Inspection on 16/08/05 for Sevenoaks

This inspection was carried out on 16th August 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

Sevenoaks 11/02/09

Sevenoaks 22/02/07

Sevenoaks 22/03/06

Sevenoaks 15/02/05

Sevenoaks 01/12/04

Sevenoaks 16/02/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Sevenoaks Lords Hill Coleford Gloucestershire GL16 8BG Lead Inspector Lynne Bennett Unannounced 16 August 2005, 10:30 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. Sevenoaks D51_D03_16575_Sevenoaks_v243705_160805_UI_stage4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Sevenoaks Address Lords Hill Coleford Gloucestershire GL16 8BG 01594 832679 01594 861100 Sevenoaks@orchard.trust.gov.uk The Orchard Trust 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) Mrs Elizabeth Jones Care Home 10 Category(ies) of LD Learning Disability (10) registration, with number SI Sensory Impairment (5) of places LD Learning Disability 16 years - 17 years Sevenoaks D51_D03_16575_Sevenoaks_v243705_160805_UI_stage4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1) Sevenoaks can accommodate one named service user, aged 17 years. This condition will lapse when service user reaches the age of 18 years. Date of last inspection 15th February 2005 Brief Description of the Service: Sevenoaks is a modern detached split-level bungalow situated within half a mile of Coleford Town Centre in the Forest of Dean. The home accommodates up to ten people with learning disabilities, five of whom may have a sensory impairment. The accommodation comprises of 10 single bedrooms, six of which have en-suite facilities.The house is separated into two wings, known as Phase 1 and Phase 2. Each has its own separate dining and lounge areas, kitchen, offices and communal bathrooms. The original home retains sleeping-in facilities for staff and a small laundry. The newer home has a larger laundry. At the rear of the property there is a parking area and landscaped garden. Residents have access to three vehicles. The home is part of the Orchard Trust group. Sevenoaks D51_D03_16575_Sevenoaks_v243705_160805_UI_stage4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on a day in August 2005 and lasted just over six hours. Two inspectors visited the home and spent time with some of the people living there. The care of four people was observed. One person talked to the inspectors. Other people have limited verbal expression. Their care was discussed with three members of staff and a visiting professional. A range of records were examined including service user plans, staff records, communication books, medication and health and safety records. A tour of the premises was conducted with the registered manager. One of the people living at the home showed the inspectors around Phase 1 of the home. The registered manager was present throughout the inspection. She has recently returned to work after a leave of absence. What the service does well: What has improved since the last inspection? Improvements to the environment include a new dining room floor and a blind in an en suite. Medication systems have improved. Additional checks are in place to reduce the risk of errors. Sevenoaks D51_D03_16575_Sevenoaks_v243705_160805_UI_stage4.doc Version 1.40 Page 6 Staff receive training specific to their roles and responsibilities and the needs of the people they support. 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. Sevenoaks D51_D03_16575_Sevenoaks_v243705_160805_UI_stage4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Sevenoaks D51_D03_16575_Sevenoaks_v243705_160805_UI_stage4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,3 and 4. The Statement of Purpose and Service User Guide are being reviewed to ensure that people living at the home have access to the latest information A robust admissions process is in place ensuring that people wishing to move into the home can be confident that it can meet their needs. EVIDENCE: The Statement of Purpose and Service User Guide have been reviewed although copies could not be found at the time of the inspection. These will be forwarded to the Commission. The original documents are available in the home and must be replaced with the amended versions. Since the last inspection a new person has been admitted to the home. Comprehensive admission information was received from the placing authority and school prior to moving into the home. Several visits were also conducted. There was evidence of good multi disciplinary liaison with the home, team formerly responsible for their care and the local Community Learning Disability Team. The person was under 18 at the time of admittance and a variation to registration was put in place. This will be removed as they reach 18 next month. Staff attended training in Child Protection and appropriate measures and risk assessments were put in place to ensure their protection until they reach the age of 18. Discussions with staff confirmed that they have a good understanding of the person’s complex needs. Sevenoaks D51_D03_16575_Sevenoaks_v243705_160805_UI_stage4.doc Version 1.40 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) 6,7,9 and 10. Improvements in the care planning system will provide staff with the information they require to meet the needs of people living at the home. A variety of methods are used to enable people living at the home to communicate their needs. Changes to risk assessments need to be made to ensure that they protect people living at the home from hazards or risks in their daily lives. The security of personal records needs to be improved to ensure confidentiality of information. EVIDENCE: The care of three people was case tracked. This involved examining their personal files, medication records, looking at their rooms and observing or talking to them during the day. Staff were also spoken