Inspection on 23/09/05 for Rose Cottage

This inspection was carried out on 23rd September 2005.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Rose Cottage 28/06/06

Rose Cottage 05/01/06

Rose Cottage 27/05/04

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 Rose Cottage Rose Cottage Church Road Mersham Ashford Kent TN25 6NT Lead Inspector Julian Graham Announced Inspection 09:30 23 , 26 and 27 September 2005 rd th th Rose Cottage DS0000023535.V249938.R01.S.doc Version 5.0 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Rose Cottage DS0000023535.V249938.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Rose Cottage DS0000023535.V249938.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Rose Cottage Address 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) Rose Cottage Church Road Mersham Ashford Kent TN25 6NT 01233 502223 rosecottage@counticare.co.uk Counticare Limited Andrew Shore Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Rose Cottage DS0000023535.V249938.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10th March 2005 Brief Description of the Service: Rose Cottage provides accommodation for a maximum of four people with a learning disability aged between 18 and 65. The premises consists of a spacious cottage situated in the rural village of Mersham. The local pubs and village shop are a short walk from the home. There is a public bus service to the larger towns of Ashford, Hythe and Folkestone. The home has a large secluded garden and access to country walks. Rose Cottage DS0000023535.V249938.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was announced and lasted twelve hours over a three day period. All four residents were at home at varying times of the inspection and were spoken with, two individually in the privacy of their bedrooms. The inspector also spoke in private with a senior team leader and two of the support workers about their work. Both indirect and direct observation of staff carrying out their duties were used throughout the inspection. There were a large number of requirements and recommendations from previous inspections, and therefore a lot of time was spent with the manager discussing these and other aspects of the care and service provided. The manager gave every assistance and responded positively to the whole inspection process. A tour of the premises was undertaken which included being shown bedrooms by two of the residents. Some documentation was examined, including residents’ Life Plans and some staff files. Feedback cards were received from relatives of two of the residents and these were generally positive. The residents, manager and staff are thanked for their welcome and assistance during the inspection. What the service does well: Most of the residents to varying degrees have some difficulty in communicating. Two were able to say that they like living at Rose Cottage. One said “I like it here, I don’t want to be anywhere else”. All the residents were seen to be comfortable with staff and a relaxed and welcoming atmosphere in the home was noted. There is a settled staff team at Rose Cottage, which provides consistency and continuity of care which is benefiting the residents. The severity of behaviours in respect of two of the residents, for example, has significantly reduced over the past three years, the manager said, and one resident is now not taking any medication at all. One resident said that he “gets help when I get angry”. Staff said they are being well supported and spoke of a good team spirit with everyone “helping each other out”. Staff are good at involving residents in the life of the home, and during the inspection, residents were seen getting their own drinks and snacks with Rose Cottage DS0000023535.V249938.R01.S.doc Version 5.0 Page 6 support when needed. Residents said that they help out with some of the household chores like the hoovering. Staff have worked hard over the years to build up good relations in the immediate neighbourhood, and the residents are very much part of the local community, which is an achievement. What has improved since the last inspection? What they could do better: Two residents generally need the support of two staff each when they access community facilities. At weekends there are normally just two staff on duty, which is severely curtailing the opportunities for residents to go out. Similar concerns have been expressed at previous inspections, and staffing levels at weekends must be reviewed and increased. The manager is also needing more time for his administrative duties and must have more time available when he is supernumerary to the care staff on shift. It was of concern that two staff fairly new to the home, whilst knowing that all allegations of abuse must be reported, were not aware of the whistle blowing procedure nor where to record complaints if they were to be made. The abuse and whistle blowing policies and procedures still need amending and updating, and staff must receive training on adult abuse. Induction training must be completed in full for all staff, and their understanding of the issues covered in the training, such as the abuse procedure, must be