Inspection on 17/11/08 for St Brannocks

This inspection was carried out on 17th November 2008.

CSCI found this care home to be providing an Adequate service.

The inspector found no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

St Brannocks 12/12/06

St Brannocks 06/10/05

St Brannocks 14/06/05

St Brannocks 06/10/04

St Brannocks 04/05/04

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Insight - Eastchurch

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Extracts from inspection reports are licensed from CQC, this page was updated on 30/01/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: St Brannocks Dymchurch Road New Romney Kent TN28 8UF     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Kim Rogers     Date: 1 7 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 30 Information about the care home Name of care home: Address: St Brannocks Dymchurch Road New Romney Kent TN28 8UF 01797366663 Telephone number: Fax number: Email address: Provider web address: st.brannocks@craegmoor.co.uk Name of registered provider(s): Name of registered manager (if applicable) Mr Richard Carden Type of registration: Number of places registered: Parkcare Homes Ltd care home 7 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users to be accommodated is 7. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD). Date of last inspection Brief description of the care home St Brannocks is a home providing personal care and support for seven people with learning disabilities. The registered provider is Parkcare (no 2) homes. This is part of the Craegmoor group of companies. The registered manager is Richard Carden. The home is arranged over two floors and has seven single bedrooms and plenty of communal space. There is a lounge/dining area and a large conservatory. Outside there is a safe and enclosed garden. St Brannocks is situated on the main road at St Marys Bay, close to the small town of New Romney. It is within half an hour drive of the larger towns of Folkestone and Ashford. The fees for this home commence at about Care Homes for Adults (18-65 years) Page 4 of 30 Over 65 0 7 Brief description of the care home 1,584 per week. Additional charges may be made should the assessed needs of the client indicate the need for additional support. For more information about the fees and services please contact the provider. Care Homes for Adults (18-65 years) Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This was a key inspection of the service so we inspected the key minimum standards. The last key inspection was 12.12.06. Since the last inspection there is a new manager who is the registered manager. The manager assisted the process. We had a look around the home, talked to service users, staff and the manager and made observations. We sampled records relating to staff and service users. We looked at information we have received about the home including the Annual Quality Assurance Assessment. The manager completed this and it gives information about what they do well and how they plan to improve. This did not give very detailed information about how they plan to improve outcomes for service users. Care Homes for Adults (18-65 years) Page 6 of 30 Care Homes for Adults (18-65 years) Page 7 of 30 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking Care Homes for Adults (18-65 years) Page 8 of 30 following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 30 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Basic assessments of peoples needs are carried out before a person moves in but without a full picture staff may struggle to support people. There is some information about the home but it is not meaningful to everyone. Evidence: We found that an assessment tool is used by the company to assess a persons needs. This is done to ensure the home can meet the persons needs. We found that this does not include the persons aspirations so staff may not be aware of personal aspirations at an early stage. We sampled the service user plan of a person who recently moved in to the home. We found that an assessment of their basic needs was carried out. The assessment form does not allow for much detail to be recorded and is mostly tick box. The manager said the tool is used more for assessing hours of support needed and therefore what fee they are to charge. We found that service user needs are currently challenging the service as an incomplete picture was gained of their needs at the assessment stage. This means that the staff numbers and skills and compatibility issues may not be considered fully before the person moved in. Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: There is some information about the home, which is written. Some information has symbols with text. The manager agreed that this could be improved, as it is not meaningful to everyone. The Statement of Purpose is displayed across the hallway wall with other information like the certificate of public liability insurance. You see this as you enter the home and it does make it feel homely but like an obvious care home. The manager agreed and said he would talk to service users about this. We found that people have the opportunity to have trial stays and visits to help them decide about moving permanently to the home. Care Homes for Adults (18-65 years) Page 12 of 30 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Without detailed plans of support people will not achieve their goals, develop new skills and grow in independence. People cannot be sure that all of their needs will be recorded and supported. Communication should be better supported so people can make real choices and decisions and have more control. Evidence: Some service user plans were sampled and we spoke to staff, the manager and service users. Service user plans should detail the persons needs and goals as well as show what staff support is needed to support the person. We found not all needs and goals are recorded and there is a lack of support plans. This means that there are no plans for staff to follow and people may not have the support they need to keep them healthy and safe and achieve their goals. All service user plans look the same so none are individual to the person. All are written so may not be meaningful to everyone. Some people have signed each page and this is the only evidence of their involvement. Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: We found that some personal goals are recorded but there are no plans in place to say how staff should support goals, what they should do and by when. Without detailed plans of support people will not achieve their goals and learn new skills. For example one person would like to move, another person would like a job and try yoga but there are no plans to say how this will be supported. We found that there is an evaluation sheet with dates on it. It is unclear who evaluates the plan and whether service users are involved .We found that no changes had been made to plans and some had out of date information suggesting the review needs to be more effective. We found that some people are at potential risk of harm due to the lack of clear behavior support plans, the lack of review of strategies used to support behaviors and the way staff use restraint and restrictive physical intervention. There is more evidence about this under standard 23 of this report. We found some risks are recorded and assessed. The action staff should take to reduce risks is recorded. There is no record of when a risk last occurred so some risk assessments may no longer be relevant or may need updating or changing. We found that there is only very basic information about communication needs. For example one plan just said talking when it was apparent that the person has communication needs. Without detailed plans of support people may not have the support they need to make choices and decisions about their lives. We found that not all information is presented in a way that is meaningful to all service users. For example people said they only know who is on duty or what is happening that day if they ask staff. This means that they are not in control of finding out for themselves. Due to lack of communication support and support plans we found that choice and decision making is limited. For example people are making choices about wanting to move on or learn new skills and there are no plans of support so people are not achieving. The manager said he has recognised the need to improve service user plans, behavior support plans etc and plans to approach the local community team for advice and support. Training in person centred planning and Positive Behavior Support would help the manager and staff to give people better support. Care Homes for Adults (18-65 years) Page 14 of 30 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users have access to some activities although the range is limited. There are limited opportunities for personal and skills development. There is potential for people to be more involved in the running of the home. Evidence: We found that there are some activities on offer that people have the opportunity to take part in. Most of the activities are group activities provided by the company and held at a local community centre. Evening activities like discos are also offered although there are not always enough staff to take people. Each person has an activity planner covering seven days and evenings. One persons was blank for some of the days. If nothing is planned in advance there is no opportunity to opt in or out. Some people said they would like a job and this is recorded in their plans. There are no plans in place though to say how staff are going to support people to get jobs. Some people Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: would like to move on to more independent living although again there are no plans in place to say how staff will support them to learn the skills they will need like cooking and budgeting. We found that relationships could be better supported. Some people said they do not get on with other people living at the home and that other residents wind them up. We found a lack of support plans to support making and keeping friends and the manager said referrals for support have not been made recently. This means that there could be equality issues for people with more profound needs. Records are kept of contact with family and friends. We found that staff do most of the cooking and cleaning which means that service users do not get much opportunity to learn to cook etc. Service users said they cook once a week, have a take away once a week and usually make their own breakfast. Some said they go to the local shops to buy small personal items and are involved in the food shopping for the home. The menu is displayed so people can see what is for dinner although this is not meaningful to everybody. Service users said they could have an alternative if they do not like what is on the menu. People have snacks in their rooms and can make drinks throughout the day. For some access to the kitchen has been restricted. We discussed restrictions with the manager, any restriction must be made in service users best interests, be the least restrictive option and be regularly reviewed. People have support to access the community like local pubs, shops, and cafes. People said they use the local shops. Some people are taking part in gaining an award though Mencap. We found that people are charged for an annual holiday as part of their fee for living at the home. However not everyone has had a holiday. The manager said that anyone who has not had a holiday this year will be able to put this years money towards a holiday next year. Care Homes for Adults (18-65 years) Page 16 of 30 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People know their basic personal and health needs will be supported. Medication practice is safe but there is potential for more people to have some control over their medication. Evidence: We found that personal and health care needs are recorded in service user plans. We found no plans in place to develop or increase peoples skills and control with personal or health care. This means that skills may not be developed so