Inspection on 30/01/09 for St Helen`s Down

This inspection was carried out on 30th January 2009.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

St Helen`s Down 01/02/08

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Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: St Helen`s Down 46 St Helen`s Down Hastings East Sussex TN34 2BQ     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: Caroline Johnson     Date: 3 0 0 1 2 0 0 9 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. that people have said are important to them: They reflect the things 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 © (2009) 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 Helen`s Down 46 St Helen`s Down Hastings East Sussex TN34 2BQ Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Evesleigh (East Sussex) Ltd Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 6 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 6 The maximum number of service users to be accommodated is 6. 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 The registered providers of the service are Evesleigh (East Sussex) Ltd. The property is registered to accommodate six people with learning disabilities. St Helens Down is situated in a quiet residential area of Hastings. All resident accommodation is on the ground floor. Three of the six bedrooms on the ground floor have en-suite facilities. Communal areas are generous in terms of space and a large secure decking area has been created in the garden area for use during summer months. Care Homes for Adults (18-65 years) Page 4 of 30 Brief description of the care home A copy of the latest inspection report is on display at the entrance to the home. Fees can be seen in the summary section of this report. 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: For the purpose of this report the people living at St Helens Down will be referred to as residents. As part of the inspection process a site visit was carried out on 30 January 2009 and it lasted from 10:05am until 16:40pm. The registered manager facilitated the inspection. Over the course of the inspection there was an opportunity to have lunch with one resident and to meet with another two residents. In addition time was spent with two members of staff. A full tour of the home was undertaken. Two care plans were examined in detail. In addition records seen included; staff rotas, training, medication, menus, health and safety, quality assurance and leisure activities. Care Homes for Adults (18-65 years) Page 6 of 30 Since the last inspection of the home the registered manager stepped down from her position as manager to take on the deputy manager role. A manager from one of the sister homes has taken on the role of appointed manager. He has yet to submit his application for registration as manager. The last inspection of the home was carried out on 1 February 2008. The range of fees is 750-1,078 pounds per week. In addition to this, residents pay for their own toiletries, hairdressing and magazines etc. 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 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 8 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 9 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. Prospective residents receive information about the services on offer in a format that can be easily understood. More thorough pre admission assessment would assist in ensuring that the home could meet the needs of prospective residents. Evidence: There is a detailed statement of purpose in place. The service user guide has been updated and is on display in the porch. All residents have a copy of the document. Two of the residents have an audio version of the guide and the manager advised that they are making a third tape now for another resident. Residents have signed their contracts. There is a detailed admission procedure in place. Records were seen in relation to one resident who has been admitted to the home since the last inspection. It was reported that the resident visited the home once and decided they did not want to have a transition plan but opted instead to move in straight away. As a result there Care Homes for Adults (18-65 years) Page 10 of 30 Evidence: was no detailed pre-admission assessment but a brief assessment was carried out on the day of the visit to the home. Issues raised in the assessment were not carried through to the residents care plan. The resident chose to bring some of their own furniture with them on admission. They advised that all the residents made them feel very welcome. They were also very pleased that they now have a new table for doing jigsaws and advised I thought I would not be able to carry on with this hobby when I moved into the home. They also stated that they have enjoyed being able to invite a friend for tea and all the residents enjoyed playing bingo together. Care Homes for Adults (18-65 years) Page 11 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. Improved care planning and risk assessments would better promote residents health and welfare. Evidence: Two care plans were examined in detail. In relation to one it was noted that only four of the staff had signed to say that they had read the care plan. This plan included a wealth of information about the resident and their needs. There was a pen picture of the resident and a summary of their key needs. There was a wide range of risk assessments in place but they were not all of a good quality. For example the reasons given for the risk of the resident having a key to their door could have been easily overcome enabling the resident to have a key to their room. Review minutes seen were detailed and highlighted a wide range of issues most of which were then cross referenced through to the care plan. Goals were discussed as part of this process. In relation to some goals that were highlighted it is clear what it was hoped to achieve, but the specifics of how they were