thoroughly checked. Whilst staff are accessing some training courses, the inspection identified some gaps in their basic training, such as infection control and moving and handling. Other training more specific to the needs of the home, such as autism, Rose Cottage DS0000023535.V249938.R01.S.doc Version 5.0 Page 7 makaton and crisis intervention (SCIP), have not yet been provided to some staff, and need updating for others. A more proactive role on the part of the manager is required to ensure that staff receive the training they need. Some progress has been made with regards the environment, although several parts of the home, including the lounge and dining room, remain in need of upgrading and refurbishment. The competence of staff to administer medication remains in need of proper assessment. Regulation 26 visits must be undertaken monthly and include discussions with residents and staff. 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. Rose Cottage DS0000023535.V249938.R01.S.doc Version 5.0 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Rose Cottage DS0000023535.V249938.R01.S.doc Version 5.0 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 5 The Statement of Purpose, Service User Guide and contract do not make clear what additional charges residents may be asked to bear, including staff entry fees to events in the community. EVIDENCE: There have been no recent admissions to the home, and the admissions procedure was not inspected. Previous inspections have required greater clarity in the Statement of Purpose, Service User Guide and statement of terms and conditions with regards any additional charges residents are expected to bear over and above the basic fee. This remains outstanding. The manager said that an amenity fund is now well established, and which provides monies for residents to do more activities, including funding some staff entry fees to community events. There must be greater clarity in the contract and the other documents as to the circumstances when residents are still expected to contribute to the cost of staff accompanying them on community outings. There have been no recent admissions to the home. Admission policies and procedures are in place. Rose Cottage DS0000023535.V249938.R01.S.doc Version 5.0 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9,10 Residents’ personal goals are reflected in their Life Plans (care plans) which are clear, informative and accessible. Risks are generally well managed, although the assessments could be more detailed in some instances. Whilst residents are given support and encouragement to communicate their wishes, this could be more effective through accessing input from the speech and language therapist, and by all staff being trained in the use of makaton. Residents participate in the life of the home. The office is on a “through” route in the home, and it is therefore difficult to maintain privacy, thereby compromising confidentiality. EVIDENCE: A sample of Life Plans were examined, which contain a lot of detailed information regarding the residents’ strengths and needs. They are clear and accessible and cover areas ranging from self care to communication to personal relationships. A small number of personal goals are being worked on, and staff reported that one of these involved a resident learning how to make a simple snack for himself, which he is now able to do. Indeed, residents were seen on several occasions during the inspection helping out in the kitchen. One resident said that the staff assist him with cleaning his room. Staff who were Rose Cottage DS0000023535.V249938.R01.S.doc Version 5.0 Page 11 interviewed were very clear that part of their role is to support residents in doing more for themselves. Risk assessments were generally useful in identifying what could be hazardous to residents and how the associated risks can be managed. The risk assessment with regards residents going out independently needs to be more detailed, however, and clearly record the outcome of the assessment (whether or not the person is safe to go out on his own), and the degree to which this needs to be monitored, and in what way. Guidelines for support in managing difficult behaviours are in place, but some of these have not been reviewed for a while and have not been signed. It is a recommendation of this report that the involvement of suitable health and social care specialists, for example, from the Community Learning Disability Team, is sought to assist staff in reviewing strategies and guidelines in working with residents. Additionally, speech and language therapy input for those residents with communication difficulties, and training for all staff in the use of makaton, is required. The manager is very aware of the inappropriate positioning of the office, which is situated between the hall and the dining room, and is looking at an alternative siting with the company. Rose Cottage DS0000023535.V249938.