to about their care. Since the last inspection care plans and risk assessments have been changed providing a large amount of information. One file contained over thirty care plans relating to personal, social and healthcare needs. Although staff appeared to have a good understanding of the person’s needs they and the Sevenoaks D51_D03_16575_Sevenoaks_v243705_160805_UI_stage4.doc Version 1.40 Page 10 registered manager felt that these could be streamlined to provide clearer information. The files and care plans are being changed to ensure that they provide staff with the information they need to meet people’s needs. There was some inconsistency in the review of care plans. One plan was due for an annual review whereas others are being reviewed each month. Annual reviews with the placing authority are taking place and there was evidence of good multi disciplinary liaison and co-operation with the local Community Learning Disability Team. Plans are in place for the person presently under 18 to transfer to adult services. Consent is obtained from representatives of people living in the home for the use of such things as a listening device or bedsides. These were not in place for the person who recently moved into the home. A probationary review is due and these must be obtained then. Staff have a good understanding of the communication needs of people living at the home, using sign language, objects of reference, photograph and symbol to enable people to communicate their needs. Risk assessments are in place and being reviewed regularly. Some risk assessments indicate that ‘staff must be aware’ but do not adequately describe the hazard or how they should minimise the risks. These must be reviewed. The registered manager said that she is planning to amend these risk assessments and will put this in place. At the time of the inspection some of the files containing personal information about people living at the home were being kept on a dresser in the dining room. These must be stored securely. Sevenoaks D51_D03_16575_Sevenoaks_v243705_160805_UI_stage4.doc Version 1.40 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) 12,13,14 and 17. Educational and leisure activities enable people living at the home to access their local community. The needs of people with a sensory disability are well catered for using a range of creative activities and equipment. Evidence needs to be provided that people living at the home have a nutritional and healthy diet. EVIDENCE: People living at the home have access to a range of educational, social and leisure activities. One person said they enjoyed attending a day centre several times a week. Others attend The Barn, owned by the Orchard Trust and run in conjunction with Gloscat. During term time people also use the local college. On the day of the inspection a group went into Gloucester to complete the weekly shopping run. Other regular activities include hydrotherapy, rebound and music therapy. A range of home entertainment equipment as well as interactive and sensory equipment is provided. One person was observed Sevenoaks D51_D03_16575_Sevenoaks_v243705_160805_UI_stage4.doc Version 1.40 Page 12 playing the electronic organ and another using interactive toys. Staff were observed spending time with people, listening to music, having lunch and interacting in a positive way. One person helped to bake a cake and obviously enjoyed this. Later on others were planning to do some artwork. Throughout the inspection people living in the home were happy and relaxed, choosing where to spend their time and with whom. Staff said that the home is a ‘lovely place to be’ and is ‘lively’. The atmosphere on the day of the inspection confirmed this. Menus are planned on a rolling programme although staff indicated that this might occasionally be changed. Alternatives are provided to the main meal and specialist diets catered for. A range of fresh and frozen foods are provided. Meals are recorded in handover records but these are not consistent. Each person living at the home must have a record of meals eaten so that their diet can be monitored. Dieticians are involved in the care of some people living at the home. It is important that the diet and fluid intake of one person is closely monitored and it was evident that this is being done. Staff spoken to have a good understanding of this person’s dietary needs. The total amount of fluids provided each day is not always being completed on the record sheets. This must be done so that staff can assess whether or not they have been given the appropriate amount of fluid in any one-day. Sevenoaks D51_D03_16575_Sevenoaks_v243705_160805_UI_stage4.doc Version 1.40 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 and 20. Comprehensive records provide staff with information about the way in which people living at the home would like to be supported. The healthcare needs of people are well met with evidence of multi disciplinary support on a regular basis. Systems for the administration and control of medication are getting better although there is still room for improvement to ensure that people living at the home are not put at risk. EVIDENCE: Records indicate the way in which people living at the home wish to be supported. Additional information is provided in some of their rooms. This is written in the first person. Staff spoken to have a good understanding of the way in which people should be supported. Health Action Plans are being introduced for people living at the home. They are registered with a local Doctor and records are kept of any visits to their GP and to other healthcare professionals. Some people living at the home have complex needs and support is provided from physiotherapists and speech therapists. Staff receive training to undertake any daily physiotherapy exercises that need to be carried