Inspection on 20/04/05 for Rosier Home

This inspection was carried out on 20th April 2005.

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

Other inspections for this house

Rosier Home 19/04/07

Rosier Home 02/05/06

Rosier Home 17/11/05

Rosier Home 02/11/04

Rosier Home 09/06/04

Similar services:

Claremont House

Oak Ridge

Coopers Mill Ltd

Sun Court Nursing Home

Ashville House

Bramley Avenue (73)

Paradise Lodge

Grangewood

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

CARE HOMES FOR OLDER PEOPLE Rosier Home 22-24 Harold Road Clacton on Sea Essex CO15 6AJ Lead Inspector Marion Angold Unannounced 20/04/05 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 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 Older People. 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. Rosier Home Version 1.10 Page 3 SERVICE INFORMATION Name of service Rosier Home Address 22-24 Harold Road Clacton on Sea Essex CO15 6AJ 01255 427604 01255 223984 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr Darren John Marles Miss Sonya Wase Miss Sonya Wase Care Home 16 Category(ies) of Dementia - over 65 years of age (6), Old age, registration, with number not falling within any other category (16) of places Rosier Home Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 2/11/2004 Brief Description of the Service: Rosier Home is an established care home close to Clacton on Sea’s town centre and the seafront. Accommodation is offered on two floors, with the top floor accessed by stairs or a passenger lift. The home was originally registered under the Care Standards Act 2000 for sixteen older people. The registration was subsequently varied in acknowledgement that the home was caring for six older people with dementia. However, this variation is for specific service users and does not permit the home to accept any new service users with dementia. Rosier Home Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place between 10.00 and 19.30 hours with the assistance of one of the registered providers, Mr Darren Marles. The registered manager, Miss Sonya Wase, was on holiday at the time, and two of the sixteen service users were in hospital. The inspection focussed very much on the views of service users, seven of whom spoke at some length with the inspector about their experience of living at Rosier Home. Most of their comments indicated their satisfaction with the care provided and the home’s suitability for meeting their needs. Of the 16 Standards inspected, 8 were met and the remainder consisted of minor shortfalls. The last inspection in November 2004 generated 5 requirements, all of which had been brought forward from the previous inspection. Although some progress has since been made towards addressing these shortfalls, it was insufficient to meet the Standard and they have been brought forward again into this report. Of the 13 recommendations made at the last inspection, 9 have also needed to be repeated in this report. Although the Commission acknowledges that much of the providers’ time has been devoted to resolving a complaint made by one service user against a member of staff, this cannot fully account for the failure to address the key inspection issues within timescale. What the service does well: Rosier Home is run on family lines, with a friendly staff team, welcoming atmosphere and considerable hands-on involvement from the registered providers/manager. Service users appeared relaxed and those, who expressed a view, were positive about most aspects of the home and its ability to meet their needs. A good rapport was observed between service users and the staff on duty and this was confirmed in conversation with service users. Service users’ health needs were receiving due monitoring and attention. Service users were being supported to go out and their visitors welcomed. The home continued to log negative comments and complaints and to record any action taken. Rosier Home Version 1.10 Page 6 Management had also taken appropriate advice and action in response to an allegation made by a service user against a member of staff. The environment was clean, comfortable and homely with ample communal space provided in two lounges and a separate dining room. The downstairs bathroom was well equipped for service users with impaired mobility. The garden had been attractively maintained. On the whole, the home was adhering to good recruitment practice and providing opportunities for training in both statutory and practice topics. What has improved since the last inspection? What they could do better: Not everyone had received a comprehensive and written assessment of their needs before coming to the home. Some care plans had been developed since the last inspection but still needed some further work. Other care plans had not been progressed and did not fully reflect the individual’s needs, or the Rosier Home Version 1.10 Page 7 actual care they were receiving. Specialist advice was needed in connection with one service user with extremely complex needs, who remained in bed. The providers need to evidence that their staffing levels are always adequate to meet the changing needs of service users. Arrangements for meal provision would be enhanced, if service users were offered menus and a choice of meals. Service users, whose meals are liquidised, should not be subject to a restricted menu at tea-time. To consolidate their recruitment procedures for the protection of service users, the providers should obtain a full employment history from prospective candidates, so that any gaps can be explored. The providers need to evidence that all their operations are based on a robust system of quality monitoring, which includes regular consultation with service users and their representatives about the service provided. In this connection, they should also develop a business plan, which takes account of the views of service users and the aims and objectives of the home. The provision of additional radiator covers, and pre-set valves to provide water close to 43oF, would enhance the convenience and safety of service users. Accidents to staff and service users were being recorded but the home should seek further guidance from the Health and Safety Executive about their methodology. Although the providers have been informing the Commission of certain significant occurrences in the home, they need to report all the circumstances outlined under Regulation 37 of the Care Homes Regulations 2001. Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Rosier Home Version 1.10 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Rosier Home Version 1.10 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 and 4 Not all admissions to the home had been based on comprehensive, written needs assessments. The home was meeting the needs of service users to the satisfaction of those who were able to comment but additional staff would make it possible for the home to enhance the quality of care given to service users with high dependency levels. EVIDENCE: Records sampled evidenced some inconsistency in the practice of basing decisions to admit a service user to the home on the completion of a full holistic assessment of their needs. In the case of one service user, admitted to the home towards the end of 2004, for example, both the assessment and care plan were incomplete, although a risk assessment and infringement of rights documentation, appropriate to their situation, had been completed and reviewed, and a log of falls maintained. It was evident that the referring authority had not made it clear that this person had dementia and that they had, in fact, been inappropriately placed in a home not registered for this category of service user. Rosier Home Version 1.10 Page 10 All the service users who spoke with the inspector were positive about their experience of Rosier Home and the ability of staff to meet their needs. For example, one service user stated that they had always been content at Rosier Home. Another expressed concern in case they ever had to go elsewhere. One service user, with particularly complex needs, spent all their time in bed. Although the community nursing team was involved for their physical well being, the lack of any quality of life for this person was of concern. Consultation with a specialist in the needs of older people with learning disability and dementia, should be a priority for the home. Staff were observed providing appropriate support and interaction, for example, giving time to service users as they went about their duties, responding to non-verbal cues, offering cups of tea to service users, who engaged them in conversation, providing impromptu help and reassurance to others who needed it. A number of service users were observed at different times to be in a state of well being, smiling, laughing, bright-eyed. These tended to be those who were more independent and able to interact socially with staff and each other, and occupy themselves with their own interests. Service users presenting as withdrawn or disengaged, were those who were known to be unwell or, whose dementia, made them heavily dependent on staff for stimulation. Inevitably, with the mental and physical frailty of some of the existing service users, staff were mostly occupied with meeting their physical needs. The need for service users’ dependency to be taken into account when determining staffing levels has been highlighted under National Minimum Standards 12 and 27. A number of the existing service users had developed dementia since their admission to the home and remained in residence as a condition of the home’s registration. Given that changes had occurred in the resident population of Rosier Home and that the certificate was no longer accurate, appropriate adjustment to the details of the registration will need to be made outside of this inspection. During the course of this inspection, discussions took place with the provider about their plans for developing the home as a service providing specialist dementia care. A number of staff had already undertaken a day of training for dementia care and Mr Marles and Mrs Wase were to attend a four-day course for managers. Rosier Home Version 1.10 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8 and 11 Care plans were in varying stages of development but were reviewed on a monthly basis; the best ones included a personal profile and instructions to staff about how to meet the identified needs of the service users concerned. Appropriate arrangements were in place for meeting the health care needs of service users. Appropriate action was being taken to ensure that service users wishes were respected in matters relating to their death. EVIDENCE: Work had commenced on developing the care plans, as discussed at the last inspection. The outcome was variable and, to some extent, depended on the skills and application of the person, delegated with the responsibility for the particular care plan. The inspector discussed with the provider the positive aspects, particularly the use of life histories and the inclusion of goals and detailed instructions to staff. These positive features need to be common to all care plans. Rosier Home Version 1.10 Page 12 A rota for care plan reviews was displayed at the staff’s work station. One care plan sampled evidenced the service user’s participation in these monthly reviews. However, examples were found of care plan review dates being crossed out and replaced by the date of the subsequent review. Advice against this practice was passed on through the provider. The provider acknowledged that some staff struggled with care plans. He was advised that the initial care plan should be drawn up by the