Inspection on 09/06/05 for Searchlight Workshops - Powell House

This inspection was carried out on 9th June 2005.

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 11 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Searchlight Workshops - Powell... 30/10/08

Searchlight Workshops - Powell... 01/11/06

Searchlight Workshops - Powell... 22/11/05

Searchlight Workshops - Powell... 07/12/04

Searchlight Workshops - Powell... 11/06/04

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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 Searchlight Workshops - Powell House Searchlight Workshops - Powell House Claremont Road Newhaven BN9 0NQ Lead Inspector Jennie Williams Unannounced 9 June 2005 09.30 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Searchlight Workshops - Powell House H59-H10 S59127 Powell House V218836 090605 stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Searchlight Workshops - Powell House Address Claremont Road Mount Pleasant Newhaven East Sussex BN9 0NQ 01273 514007 01273 611289 enquiries@search-light.org.uk Searchlight Workshops 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) Ms Paula Elizbeth Crowhurst Care Home 16 Category(ies) of Physical Disability (PD) 16 registration, with number of places Searchlight Workshops - Powell House H59-H10 S59127 Powell House V218836 090605 stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. That service users accommodated are aged eighteen (18) to sixty-five (65) years. 2. That service users will have a physical disability. 3. That the number of service users accomodated must not exceed sixteen (16). 4. That service users with a physical disability may also have a mild learning disability. Date of last inspection 17 January 2005 Brief Description of the Service: Powell House is a home within the Searchlight Workshops organisation that is registered for 16 places for residents aged 18 to 65 years of age. It is registered for physical disability. Residents with a physical disability may also have a mild learning disabiliy. There is no nursing care provided at this home. There are three registered establishments at this one site within the organisation of Searchlight Workshops. There is also a workshop on the site available to residents and others within the community. A variety of crafts/activities are offered at the workshop. A social club is ran on site and this opens a couple of evenings a week. All rooms are for single occupancy and are located over two floors. There is a passanger shaft lift availabe to residents who are unable to move independently between floors. The home is situated on the top of a hill on the outskirts of Newhaven. The home has access to a mini bus. There are local amenities and access to public bus routes at the bottom of the hill. Some of the facilities provided require updating and there are plans in place to commence this work. Searchlight Workshops - Powell House H59-H10 S59127 Powell House V218836 090605 stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The reader should be aware that the Care Standards Act 2000 and Care Homes Regulation Act 2001, uses the term ‘service user’ to describe those living in care home settings. For the purpose of this report, those living at Powell House will be referred to as ‘residents’. This unannounced inspection took place over seven and a half hours on the 9 June 2005. A tour of the home was not required, as the Inspector had previously inspected the home. Individual rooms were spot-checked. Care plans were spot-checked. A visitor, residents and staff were spoken with throughout the inspection process. There were 16 residents residing at the home on the day of the inspection. Some residents were not spoken with as they were on an outing for the day. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Searchlight Workshops - Powell House H59-H10 S59127 Powell House V218836 090605 stage 4.doc Version 1.30 Page 6 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 Standards Statutory Requirements Identified During the Inspection Searchlight Workshops - Powell House H59-H10 S59127 Powell House V218836 090605 stage 4.doc Version 1.30 Page 7 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2, 3 & 4 The home has information available to prospective residents and their representatives to make an informed decision if the home is suitable for their needs. All prospective residents are assessed prior to moving into the home. EVIDENCE: The home has a Statement of Purpose and Service User Guide that is available upon request and provides prospective residents and their representative information on the services and care provided at the home. There is a copy of the most recent inspection report by the entrance of the home. The manager undertakes all pre assessments of prospective residents. A copy of social services assessment is obtained wherever possible. Prospective residents are able to visit the home prior to moving in if they wish. The manager has been advised to ensure that another pre assessment is undertaken if a resident has spent a period of time in hospital. This is to ensure that the needs of the individual have not greatly changed and can still be met by the home. Specialist services are accessible to the home when the need arises. The home will access the required information when required, for the needs and preferences of specific minority ethnic communities, social /cultural or religious groups. Staff individually and collectively have the skills and experience to deliver the services and care which the home offers to provide. Searchlight Workshops - Powell House H59-H10 S59127 Powell House V218836 090605 stage 4.doc Version 1.30 Page 8 Some residents have resided at Powell House for over 20 to 50 years. It has been agreed with CSCI that those who fall outside of the homes category of registration may remain living at the home for as long as they wish and their