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,14,15,16,17 The relationships between residents and staff are good, and staff are supportive and caring. Routines in the home are flexible. Residents are supported in taking part in some social, leisure and work activities during weekdays, largely confined to the company’s own day care facility. Opportunities to access facilities in the wider community at weekends, is limited owing to insufficient staffing levels. EVIDENCE: The majority of staff have been working with the residents for several years and evidently know them well. Residents were interacting with staff positively and were relaxed in their company. Two of the residents have a busy schedule of day activities primarily centred at the Martello day centre where a wide range of activities are provided. The other two residents combine sessions at the Martello with other activities based around the home, and the local community. The value of considering and seeking out further opportunities for activities during the day, and not Rose Cottage DS0000023535.V249938.R01.S.doc Version 5.0 Page 13 necessarily based at the Martello and including college courses, was discussed with the manager. Leisure activities include walks in the local area, trips to the pub and swimming. Evening activities, again at the Martello, include the Monday Social Club and a disco. Two residents had shortly returned from a week’s holiday in Spain supported by staff. Earlier in the summer, the other two residents had enjoyed a stay at Butlin’s. Another weekend’s stay has been planned for one of the residents later on in the year, as he particularly enjoys the holiday camp experience. When two of the residents access community facilities, generally they each need the support of two carers, although two staff have been risk assessed as being able to support them individually. The activities records for the residents over the four weeks prior to this inspection showed very few activities outside the home, with two of the residents having no community outings at all on two of these weekends. Whilst additional staff can be rota’d to work on the weekend if an activity has been planned in advance, normally there are just the two staff available, which is severely limiting choices for residents. It was disappointing to note that it is not the company’s policy and therefore not normal practice for staff to share meals with the residents. This is a lost opportunity for positive social interaction and good role modelling; and it is a recommendation of the report that this matter is reviewed. The manager and staff in the home said that they support the practice of eating meals with the residents. Rose Cottage DS0000023535.V249938.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20 Staff have a good understanding of residents’ support needs and residents’ healthcare is generally promoted. Staff’s competence in administering medication has still to be assessed, and not all staff have had suitable training in medication, therefore potentially putting residents at risk. EVIDENCE: Staff were seen interacting with residents with respect and good humour, and support was provided in a way that respected their dignity. Life plans outlined the support and health needs of residents. Case tracking showed that a resident’s medical condition referred to in the Life Plan had been followed up with an appointment with the person’s GP. One resident, on the other hand, is overdue for his annual visit to the dentist. Medication continues to be stored in the laundry room which is not a suitable location. The manager is aware of this and is looking at alternatives. Generally the arrangements for the security and administration of medication are good, with clear and accessible policies and procedures. Medication records were in order. However, staff continue to require suitable training, and an internal competency assessment to demonstrate sound understanding and safe practice remains outstanding. Rose Cottage DS0000023535.V249938.R01.S.doc Version 5.0 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Some staff’s knowledge and understanding of adult protection issues is unsatisfactory. This, coupled with not knowing where to record complaints, places residents at possible risk of abuse. EVIDENCE: The manager has tried hard to simplify the written complaints procedure to make it easier for the residents to understand. Ways of communicating this to the residents was discussed with the manager. Reinforcing residents’ rights to complain in key worker monthly meetings, soon to be introduced, could be one way. One resident said that if he had a concern or a complaint, he “would definitely talk to Andy (the manager)”. Feedback from a relative prior to the inspection was that a complaint made a while ago was handled well and that the issue had been addressed. Two staff who were interviewed did not know where to record a complaint if they received one. The requirement made at the last two inspections to update the whistle blowing policy to ensure compliance with the DOH “No Secrets” guidelines remains outstanding. The home’s policy on adult protection was viewed and does not clearly outline the steps to take to inform Social Services of an allegation of abuse in line with the Kent and Medway adult protection protocol; nor the regulatory requirement to inform CSCI. It was