person completing the pre-admission assessment and that staff should receive training, if they held responsibility for the ongoing development and review of care plans. Care plans evidenced weight monitoring, consultations with surgeries and community nursing teams, inoculation programmes, chiropody and dental checks. Pressure relieving beds had been obtained by the home for service users more or less confined to bed and guidance for staff about pressure reduction was found in the care plan of one service user’s concerned. Detailed records had been kept for one service user sampled, pertaining to their medical condition, consultations and treatment. The Care Programme Approach was in use for particular service users with mental health needs. The provider was advised to consult the learning disability team for advice about the care of one service user with increasing and very complex needs. The home were continuing the process of ascertaining the wishes of service users or their representatives in the event of their death. Staff had attended courses in relation to death and bereavement and funeral arrangements. Rosier Home Version 1.10 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 14 and 15 Opportunities for service users to engage in supported activity were dependent on staffing levels and other constraints on staff time. The therapeutic benefits of stimulation and meaningful activity had been realised through some recent dementia training and the home had taken the first steps towards modifying their approach to activities. Not all service users, who were unable to voice their needs and preferences, had someone, independent of the home or Social Services, to represent their best interests. Most aspects of meal provision were positive but there was scope for improvement in relation to choice, timing and, in some cases, variety. EVIDENCE: A mixed picture was presented in relation to activities in the home. It was evident from discussion that some members of staff made particular efforts to take service users out. A trip to Colchester Zoo had been organised for 9 service users, one member of staff having obtained authority to drive an accessible bus, available to the home by arrangement. One service user’s care plan evidenced that they had been taken to the library, shops, and on other outings on a one-to-one basis. Some service users were able to engage independently in purposeful activity, such as reading the newspaper or taking Rosier Home Version 1.10 Page 14 themselves for a walk. One service user said they would like the opportunity to play scrabble and this should be included in their care plan. However, others, due to their complex needs, depended almost entirely on the support and availability of staff for any meaningful or therapeutic activity and, generally, staffing levels in the home did not allow time for this. Consequently, as observed during the inspection, some service users, apart from mealtimes, remained without stimulation for much of the day. Music or television were the only means of stimulation for one service user, who remained in bed. Although the home had still to adopt a person-centred approach to planning activities, the therapeutic value of stimulation and meaningful activity for enhancing service users’ well-being had been realised through recent dementia training. Arising from this, it was encouraging to find that the management had obtained a resource pack form the Alzheimer’s Disease Society to help them develop their activities programme along the right lines. In this context, Mr Marles was given the website details of another resource, the National Association of Providers of Activities for older people (NAPA). Not all service users had family or representatives supporting them. This was discussed with the provider. It was clear that steps had been taken to help service users contact their family and, where this had failed, to progress advocacy. This will be looked at again at subsequent inspections. General comments from service users about their meals were favourable although it was evident that the daily menu was not made available in advance, and service users were not offered a choice. One service user said that an alternative would be nice and they found tea at 16.00 hours a little early. By contrast, two other service users stated that the mealtimes suited them. It was evident from observation and discussion that the interval between tea and breakfast at 8.00 hours well exceeded the maximum of 12 hours set under National Minimum Standard 15. Discussion took place with the provider about the impact of this for service users, who went to bed before the evening supper drink, and particularly for those, who were unable to voice any need for food and drink. The lack of variation in the tea time menu for service users who needed their food liquidised was highlighted both in discussion and from records. The provider agreed to address this shortfall immediately. Rosier Home Version 1.10 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 The home had adopted an open and constructive approach to complaints. EVIDENCE: It was encouraging to find that the home had continued to log negative comments and complaints and to record any action taken. An allegation, which came to the attention of the Commission and has been addressed mainly outside of this inspection, was discussed with the provider and the service user concerned. The allegations made against the member of staff were not proved, although it was evident that the person concerned had some difficulty, initially, in remaining detached and handling the situation professionally. The situation was complicated by the fact that both parties were related to other people working in the home but, with the assistance of Social Services, some progress had been made towards a resolution. Records