out. Sevenoaks D51_D03_16575_Sevenoaks_v243705_160805_UI_stage4.doc Version 1.40 Page 14 Those spoken to have a good understanding of the importance of enabling people using wheelchairs to spend time in other forms of seating or on beds. It was suggested that a course in pressure sore prevention might be of use to staff. Systems for the administration of medication were examined in Phase 1. These are satisfactory. Systems for checking the administration of medication reduce the risk of errors. Any medication kept in the home for staff must be clearly labelled that this is for staff use only. The homely remedies list for Phase 2 has not yet been put in place. This must be completed. Sevenoaks D51_D03_16575_Sevenoaks_v243705_160805_UI_stage4.doc Version 1.40 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 The home has a satisfactory complaints system in place with evidence that complainants’ views are listened to and acted upon. EVIDENCE: The home has a complaints policy and procedure. Previously full records have been kept of complaints. One complaint was received recently and this is being investigated by the organisation. Sevenoaks D51_D03_16575_Sevenoaks_v243705_160805_UI_stage4.doc Version 1.40 Page 16 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) 24,25,26,27,28,29 and 30. The environment is homely and comfortably furnished. There is an ongoing maintenance and refurbishment programme in place making sure that the home continues to meet the needs of the people living there. A stimulating environment has been created for people with sensory disabilities. A review of security arrangements will ensure the safety of people living at the home. EVIDENCE: Severnoaks provides comfortable, pleasantly decorated accommodation. An interlinking corridor divides Phase 1 and Phase 2. A sensory area between the two buildings provides additional communal space for people living in Phase 2. Phase 1 The communal living areas have significantly improved. New flooring has been fitted in the dining room. Personal rooms reflect the interests and lifestyles of people living in the home. A patio area outside the kitchen provides additional tables and chairs. Phase 2 Sevenoaks D51_D03_16575_Sevenoaks_v243705_160805_UI_stage4.doc Version 1.40 Page 17 Walls around this part of the home are showing signs of wear and tear. Redecoration is planned. There are also plans to redecorate the lounge and provide additional tactile objects in this room. Good use is made throughout this phase of stimulating tactile and sensory objects and creative lighting. A blind has been fitted to the en suite identified in the last report. Paper towels and soap dispensers are available in the laundry. The garden has a patio and lawn. A range of equipment is available for people living in this phase, including a swing and slide. Bathrooms and shower rooms are provided in both phases. These are maintained in a good condition. Specialist equipment and adaptations are provided. The home has regular contact with a Physiotherapist and Occupational Therapist to ensure these continue to meet the needs of people living at the home. On the day of the inspection the home was clean and tidy. Personal protective equipment is provided and information about infection control is displayed in the laundries. Several fire exits have been fitted with additional bolts and chains after a recent theft. The registered manager must confer with Gloucestershire Fire Services about whether these are acceptable. Sevenoaks D51_D03_16575_Sevenoaks_v243705_160805_UI_stage4.doc Version 1.40 Page 18 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) 34 and 35 The standard of vetting and recruitment practices has improved but service users are still potentially at risk as a result of inconsistencies in the validation of staff. The provision of training for staff provides a staff team who have the necessary qualifications to support people living at the home. EVIDENCE: There have been considerable changes to the staff team over the past six months. The home has five full time vacancies to which they are presently recruiting. They are using agency staff to supplement the home’s bank staff. Files for five new members of staff were examined. These contained evidence that two written references are being obtained prior to employment and evidence of identification. Written confirmation of why people left their former employment in care is being obtained. The registered manager must ensure that she obtains from the Human Resources department: • • Evidence that a Povafirst check has been obtained where staff start work without a CRB A full employment history for new staff, checking any gaps in employment history D51_D03_16575_Sevenoaks_v243705_160805_UI_stage4.doc Version 1.40 Page 19 Sevenoaks The Orchard Trust amended the application form to comply with changes in the Regulations in July 2004 however it appears that occasionally the old application form is being sent out requesting a 10 year employment history. The new forms requesting a full employment history must be used. The registered manager must also ensure that: • • Where verbal references are taken and recorded on the reference request form this is indicated on the form. (Written references were later received before the start of employment.) A risk assessment is in place for people starting work without a CRB outlining what duties they may undertake. Criminal Record Bureau checks for new staff were examined. These can now be destroyed. In some cases a photocopy of the check was on file. This is contrary to Data Protection. Photocopies of these checks should not be taken. A comprehensive training matrix is maintained by the registered manager confirming that staff have access to core training, Learning Disability Award Framework and the NVQ Care Awards. Training specific to