Inspection on 19/09/06 for Somewhere House

This inspection was carried out on 19th September 2006.

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 no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Somewhere House 15/08/07

Similar services:

Clouds House

Closereach

Westcliffe House

Hilldales

Longreach

Chandos House

Cherry Orchards Camphill Community Ltd

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

CARE HOME ADULTS 18-65 Somewhere House 68 Berrow Road Burnham on Sea Somerset TA8 2EZ Lead Inspector Sue Burn Unannounced Inspection 19th September 2006 10:00 Somewhere House DS0000067022.V307921.R03.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 Somewhere House DS0000067022.V307921.R03.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. Somewhere House DS0000067022.V307921.R03.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Somewhere House Address 68 Berrow Road Burnham on Sea Somerset TA8 2EZ 01278 795236 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) Somewhere House Limited Angie Clarke Care Home 12 Category(ies) of Past or present alcohol dependence (12), Past or registration, with number present drug dependence (12) of places Somewhere House DS0000067022.V307921.R03.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: The home may accommodate a named service user over the age of 65 years, as detailed in the application received on 4.8.06. Date of last inspection Not applicable – new service. Brief Description of the Service: Somewhere House is a large Victorian style property in a residential area of Burnham on Sea. It is close to a range of local amenities, including relevant support groups. The house has been adapted to provide single, double and triple bedrooms in keeping with the supportive nature of this type of service. There is also a group room, provision for individual work, domestic kitchen, laundry and indoor and outdoor communal areas. Somewhere House provides support for adults recovering from drug and alcohol misuse, usually for up to a 6-month stay. Addiction workers, support workers and volunteers support Service users. Somewhere House DS0000067022.V307921.R03.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first inspection of the service following its registration with CSCI. The first inspection of services is conducted within 6 months of the registration date. The inspection was carried out using the Inspection for Better Lives inspection process focussing on service user outcomes and the quality of the provision. One inspector carried out the inspection over a period of 6.5 hours. The management of Somewhere House had agreed to participate in the piloting of the new Annual Quality Assurance Assessment Tool (AQAA) and data set. Some of this information was used to inform the following report. The Registered Manager was on leave and the administrator, addiction workers and support workers staffed the home during the inspection. The inspector spent time with staff and service users, toured the premises and reviewed a range of records. Telephone feedback was sought from referrers to Somewhere House after the inspection visit. This feedback indicated that they found the service to be very good and that it is flexible in meeting the needs of service users. The fees for the home are £495 per week. Feedback was given to the administrator and an addiction worker at the end of the inspection. The inspector would like to thank service users and staff for their welcome and assistance during the visit. The inspection has raised some requirements and recommendations, however this was a positive inspection of a new service. What the service does well: Full and detailed information is provided to service users before and at the beginning of their stay to ensure that they are making an informed decision about moving in. Restrictions, house rules and routines are clearly displayed and understood by all service users and staff and are based on principles of safety and risk taking, appropriate to the service offered. Weekly meetings offer opportunities for service users to be involved in the daily running of the home. Service users benefit from a structured, ordered and supportive lifestyle. Somewhere House DS0000067022.V307921.R03.S.doc Version 5.2 Page 6 The home is clean, homely and suitably furnished for the service users. Service users feel well supported by all staff. The feedback was very positive about all the staff and the manager. They are actively involved in deciding their approach to recovery and writing and reviewing their care plan. The staff team is suitably qualified and experienced and understand the ethos and philosophy of the service. The home is committed to supporting staff development. Staff are well supported by an experienced and open management style. There is a strong ethos of training and supervision for the team. What has improved since the last inspection? What they could do better: Medication management could be improved through the introduction of risk assessments for those who self medicate and to ensure that all recording of medication complies with the relevant published guidance. The recruitment procedures do not follow robust and thorough practice to ensure that all suitable checks and supervision are made before and after employment. A letter has been sent to the provider requiring them to take immediate action to rectify this. There needs to be more staff trained in Emergency First Aid to cover all shifts. The home should look to developing formal, measurable quality assurance tools that will enable the provider to measure outcomes for service users in a range of areas. Somewhere House DS0000067022.V307921.R03.S.doc Version 5.2 Page 7 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. Somewhere House DS0000067022.V307921.R03.S.doc Version 5.2 Page 8 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 Somewhere House DS0000067022.V307921.R03.S.doc Version 5.2 Page 9 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 the following standard(s): 1, 2, 3, 4, 5. The quality of this outcome group is good. Service users have a range of information provided that enables them to make an informed decision about the service. Service users benefit from having both financial and therapeutic contracts with the home. EVIDENCE: The home has a Statement of Purpose which was submitted as part of the registration process. There is a Client Handbook on display in the home, which