evidenced that the staff member concerned had received appropriate support and supervision in connection with the matter. Arrangements had been made for the staff to receive vulnerable adults training from an independent provider. It was proposed that the provider also access for staff a programme of free training, organised by the Essex Vulnerable Adults Protection Committee (EVAPC) and available throughout this year. Rosier Home Version 1.10 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 and 26 Rosier Home is comfortable and homely and subject to an ongoing programme of safety and environmental improvement. The home presented as clean and fresh on the day of inspection. EVIDENCE: The home’s ongoing programme of maintenance had included, since the last inspection, the painting of the entrance hall and downstairs corridor, the erection of a new fence separating the home from a neighbouring property, and the front garden being attractively planted with shrubs and flowers. The provider indicated that service users were offered a lockable facility in their room on admission but most service users and their representatives preferred to lodge their valuables with the home for safe-keeping. One service user’s file sampled contained a disclaimer, pertaining to lockable storage, signed by the service user concerned. One service user confirmed that they were happy for their valuables to be held by the home. Rosier Home Version 1.10 Page 17 All communal areas and a sample of service users rooms were found to be clean and fresh. One service user, who had always cleaned their own room, said that they wished to continue doing so. Ancillary staff included a cleaner, whose duties were supplemented by care staff on all shifts. Basic cleaning duties were time-tabled to ensure that all areas were covered regularly. Separate hand-washing facilities were available in the laundry and detailed instructions for hand-washing displayed in the staff toilet. Rosier Home Version 1.10 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29 and 30 Staffing levels were adequate for meeting service users’ personal care and physical needs, but were mostly not high enough to sustain a person-centred approach to social and recreational activities. The home was adhering to accepted recruitment procedures, although not obtaining a full employment history. Staff were able to maintain their skills through periodic training. EVIDENCE: The staffing ratio at the time of inspection was as indicated by the roster and typical for the home. Two staff were on duty throughout the day, supplemented by the manager, as necessary, and an extra person at lunch time to meet the needs of five service users, who needed assistance with eating. Ancillary personnel included a cook and domestic. Although, in the course of their duties, staff were observed in conversation with, and making cups of tea for, service users, it was evident from observation and discussion that a ratio of two staff to 14-16 service users did not allow staff time for person-centred activities. This aspect of provision is also covered under the section headed ‘Daily Life and Social Activities’ on page 14. Although the provider had continued to experience difficulties with the Residential Forum guidance (a Department of Health tool for calculating Rosier Home Version 1.10 Page 19 staffing levels), the home was in the process of recruiting two new staff. Moreover, the provider indicated that, the increase in Social Services’ contract prices from April 2005, would gradually be reflected in improved staffing levels. Meanwhile, the provider explained that they had several staff in reserve to cover absences or special events. This was evidenced on the day of inspection, when one member of staff, who went off sick, was replaced at short notice. Criminal Record Bureau checks and other recruitment documentation, required by regulation, were in place on the staff files sampled. The absence of a birth certificate on one staff file was noted. Advice was given to the provider about ensuring that, by adjustment to their job application form, staff are required to give a full employment history, in which any gaps can be explored at interview. The home was using the Skills for Care induction programme with new staff. Since the last inspection, staff had attended statutory training and courses related to death and bereavement, funeral arrangements and dementia care. Service users spoke favourably about the competence of the staff to meet their needs. Rosier Home Version 1.10 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 36 and 38 There was scope for the home to improve its own monitoring of outcomes for service users. Staff were appropriately supervised. Arrangements for the health, safety and welfare of service users were mostly satisfactory as sampled but some risk was presented by exposed radiators and hot water taps. EVIDENCE: National Minimum Standard 33 was not fully inspected but the provider acknowledged that the home had made little progress in this area since the last inspection. Staff worked to comprehensive job descriptions, covering the holistic needs of service users. They had also received, at the point of employment, a guide to Rosier Home Version 1.10 Page 21 the home’s objectives and policies relating to care planning, the administration of medication and health and safety issues. These, together with the Skills for Care induction training undertaken by staff in supervision, indicated that they were given a good grounding for developing the skills required by their roles. Records for one member of staff, against whom an allegation had been made, evidenced robust supervision. National Minimum Standard 37 was not fully inspected but the home had not notified the Commission of the events leading to one service user having their leg amputated or another’s