Inspection on 16/01/07 for Rose House

This inspection was carried out on 16th January 2007.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 10 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Rose House 23/07/07

Rose House 22/09/05

Rose House 09/08/04

Rose House 17/05/04

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 09/07/2008.

CARE HOME ADULTS 18-65 Rose House 63 Wigton Road Harold Hill Romford Essex RM3 9HB Lead Inspector Joanna Moore Unannounced Inspection 16th January 2007 10:00 Rose House DS0000027891.V327915.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 Rose House DS0000027891.V327915.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. Rose House DS0000027891.V327915.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rose House Address 63 Wigton Road Harold Hill Romford Essex RM3 9HB 01708 349212 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) Mrs Michelle Paddit Macadangdang Jean Davis Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Rose House DS0000027891.V327915.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22nd September 2005 Brief Description of the Service: Rose House is a registered care home for four people with learning disabilities, situated in a residential part of Harold wood. The home has one vacancy. Furnishing and decoration are domestic in nature, and the home is run so as to maximise the independence and choice of the service users. It is privately owned and the owner visits on a regular basis. There are currently three women living in the home, all of whom have long-term need of accommodation and personal support. All bedrooms are single, and furnished to match the needs and wishes of each service user. Care staff support service users, both within the home and in the local community, in order to ensure they have a full and satisfying lifestyle. Health needs are met by staff accompanying service users to appointments with health professionals, such as GPs. Currently night hours are covered by a sleep-in member of staff, but this will change to having a waking staff member once there are four service users. Rose House DS0000027891.V327915.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out as part of the annual inspection program. It took place between the hours of 10 and 4. The inspector-spent time talking to the service users, the manager and deputy as well as touring the building. What the service does well: What has improved since the last inspection? What they could do better: The home would benefit greatly from quality auditing itself to understand where it is starting to fall behind on areas which were previously good, this would ensure that where shortfalls do arise these are picked up and addressed before an inspection. Rose House DS0000027891.V327915.R01.S.doc Version 5.2 Page 6 Staff training must be able to be evidenced. Staff training at this inspection could not for most staff be evidenced as having happened even in the most basis areas such as health and safety and adult protection. 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. Rose House DS0000027891.V327915.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 Rose House DS0000027891.V327915.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people currently living in the home had the information they, and their representatives, needed to make an informed choice about where to live. Their needs were assessed, and they visited and “test drove” the home. They have individual contracts. EVIDENCE: The manager provided a copy of the revised Statement of Purpose, and this contains all the required information. Previous inspections have stated that the service user guide is a useful document. This was not viewed as part of this inspection. There has been no recent admission, but full assessment of the current service users was carried out prior to them moving in. The manager and deputy manager are very clear about the need to fully assess anyone being referred for the fourth bedroom, including their compatibility with the three women currently living there. This was evidenced by information initially received on a referral made which did not go ahead. The prospective service user will be invited to visit the home, and to spend time with the three service users, and their views will be sought. Rose House DS0000027891.V327915.R01.S.doc Version 5.2 Page 9 Each service user has a detailed care plan and an individual contract. Rose House DS0000027891.V327915.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): 6,7,8 &9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are supported by staff who know them well and the care plan is used as a tool for supporting this. Care plans to be useful must be kept up to date to reflect changes in support needs. Service users are encouraged to incorporate risk in a controlled way into their everyday living. EVIDENCE: Two care plans were examined these outlined clearly the needs of service users but had not been updated in all areas within the past twelve months. It is strongly recommended that the home clearly record that all areas have been reviewed on a six monthly basis. Care staff were clearly aware of the needs of each service user. Service users were seen to be consulted about day to day aspects of their lives and where care characteristics make this difficult staff use Rose House DS0000027891.V327915.R01.S.doc Version 5.2 Page 11 their knowledge of the service user to support them. Service users require a lot of support due to their care characteristics but staff do encourage them to do as many things as possible for themselves for example participating in cooking and other household chores. Risk assessments were in place in respect of diabetes, domestic tasks and traveling however these need to be reviewed at least annually. Rose House DS0000027891.V327915.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.Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from a lifestyle which is designed to keep them active and to offer new opportunities to learn skills and develop their confidence. Meals in the home are varied and nutritious. Service users said there was lots to do. EVIDENCE: The menu is varied and on a four week rolling program providing a variety of mostly home cooked food and reflecting service user choice. Two service users talked to the inspector about what they liked doing with their time. One service user especially likes to visit coffee shops and said they had particularly enjoyed their holiday last year, a tour of Italy visiting Pompeii, Rome and the isle of Capri where they spent lots of time soaking up the atmosphere in local coffee shops. This lady attends college and said she particularly enjoyed this and likes to do painting. Another service user attends college and is transported there by the home transport. Each service user has Rose House DS0000027891.V327915.R01.S.doc Version 5.2 Page 13 an activity plan to supplement college attendance and this includes pampering sessions as well as gardening and domestic chores. Service users enjoyed visits to cinemas, the shops, cinemas and other leisure facilities. Service users were actively encouraged to participate in household chores and receive staff support to do this. Rose House DS0000027891.V327915.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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users receive appropriate healthcare support. Medication as assessed by the local pharmacist is safely managed. EVIDENCE: Service users are supported by health care professionals such as the GP, community nurse, diabetes nurse, chiropodist an, optician and dentist. Well women checks have been offered to service users and blood checks are carried out for diabetic service users. Service users are supported by their community nurses who ensure formal reviews under the care program approach take place annually. The pharmacist visited the home on the day of inspection and checked all medication and recording in the home and confirmed arrangements were satisfactory. Staff underwent an update on medication training. One service user is Jewish and one Moslem but neither are practicing their faiths and were not on arrival at the home. These issues are documented as having been explored with the placing authority and their families. One service user on arrival at the home was not able to speak and understand English Rose House DS0000027891.V327915.R01.S.doc Version 5.2 Page 15 fluently and an Arabic-speaking staff was employed. Since this time the service user has increased in understanding and confidence and is able to communicate effectively with staff. Where service users exhibit behaviour which may challenge where possible these have been incorporated into daily routines for example one service user is encouraged to get ready to go out well before other people might in order to enable the set routines that they need to complete due to their autistic tendencies to be carried out. Another service user will tidy things away immediately for example crockery before they have been washed. Rather than confronting the service user staff observe this and remove the items to be washed up as soon as the service user leaves the room. Staff are therefore working with service users rather than trying to force changes that may induce for the service user severe distress. Rose House DS0000027891.V327915.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 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users were confident that they could talk to staff about issues that worried them. In order to fully meet the standards all staff and management must receive adult protection training. EVIDENCE: Service users have access to an advocate from the Northeast London Advocacy service if required. The complaints book shows no complaints have been made and service users confirmed Rose house to be a nice place to live. Service users said that if they were unhappy they would talk to the manager. One service user is subject to Court of Protection to support and protect the management of her finances. Two service users finances were checked. Receipts were held and these tallied with expenditure. The expenditure records were dated according to the date the entry was made rather than when the expenditure was incurred effectively meaning that receipt dates and financial entries did not initially tally. This is a recording practice, which could be improved easily. It is recommended that the home log the expenditure as of the date it was spent not the date it was logged for the purposes of easier financial auditing. Service users are invoiced for any mileage incurred within the homes vehicle and this is on a cost per mile basis and an invoice is similarly provided for the cost of care that the service user pays. The adult protection procedure in place had been reviewed at previous inspection s and found to be satisfactory and was not viewed as part of their Rose House DS0000027891.V327915.R01.S.doc Version 5.2 Page 17 inspection. No staff could be evidenced as having had adult protection training. The registered person is required to ensure that they and all care staff receive adult protection training. Rose House DS0000027891.V327915.