2 YA6 3 YA19 Riverside Drive 4 4 YA20 YA33 5 6 YA37 YA39 reviewed and updated at regular intervals. To allow for an audit trail of medication any medication still held when new stocks are supplied should be carried forward to add to the number held in the service. To ensure that people who use the service are supported by sufficient staff to meet their social needs a review of the arrangements for covering staff sickness should be carried out. Systems should be in place for senior staff to monitor the care planning systems in the service to make sure that these remain up to date and accurate. To ensure that the views of people who use the service underpin the development of the service an annual review of the support provided should be carried out. This review should include seeking the views of people who use the service and other stakeholders, which should form the basis of an annual development plan. The views of people who use the service should be published and made available to any interested parties. Riverside Drive DS0000033994.V364769.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG 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 Riverside Drive DS0000033994.V364769.R01.S.doc Version 5.2 Page 28 - 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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