also of concern that two staff, new to the home but not to the company, were not aware of any whistle blowing policy. Three staff who were interviewed privately knew that allegations or suspicions of abuse must be reported to their line manager, but one did not know what to do if the alleged victim of abuse requested the information given to be kept confidential. Training on adult protection must be given to all staff. The home must take prompt action to address these findings and ensure the residents are protected from harm at all times. Rose Cottage DS0000023535.V249938.R01.S.doc Version 5.0 Page 16 With regards to residents’ monies, the manager advised that all residents now have individual bank accounts, and that one resident’s benefits are now being paid directly into this person’s High Street bank account. The other three residents have individual accounts held centrally at the Company’s head office. Records held in the home with regards to residents’ finances are clear and auditable. Rose Cottage DS0000023535.V249938.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26,27,28,29 Improvements to the environment have taken place, but some areas remain in need of upgrading and refurbishment. EVIDENCE: Since the last inspection, a new kitchen and bathroom have been fitted, the walls of a toilet retiled, and two residents’ bedrooms redecorated, and an ensuite bathroom fitted. Plans to refurbish the home have been ongoing for some time now, linked to a possible extension of the premises, (now apparently shelved), and it was good to see that the process has commenced. This must now extend to other parts of the home, which are badly in need of upgrading and refurbishment. These include the lounge which is looking shabby. The carpet is badly stained in places and the curtains need replacing. The two settees are very old and unsuitable, being low to the ground and the cushions have lost their “spring” and provide minimal support. The dining room, too, needs redecorating with the walls chipped and grubby in places. (See also the section on Lifestyle regarding the dining room and mealtimes.) All four of the bedrooms were inspected with the permission of the residents, two of whom were happy to show the inspector their rooms themselves. These are of a good size and with the exception of one room which was bare in line with the resident’s wishes, were nicely personalised. Two of the rooms need freshening up. An audit of furniture and fittings in bedrooms against the Rose Cottage DS0000023535.V249938.R01.S.doc Version 5.0 Page 18 Standard is recommended as some for example do not have a comfy chair. Bedroom door keys have not been given to residents, and it is advised that this matter is looked at again, within a risk assessment framework. Rose Cottage DS0000023535.V249938.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): There is a good team spirit amongst staff who feel well supported in their work. A more proactive approach towards ensuring staff keep up to date with training in key areas is needed; and the process of inducting new staff needs to improve. The recruitment process is mainly sound, although there must be more persistent chasing up of police checks. Staffing levels at weekends are not sufficient to meet residents’ needs. EVIDENCE: A senior team leader and two support workers were interviewed individually and spoke of a good team spirit in the home. They all said that they are receiving regular supervision from the manager who is approachable and supportive. The manager said that all but one staff have had their annual appraisal. A training matrix is being maintained but shows a number of gaps in core mandatory courses such as moving and handling and First Aid, and also more specific training appropriate to the needs of the particular residents, including makaton and epilepsy. The induction programme of a staff member who has been working in the home for four months is still not complete which is unsatisfactory. This person had been working in another of the company’s homes before transferring to Rose Cottage, and the home is still awaiting a satisfactory CRB despite submitting an application some time ago. In order to safeguard residents ,the company must rigorously chase up these important checks. The manager said that this person is not working unsupervised. Rose Cottage DS0000023535.V249938.R01.S.doc Version 5.0 Page 20 Staffing levels at weekends are insufficient. See the Lifestyle section of this report. Rose Cottage DS0000023535.V249938.