people have to continue to rely on staff. Everyone has a GP and people said they see their GP when they need to. Some people have a health checklist assessment sheet but no plans of how health needs are to be supported and healthy lifestyles promoted. We found that medication storage is safe but the site of storage could be better. At present the medication is stored in a busy office where staff are at risk of being interrupted or disturbed. The manager said he plans to buy individual medication cupboards for each persons Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: bedroom. This will make medication administration more private and give people more control of their medication. There are good records of receipt and administration of medication. We found that staff have training before they administer medicines. Care Homes for Adults (18-65 years) Page 18 of 30 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service know who to complain to. Service users are at risk because of the lack of understanding of challenging behaviors and the use of restraint. Evidence: We found that there is a written complaints procedure displayed in the home. This is also produced with text and symbols. The manager agreed that this is not meaningful to everyone so people who use the service may not know about the complaints procedures. The manager said that there have been no complaints. We have received a complaint about the home since the last inspection. This involved a member of the public allegedly witnessing staff humiliating a service user in public. This was referred to adult protection at social services to investigate. For more information please contact the provider. There is a safeguarding vulnerable adults and whistle blowing policy and procedure. We found that staff are generally aware of these policies and procedures. Staff attend training in safeguarding vulnerable adults. Staff said that they would report any concerns to the manager. We found that staff react to incidents of challenging behaviour rather than being proactive and stopping incidents from occurring. We found a lack of clear up to date guidelines for staff to follow to support problem behaviors. We found that they are not Care Homes for Adults (18-65 years) Page 19 of 30 Evidence: following best practice guidance in the use of restrictive physical intervention. We found a lack of assessment and no functional assessment so staff do not know the function or reason for certain behaviors. We found that staff do not always use restraint as a last resort. Some incident reports stated things like escorted to her room, restrained for 15 minutes, staff then grabbed hold of service user. Some reports showed a lack of staff values for example some reports said x was pestering staff, x was very moody, staff needed to take control. This showed a general lack of empathy and understanding of peoples needs. We found that some staff have raised concerns about other staff not following guidelines and therefore making incidents worse. We found staff have raised concerns about a staffs very aggressive attitude. We found that a staff has acted in an unacceptable manner when out in the community with service users. We found that no action has been taken to address this member of staffs attitude and behavior. We found that incidents are not fully de briefed with staff and incident reports show no signature or action by the manager. This means that strategies are not reviewed and so continue whether successful and appropriate or not. We found a lack of monitoring of incidents by the manager or higher manager. This means that strategies are not reviewed and no tally of restraint use kept for monitoring purposes. We found a lack of involvement, agreement and consent by service users to being restrained, punished, restricted and taken for time out, which are the strategies in use. We found that staff work long shifts of up to 15 hours which means that they could be tired and stressed and could have a negative impact on service users. We found that staff are restraining some service users while wearing large bunches of keys on their belts. This could cause a serious avoidable injury. We found there is a lack of supervision of staff so they may not have the support, coaching and mentoring they need. We found that all of this means service users are at potential risk of harm. We made a safeguarding alert to adult protection at social services following this inspection. Care Homes for Adults (18-65 years) Page 20 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well maintained and a safe place to live. Evidence: The home is well maintained with adequate furniture and fittings. There are communal areas like lounge, dining area and conservatory and each bedroom is single with a wash hand basin. This means that people can have some private space if they need it. People said there are enough bathrooms and showers for them and that they are happy with their rooms. One of the bedroom smelled of damp with reports that silver fish had been seen in the room. The manager said he would address this. There is unrestricted access to the back garden so people can get fresh air when they want. Some people have a key to their bedroom and for others keys are restricted. The front door is opened by staff and no one can exit by the front without staff. The laundry is locked and at times there are restrictions on entering the kitchen. We found that these restrictions may not be the least restrictive option and should be reviewed. On entering the house from the front door we found lots of company information displayed on the walls. This does not make the home feel homely and ordinary but like a care home. The manager said he would discuss with service users about putting this information in a file so it looks more homely. Care Homes for Adults (18-65 years) Page 21 of 30 Care Homes for Adults (18-65 years) Page 22 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are not always enough staff to meet service users needs. Recruitment checks are robust protecting service users. Staff need access to regular supervision to