is accessible to all. This sets out the lifestyle offered at the home, boundaries and restrictions and the housekeeping tasks that all are involved in. Service users and their referrers are invited to visit the home prior to any decision being made and the service user spends some time within the home. A pre-admission assessment is carried out by staff at this time. 5 preadmission assessments were seen and contained adequate information completed by both staff and service user. There was evidence on all files seen of relevant information from the referrer. Referrer feedback confirmed that the home carries out through assessments and includes the service user in this process. Somewhere House DS0000067022.V307921.R03.S.doc Version 5.2 Page 10 All files seen contained signed Client Contracts detailing the expectations and boundaries of Somewhere House. One financial agreement was seen which detailed who was responsible for the payment of fees and other monies. Somewhere House DS0000067022.V307921.R03.S.doc Version 5.2 Page 11 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 the following standard(s): 6,7,8,9,10 The quality in this outcome group is good. Service users benefit from real inclusion in the development of their personcentred care plans. Service users can be confident that personal information is handled in their best interests. EVIDENCE: 5 care records were inspected and all had care plans generated from the assessment and the expressed needs and goals of the service users. Service users are encouraged to write their own care plans either based on the 12-step model of recovery or an approach that they feel best suits their needs. The plan is reviewed with the service user with their individual counsellor/addiction worker. Each care record contained a signed confidentiality agreement, that also confirmed that the home would maintain their records in line with the Data Protection Act 1998. The inspector was also asked to read and agree to the confidentiality policy on arrival, as are all visitors. Somewhere House DS0000067022.V307921.R03.S.doc Version 5.2 Page 12 Service users spoken to all knew what they were there to achieve and how they were being supported to do this. There is a weekly house meeting where all decide how the ‘household’ will be run for the next week and have the opportunity to feedback to staff about related issues. Somewhere House DS0000067022.V307921.R03.S.doc Version 5.2 Page 13 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 the following standard(s): 11, 12, 13, 14, 15, 16, 17 The quality in this outcome group was good. The routines and activities of the home enable service users to develop socially and emotionally with a structured and supportive environment. Service users are encouraged to plan for leaving the home and return to the community as they wish. All are supported to be part of the local community and take part in activities within the home. Service users benefit from a varied menu and access to a domestic kitchen. EVIDENCE: The home has clear routines appropriate to the service offered at the home. All are encouraged to take part in a morning exercise of their choosing. Some of the service users spoken to felt this was very useful and planned to continue after they leave. There are 2 therapeutic group meetings daily and a relaxation session. There is private time after lunch and tea. Somewhere House DS0000067022.V307921.R03.S.doc Version 5.2 Page 14 Service users spoken to confirmed that they spend time with their identified ‘counsellor’ to work on the goals in their care plans and prepare for leaving Somewhere House. All felt that although the time at the home is ‘hard work’ it was helping them to achieve what they needed. Evidence was seen of support to attend local groups and maintain links with Jobseekers. Staff confirmed that the manager was still making links with the local community to expand opportunities. All were aware of the systems of peer support in place and the arrangements for leaving the home. All spoken to could understand the reasons for this and felt the peer support worked well. Guidance on relationships whilst at the home is included in the therapeutic contract. Independence and domestic skills are maintained through responsibility for own bedrooms, and shared household tasks agreed each week. Staff support service users with the cooking depending on ability and any particular commitments. The menu is agreed each week in the house meeting from a choice of 30 meals. Some service users did not always find the choice of meals to their taste, but stated they could make themselves something else. Fresh fruit is readily available and the kitchen is always accessible. 2 service users do the shopping each week with the administrator at the local shops. The inspector joined service users and staff for lunch. This was a very pleasant meal in relaxed and happy surroundings in the dining room. Somewhere House DS0000067022.V307921.R03.S.doc Version 5.2 Page 15 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 the following standard(s): 18, 19, 20. The quality in this outcome group is adequate. Service users do not require assistance with personal care and do not need staff support. Service users benefit from the consistent support of a local GP and health monitoring as needed. Medication is mostly well managed but needs more robust risk assessments and thorough recording in some areas to minimise the risk of errors. EVIDENCE: The manager has made arrangements for one local GP to provide medical cover for each service user; this includes the provision of a detailed medical history. This ensures consistent support in a specialist area. Evidence was seen of drug monitoring and staff were familiar with the medical support that some service users needed. Medication receipt, storage and disposal is well managed and supports service users to manage their own medication where appropriate. It is required that where service users do manage their own medication this is clearly recorded Somewhere House DS0000067022.V307921.R03.S.doc Version 5.2 Page 16 and a risk assessment is put in place, this should include storage arrangements. It is also recommended that the following is put in place to minimise the risk of errors; • All hand transcribed medication should have 2 signatures • All receipts and disposal should be signed by 2 staff • All medication records should be clearly dated • Where medication is