readmission to hospital for a mental health assessment. This was necessary in line with the Care Homes Regulations 2001, Regulation 37. Staff had signed as ‘read and understood’ copies of the health and safety policy. Records and discussions evidenced that they had continued the process of updating their statutory training. The provider acknowledged that moving and handling training was a little overdue and gave assurance that arrangements would soon be in hand. Individual risk assessments for exposed radiators and hot water outlets had been completed in 2003, but not updated. The programme of covering radiators had commenced and the provider reported that the fitting of safety valves to regulate the temperature of hot water used by residents was under consideration. These areas of work should be progressed. The shower in the downstairs bathroom was being used for storage. The registered persons should also ensure this presents no risk to water safety by running the shower for a minimum of 3 minutes weekly. The provider was advised that, as well as logging accidents and incidents in service user’s individual files, a separate record for all service users should be maintained, in line with guidance from the Health and Safety Executive. It was recommended that the same methodology be used to record accidents to staff rather than their present log book. Rosier Home Version 1.10 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. Where there is no score against a standard it has not been looked at during this inspection. 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 2 2 x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 x 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 x 14 2 15 2 COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 2 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x x x x x x 3 x 2 Rosier Home Version 1.10 Page 23 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 3, 7 Regulation 15, 12 Requirement Timescale for action 31 May 2005 2. 4, 12, 27 3. 33 The registered person must ensure that all service users have a detailed plan as to how the home is meeting their needs. THIS IS A REPEAT REQUIREMENT THAT HAS EXCEEDED AGREED TIMESCALES FOR ACTION OVER SUCCESSIVE INSPECTIONS. 12, 16, 18 The registered person must ensure sufficient staffing levels to meet service users expectations, preferences and capacities in relation to activities. The registered person must further ensure the numbers of staff are sufficient for the health and welfare of service users. THIS IS A REPEAT REQUIREMENT THAT HAS EXCEEDED AGREED TIMESCALES FOR ACTION OVER SUCCESSIVE INSPECTIONS. 24 The registered person must continue to develop their methods for reviewing and improving the quality of care in the home. The process must include systematic consultation with service users and their representatives and lead to a Version 1.10 31 May 2005 31 May 2005 Rosier Home Page 24 4. 19, 25, 38 13, 16 5. 31 37 6. 3 14 report that is supplied to the Commission and made available to service users. THIS IS A REPEAT REQUIREMENT THAT HAS EXCEEDED AGREED TIMESCALES FOR ACTION OVER SUCCESIVE INSPECTIONS. The registered person must ensure that, once risks to the health and safety of service users have been identified, early actoin is taken to eliminate them. They must also ensure that the homes water supply and fittings conform to regulations. THIS IS A REPEAT REQUIREMENT THAT HAS EXCEEDED AGREED TIMESCALES FOR ACTION OVER SUCCESSIVE INSPECTIONS. The registered person must inform the Commission of any significant incidents in the care home. THIS IS A REPEAT REQUIREMENT THAT HAS EXCEEDED AGREED TIMESCALES FOR ACTION OVER SUCCESSIVE INSPECTIONS. The registered person must ensure that service users are only admitted to the home on the basis of a full, written needs assessment. 31 May 2005 31 May 2005 1 May 2005 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. Refer to Standard 7 4, 27 Good Practice Recommendations Care plans should have clearly defined goals and actions based on each of the service user’s assessed needs. The registered person should calculate staffing levels using the Residential Forum guidance issued by the Department of Health. Version 1.10 Page 25 Rosier Home 3. 4. 5. 34 11, 17 31 6. 7. 4 15 8. 9. 10. 28 29 37, 38 The registered person should produce a business and financial plan for the purpose of achieving the aims and objectives of the home. The registered person should arrange an advocate for any service user without family or others to represent their interests. The registered persons should ensure that they achieve the National Vocational Qualification, Level 4, in management and care by 2005 and attend periodic training to update their knowledge and competencies for managing a care home for the elderly. The registered person should seek advice from their local Social Care Learning Disability Team in relation to the needs of one service user. The registered person should ensure that a daily menu is displayed or in some way made available to all service users and that alternatives to the menu are offered. Service users needing liquidised meals should not be disadvantaged as to choice or range of menu. The registered person should take appropriate steps to ensure that 50 of staff has National Vocational Qualification in care Level 2 by 2005. The registered person should obtain full employment histories for potential staff, so that any gaps can be explored. The registered person should revise their methodology for recording accidents to staff and service users. Rosier Home Version 1.10 Page 26 Commission for Social Care Inspection Fairfax House Causton Road Colchester CO1 1RJ 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 Rosier Home Version 1.10 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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