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): 24,25,26,27,28,29 &30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The building is able to meet the needs of the people living there. There were however a number of requirements and recommendations made to ensure the environment meets national minimum standards. EVIDENCE: The house was toured, including seeing all the bedrooms. This is a small house for adults with learning disabilities, who have long-term accommodation and personal care needs, and the accommodation is suitable for this purpose. Communal areas are rather bare in style but this is specifically due to the behaviour of one service user. Service user has their own lockable bedrooms and all three of these were viewed. Two were furnished with lots of bits and pieces of interest to the lady accommodated and they discussed their enjoyment of these items. The third was extremely bare and the wardrobe locked this was due to the specific behaviours of the service user who is unable to cope with curtains and other items in their room. Privacy for this lady is Rose House DS0000027891.V327915.R01.S.doc Version 5.2 Page 19 maintained though special screening fixed to the glass. The specific needs and practices in relation to this lady’s behaviour must be detailed in her care plan. A conservatory has been added to the back of the kitchen, which is used as an office for the manager. The kitchen paintwork was peeling and this area requires repainting. The loft has been converted to a bedroom with an ensuite shower and toilet, creating a very pleasant space furnishing this room will occur once a new recent has been identified so that they can choose furniture. Care on who moves into this area will need to be taken because of the sloping ceiling and steep narrow staircase to this floor. The bathroom to the first floor requires improving, the shower tray was purely rested in blocks of wood and the shower holder was broken. The garden is a pleasant area for service users to enjoy in the simmer moths. A number of items such as an old rusted locker and office chair were left in the garden, which detract from the overall high standard of this area. The registered person is required to have all items of rubbish removed. The home was clean and disposable gloves were provided. Staff were however in the practice of washing out disposable food bags and drying these individually bag open over the garden picket fence, this poses a contamination hazard. This practice is to cease immediately. Not all staff had completed food handing and hygiene training, on the day of inspection the person preparing food had not undertaken this training. All staff preparing food must complete approved food handling training. Rose House DS0000027891.V327915.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 & 36 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Sufficient staff are available to respond to service users needs and staff are familiar with the needs of service users. The home was unable however to evidence that staff recruitment and training was at an acceptable level. EVIDENCE: Staffing records provided were unable to evidence that the current team of staff have all completed basic training in the areas of health and safety, food handling, first aid, learning disability awareness and adult protection. The registered person must ensure that all staff are provided with this training. Some staff may have covered this training though units on their NVQ but this could not be evidenced. The inspector was advised that one care staff had completed NVQ level 2 training and that 3 more were in progress. Once these staff have completed then the home will meet the national minimum standards for staff NVQ training. Staff recruitment files evidenced the home was working towards meeting all regulatory requirements in relation to staff recruitment however all staff files must include a current or recent photograph. The home had obtained Criminal records checks for staff or where these were awaited they were working in a Rose House DS0000027891.V327915.R01.S.doc Version 5.2 Page 21 supervised capacity and had a POVA first check carried out in line with current guidance. Two references were in place however it was not always clear whom these references were from as they were completed on a pro-forma provided by rose house but no company stamp or letterhead was attached and therefore could have originated from anywhere. It is required that the home ensures that it can be shown that references include one from a present of most recent employer. Where a staff member declares that they have no employment history this should be clearly detailed on their file. The home had checked staffs’ ability to work in the UK. Staff were recorded as having regular supervision. Staff were recorded as having completed an in-house induction package, which orientated them to the building. The induction package would however benefit from being expanded in line with current skills for care guidance. Rose House DS0000027891.V327915.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): Quality in this outcome area is (excellent, good, adequate or poor) This judgement has been made using available evidence including a visit to this service. The manager and registered person are familiar with the needs of service users and the flexibility of approach suits the home. However in order to meet the national minimum standards the manager and registered person EVIDENCE: The manager hold appropriate qualifications for her role and experience in working with people with learning disabilities. The managers’ management style suits this smaller home where flexibility is a key issue. The service users needs are well known and supported but the manager does need to tighten up on some of the administrative side of the running of the home. The registered person is also qualified and experienced in working with people with learning disabilities and the staff and service users benefit from both having clear knowledge of the service users care needs. Rose House DS0000027891.V327915.R01.S.doc Version 5.2 Page 23 The registered person however must ensure that they are reviewing quality of care within the home including the administrative practices. There were no records of visits carried out by the responsible person in line with regulation 26. The registered person is required to visit the home on a monthly basis to review standards of care within the home and the quality of the service. The registered person is then required to compile a report of their findings and provide a copy of this to the manager of the home and a copy to the Commission. The commission provides sample regulation 26 visits on its website which the registered person may find helpful to use. There was no evidence of any system to measure service user or their families’ views as to the quality of care within the home. It is strongly