CARE HOME ADULTS 18-65
St Martins Haven 86 Culverly Road Catford London SE6 2JY Lead Inspector
Kate Matson Unannounced 22 September 2005
nd The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. St Martins Haven G52-G02 S25644 StMartinsHaven V245592 220905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service St Martins Haven Address 86 Culverley Road, Catford, London, SE6 2JY Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 020 8465 0020 Elizabeth Peters Care Homes Limited Jayne Bird CRH Care Home PC Care Home Only 6 Category(ies) of DE Dementia registration, with number MD Mental Disorder of places St Martins Haven G52-G02 S25644 StMartinsHaven V245592 220905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: This home is registered for 6 persons with dementia or mental health problems over 50 years. Date of last inspection 23rd December 2004 Brief Description of the Service: St Martins Haven is a small care home in a quiet residential street in Catford. The home provides care for six adults with past or present mental health problems who are aged 50 and above. The home does not currently have any vacancies. The home is located a good walk away from the town centre, although has a parade of shops within a much shorter distance. Public transport is readily available in the form of local buses and two train stations, both of which provide links into London. The home is a converted property, which means that it is in keeping with the surrounding buildings. The home is one of a group of homes run by Elizabeth Peters Care Homes Limited. St Martins Haven G52-G02 S25644 StMartinsHaven V245592 220905 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This statutory unannounced inspection was conducted over eight hours. The inspection included discussion with five service users, the acting manager, other staff and the registered provider, a tour of the premises, and examination of care plans and other records. The manager was on maternity leave at the time of the inspection and CSCI had not been notified of this as required by regulation; however on the day of the inspection the registered provider supplied the inspector with a letter stating that a senior carer would be acting as manager in the managers absence with support from herself. What the service does well: What has improved since the last inspection?
The minutes of the service user meetings had been improved in accordance with a recommendation from a previous inspection; however, in order to meet the recommendation fully, the meeting should be further developed, for example, by providing service users with an agenda and previous minutes. The staff also described the support that had been given to service users who had expressed the desire to move, though this would be better evidenced by producing care plans around the issue for those to whom it applies. Detailed risk assessments were in place for service users including risks posed by physical and mental health conditions; however, the work staff have done with service users around risk could be better evidenced. A new kitchen was being fitted at the home at the time of the inspection in accordance with a previous requirement and this was due to be completed very shortly. St Martins Haven G52-G02 S25644 StMartinsHaven V245592 220905 Stage 4.doc Version 1.40 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office.
St Martins Haven G52-G02 S25644 StMartinsHaven V245592 220905 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection St Martins Haven G52-G02 S25644 StMartinsHaven V245592 220905 Stage 4.doc Version 1.40 Page 8 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2 Service users needs are assessed before moving into the home. EVIDENCE: Most service users had lived at the home for some time. All of the files examined included an assessment of needs completed by the home. Most personal files also included a needs assessment completed under the care management process. However one service user had very little information on file relating to their mental health condition. The registered provider stated that this was because they had lived at the home for many years and the information had been archived, however it is recommended that information about service users past is easily accessible on service users files so that all staff working with the service user know about their needs and can communicate with them about their past where appropriate. St Martins Haven G52-G02 S25644 StMartinsHaven V245592 220905 Stage 4.doc Version 1.40 Page 9 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7 and 9 The home has some effective care recording and planning systems in operation; however there is some duplication and this could be confusing for care staff. Service users are supported to make their own decisions however they could be encouraged to participate better if residents meetings were further developed and care plans should be developed to ensure that ‘move on’ needs are fully addressed. Service users are supported to take risks though the work staff do around risk management could be better evidenced. EVIDENCE: St Martins Haven G52-G02 S25644 StMartinsHaven V245592 220905 Stage 4.doc Version 1.40 Page 10 Four care plans were examined, and these were well organised and easy to follow. They were regularly updated and evidenced that service users participated in the process. The care plans initially examined only covered a few specific areas of need for service users and did not evidence that care provided is holistic. However later in the inspection a file of further care plans was found to include this missing information. These were almost exclusively completed by the manager, and it was unclear if other staff had been involved in their development. It is recommended that the home uses one care planning system and ensures that all staff are aware of the system in use. Staff should also be encouraged to participate in the care planning process to ensure that they are as informed as possible about the needs of service users. At the previous inspection it was found that staff supported service users to make decisions and provide information and assistance as required. It was recommended that the format and agenda of the service user meeting should be developed to ensure the meeting is as productive and participative as possible. It was also recommended that where service users have expressed a desire to move they should be made aware of alternative living options and supported to make any changes they wished to make. At this inspection it was found that service user meetings