the needs of people living at the home is provided including training in Child Protection, sensory awareness and managing challenging behaviour. Training in Adult Protection is being arranged. Training was provided internally in learning disability awareness and abuse. This meets with requirements issued at previous inspections. Sevenoaks D51_D03_16575_Sevenoaks_v243705_160805_UI_stage4.doc Version 1.40 Page 20 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) 37,38,39 and 42. The registered manager has a clear developmental plan for the home that promotes the rights and best interests of people living there. The home is not reviewing aspects of its performance to ascertain whether the service continues to meet the needs of people living there. A safe environment for all people in the home will be promoted by providing additional risk assessments. EVIDENCE: The registered manager recently returned from a leave of absence. Her hours have been reduced to 30 per week. A full time deputy manager supports her. She has identified processes and systems that need reviewing or amending and is working with the teams to put this in place. Sevenoaks D51_D03_16575_Sevenoaks_v243705_160805_UI_stage4.doc Version 1.40 Page 21 At the last inspection it was noted that the insurance certificate displayed in Phase 1 is out of date, although the current certificate is displayed in the office in Phase 2. This certificate should be replaced. Staff spoken to say that they are happy that the registered manager has returned from leave. They say that morale has been low due to staff changes and shortages over previous months but that they felt it is getting better. They say that the registered manager is open and accessible, encouraging good communication between the teams. The home has a quality assurance system in place although audits have not been carried out whilst the registered manager was on leave. Monthlyunannounced visits from The Orchard Trust must be reinstated. The registered manager is re-scheduling the in house audits. An internal audit by the Orchard Trust was completed in June this year. Health and safety systems were examined. Records confirmed that regular checks are in place and being carried out at satisfactory intervals. A recent complaint highlighted that risk assessments must be put in place when the maintenance team or external contractors are working in the home and all staff must be aware of this assessment. Sevenoaks D51_D03_16575_Sevenoaks_v243705_160805_UI_stage4.doc Version 1.40 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 3 3 3 x Standard No 22 23 ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 2 x 2 2 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 x 3 3 3 x x 2 Standard No 31 32 33 34 35 36 Score x x x 2 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Sevenoaks Score x x x x Standard No 37 38 39 40 41 42 43 Score 3 3 2 x x 2 x D51_D03_16575_Sevenoaks_v243705_160805_UI_stage4.doc Version 1.40 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 1 Regulation 6 Requirement The service user guide must be reviewed to include reference to charges for their holidays. This document must replace the copy available in the home. (Timescale of 31/3/05 not met) A record of any restrictions or limitations on the service users freedom of choice or movement (such as bedsides or a listening device) must be recorded. Risk assessments must provide clear guidelines on how hazards and risks are to be minimised and managed. Information about service users must be stored securely. A record of food provided for each service user must be completed. A list of homely remedies must be kept authorised by the homes pharmacist.(Timescale of 31 March 2005 not met) Medication for use of staff must be clearly labelled. The registered person must ensure that all persons in the care home can be evacuated safely. Timescale for action 30 September 2005 2. 7 17(1)(a) Sch 3.3(q) 13(4) 30 September 2005 31 October 2005 10 September 2005 10 September 2005 30 September 2005 3. 9 4. 5. 6. 10 17 20 17(1)(b) 17(2) Sch 4.13 13(2) 7. 24 23(4)(c) 30 September 2005 Page 24 Sevenoaks D51_D03_16575_Sevenoaks_v243705_160805_UI_stage4.doc Version 1.40 8. 34 19(1)(b), 11 Sch 2.6 9. 39 26 10. 42 13(4) A full employment history for staff must be obtained. Evidence of a Povafirst check must be available for staff. Staff commencing work before a CRB is received must be supervised by an experienced staff member and not undertake duties unsupervised. Monthly unannounced inspections must be carried out at the home and copies of the report sent to the Commission. A risk assessment must be put in place when the maintenance team or external contractors are on site. 30 September 2005 30 September 2005 20 September 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. 3. 4. 5. 6. 7. Refer to Standard 6 6 17 19 34 34 38 Good Practice Recommendations Care plans should be reviewed at least every six months. The content of care plans should provide staff with a clear understanding of the needs of service users. Fluid charts should record the total amount of fluids provided in any one day. Training in pressure sore prevention should be arranged. Where a verbal reference is written directly onto a reference request form this should be indicated on the form. CRB checks should not be photocopied. A current certificate of insurance should be displayed in Phase 1. Sevenoaks D51_D03_16575_Sevenoaks_v243705_160805_UI_stage4.doc Version 1.40 Page 25 Commission for Social Care Inspection Unit 1210 Lansdowne Court Gloucester Business Park Brockwoth Gloucester GL 4AB 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 Sevenoaks D51_D03_16575_Sevenoaks_v243705_160805_UI_stage4.doc Version 1.40 Page 26 - 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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