Inspection on 08/06/07 for Ryder House

This inspection was carried out on 8th June 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 7 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Ryder House 29/01/07

Ryder House 11/07/06

Ryder House 13/12/05

Ryder House 05/05/05

Ryder House 14/02/05

Ryder House 27/09/04

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Thorndene

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Southfields

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

CARE HOME ADULTS 18-65 Ryder House 115/116 London Road Dover Kent CT17 0TQ Lead Inspector Kim Rogers Unannounced Inspection 8th June 2007 10:15 Ryder House DS0000023532.V340173.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 Ryder House DS0000023532.V340173.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. Ryder House DS0000023532.V340173.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ryder House Address 115/116 London Road Dover Kent CT17 0TQ 01304 214832 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) ryder.house@robinia.co.uk The Robinia Care Group Ltd Post Vacant Care Home 14 Category(ies) of Learning disability (12), Physical disability (4) registration, with number of places Ryder House DS0000023532.V340173.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Date of last inspection 29th January 2007 Brief Description of the Service: Ryder House is part of the company Robinia Care, who provide residential care and support services for people with a learning disability. Ryder House provides personal care and support to up to 14 people with a learning disability. Some may also have a physical disability. The home is a large detached property with accommodation for service users on three floors. There are a mixture of single and shared rooms. The home is located in Dover with easy access to local amenities, and public transport. There is a garden to the rear of the property and parking to the front. The fee range for Ryder House is about £45,000 to £55,000 per year. For information about fees and services please contact the Provider. Pervious inspection reports are available from the Provider or can be viewed and downloaded from www.csci.org.uk Ryder House DS0000023532.V340173.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was unannounced and carried out by two inspectors. The site visit to the home took about 6.5 hours. During the site visit the inspector spoke to service users, the assistant manager and staff, made observations and checked some records. The current structure of the home is assistant manager, three team leaders and support staff. There are 7 service users in residence. The inspectors looked at progress towards meeting previous requirements and recommendations. Some requirements and recommendations remain unmet. The home has had several inspections since April 2006 and was served with statutory enforcement notices in September 2006, following findings of poor practice and breaches of the Care Homes Regulations. Since then, some improvements have been made and the Provider has produced an action plan to improve. However, there remain some unmet requirements, and improvement is slow. What the service does well: What has improved since the last inspection? Facilities have been installed in the dining room to enable service users to prepare their own food and drinks. The home has introduced a person centred assessment tool. A start has been made by key workers to complete these. Whilst the tool is an improvement, person centred planning and assessment is at a very early stage, therefore having little impact on outcomes for service users. Some people are going out more. One bathroom has been decorated, another is in the process of being updated and tiled. Ryder House DS0000023532.V340173.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Ryder House DS0000023532.V340173.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 Ryder House DS0000023532.V340173.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2,5 A start has been made to assess current service users needs and aspirations using a person centred tool. Service users are unaware of the terms and conditions of their stay. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. EVIDENCE: No new people have moved in since the last inspection so there were no pre admission assessments to sample. For existing people a start has been made to assess their needs and aspirations using a person centred assessment tool. This work is at an early stage, so aspirations have not been transferred to individual plans detailing the support people need. Subsequently the requirement made at the last inspection has not been met. Contracts of terms and conditions of residency were found at the last inspection to contain omissions, and were out of date. Contracts are produced in a standard format, which most people cannot understand. Ryder House DS0000023532.V340173.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 People cannot be sure their personal goals will be supported. Service users continue to need better support to make choices and decisions. Taking risks is not seen as an area for development and therefore risk management can still be restricting. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Each service user has a service user plan. Two plans were sampled with no change noted, since the last inspection. These are needs lead plans with a focus on deficiencies e.g. ‘area of difficulty ‘ For example one plan read ‘He cannot…He is unable …He is not…..’ rather than focus on what the person can do and be supported to do. Aspirations and goals are not recorded nor the persons background and history. After reading plans you do not get a feel for who the person is, where Ryder House DS0000023532.V340173.R01.S.doc Version 5.2 Page 10 they are from and any significant life events. Both plans contained some contradictory and out of date information. The assistant manager hopes to develop individual person centred plans, which will include this missing information. An advocacy agency has worked with individual service users to start a person centred planning process, however staff need training and support if person centred planning is to be fully implemented, and make a difference to people’s lives. Risk assessments are completed but these are basic and mainly focus on keeping people who use the service safe. There is no record of when a risk last occurred making review less effective. Where limitations are in place, there is some evidence that decisions are agreed with the individual but this is not consistent or regularly reviewed. Two service users with no verbal communication were case tracked. There is limited detail about their communication needs and no communication assessment or interventions in place. Some contradictions were noted in service user plans. For example one said ‘does not use Makaton’ while an assessment by a professional said ‘use Makaton’. Another said ‘seems to have good comprehension’ and ‘it’s difficult to assess level of comprehension’. One plan said ‘observe the non verbal communication ‘ and ‘understands simple words’ but there was no mention of what these were. A requirement was made previously to ensure service users have the communication support they need and this is not met. There is now a photo board showing who is on duty and board showing daily meal options in a format people can understand. Some people have had specialist support and advice to develop skills and manage behaviours. Strategies have not been transferred to individual plans. The service recognises the right of individuals to take control of their lives and to make their own decisions and choices. This does not always happen in practice as staff have a limited understanding of how to do this effectively. There is some evidence that individuals are involved in some decision making about the home, such as day to day living and social activities. Areas where individuals can affect change are limited. Ryder House DS0000023532.V340173.R01.S.doc Version 5.2 Page 11 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 For some there is a lack of opportunity for meaningful activities and limited access to the community. Current relationships are supported but some service users need more support to make new friends. Service users rights and responsibilities should be better respected and supported. Service users enjoy a healthy diet. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Each person has an individual activity planner covering morning and afternoons Monday to Friday. One activity plan indicated lots of 1-1 or ‘relaxation’ sessions in the person’s bedroom. Staff said that the 1-1 time was not planned and staff are not allocated to this time. Details of service users family and friends are recorded in service user plans. Service users talked about seeing their family and keeping in touch with old Ryder House DS0000023532.V340173.R01.S.doc Version 5.2 Page 12 friends. Some people have no family or friends with no plans in place to support service users to make new friends and develop relationships. There was little evidence that the daily routines promote independence. Developing independent living skills is not seen as important with no mention in individual plans to support this. The home has a cook and a cleaner and observations showed that no service user is involved in any cooking or cleaning. Opportunities are available for residents to be involved in food shopping and menu planning, although there is a focus on the more able individuals so the maximum potential of all people using the service is not recognised and developed. Since the last inspection some cupboards, work surface and a sink have been installed in the dining room. Staff said the plan is for service users to have the opportunity to prepare their own food and drinks. Staff resources are not used effectively. There is no shift plan in place so activities are ad hoc and depend on staff on duty having the ideas, choosing the activity and offering opportunities. Assessments have been carried out about ability to have a bedroom door key, which found that service users do not have the ability to have an everyday door key so locks have been removed from bedroom doors. Most service users rooms have no lockable storage for valuables. No research has been done to find suitable alternative locking devices to meet individual needs and ensure privacy. No service user has a front door key. Service users have not had support to plan and book their holidays yet. Some people go out to the local shops, clubs and day centre. For others opportunities are limited. The home has a car and minibus although the mini bus has not worked for some years. Staff feel this limits opportunities to access the community. Ryder House DS0000023532.V340173.R01.S.doc Version 5.2 Page 13 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 Service users cannot be sure they will be supported with their personal care in the way they prefer. Service users have support to access health care advice and support. Medication practice is adequate but has not moved on to give people more control. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. EVIDENCE: As found at the last inspection, personal care needs are recorded in service user plans. Some need more detail to ensure service users are supported in the way they prefer. For example one plan said ‘full bed bath in morning’ and ‘needs teeth cleaned’ Another stated ‘needs full support’ with no mention of what that means. There should be more emphasis on maintaining and maximising independence. Bathroom and shower facilities remain unchanged and unsuitable for some people so some have to have bed baths. This home is registered to provide personal care support to up to four service users who have physical disabilities so should be able to support the personal care needs of everyone. Ryder House DS0000023532.V340173.R01.S.doc Version 5.2 Page 14 The assistant manager said there are plans to improve one of the bathrooms by converting it to a walk in shower. People who use services have access to health care services both within the home and in the local community. The majority of people who use services are able to choose their own GP and attend local dentists, opticians and other community services. People who use services unable to access local services are managed by visits to the home by health care professionals. Some health information is included in individual plans although this is minimal and mainly a record of attended health appointments. Some work was started on individual health action plans although there was no evidence that this has moved on and has had any impact on outcomes for people. Aspects of medication practice were sampled and administration observed. Records of administration are generally in order but hand entries are not countersigned. Storage needs to be improved to comply with the minimum standard. The security of the medication cupboard key should be reviewed. No service user currently controls their own medication and there are no plans in place to develop people’s skills in this area. As found at the last inspection, guidelines are in place for ‘when needed’ medication however, these are ambiguous and do not detail how a person lets you know that they need the medication. This is especially important for service users who do not communicate verbally. When asked staff said they would not know how to recognise if certain people were in pain. An attempt has been made to deal with issues of consent. Unfortunately this does not comply with the Mental Capacity Act 2005. For example one service user plan stated ‘not able to consent due to learning disability’. Ryder House DS0000023532.V340173.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Without the communication support they need service users cannot make complaints and disclosures. Following training staff are more aware of what abuse is. Some people have potential to take more control of their money. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The service has a complaints procedure that meets the National Minimum Standards and Regulations. The procedure is up to date and is displayed on a notice board in the home but is not available in any alternative formats that people can understand. The lack of communication support means that service users may not have the help they need to make disclosures and complaints. There is a policy and procedure to safeguard people from abuse and harm. Staff attend safeguarding adults training on a rolling programme. No one controls their own money and there are no plans in place to develop skills in this area, even though the assistant manager said that some people have potential to take more control of their money. Records of income and expenditure are in order with good systems in place to protect against financial abuse. Ryder House DS0000023532.V340173.R01.S.doc Version 5.2 Page 16 Ryder House DS0000023532.V340173.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24,30 The home is generally safe, clean and well maintained. More could be done to ensure service users privacy and to give people more control of their home. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The inspectors had a look around the home, which was generally clean and well maintained. The home has some shared rooms and some single rooms. There are no en suite rooms. Some people who share have not been offered a single room even though there are some available. No room has a suitable lock fitted, some have no lock at all and some bedroom doors were propped open. Although assessments have been carried out to establish if service users can use a conventional key or not, no alternative has Ryder House DS0000023532.V340173.R01.S.doc Version 5.2 Page 18 been provided. The acting manager said that there is no lockable storage provided for valuables. No service user has a front door key and cannot let themselves in or out. Bathrooms and shower facilities are still unsuitable for some people and lack the aids and adaptations they need. Ryder House DS0000023532.V340173.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35 Recruitment checks are carried out but potential risks to staff must be assessed and managed. The range of training has increased but needs to be maintained and generalised to benefit service users. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Statutory training is offered and attended on a rolling programme. This includes some training related to service users needs. Staff need training and support if they are to continue to the work started on person centred planning. The assistant manager said that training is planned. Staff talked about training they had attended, which benefited service users. Unfortunately this has not been cascaded to other staff or implemented within the home. Therefore some short-term positive affects on people’s lives have fizzled out. There are generally enough staff but rotas are not planned around individual needs and this limits opportunities. Ryder House DS0000023532.V340173.R01.S.doc Version 5.2 Page 20 Staff files were sampled. Recruitment is dealt with by head office so service users are not fully involved in recruiting new staff. Recruitment checks are carried out before a person starts work at the home. Two staff files were sampled. One had no proof of identity and both had only five years of employment history. The previous two inspections found that some staff have declared health issues that need assessing and supporting. There was no evidence in files that these assessments have been carried out. The assistant manager confirmed this. Ryder House DS0000023532.V340173.