needs continue to be met. Searchlight Workshops - Powell House H59-H10 S59127 Powell House V218836 090605 stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7, 8, 9 & 10 Some needs are at risk of not being met due to lack of documentation in the care plans. Residents could be provided with more opportunity to be involved in the processes of running the home. Residents’ routine and lifestyle is their own choice. EVIDENCE: Care plans were only spot-checked on this occasion as it was confirmed that not all care plans have been transferred onto the new format. Staff need to improve documentation in the care plans. Care plans must reflect actual current practice. The Inspector noted that a resident had not had any oral hygiene issues addressed over a one-week period. This was discussed at length with the Responsible Individual and Registered Manager. Staff were also made aware of this shortfall. It has been emphasised to the home the importance of documentation and ensuring care plans reflect all needs as stated in Standard 2. This remains an outstanding requirement. Staff need to ensure that all information obtained at the pre assessment stage is reflected in the care plan. Residents spoken to confirmed they participate in the reviewing process of their care plans. Each resident has a named key worker. Searchlight Workshops - Powell House H59-H10 S59127 Powell House V218836 090605 stage 4.doc Version 1.30 Page 10 Residents spoken with confirmed that their routine of life is their decision. Staff encourage residents to make their own decisions. The finance department of the home looks after residents’ monies. Between the three Searchlight Workshop homes, all individuals’ monies are pooled into the one account. It has been made a requirement at previous inspections that arrangements are made to provide individual bank or other savings accounts for residents. The home is still trying to find suitable arrangements to address this shortfall. No new residents have been able to join the current system. Some residents have been supported in commencing to use their own banking accounts. Residents are restricted in opportunities to participate in activities, which enable them to influence key decisions in the home. Residents are not involved in the reviewing of policies and procedures or in the recruitment of staff. A resident spoken to stated that they would be interested in being involved in interviewing staff. The home should undertake a survey to ascertain who would like to be more involved in the decision making of the home and provide the opportunity for participation in these activities. The home has undertaken appropriate risk assessments for all residents and activities they may participate in. All personal information is kept securely at the home. Residents have access to their records if they wish. Information given in confidence is not share with families/friends against the residents’ wishes. Searchlight Workshops - Powell House H59-H10 S59127 Powell House V218836 090605 stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11, 12, 13, 14, 15, 16 & 17 Residents are provided with opportunities for personal development and to be involved in the local community if they wish. The provision of evening meals needs to be improved. EVIDENCE: There is a workshop and social club located on the same site as Powell House. Residents of the home are able to use these facilities if they choose. People that live outside of the home environment may also use these facilities. On the day of the inspection, some residents had been taken out on a trip for the day. There is a bus available at the home to transport residents. Wheelchairs can be accommodated in the bus. There were no residents working in jobs outside of the home environment. Some assist at the reception for Searchlight Workshops. Individuals are encouraged to continue their activities they are engaged in prior to entering the home. Residents are encouraged to participate within the local community. Searchlight Workshops - Powell House H59-H10 S59127 Powell House V218836 090605 stage 4.doc Version 1.30 Page 12 Residents spoken to are pleased that there are more opportunities being offered to become involved in activities. There was evidence that Searchlight Workshop are working positively toward ensuring the facilities available on site are used more effectively. Visitors are welcomed at the home. Residents may see visitors in their own rooms if they wish. One visitor spoken to confirmed that they were able to visit at any time and were happy with the care and services provided at the home. Residents spoken with confirmed that they choose their own daily routines. Some residents had been taken out for the day. Others were observed to move freely within and outside of the home environment. Residents spoken to confirmed that they felt their privacy and dignity is respected. There were mixed feelings regarding the quality of the food. It became apparent that the evening meals being provided were not always of adequate standard. Some residents informed the Inspector that they were purchasing their own food some evenings, due to the poor quality being provided at the home. Management, who are taking steps to address this shortfall, had already noted this. There are no suitable facilities provided for residents to be independent with cooking meals. Meals come from the main kitchen. Plans have been developed for the refurbishment programme of Powell House and will include in-house catering facilities that will be accessible to residents. The timescale from the previous inspection has not been met. It has been confirmed that the refurbishment programme will be completed by October 2006. Environmental Health inspects the kitchen and awarded a Five Year Achievement Award, 2001 to 2005. This is ‘given in recognition of high standards of food hygiene and staff training in this establishment.’ Searchlight Workshops - Powell House H59-H10 S59127 Powell House V218836 090605 stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19 & 20 Residents’ routines of daily activities are flexible. Residents may be placed at risk due to the lack of recording medication at the time of administration. The double-checking of handwritten MAR charts would ensure the safety of residents more effectively. EVIDENCE: Residents spoken with confirmed that they felt all of their needs were being met and routines of daily activities are flexible. Changes in residents health are monitored and advice is sought whenever required. A care plan spotchecked demonstrated the preferred way in which the individual receives personal support. It was made an immediate requirement that medication is signed for at the time of administration. On inspecting the MAR charts, some morning and midday medications had been administered, but not signed for. Medications must only be used for whom it has been prescribed. There were dressings found in an individuals’ room for whom they had not been prescribed. It is recommended as good practice that any handwritten medication entries onto the MAR charts are double checked by two staff that are medication trained. This will reduce the risk of errors occurring. Searchlight Workshops - Powell House H59-H10 S59127 Powell House V218836 090605 stage 4.doc Version 1.30 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 & 23 The home has adequate systems in place to ensure that complaints are dealt with appropriately. Staff are provided with sufficient information to inform them of the correct procedures if an allegation of abuse is made. EVIDENCE: There is a complaints procedure available at the home. Residents spoken to confirmed that they know who to speak to if they needed to make a complaint. There is a record kept of complaints. There have been no complaints made to CSCI since the last inspection. There are policies and procedures in place for dealing with allegations of abuse. Staff spoken with confirmed that they have received training in adult protection. There have been no allegations of abuse made since the last inspection. Searchlight Workshops - Powell House H59-H10 S59127 Powell House V218836 090605 stage 4.doc Version 1.30 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 25, 27 & 30 Residents will be provided with opportunities for increasing their independency when the refurbishment programme is completed. Some facilities at the home require updating but are currently meeting the needs of the residents residing at the home. EVIDENCE: Rooms are located over two floors and a passenger shaft lift is provided to assist residents is accessing all areas of the home. All rooms are for single occupancy. Residents spoken to confirmed that they were happy with their individual room. Rooms that were spot-checked were seen to be personalised to reflect the individual’s choice and personality. The home is proposing to make changes to Powell House and upgrade the facilities currently being provided. Discussions have taken place between the CSCI and the organisation to ensure changes that are made comply with the Regulations and will provide facilities that promote independence. It has been a requirement from previous inspections that the bathrooms and toilets are refurbished with particular attention being paid to ensuring that wheelchair users can easily access them. The refurbishment programme should be completed by October 2006. Searchlight Workshops - Powell House H59-H10 S59127 Powell House V218836 090605 stage 4.doc Version 1.30 Page 16 There is sufficient domestic staff on duty. Two cleaners were spoken to who confirmed that they have received updated training relevant to their role. There is a central laundry that provides a washing service to all three homes located at this site. There was a bin noted in an individuals’ room that was being used for dirty linen. This bin must be provided with a lid to promote infection control. There were no offensive odours noted during the inspection. Searchlight Workshops - Powell House H59-H10 S59127 Powell House V218836 090605 stage 4.doc Version 1.30 Page 17 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 35 & 36 There is low staff morale at the home. Residents are at risk of not having all there needs met due to the shortage of staffing numbers. Staff are suitably trained to meet the needs of the individuals currently residing at the home. EVIDENCE: Residents and staff spoken with all confirmed that they felt there were insufficient numbers of staff on duty. Some residents’ needs were very high and staffing numbers had not been adjusted accordingly. The manager, staff and residents all felt that the morale of staff was low due to increase of workload. Staff and residents both confirmed that they don’t have time anymore to sit down and have one to one discussions. One resident has very high needs, who is currently receiving input from the district nurses. Management must liaise with district nurses and the care staff at the home to ensure that the complex needs will remain to be fully met. The day after the inspection, the Residential Forum staffing level guidelines was checked and it was made an immediate requirement that there are five staff on duty during waking hours and two waking staff members at night. The rota demonstrated that there were insufficient numbers of staff on duty for the number and dependency level of residents residing at the home. Searchlight Workshops - Powell House H59-H10 S59127 Powell House V218836 090605 stage 4.doc Version 1.30 Page 18 There are currently two staff vacancies at this home. Agency staff is having to be used nearly on a daily basis. Continuity of care is provided by the agency wherever possible. Staff spoken with confirmed that they have received mandatory training and are provided with opportunities to undertake training provided