feel valued, supported and mentored. Staff need training to understand and support service users needs. Evidence: We found that access to mandatory training is good and the induction is adequate. Some staff have attended training relating to service users needs like communication and autism although training is person centred planning is very limited. This means that staff are not competent in developing person centred plans with individuals to support them achieve their goals and live the lives they want. We found the culture of the home is that staff are in control. Staff spoke of having to be in control and incident reports showed that staff feel they should be in control. We found that concerns have been raised about the aggressive and unprofessional attitude of some staff. We found that no action has been taken to address this. We received a complaint this year about a staff member allegedly humiliating a service user in public. The adult protection team at social services and the manager investigated this and a staff member was disciplined. Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: We found that recruitment checks are carried out before a person starts work at the home. The home employs some overseas staff and commissions a company to carry out the required checks on these staff. This protects service users. The manager said that the home is fully staff with some long standing staff who know service users well. We found that there are usually three to five staff on duty during the day and two staff at night. We found that there are not enough staff on duty to support all activity choices. For example on the day of the visit there was an evening disco that had to be missed due to only having three staff on duty. We found that staff meetings are held regularly but staff supervision meetings are not as frequently as the Minimum Standard requires, that is at least 6 meetings a year. This means staff may not have the opportunity to talk about issues like performance, development, de briefing of incidents and training and get the mentoring and support they need. We found that staff work fourteen and fifteen hours shifts followed by a sleep in and then a ten hour shift. This means that staff could be tired and stressed in such a challenging environment and this should be reviewed. Care Homes for Adults (18-65 years) Page 24 of 30 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is adequately managed. Health and safety is protected but service users cannot be sure it is their views that will change practice. Monitoring of incidents must improve to protect service users. Evidence: Since the last inspection there has been a change of manager. The manager has been at the home for over six years and is the Registered manager. This means that he has passed the fit person process. The manager has support from an area manager. The manager has a Registered managers award qualification but has no qualification in learning disabilities. There were constant interruptions and demands placed on the manager during the visit, the manager was patient and calm throughout the visit. The manager has recognised shortfalls in care planning and needs support and training if he is to introduce person centred planning and Positive Behavior Support to improve outcomes for people. We found that the manager or company have not followed up on concerns raised about some staff. This means service users could be at risk. We found that incidents and the use of restraint has gone unmonitored so continues with no Care Homes for Adults (18-65 years) Page 25 of 30 Evidence: review or changes. We found that there are some quality assurance systems in place. The manager completes weekly and monthly returns for head office. Surveys are sent out to stakeholders by head office. We found that service users meetings are held so people get to air their views. The AQAA gives only basic examples of changes that have been made based on service users views and this is limited to paint colour choices, menu choices and holidays. This means that service users can not instigate change at the service. An area manager or other senior manger makes monthly visits to the home. We found that reports are completed and show that service users and staff are spoken to. We found that the manager needs more frequent supervision to meet the Minimum Standard. The AQAA shows that health and safety checks are carried out. We found that staff attend training related to health and safety including food safety and first aid. We found that regular fire drills are held and fire equipment is checked regularly. Care Homes for Adults (18-65 years) Page 26 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 27 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 6 15 Peoples needs and personal goals must be recorded and have plans in place to show what staff need to do to support needs and goals. To ensure that people have the support they need to achieve and develop. 31/12/2008 2 23 13 The use of restraint or 31/12/2008 restrictive physical intervention must only be used in line with the Minimum Standard and good practice guidance. To protect service users from harm and abuse and to protect peoples Human Rights and health and safety. 3 23 13 People must have clear up to date agreed guidelines to support and manage problem behaviors. Guidelines must be kept under review with the persons involvement. 31/12/2008 Care Homes for Adults (18-65 years) Page 28 of 30 To ensure that service users are involved and protected and staff know how to positively manage behaviors. 4 32 18 There must be enough competent staff on duty to meet service users needs including facilitating activities. To ensure service users do not miss out on opportunities and have the support they need. 31/12/2008 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 2 The assessment should include aspirations and personal goals to ensure that peoples full range of needs is supported. Care Homes for Adults (18-65 years) Page 29 of 30 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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