Inspection on 25/01/07 for Riverside House

This inspection was carried out on 25th January 2007.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Riverside House 15/01/09

Riverside House 10/01/06

Riverside House 25/01/05

Riverside House 27/07/04

Riverside House 18/03/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Riverside House Quay Lane Broadoak Newnham-on-Severn Glos GL14 1JF Lead Inspector Nick Jones Unannounced Inspection 25th January 2007 10:00 Riverside House DS0000016560.V320388.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 House DS0000016560.V320388.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 House DS0000016560.V320388.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Riverside House Address Quay Lane Broadoak Newnham-on-Severn Glos GL14 1JF 01594 516291 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) Stepping Stones Resettlement Unit Limited Mr Peter Malcolm Williams Care Home 13 Category(ies) of Learning disability (13) registration, with number of places Riverside House DS0000016560.V320388.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10th January 2006 Brief Description of the Service: Riverside House is a residential care home for 13 people with learning disabilities who may also present challenges to the service. The property is an old rambling building of character. There are many levels and accommodation is broadly provided over three floors plus a mezzanine area and basement. Each person has single accommodation with a hand wash basin and access to either a bath or shower room. People living at the home have access to two lounges and a dining room, plus a games room in the basement. One person living on the top floor has a separate lounge. Gardens to the rear are well maintained. Riverside House is situated approximately 14 miles from Gloucester in a rural area with views of the River Severn. It is owned by Stepping Stones Resettlement Unit Ltd, which owns five other homes in the area. Prospective service users and others involved in their care are offered information about the home including copies of the Statement of Purpose and Service Users Guide. Up to date information about fee levels was not obtained during this visit. Riverside House DS0000016560.V320388.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The judgements contained in this report have been made from evidence gathered during the inspection, which included a visit to the service. The inspection took place during one day on the 25th January and a morning on the 26th January. During the visits various documents were checked including examples of care plans, risk assessments, medication charts, health and safety records, daily records and staffing files. Some staff and clients were spoken with in-depth and time was also spent with the manager. The manager stated service users have stated they prefer ‘client’ as a descriptive term and will be referred to as such throughout this report. Some general observation of life in the home took place and the premises were inspected. All staff were helpful and knowledgeable during both days of the inspection. Before the visit survey cards were sent out to staff and to relatives of clients, providing written feedback. What the service does well: Good local procedures and practices are in place around referrals and admissions, increasing the likelihood that appropriate admissions will be made. The manager and staff team are committed to providing a person centred approach to meet the needs of clients. They provide a flexible service that recognises the wide variety of support needs of clients. Care plans and risk assessments provide detailed information as to how people should be supported. Discussions with staff showed that staff have a very good knowledge of these support needs. People living at the home have access to a wide range of day care, college, work opportunities and leisure. They say they enjoy going out to the pub, going for walks and on holidays. Clients were able to express their views about a range of issues both in meetings and on a one to one basis. The service works positively with health professionals to ensure the communication and health needs of service users are met. Measures are in place that help to protect people from harm and abuse. Support is provided for people to stay in contact with friends and family. Returned comment cards received from relatives were entirely positive about the service provided at the home. Riverside House DS0000016560.V320388.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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 House DS0000016560.V320388.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 House DS0000016560.V320388.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): 2 and 4. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A thorough assessment and transition process ensures that only people whose needs can be met are admitted to the home. EVIDENCE: A new person has been admitted to the home from the main Stepping Stones home. All information relating to this person is available in the home providing staff with clear information about their needs and the way in which they like to be supported. Staff spoken with had a good understanding of the person’s needs. There was evidence that the funding authority had undertaken a needs assessment and produced a care plan. Several visits to the home were facilitated for the person as part of the transition before moving to the home. Meetings were held to review progress of the transition and once the person had moved in. Records of these were kept in the client’s personal file. The Statement of Purpose has recently been reviewed and amended. Riverside House DS0000016560.V320388.R01.S.doc Version 5.2 Page 9 Riverside House DS0000016560.V320388.