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 The home is adequately run but not all service users are supported to give their views about the service. Views that are given are not always listened to and actioned. Service users and staff cannot be sure their health and safety will be protected. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Management of the home has been inconsistent over the past year or so. A full time assistant manager is now in post and has applied to be the manager. The assistant manager also spends time working shifts. The assistant manager has experience in working with people with a learning disability in a supervisory management role but does not yet have the required qualification and has minimal experience in managing a home. Ryder House DS0000023532.V340173.R01.S.doc Version 5.2 Page 22 A new area manager is in post since the last inspection. Monthly monitoring visits are now made to the home by an area manager as required. An action plan from a visit in March 2006 asked that a service user be supported to have a hair cut. The assistant manager said this has not been done and there was no plan for it in the person’s individual plan. There are some unmet requirements and recommendations from the previous inspection. The home has produced an action plan but progress to improve outcomes for people has been slow. There continues to be little evidence that service users and stakeholders (including staff) views underpin the review and development of the service. Weekly service user meetings are held but no action plan is produced to show responses and action to issues raised. Meetings mainly focus on menu and activity choices. There is no annual audit of the service or development plan inked to service users views and continuous improvement. Questionnaires have been given to service users but are not appropriate to all service users needs. Lack of communication support means that some service users do not have the support they need to air their views. Records must be kept and recorded in line with the Data Protection Act. For example some sensitive information is recorded in the service user meeting minutes. This should be in individual plans for effective evaluation and to ensure confidentiality. As found at previous inspections not all staff have attended a fire drill and staff health needs have not been risk assessed. Accidents and incidents have been reported appropriately. Ryder House DS0000023532.V340173.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 2 3 X 4 X 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 2 ENVIRONMENT Standard No Score 24 2 25 2 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 2 33 X 34 2 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 2 X 2 X LIFESTYLES Standard No Score 11 X 12 2 13 2 14 X 15 2 16 2 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 3 2 X 2 X 2 X X 2 X Ryder House DS0000023532.V340173.R01.S.doc Version 5.2 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 YA7 Regulation 12, Sch.3 Requirement (Standards 7,22,23) the registered person must ensure that service users have the communication support they need to make choices and decisions about their lives and enable them to air their views. Individual communication guidelines should be developed by 30/04/07 NOT MET FROM PREVIOUS INSPECTION. The registered person must ensure there are suitable facilities such as bathrooms and showers to meet service users personal care needs and preferences. FROM PREVIOUS INSPECTION. Service users aspirations and personal goals must be assessed, recorded and supported in a person centred way by 30/04/07 NOT MET FRON PREVIOUS INSPECTION. The home must be run in a way that respects service users privacy and dignity. DS0000023532.V340173.R01.S.doc Timescale for action 31/07/07 2. YA18 23 31/07/07 3. YA2 14 31/07/07 4. YA16 12 31/07/07 Ryder House Version 5.2 Page 25 Suitable locking devices should be provided for bedroom doors and lockable storage should be provided for service users valuables by 30/04/07 NOT MET FROM PREVIOUS INSPECTIONS. 5. YA9 13 Risk management strategies must be reviewed to ensure more emphasis on enabling people rather than restricting them. Risk should be evaluated as an area for development as part of individual PCP’s and kept under review. Staff health issues must be risk assessed. All staff must be competent in evacuating the building in the event of fire. Medication practice must be in line with the minimum standards especially storage and guidelines for ‘when needed’ medication. 30/09/07 6. 7. YA42 YA20 23 13 30/06/07 31/07/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard YA5 YA20 Good Practice Recommendations Individual terms and conditions of residency should be developed with each person in line with the standard. NOT MET FROM PREVIOUS INSPECTION Service users consent to medication and other treatment should be obtained and recorded to comply with the Mental Capacity Act 2005. NOT MET FROM PREVIOUS INSPECTION Ensure people in shared rooms are offered a single room when one is available. Ensure staff deployment, by way of shift planning and other methods, is effective to meet service users needs and increase opportunities. DS0000023532.V340173.R01.S.doc Version 5.2 Page 26 3. 4. YA25 YA16 Ryder House Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Ryder House DS0000023532.V340173.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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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