prescribed ‘as required’ there should be a reason for this administration recorded • Arrangements for the handling of medicine cupboard keys should be reviewed as discussed The home was advised to obtain a copy of the Royal Pharmaceutical Society of Great Britain guidance on the administration of medicines in care homes. All staff received training from the manager in the management of medicines prior to the home opening. Somewhere House DS0000067022.V307921.R03.S.doc Version 5.2 Page 17 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 the following standard(s): 22,23 The quality of this outcome group is adequate. There are clear arrangements for the management of complaints. The arrangements for the management of personal monies protect service users from any misuse of their money. The home has policies to protect service users from abuse and staff are aware of action to take. Recruitment procedures do not fully protect service users (see standard 34). EVIDENCE: The home has a complaints policy and a complaints book is also made available within the home. Service users can raise concerns at the weekly meeting. The complaint procedure is also included in the service user contract. It is recommended that this also includes details of the contact for the relevant funding social service complaints teams as well as CSCI. There have not been any complaints since the home opened. Staff spoken to were aware of what to do should they be concerned about anything. All service users told the inspector that they felt safe at Somewhere House. Arrangements for the management of personal monies held by the home were examined and found to be satisfactory well maintained. Recruitment procedures were not suitably robust to ensure that employees were ‘fit’ to work in care home prior to employment (see standard 34). Somewhere House DS0000067022.V307921.R03.S.doc Version 5.2 Page 18 Somewhere House DS0000067022.V307921.R03.S.doc Version 5.2 Page 19 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 the following standard(s): 24,25,27,28,30 The quality in this outcome group is good. The home is comfortable, clean and homely. Service users benefit from suitable bedrooms and a range of communal and therapy areas. EVIDENCE: A tour of the premises was made. The home is suitable for people who are physically able as all bedrooms are upstairs, there is not a lift. The use of locks is determined by the type of service provided and it is not appropriate to lock doors, although rooms are locked if a service user is away from the home. Most rooms are shared. This choice is made before a service user moves in as shared rooms are consistent with the supportive philosophy of this type of service. Some rooms have ensuite shower and toilet, whilst 3 rooms share a bathroom and toilet close to the rooms. All rooms seen were suitably furnished and had a homely and domestic feel. There are 3 outside areas, one area is designated for those who wish to smoke. Somewhere House DS0000067022.V307921.R03.S.doc Version 5.2 Page 20 A laundry is provided for service users and the kitchen is equipped with sufficient equipment. Service users are given advice by staff regarding food hygiene. All areas were suitably clean, although a number of carpets were marked. 2 were due to be replaced at the weekend and the others on a rolling programme. Cotton hand towels were in use in a communal toilet and staff area. The administrator was advised to replace theses with paper hand towels to minimise any risks of cross infection. This was done during the inspection visit. Service users select and buy the cleaning materials for their own room. The administrator confirmed that dangerous chemicals such as bleach are not permitted. Somewhere House DS0000067022.V307921.R03.S.doc Version 5.2 Page 21 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35, 36 The quality in this outcome group is adequate. Staff and service users are clear about staff roles within the home. Service users benefit from suitably experienced and trained staff. There are sufficient staff on duty to provide the level of support needed by the current service users. Staff training is provided and the organisation is committed to staff development. Some areas need further development to ensure that all requirements of the service can be met. The service does not ensure that a robust recruitment procedure is followed to ensure the protection of individuals. Staff are well supported through frequent supervision and team meetings. EVIDENCE: Staff and service users spoken to were all clear about the roles of staff within the home. There is clear allocation of responsibilities, including named addiction workers allocated to service users. Volunteers are also engaged at Somewhere House DS0000067022.V307921.R03.S.doc Version 5.2 Page 22 the home who have experience in the type of work and are pursuing counselling training. There are rotas kept for support workers but although it is known when people work there is not a formal rota kept for other staff, who usually work Monday to Friday. The administrator confirmed that there is a support worker on duty 24 hours a day, sleeping in at night. During the week there is usually the manager, administrator and 2 addiction workers on duty. One of the directors is responsible for maintenance. Theses numbers and skill mix of staff are sufficient to meet the needs of the service users. It is anticipated that a formal rota is kept of all staff to comply with schedule 4 and will be followed up at the next inspection. All staff records were seen. A comprehensive application form is used and all staff had detailed contracts of employment. Health and rehabilitation of offenders declarations are signed. CRB checks are made through an umbrella body. A significant number of concerns were identified with the recruitment procedure followed including; 5 staff had gaps in their employment history. It could not be evidenced that these gaps had been satisfactorily explored with the employee. (The Registered Manager has since confirmed that this discussion is recorded on interview notes held on the file). 1 staff record had references on file that were for a college course, not about their suitability for employment at Somewhere House. 1 member of staff started employment on 15.6.06. The CRB check was dated 5.7.06. 