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 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care planning in the home is generally good promoting the development of skills and independence. Risk assessments encourage and support people living at the home to challenge and deal with problem areas in their lives. People’s choices are ascertained and respected as far as possible, helping to empower clients to take control of their lives. Arrangements are in place to assess and manage risks, promoting clients’ safety with minimal restrictions and limitations. EVIDENCE: Clients’ files were viewed, three in more detail as part of case tracking. Riverside House DS0000016560.V320388.R01.S.doc Version 5.2 Page 11 Records seen were, in the main, comprehensive, well written and provide evidence of review for care plans and risk assessments. There was also a general ‘person centred approach’ file that contained care plans and risk assessments for different clients that described various activities that clients could be involved in. They provided good details as to how staff should support a client with a particular activity. Discussions with staff and clients indicated that this has been a positive development within the home. It has focussed recording of work undertaken in the home to support clients to develop their independent living skills. Aspects of life described in care plans and risk assessments included details about support with personal and health care, use of community facilities, undertaking a variety of domestic tasks, cycling, mowing the lawn, communication, emotional and psychological support, various leisure pursuits and mealtimes. The documents described the amount of staff support to be offered to a client. The need to organise files was discussed so that any new member of staff has a clear format to access information about a client in one up to date file. Some care plan and risk assessment entries were not signed or dated. The manager stated the aim was to transfer all clients’ care plans into the person centred format. There is good use of monitoring forms including body maps, ABC and incident and accident records. These can be clearly cross-referenced to provide a complete picture of incidents occurring within the home. Discussions with clients showed they were involved in the process of care planning. Staff were clear that clients were able to make their own decisions as much as possible. Clients were observed to make choices about where they spent time and with whom. Limitations to choices are documented as to why it is in the person’s best interests. Minutes were viewed of monthly house meetings held for clients to discuss issues important to them. One client stated they liked being able to talk about things. Topics discussed included activities, menus, holidays, requests for SKY TV, the needs for new furniture and review meetings. Riverside House DS0000016560.V320388.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, 14, 15, 16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Clients enjoy a variety of activities within the local community and friends and family are welcomed. People have individual interest and routines that are accommodated and respected. A varied and healthy diet supports clients to lead active lifestyles. EVIDENCE: People living at the home have access to a range of educational, social and leisure activities. During the week they have the opportunity to attend a day service at Stepping Stones. This includes college courses, working on a farm and horse riding. Staff at the day service produce monthly feedback reports. Some people choose to spend a day at home, helping with their washing and Riverside House DS0000016560.V320388.R01.S.doc Version 5.2 Page 13 cleaning their rooms often followed by shopping and a meal out. This is arranged flexibly for some who have anxieties about daily routines. People living at the home said they enjoy going out for meals to the local pubs, going to cafes, shopping and walking along the river. People are supported to attend local pubs and clubs, and are offered opportunities for a variety of day trips at weekends. People are consulted about holiday choices. A variety of holidays have been taken by clients, sometimes going with people living in other Stepping Stones’ services. They have included stays in Cornwall and Euro Disney. Some clients have been offered more than just one annual holiday. Clients have access to a wide range of leisure activities in the home including Sky TV, computers, a pool table, games, cards and puzzles. Discussions with staff and clients, and viewing records, showed the home supports clients to maintain friendships and family contact that meet the individual needs of the clients. Staff described flexible routines operating in the home; such as the times people went to bed and when people had a drink or snack. This corresponded to care plans and to observations over the two days. Staff also described the importance of consistent routines for some people. Staff also described morning routines being made more flexible as to the times people were supported to get up. This has made this time of day less hectic for clients. People living in the home were seen to move around freely and to treat Riverside very much as their home. Survey cards from relatives provided further evidence to back up this impression. Staff were seen to be respectful and sensitive to people’s individual needs and wishes. Clients were also seen to be involved in various household routines where possible. All except one person have keys to their rooms and were observed using them during the day. Menus and records of food consumed provided evidence that people living in the home were offered a varied, balanced diet including fresh ingredients. The kitchen (including fridges and freezers) was well stocked. Staff described how clients were offered choice around food and drink. Requests from clients have been incorporated into menu plans. A meal was observed. People ate together in a relaxed atmosphere and appeared to be enjoying their food. Riverside House DS0000016560.V320388.