by outside agencies. It was confirmed by the manager that staff are currently receiving supervision two to three times a year. Staff spoken with confirmed that they find management at all levels approachable. Staff should be provided with supervision at least six times per year. Residents were very complimentary about the staff working at the home. Searchlight Workshops - Powell House H59-H10 S59127 Powell House V218836 090605 stage 4.doc Version 1.30 Page 19 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39, 40 & 42 Residents are protected by the systems in place to manage the health and safety of the home. A developed and implemented quality assurance and quality monitoring programme would enable management to assess the suitably of services provided at the home and identify areas that can be improved. EVIDENCE: Staff and residents spoken to confirmed that they found management at all levels approachable. It was confirmed that there is still work being done within the organisation to develop an effective quality assurance and quality monitoring system. The Responsible Individual confirmed that this will be completed by mid-July. There are surveys kept at the entrance of the home for people to complete if they wish. Trustees of the organisation undertake monthly unannounced visits to the home to monitor practices and provides a report to the home and CSCI. Searchlight Workshops - Powell House H59-H10 S59127 Powell House V218836 090605 stage 4.doc Version 1.30 Page 20 The organisation has purchased a set of policies and procedures from a company and is currently in the process of personalising them to the home. The home must ensure these comply with Appendix 2 of the NMS. This has now been made a requirement, as this has been an outstanding recommendation for the last two inspection reports. The Responsible Individual confirmed that this would be completed by the end of July. A manager of one of the other homes is also the designated health and safety officer. It was confirmed that all relevant checks are undertaken and up to date. Staff receive all mandatory training relating to health and safety. Hot water taps sampled demonstrated that it is being dispensed around the recommended temperature. A record is kept of any accident/incident that occurs. There was a call bell noted in one of the room to be hanging off the wall. The home has identified problems with the call bell system at night due to some residents unable to be able to press the buttons. This has not been reflected as a requirement, as the home has demonstrated that action is being taken to resolve this problem. Searchlight Workshops - Powell House H59-H10 S59127 Powell House V218836 090605 stage 4.doc Version 1.30 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 3 x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 2 2 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 x 2 x x 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 2 Standard No 31 32 33 34 35 36 Score x x 2 x 3 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Searchlight Workshops - Powell House Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score x x 2 2 x 3 x H59-H10 S59127 Powell House V218836 090605 stage 4.doc Version 1.30 Page 22 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 YA6 Regulation 15 Requirement That the care plan format covers all areas as stated in Standard 2. (Timescale 30.08.04 & 28.02.05 not met) That all information obtained in the pre assessment regarding care needs are reflected in the care plans. That a survey is undertaken to ascertain which service users would like to participate in activities which enable them to influence key decisions in the home. That arrangements are made for providing individual bank or saving accounts for service users. (Outstanding from previous three inspections, see content of report.) That suitable in-house catering facilities be provided for the service users to prepare their own meals. (Timescale 30.06.05 will not be met. See content of report) That medication is signed for at the time of administration. That medication is only used for whom it has been prescribed. That the bathrooms and toilets Timescale for action 31.07.05 2. YA6 15 31.07.05 3. YA8 12.2 & 12.3 15.08.05 4. YA7 20 30.08.05 5. YA17 16.2(h) 30.06.07 6. 7. 8. YA20 YA20 YA27 13.2 13.2 23.2(j) 09.06.05 09.06.05 30.06.07 Page 23 Searchlight Workshops - Powell House H59-H10 S59127 Powell House V218836 090605 stage 4.doc Version 1.30 9. 10. YA33 YA39 18.1 24 11. YA40 Appendix 2 are refurbished with particular attention being paid to ensuring that wheelchair users can easily access them.(Timescale 31.12.04 not met) That there are five staff on duty 10.06.05 during waking hours and two waking staff members at night. That an effective quality 31.08.05 assurance and quality monitoring system is developed and implemented. That policies and procedures are 31.08.05 reviewed on an annual basis and comply with Appendix 2 of the NMS. 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 YA2 YA20 YA30 YA36 YA42 Good Practice Recommendations That an additional pre assessment is undertaken if a resident has spent a period of time in hospital. That hand written MAR charts are double checked by two staff who have completed medication training. That lids are provided for bins. That staff are provided with formal supervision at least six times per year. That the call bell is reattached to the wall. Searchlight Workshops - Powell House H59-H10 S59127 Powell House V218836 090605 stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection Ivy House, 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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 Searchlight Workshops - Powell House H59-H10 S59127 Powell House V218836 090605 stage 4.doc Version 1.30 Page 25 - 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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