were held every 2 or 3 months. The minutes of the meeting were being recorded more fully and evidenced that service users were consulted about various things. However one said they didn’t have meetings, one said that they didn’t attend and three others said they didn’t find them that useful. It was also noted that service users did not receive an agenda to contribute to or a copy of the minutes and previous meeting minutes were not discussed. Further work is recommended in order to encourage service users to participate more fully in the meeting. The acting manager and registered provider were able to demonstrate how service users who had expressed a desire to move on had been supported and this recommendation is considered met, however it is recommended that in order to evidence work around this issue better service users have a care plan around this area where appropriate. It was noted at the last inspection that service users were encouraged and supported to take responsible risks as part of developing a more independent lifestyle. Risk assessments had been devised in relation to service user issues and these were reviewed on a regular basis. However it was recommended that service user risk assessments should be further developed. At this inspection it was noted that there were two risk assessment systems. One in the care plan largely focussed on physical risks such as falling and other risks such as those related to mental health issues were in another file. Again it is recommended that only one system be used and that staff are all made aware of the system in place so that staff are fully informed of all risks relating to each service user. Also although these risk assessments were thorough it was not clear what the risk management strategies were. The inspectors were told of some of the risks that service users took such as not telling staff where they were going or refusing to seek medical help when necessary. However risk assessments should evidence the work that staff do with service users around risk.
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The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 14, 16 and 17 Service users are largely independent in the activities in which they take part and more organised activities could be offered at the home on an individual and group basis to meet service users personal development and leisure needs. Although service users had been offered the opportunity of a holiday they need to be consulted about this in order to ensure that it meets their preferences as far as possible. Daily routines at the home respect the rights of service users. Service users are provided with a flexible choice of meals that a nutritious and balanced. EVIDENCE: One service user goes to a day centre three days per week and another attends a support group once per week. Other service users choose to spend their time mainly independently. It was clear that staff encouraged service users to go out but service users were often reluctant to do so. It is recommended that more organised activities are offered in the home on an individual and group basis to ensure that service users are given as many structured activity opportunities as possible for personal development and for leisure.
St Martins Haven G52-G02 S25644 StMartinsHaven V245592 220905 Stage 4.doc Version 1.40 Page 12 Service users tend to spend their leisure time independently going for walks, visiting local shops and cafes, going to the pub and betting shop, and watching television. However some service users had been with staff on trips out to the coast, theatre productions, and concerts. One service user had gone with a member of staff to a Bob Dylan concert and also reported that they had a karaoke evening a few months ago and stated, “I enjoyed that it was quite a laugh”. However this had not been repeated since. All of the service users had been offered the opportunity of a holiday though only one had taken the opportunity and had enjoyed a week in Margate. One service user who had declined the holiday stated that they would prefer a holiday with different people. In order to ensure that service users preferences and wishes are met as far as possible they must be consulted about different holiday options. All of the service users spoken with confirmed that daily routines are flexible. They were seen to come and go from the home and move around within the home freely on the day of the inspection. Service users confirmed that there are no unnecessary rules and restrictions, they have the keys to their rooms and that staff ask permission before entering their rooms. One service user said, “I can bring a girlfriend back if I want”. Service users gave mainly positive feedback about the food. Comments included, “Meals are decent”, and “You get plenty” and service users confirmed that although there is a menu, something else is provided if they don’t want the meal on offer. The menu record evidenced that service users are provided with a balanced and nutritious diet. St Martins Haven G52-G02 S25644 StMartinsHaven V245592 220905 Stage 4.doc Version 1.40 Page 13 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 and 21 Service users receive individualised support though support received from professionals outside of the home could be better evidenced. The home helps service users to plan for their death to ensure that their wishes are carried out. EVIDENCE: There is a key worker system in operation to ensure consistency and continuity for service users. Care plans indicated the level of support that service users require with their care including personal hygiene. Staff described the support that was given to service users who needed a lot of encouragement with their personal care. Service users had received visits from health professionals and this was recorded by the home but it is recommended that visiting professionals be encouraged to make their own entries in the service users care plan to better evidence the multi agency care that service users receive. It was also noted that some of the service users received mental health care under the Care Programme Approach (CPA) though minutes from previous CPA meetings many months previously had not yet been sent to the home. It is recommended that these be chased up to assist in care planning for the individual concerned. Care plans evidenced that discussions had been held with service users about their wishes in the event of their death and care plans included details about this such as who service users wished to be informed, and choice of music to be played at a funeral.