to be achieved was not always detailed. Care Homes for Adults (18-65 years) Page 12 of 30 Evidence: In relation to another resident it was noted that although they have been living in the home for several months now there was no proper care plan and no risk assessments. It was noted that the resident had had falls prior to admission and three falls since admission but there was still no risk assessment in place in relation to falls. It was reported that the home has just started the practice of writing monthly summary reports. There was only one completed and this was viewed. This stated that the resident had seen the optician on 31/1/09 and it was signed on 29/1/09. The report was detailed and included very relevant information. However, the residents views on their month were added after the report was typed and not included as part of the report. Residents meetings are held regularly and records seen showed that all residents are able to contribute towards the meeting. Minutes of the last meeting contained all the issues raised by the residents. In each case it referred to an item that they would each like to be purchased. A record was then made of which member of staff had responsibility for purchasing each item. There was no reference to any of the residents being involved in the purchasing of any of the items. It was also noted that the manager and deputy were to look for a suitable dining room chair for a resident but again no reference to the resident being involved in this process. Staff signed that they had read the minutes and a record was made when each issue had been addressed. Care Homes for Adults (18-65 years) Page 13 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are offered a good range of varied and stimulating activities to meet their individual needs. Evidence: Each of the residents has a weekly planner stating their activities throughout the week. All of the residents attend day centres throughout the week, some on a full time basis and some part-time. This is based on individual needs and wishes. On the day of inspection there were two residents in the home but they had stayed at home for a specific reason. Both residents stated that they love going to their day centres and enjoy the activities on offer. One resident is in training for the Special Olympics and as a result there are lots of training events to attend and if they qualify this will involve trips to London, Care Homes for Adults (18-65 years) Page 14 of 30 Evidence: Eastbourne and Leicester. A staff member said that generally at the weekends residents like to relax. On Saturdays those who chose to are taken to the shops to buy a magazine and there are generally visitors in the home. On Sundays one resident goes to Church, one visits their family and one resident has their training for the Olympics. Residents participate in daily living tasks around their home and their individual responsibilities are stated in their weekly planner. There are guidelines and risk assessments in place in relation to these tasks. There is a four-week menu that is changed seasonally. A choice of meal is provided and the meals chosen are then recorded in the daily diary. If a resident is on a specific diet then this recorded separately. Residents are given their choice of meal each morning so that this can be prepared for in the evening. Care Homes for Adults (18-65 years) Page 15 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. Lack of recent staff training and some of the systems for monitoring of healthcare do not follow good practice guidance and could place residents at risk. Evidence: Prior to staff administering medication in the home they must complete a medication competency assessment. As part of this assessment there is both a theory and a practical assessment. It was noted that four staff had started their assessments. Each of the four had completed the practical tests but only one staff member had completed the theory test. All but one staff member administers medication. Two staff are booked to complete a foundation one course in medication and the remainder of the staff team completed this is 2006 and 2007. It was reported that further training is also being arranged in this area. Records seen in relation to the administration of medication were in order. Individual lists of homely remedies have been drawn up for residents and they have been signed by the relevant GPs. In addition the GP has signed for use of aromatherapy. The home has started the process of completing health action plans for the residents Care Homes for Adults (18-65 years) Page 16 of 30 Evidence: accommodated. A medication checklist is carried out weekly as part of the homes audit. A record of the temperature of the medication cupboard is kept. The procedures in place for arranging medication for residents on leave from the home were discussed and were appropriate. Residents have all signed that they are happy for their meds to be administered. Staff observed working with residents over the course of the inspection were courteous and respectful and there was a very relaxed atmosphere in the home. In relation to one resident admitted to the home since the last inspection it was noted that a physiotherapy report carried out in June 2007, recommended exercises (daily but different exercises to be carried out on different days). It also stated that the physiotherapist would review the resident once they moved to a permanent address. Records included a blank format for an exercise chart. There was no reference in the daily notes to any exercises being carried out. However, within staff meeting minutes there was reference to this resident suffering a decline in their physical health. During the inspection the manager spoke with the resident about the need to recommence these daily exercises. A questionnaire was sent to the relatives of the residents to seek their views in relation to dying and death. Four out of six questionnaires