1 staff record did not have a CRB on file. This had been applied for but had yet to be received as there had been problems processing the application by the CRB. The employee started work with service users on 22.5.06; a POVA First check was not received until 20.7.06. Only one reference had been received prior to one employee starting work. The second reference was received 6 weeks after employment. 1 employee did not have any references on file. A letter has been sent to the provider requiring them to address the above points and one other immediately to ensure the protection of service users. This may be followed up by a further visit to the service. Staff records confirmed that staff have received induction and food hygiene training. All staff employed have a qualification relevant to the work they do. One support worker has NVQ2 in Care. The administrator has suitable qualifications, including a course in Equality and Diversity. All other staff have counselling qualifications and experience in the addiction field, and some are being supported to continue this training. One member of staff is also undertaking a management degree. Somewhere House DS0000067022.V307921.R03.S.doc Version 5.2 Page 23 Although the induction training listed a wide range of topics, the programme is not competency based. This should be developed for future employees to meet the Skills for Care framework. Some staff have undertaken Emergency First Aid training, however the certificates seen on the staff files were out of date, this training should be updated every 3 years. Sufficient staff must be trained in Emergency First Aid to ensure that there is always one trained person on duty. It was advised during the inspection that training plans be developed, along with annual appraisal to continue to support the staff development. Somewhere House DS0000067022.V307921.R03.S.doc Version 5.2 Page 24 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 38, 39, 42 The quality in this outcome group is good. The home has a declared ethos that all are aware of and is stated in the service user information. Systems are in place to ensure the health and safety of service users. EVIDENCE: The home’s programme is based on that of abstinence and honesty. This approach was echoed in discussions with both staff and service users and in observations of interactions between staff and service users. This approach is also clearly stated in service user information. All staff spoken to were aware of what was happening in the home and information was readily accessible. Equal opportunities are promoted through the recruitment process and the weekly service user meetings. Staff felt well supported by the manager and received regular support. Somewhere House DS0000067022.V307921.R03.S.doc Version 5.2 Page 25 The home has started to develop quality audit tools and would benefit from developing these further to inform the AQAA which will be required annually. They provide some information to the National Drug Treatment Agency; it may be possible to use some of this information. Service user surveys are conducted when people leave and these could be analysed to feed into service development. Feedback from referrers would be useful as would audits of such areas as record keeping. Fire records were examined and confirmed that all necessary maintenance and checks have been carried out. Staff have been trained in fire safety on induction and regular fire drills are held. The home did not have Fire Risk Assessment, they were advised to seek the advice of the local Fire Safety Officer and carry out a risk assessment. Gas and electricity checks have all been completed during and since opening the home. Somewhere House DS0000067022.V307921.R03.S.doc Version 5.2 Page 26 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 1 35 2 36 4 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 4 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score N/a 3 2 x X X 3 X X 3 x Somewhere House DS0000067022.V307921.R03.S.doc Version 5.2 Page 27 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 YA20 Regulation 13(2) Requirement It is required that where service users do manage their own medication this is clearly recorded and a risk assessment is put in place, this should include storage arrangements. All staff must have thorough preemployment checks completed as detailed below; • Employees must not commence work until either a satisfactory enhanced CRB check or POVA 1st check have been received. • Where employees start on the receipt of a POVA 1st check only they must be supervised as defined in the regulations. • 2 satisfactory references must be obtained for all employees before they start work. • The risk assessments referred to in the Immediate Requirement letter must be carried out as a necessary. Immediate requirement issued. DS0000067022.V307921.R03.S.doc Timescale for action 07/10/06 1 YA34 19(1)(a)(b) (c)(4)(a)(i) Schedule 2 29/09/06 Somewhere House Version 5.2 Page 28 2 YA35 13(4) Sufficient staff must be trained in Emergency First Aid to ensure that there is always one trained person on duty. 31/03/07 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 YA22 YA23 Good Practice Recommendations It is recommended that the complaints procedure also includes details of the contact for the relevant funding social service complaints teams The following best practices should be put in place; • All hand transcribed medication should have 2 signatures on the administration chart • All receipts and disposal should be signed by 2 staff • All medication records should be clearly dated • Where medication is prescribed ‘as required’ there should be a reason documented for why/when this is required • Arrangements for the handling of medicine cupboard keys should be reviewed as discussed • All creams should be dated as opened to ensure that they are not in use beyond the expiry date The induction programme should be developed for future employees to meet the Skills for Care framework. The Registered Provider should develop formal, measurable quality assurance tools that will enable the provider to measure outcomes for service users in a range of areas. The Registered Provider should seek the advice of the local Fire Safety Officer and carry out a risk assessment. 3 4 YA34 YA39 5 YA42 Somewhere House DS0000067022.V307921.R03.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 Somewhere House DS0000067022.V307921.R03.S.doc Version 5.2 Page 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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