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The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 Service users had no complaints and were happy to complain if necessary; however, the procedure contains outdated information. EVIDENCE: None of the service users spoken with had made a complaint though they confirmed that they would be happy to raise a concern if necessary. One service user said, “I wouldn’t hold back if I had a complaint”. The complaints procedure was clearly located in the hallway and included the option of referring a complaint to the Commission, however it was noted that the details had not been updated to reflect the new name of the commission and referred to NCSC. This must be clarified to ensure that service users are clear about their complaint options. St Martins Haven G52-G02 S25644 StMartinsHaven V245592 220905 Stage 4.doc Version 1.40 Page 15 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 26, 28 and 30 The home is homely, comfortable and safe. Service users’ bedrooms reflect their personalities. There is sufficient shared and personal space. The home is clean though unpleasant odours were detected in the lounge area. EVIDENCE: The home is an older property located in a residential area a reasonable walk from the centre of Catford. However it is close to bus routes. The home is not recognisable as a care home and is well maintained and decorated and furnished in a comfortable and homely way. Service users all have their own rooms and most have en suite facilities. Service users had all of the required items of furniture and fittings and where these were not wanted this was detailed in their care plan. Service users had individualised their rooms with personal items. The home has a lounge, separate dining room and a kitchen that was currently being refurbished. Although the home was clean at the time of the inspection and one service user remarked that, “Hygiene is top class”, unpleasant odours were detected in the lounge, possibly coming from the soft cover chairs. This problem must be addressed as it detracts from the overall pleasant environment for people, living at, working at and visiting the home.
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The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 34 and 36 Service users are supported by an effective staff team though the manager should share some responsibilities with staff in order that they develop skills and to free herself up to focus on managerial tasks. Recruitment processes are largely safe though greater attention to employment references is needed and towards staff records. Staff are supported by regular team meetings and supervision with the manager, however in her absence the home must ensure this support continues. EVIDENCE: It was found that the manager was on maternity leave though the Commission had not been notified of this as required by regulation. On the day of the inspection the provider supplied a written letter stating that the manager would be absent until the middle of January 2006 and in her absence one of the senior carers would provide cover with support from the registered manager. The duty rota showed that there are two staff on duty throughout the day until 8pm at night and one member of staff sleeps in. The manager is not supernumerary yet it appears that she does most of the care planning and was coming in regularly although she was on maternity leave. It has been recommended under Standard 6 that all staff should be encouraged to participate in the care planning process. This should also help staff to develop skills further and share the burden of some work amongst the staff team leaving the manager to focus on managerial tasks.
St Martins Haven G52-G02 S25644 StMartinsHaven V245592 220905 Stage 4.doc Version 1.40 Page 17 It had been noted at previous inspections that staff files did not include all of the documents required by regulation. At this inspection six of the seven staff whose names appeared on the rota were examined. Of the files examined most had the required documents though one had no proof of identity and one had no contract. This requirement has remained unmet over several inspections and CSCI may take enforcement action about this issue. There was no file for the seventh staff and this must be addressed as records for each staff member must be avaialble within the home. Also although all staff had two references these were in some instances inadequate for example one was undated and one did not provide any information about the employee, only confirmed that the person had worked for the organisation. The registered provider must ensure that as far as possible references are sought from previous employers, on letter headed paper or with an official stamp and that these are followed up with a phonecall where insufficient information is supplied. At the last inspection it was noted that staff were encouraged to comment on and contribute to all aspects of running the home. Staff were given copies of the staff meeting minutes and encouraged to contribute to the agenda, however it was noted that meetings did not take place at least 6 times a year. At this inspection it was noted that four meetings had been held in the first six months of the year and the home was on target to meet the requirement. However in the managers absence no meetings had been held and although the previous requirement is considered met, regular meetings must continue to be held. It was also noted that although four of the six staff had received regular supervision, two staff files did not have evidence of this. This must be addressed to ensure that all staff are supported to meet the needs of service users. St Martins Haven G52-G02 S25644 StMartinsHaven V245592 220905 Stage 