have been returned. Care Homes for Adults (18-65 years) Page 17 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are procedures in place to ensure that anyone wishing to make a complaint can do so. Evidence: There is a detailed complaint procedure in place and in addition there is a simplified version of the procedure in place, which is on display in the home. The complaint procedure is also included in the service user guide and as stated previously two of the residents have a version of this on audiotape. The manager advised that there have been no complaints since the last inspection. There is a detailed procedure in place on the protection of vulnerable adults. Records showed that all but one staff member has attended training on the protection of vulnerable adults. A staff member spoken with during the course of the inspection was clear about the action they would take if they suspected abuse. It was noted that the home are due to assess the need for deprivation of liberty assessments. Care Homes for Adults (18-65 years) Page 18 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from living in a clean and comfortable environment where they are able to personalise their own rooms. Evidence: the home opened in December 2007 and at that time it had been completely refurbished and decorated to a very good standard. The manager had recently drawn up a list of minor maintenance issues that need addressing. Since the last inspection some new garden furniture has been purchased. The manager advised that additional furniture would be purchased in advance of the summer to ensure that the residents can make the most of their outside decked area. From the decked area there are steps to the lawned area. At the time of the last inspection it was reported that this area would be landscaped and made more accessible to the residents. This has yet to be done. Resident accommodation is all on ground floor level and communal areas are all open plan. The large lounge area leads from one side to the decked area in the garden and from another into the dining area. The kitchen is accessed via the dining room. Laundry room facilities include a washing machine with a sluice facility and a tumble Care Homes for Adults (18-65 years) Page 19 of 30 Evidence: drier. Cleaning equipment is also stored in this area. Three of the bedrooms have ensuite facilities. There are two adjacent bathrooms for the remaining three residents to share. Bedrooms seen have been personalised and reflected the individual tastes of the residents. A requirement was made at the time of the last inspection, that an appropriately qualified person assessed the home in relation to any environmental adaptations that might be considered appropriate, in relation to the residents that have a visual impairment. Records showed that the home had made arrangements on two occasions for a person to visit but on each occasion the visit was postponed. The second visit had been scheduled to take place on the day of this inspection and two of the residents had remained home to meet with the individual. The manager confirmed that this visit would be rescheduled as soon as possible. All areas of the home seen during the inspection were clean. Records seen showed that all but two staff had up to date training on the subject of infection control. It was noted that there was a hand towel in the staff toilet. In order to prevent cross contamination it was recommended that alternative hand drying facilities be provided. Care Homes for Adults (18-65 years) Page 20 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Inadequate staff training in some key areas could affect the outcomes for some of the residents. Evidence: Recruitment records were not seen during this inspection as it was reported that no new staff have been appointed in the past two years. Three staff have completed NVQ (national vocational qualification at level two and a further three staff are currently studying for this qualification. One staff member has completed level three. There were some gaps in the staff-training matrix but the manager confirmed that training was being booked in several areas. The main area where there was a shortfall was in relation to manual handling. In relation to specialist training it was noted that training in epilepsy and diabetes has been booked and will take place in February. It is also hoped that training will be arranged for staff in relation to working with people with a visual impairment. There was a new matrix on display in the office detailing the planned dates for staff and house meetings and the individual supervision dates for staff. The matrix showed that four of the staff team had received supervision in January 2009. Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: A staff member advised that there are plans to provide supervision on a monthly basis. There is a new agenda sheet to be completed in advance of the supervision and the supervisor also has to complete one. It was reported that although supervisions were planned regularly last year, they were not carried out. However, a staff member confirmed that they had had a recent supervision and found this very helpful. Care Homes for Adults (18-65 years) Page 22 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. There are some good systems in place to monitor the quality of the care provided but this needs to be more robust in ensuring that where shortfalls are identified they are addressed. Evidence: Since the last inspection of the home the registered manager stepped down from her position as manager to take on the deputy manager role. A manager from one of the sister homes took on the role of appointed manager in September 2008. He has yet to submit his application for registration as manager. He hopes to complete the RMA (Registered Managers Award) by June 2009. Staff spoken with felt well supported and stated that the manager is always here and will listen to what you have to say. They also stated that he was very helpful in clarifying issues regarding their NVQ. There was a good system in place for handing over between each shift. However it was noted that on the day of inspection the handover sheet for the morning shift which was due to finish at 2pm had already been completed and signed at 12.30pm. Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: Records show that a compliance officer visits the home unannounced on a monthly basis to report on the running of the home. As at the last inspection of the home there is still no space for either the person conducting the visit or for the manager to sign the document. In addition there is also no space to record the name of the person that was in charge at the time of the visit. Records were seen in relation to the two previous months and it was noted that there was no record of the views of staff or residents. There was however, evidence that a wide range of standards had been assessed. In September 2008 there was a detailed internal compliance report on all of the minimum standards. Regular audits are carried out in relation to medication, home, fire and health and safety. It was reported that satisfaction questionnaires have yet to be distributed to residents and their relatives for their views on the quality of the care provided in the home. The management of residents finances were discussed and appeared in order. However it was noted that rent owed by the residents is often only withdrawn every few months, which could lead to misunderstanding regarding how much money is in accounts and doesnt assist with encouraging residents to budget. Records showed that the last fire drill was carried out in November 2008 and there were two staff present. The manager was reminded of the need to ensure that all staff have the opportunity to participate in a fire drill on a regular basis. In relation to health and safety a daily premises check is carried out and there are also specific weekly and monthly checks. A health and safety committee meeting is also held regularly and minutes are kept of the outcome. It was noted that reference is made on several occasions of the need to replace a shower hose. Care Homes for Adults (18-65 years) Page 24 of 30 Are there any outstanding requirements from the last inspection? Yes R No £ 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 1 22 23(2a,c) An assessment of the 30/04/2008 building must be carried out by an appropriate specialist to determine if there are any further environmental adaptations that would be of benefit to service users with a visual impairment. Care Homes for Adults (18-65 years) Page 25 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 2 14 The registered person must 30/04/2009 ensure that a detailed pre admission assessment is carried out in relation to any new service user admitted to the home and they must confirm in writing to the service user that having regard to the assessment the home can met their needs in respect of health and welfare. Prospective service users individual aspirations and needs must be assessed. 2 6 15 The registered person must ensure that each service user has a detailed plan as to how their needs are to be met. The plan must be kept under review. Service users need to know that their assessed and changing needs and personal goals are reflected in their individual plan. 30/04/2009 Care Homes for Adults (18-65 years) Page 26 of 30 3 9 13 The registered person must 30/04/2009 ensure that where there are perceived risks a detailed risk assessment must be drawn up detailing how the home will ensure that the risk of an accident or incident could be minimised. All risk assessments must be reviewed at regular intervals. Service users are supported to take risks as part of an independent lifestyle. 4 18 17 The registered person must 15/05/2009 ensure that the home make arrangements for one service user to see a physiotherapist and any that any recommendations made as a result are then implemented. Service users receive support in the way they prefer and require. 5 30 13 The registered person must ensure that in order to minimise the risk of cross infection, alternative arrangements must be available for staff in relation to hand drying. The home must be clean and hygienic. 30/04/2009 6 35 19 The registered person must 30/04/2009 ensure that all staff are up to date in mandatory training. Particular emphasis must be placed on ensuring that all staff are trained in Care Homes for Adults (18-65 years) Page 27 of 30 manual handling and the administration of medication. Service users needs must be met by appropriately trained staff. 7 37 9 The registered provider must ensure that the appointed manager submits an application for registration. Service users benefit from a well run home. 8 39 24 The registered person must 30/04/2009 ensure that as part of the homes quality assurance system there must be a system in place for seeking the views of service users and their representatives about the quality of the care provided. Service users must be confident that their views underpin all self-monitoring, review and development by the home. 15/05/2009 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 6 Where there are particular goals identified, the steps that need to be taken to assist the service user to achieve them should be clearly stated along with a record of all progress made. Arrangements should be in place for residents to pay their rent on a monthly basis. 2 41 Care Homes for Adults (18-65 years) Page 28 of 30 3 41 Records should not be signed in advance of completing a task. This does not allow for alterations or changes to a planned activity. The frequency of fire drills should be increased. 4 42 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 © (2009) 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. Care Homes for Adults (18-65 years) Page 30 of 30 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!