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 38, 42 There is an open and friendly atmosphere in the home, and the manager was receptive to new ways of looking at aspects of the home’s running. In order for standards to be more efficiently met, more time for the manager to attend to administrative responsibilities is needed. EVIDENCE: Residents were relaxed and very much at home during the inspection. Staff were relating to residents well and were responsive to their needs. They spoke well of the management of the home. Rotas showed that the manager is on shift for much of the week and therefore not available for administrative duties. Quality assurance was not examined in detail on this visit, although there was some discussion with the manager regarding obtaining residents’ views on the care and service they are receiving. The manager said that monthly meetings between residents and their key workers will be arranged and that these will form part of the home’s quality assurance system. Another aspect of monitoring taking place is the regulation 26 visits conducted by a company Rose Cottage DS0000023535.V249938.R01.S.doc Version 5.0 Page 22 representative. These, however, are not happening consistently on a monthly basis, and are not including interviews with residents and staff. No obvious health and safety hazards were noted, although there is some lack of training and updating in some safe working practices. Records showed that appliances and equipment are being serviced at appropriate intervals. Rose Cottage DS0000023535.V249938.R01.S.doc Version 5.0 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 x x x 2 Standard No 22 23 Score 1 1 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 2 3 2 2 Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 2 3 3 x 3 LIFESTYLES Standard No Score 11 2 12 3 13 2 14 2 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score 2 x 1 2 2 3 CONDUCT AND MANAGEMENT OF THE HOME 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Rose Cottage Score 3 2 2 x Standard No 37 38 39 40 41 42 43 Score x 3 x x x 2 x DS0000023535.V249938.R01.S.doc Version 5.0 Page 24 yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard 5 Regulation 5 Requirement Timescale for action 27/11/05 2 9 13 3 20 13 4 22 22 5 23 13 Additional charges borne by residents to be made crystal clear in the contract. (Timescale of 01/08/04 not met.) Outcome of risk assessments 14/10/05 relating to residents going out independently to be clearly recorded. Staff competence on handling 27/10/05 and administration of medication to be assessed and suitably recorded. Staff to receive training on the 03/10/05 Complaints Procedure, and to know what action to take should a complaint be made, including recording requirements. With regards to protecting 14/10/05 residents from abuse: a) Adult abuse and whistle blowing policies to be updated to ensure compliance with the Kent and Medway adult protection protocol and the DOH guidance “No Secrets”. (timescale of 01/08/04 not met) New timescale: 05/11/05); b) staff to receive training on adult protection. Timescale: 27/12/05; and c) staff to DS0000023535.V249938.R01.S.doc Version 5.0 Page 25 Rose Cottage 6 24 23 7 33 18 8 34 19 9 35 18 10 39 26 receive training on the home’s own adult abuse and whistle blowing policies. Timescale: 14/10/05. Upgrading and refurbishment of environment to continue and include the lounge, dining room and two residents’ bedrooms. Commission to receive implementation plan with timescales. With regards to staffing: a) Weekend staffing levels to be increased to meet individual residents’ aspirations and the home’s own Statement of Purpose. (timescale of 01/08/04 not met.) b) Manager to be supernumerary to the care staff on shift. With regards to staff recruitment: a) Company to chase up outstanding CRB checks; b) documentary evidence of date CRB checks applied for, to be available at all times. With regards to training: a) all staff to receive induction training within twelve weeks of commencing employment in the home, and for inductee’s understanding on matters covered to be checked. Timescale: 27/10/05 b) staff to be updated on all core mandatory training, and to receive training on adult protection, SCIP, makaton and autism. Training plan stating timescales for implementation to be sent to the Commisssion. Unannounced Regulation 26 visits to be undertaken in accordance with regulation. Visits to include discussion with residents and staff. 14/11/05 27/10/05 27/09/05 27/11/05 27/10/05 Rose Cottage DS0000023535.V249938.R01.S.doc Version 5.0 Page 26 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 6 7 Refer to Standard 7 7 18 19 24 26 34 Good Practice Recommendations Key worker one to one monthly meetings to be implemented and documented and to cover complaints and quality assurance issues (YA 39.6). The practice of locking the kitchen at night to be reviewed. Residents and staff to share main meals together in the dining room. Referrals to be made to Community Learning Disability Team/other health care professionals as appropriate. Review siting of office and medication storage area. Residents’ bedrooms to be audited against the standard, and furniture and furnishings to be provided to residents in accordance with their wishes. Clear notes to be made of interviews with prospective staff. Rose Cottage DS0000023535.V249938.R01.S.doc Version 5.0 Page 27 Commission for Social Care Inspection Kent and Medway Area Office 11th Floor International House Dover Place Ashford Kent TN23 1HU National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Rose Cottage DS0000023535.V249938.R01.S.doc Version 5.0 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. 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. 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