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 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The support and guidance offered to clients by staff and health professionals ensure personal care and health care is adequately provided. The procedures for the prescribing, storage and administration of medicines ensures the health and welfare of clients is maintained. EVIDENCE: Care plans provided good detail about how people like to be supported with personal care. Staff spoken to have a good understanding of these needs. The change in morning routines enables staff to spend more time with clients who require support with personal care. Records are kept of health related appointments and recommendations from health professionals such as their GP or clinicians from the Community Learning Disability Team (CLDT) are implemented. There was evidence that clients are provided with regular health checks and that medical interventions such as physiotherapy are implemented Riverside House DS0000016560.V320388.R01.S.doc Version 5.2 Page 15 appropriately by staff. The prescribing of medicines was also seen to be have been reviewed appropriately with the involvement of GPs or a consultant Psychiatrist. Health Action Plans have been introduced for some clients. Some have not been fully completed and some were overdue for an annual health check review. Staff administer medicines and there was a record of the receipt, administration and disposal of prescribed medicines. Medicines were being stored appropriately. The manager stated he meets with the GP once a week to be able to ensure any issues pertaining to the health and well being of clients can be discussed without undue delay. The recording and administration of prescribed medicines appeared to have improved since the previous inspection. The change in morning routines has enabled staff to have more time with clients to administer medicines. The procedure now involves a second member of staff to verify the correct medicines have been administered. Two issues were identified that must be put in place: • • Stock records kept for PRN medication must be checked on a regular basis. A record should be maintained to show when prescribed medicines such as anti-biotics have been refused by clients. Riverside House DS0000016560.V320388.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 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Arrangements are in place for managing complaints that ensure the views of clients and their relatives are listened to and acted on. Systems are in place that help to protect clients from harm and abuse. EVIDENCE: The home has a complaints procedure that is accessible to people living at the home. Clients stated they talk to staff or the manager if they are unhappy about an issue. Evidence within this report indicates that staff listen and act upon the views and needs of clients. The home has a complaints procedure; minutes viewed of client’s house meetings contained details of discussions with clients about a wide range of issues and concerns. Staff receive training in the Protection of Vulnerable Adults and information is available about local procedures at the home. Further training is being provided for all staff. They attend training in the management of challenging behaviour by a trainer from Studio 3 accredited with BILD (British Institute of Learning Disabilities). This focuses on diversion, de-escalation and distraction. The manager stated relatives/friends and are encouraged to express any thoughts or concerns when visiting the home. The home has not received any formal complaints. Riverside House DS0000016560.V320388.R01.S.doc Version 5.2 Page 17 Records of clients’ finances were sampled and those seen appeared to be in order. All clients have building society savings accounts. Riverside House DS0000016560.V320388.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A clean, homely and comfortable environment is provided, promoting clients’ quality of life. EVIDENCE: All communal areas and several bedrooms were checked during the inspection. Riverside House was seen to be clean, homely and comfortable throughout, with clients’ rooms being attractively decorated and personalised. The manager stated the home had been decorated throughout during the year. The second floor shower room had been out of use for several months, as it required new tiling and renovation. The manager confirmed by phone the week following the inspection that the works had been completed. Riverside House DS0000016560.V320388.R01.S.doc Version 5.2 Page 19 The home was found to be clean and hygienic but an odour was detected outside of room 12, which should be investigated. The manager stated carpets had been recently cleaned. Riverside House DS0000016560.V320388.R01.S.doc Version 5.2 Page 20 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 and 36. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Support is provided by a skilled, well-trained staff team, helping to ensure that clients’ needs are met. The manager has a sound understanding of recruitment and selection ensuring clients are protected. EVIDENCE: Staff demonstrated over the course of the inspection that they are committed to meeting the needs of clients and are approachable and accessible to them. There was good evidence that the home is well supported by other professionals such as clinicians from the Community Learning Disability Team. The home has only one staff with an NVQ 2. Seven staff were undertaking their NVQ 3 in Care, with one staff member undertaking their Learning Disability Award Framework (LDAF) induction. Staff were positive about how the staff team worked together and that, in the main, there were sufficient staff working at the home to meet the needs of Riverside House DS0000016560.V320388.R01.S.doc Version 5.2 Page 21 clients. Duty rotas showed there were usually a minimum of four staff on shift with a waking night and sleep-in staff member working at night. Team meeting minutes viewed showed they take place regularly and discussed a wide range of issues. Three staff files were viewed and found to contain all the details as required under Schedule 2. The head office of the organisation receives confirmation of PoVA First and CRB checks, with details of these being passed on to the manager. The manager described the steps that he takes when recruiting staff, demonstrating a sound awareness of the relevant National Minimum Standards and Care Homes Regulations. A training matrix was being maintained identifying what training has been undertaken and when planned training is due. A new member of staff was undertaking an induction programme that includes the Learning Disability Award Framework (LDAF). Staff said that they were attending a range of mandatory training and refresher courses. Training specific to the needs of people living at the home is provided if needed. The Stepping Stones company provides a monthly training programme bulletin that the home is able to book staff on to attend. Staff surveys indicated that team members felt that they worked well together and provided high quality care to clients. Discussions with staff and viewing supervision records showed staff are provided with good support and recorded supervision sessions on a regular basis. Riverside House DS0000016560.V320388.R01.S.doc Version 5.2 Page 22 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 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well run, promoting positive outcomes for clients. Systems are in place that help to monitor and improve the quality of the service provided. Health and safety in the home is promoted which safeguard people’s wellbeing. EVIDENCE: The Registered Manager has considerable experience in the field of care and management, and has an NVQ Registered Managers Award at Level 4. Staff spoken with added that the manager was approachable and that the home was well run. He has promoted an inclusive style of management that Riverside House DS0000016560.V320388.R01.S.doc Version 5.2 Page 23 has enabled the staff team to develop in their roles and develop a clientfocused approach. Quality assurance was discussed. The manager produced a completed Annual Development Plan that described aims and objectives in the coming year for clients, staff and on-going improvements to the building. This was produced in consultation with clients and the staff team. Stepping Stones Resettlement Unit including Riverside House has the Investors in People Award that was renewed a year ago. Regular unannounced Regulation 26 monthly visits take place to the home and copies of these reports are forwarded to the Commission. Minutes of monthly meetings with clients were seen which showed the manager listens to the views of clients on a regular basis. Annual surveys were being undertaken by sending them out to relatives and outside professionals. The manager stated he was waiting for these to be returned. The home has comprehensive health and safety policies. Staff spoken with generally felt that health and safety in the home was well managed. Some staff described having recent training in health and safety. Records viewed included fire safety checks, water temperatures and servicing of equipment. A fire safety risk assessment was undertaken and written in July 2006. Quarterly fire drills were being undertaken and a record of them was viewed. Riverside House DS0000016560.V320388.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 3 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 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 3 X X 3 X Riverside House DS0000016560.V320388.R01.S.doc Version 5.2 Page 25 No 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 YA20 Regulation 13(2) Requirement Regular stock checks of PRN medications must be undertaken Timescale for action 31/05/07 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. 2. 3. 4. 5. Refer to Standard YA6 YA6 YA19 YA20 YA24 Good Practice Recommendations Care plan files to be re-organised and all care plan and risk assessment entries to be signed and dated. All care plans should be transferred to the person centred approach format being introduced at the home. Annual Health Checks should be arranged with clients’ GPs and recorded on their Health Action Plans. Staff should sign medication sheets to indicate when a client has declined to take a prescribed medicine. The odour outside Room 12 should be investigated and removed. Riverside House DS0000016560.V320388.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Gloucester Office Unit 1210 Lansdowne Court Gloucester Business Park Brockworth Gloucester, GL3 4AB 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 House DS0000016560.V320388.R01.S.doc Version 5.2 Page 27 - 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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