recommended that the home develop some formal way of ascertaining service user and other involved parties views of the quality of care provision within the home. The manager works in the home fulltime flexibly according to the needs of the service, the inspector was advised. It is required that the manager record when on site as with all staff in order to evidence staffing and who was on site at any given time should the need arise. The home was kept in a safe condition, fire checks were carried out and wired in smoke detectors were in place in line with fire officer guidance. Thermostatic control valves were fitted to ensure service users are not scaled by hot bathwater. Current gas and portable appliance certificates were in place. It was unclear as to whether the home had a valid electrical certificate as none had been issued when the conversion works to the second floor were carried out. The original certificate is to expire at the end of January and therefore the manager agreed to arrange a new electrical safety inspectionThe manager hold appropriate qualifications for her role and experience in working with people with learning disabilities. The managers’ management style suits this smaller home where flexibility is a key issue. The service users needs are well known and supported but the manager does need to tighten up on some of the administrative side of the running of the home. The registered person is also qualified and experienced in working with people with learning disabilities and the staff and service users benefit from both having clear knowledge of the service users care needs. The registered person however must ensure that they are reviewing quality of care within the home including the administrative practices. There were no records of visits carried out by the responsible person in line with regulation 26. The registered person is required to visit the home on a monthly basis to review standards of care within the home and the quality of the service. The registered person is then required to compile a report of their findings and provide a copy of this to the manager of the home and a copy to the Commission. The commission provides sample regulation 26 visits on its website which the registered person may find helpful to use. There was no Rose House DS0000027891.V327915.R01.S.doc Version 5.2 Page 24 evidence of any system to measure service user or their families’ views as to the quality of care within the home. It is strongly recommended that the home develop some formal way of ascertaining service user and other involved parties views of the quality of care provision within the home. Rose House DS0000027891.V327915.R01.S.doc Version 5.2 Page 25 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 3 2 3 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 2 25 3 26 3 27 3 28 3 29 3 30 1 STAFFING Standard No Score 31 x 32 3 33 3 34 2 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 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 3 3 3 x 3 3 1 X 3 3 X Rose House DS0000027891.V327915.R01.S.doc Version 5.2 Page 26 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 YA23 Regulation 13 (6) Requirement All staff must have adult protection training. This is a repeated requirement previous timescale given 28/02/06 Where it is thought necessary to provide less furniture or lock furniture in a service users room this must be detailed in the service user plan including the reasons why it is deemed necessary. The registered person is required to repaint the kitchen, dispose of all items of rubbish in the garden, and repair the shower and shower base. No staff without food handling training must be allowed to prepare food. The practice of washing out disposable food bags and drying over the garden fence is to cease immediately. All staff files must include a current or recent photograph. All staff must undertake training in the areas of health and safety, food handling, first aid, learning disability awareness and adult protection. DS0000027891.V327915.R01.S.doc Timescale for action 01/04/07 2 YA24 16 01/04/07 3 YA24 23 01/04/07 4 5 YA24 YA30 13 13 01/02/07 24/01/07 6 7 YA34 YA35 17 18 01/04/07 01/04/07 Rose House Version 5.2 Page 27 8 YA34 17 9 YA39 26 10 YA37 17 It is required that the home 01/04/07 ensures that it can be shown that references include one from a present of most recent employer. Where a staff member declares that they have no employment history this should be clearly detailed on their file. The registered person is required 01/02/07 to visit the home on a monthly basis to review standards of care within the home and the quality of the service. The registered person is then required to compile a report of their findings and provide a copy of this to the manager of the home and a copy to the Commission. It is required that the manager 01/02/07 record when on site as with all staff in order to evidence staffing and who was on site at any given time should the need arise. 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 YA9 YA23 YA35 YA39 Good Practice Recommendations It is strongly recommended that the home clearly record that all areas of the care plan have been reviewed on a six monthly basis. It is strongly recommended that risk assessments be reviewed at least annually. It is recommended that the home log the expenditure as of the date it was spent not the date it was logged for the purposes of easier financial auditing. It is recommended that the induction package be expanded in line with current skills for care guidance. It is strongly recommended that the home develop some formal way of ascertaining service user and other involved parties views of the quality of care provision within the home. DS0000027891.V327915.R01.S.doc Version 5.2 Page 28 Rose House Commission for Social Care Inspection Ilford Area Office Ferguson House 113 Cranbrook Road Ilford London 1G1 4PU 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 Rose House DS0000027891.V327915.R01.S.doc Version 5.2 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!