4.doc Version 1.40 Page 18 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39 and 42 The home has some effective quality assurance systems in operation, however the provider has continued to fail to produce reports of monitoring visits. The health, safety and welfare of service users is promoted and protected. EVIDENCE: The home has a number of quality assurance systems in place, kept in a quality assurance file. These consist of monthly audits of, the environment, medication system, care plans and other records, and quality questionnaires given to service users, relatives and visitors to the home. A service user survey had been completed in June 2005. Although the results of surveys were acted upon, it did not appear that the results of the surveys were summarised and made available to service users, although the service user guide was not examined and may have included comments about this. In order to evidence to service users and others contributing to quality assurance surveys that their views underpin self-monitoring, review and development of the home the registered provider should ensure that the results of surveys are made summarised and made available to all those taking part. Previous inspections had required that the registered provider make unannounced monthly visits to
St Martins Haven G52-G02 S25644 StMartinsHaven V245592 220905 Stage 4.doc Version 1.40 Page 19 the home and submit reports of the visits to CSCI. Although the registered provider and acting manager stated that these visits do take place, written reports have not been provided to the manager or CSCI as required. This requirement has remained unmet over several inspections and CSCI may take enforcement action about this issue. The home has appropriate health and safety policies in place. Staff receive appropriate training in health and safety topics such as first aid, moving and handling and food hygiene. Records indicated that fire equipment was appropriately serviced and the electrical installation and portable appliances were tested and appropriately. On the day of the inspection the gas certificate was not available but the registered provider faxed a copy of the certificate to the inspector the day after the inspection. St Martins Haven G52-G02 S25644 StMartinsHaven V245592 220905 Stage 4.doc Version 1.40 Page 20 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x x x Standard No 22 23
ENVIRONMENT Score 2 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10
LIFESTYLES Score 3 3 x 3 x
Score Standard No 24 25 26 27 28 29 30
STAFFING Score 3 x 3 x 3 x 2 Standard No 11 12 13 14 15 16 17 x 3 x 2 x 3 3 Standard No 31 32 33 34 35 36 Score x x 3 1 x 1 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
St Martins Haven Score 3 x x 3 Standard No 37 38 39 40 41 42 43 Score x x 1 x x 3 x G52-G02 S25644 StMartinsHaven V245592 220905 Stage 4.doc Version 1.40 Page 21 No 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 14 Regulation 12 (3) Requirement The registered provider must ensure that service users are consulted about different holiday options in order to ensure that service users individual preferences and wishes are met as far as possible. The registered provider must ensure that the complaints procedure is updated to reflect the new name of the Commission, CSCI. The registered provider must ensure that the home is free from unpleasant odours and address any underlying causes of the problem. The Registered Person must ensure that all staff files have the information required by schedule 2 of the Care Home Regulations (previous timescales of 30/11/03, 30/08/04 and 30/04/05 not met) The registered provider must ensure that records relating to all staff working at the home are kept at the home and are available for inspection. The registered provider must ensure that as far as possible Timescale for action 31/03/06 2. 22 22 (7) 31/12/05 3. 30 16 (2) (k) 31/12/05 4. 34 19 (b) 31/12/05 5. 34 17 (2) 31/12/05 6. 34 19 (1) (b) and (c) 31/12/05
Page 22 St Martins Haven G52-G02 S25644 StMartinsHaven V245592 220905 Stage 4.doc Version 1.40 7. 36 18 (2) 8. 39 26 (3) references are sought from previous employers, on letter headed paper or with an official stamp and that these are followed up with a phonecall where insufficient information is supplied The registered provider must ensure that staff receive formal supervision at least six times per year The Registered Person must perform monthly unannounced visits to the home and submit reports of the visits to the CSCI (previous timescales of 30/03/04, 31/07/04 and 31/03/05 not met). 31/12/05 31/12/05 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. Refer to Standard 2 Good Practice Recommendations It is recommended that information about service users social and mental health history is easily accessible on service users files so that all staff working with the service user know about their needs and can communicate with them about their past where appropriate. It is recommended that the home uses one care planning system and ensures that all staff are aware of the system in use. Staff should also be encouraged to participate in the care planning process to ensure that they are as informed as possible about the needs of service users. The Registered Provider should develop the format and agenda of resident meetings to ensure they are more productive and participative. It is recommended that in order to better evidence work around moving on, service users have a care plan around this area where appropriate. It is recommended that risk assessments evidence the work that staff do with service users around risk. It is recommended that only one system is used to assess risk and that staff are all made aware of the system in
G52-G02 S25644 StMartinsHaven V245592 220905 Stage 4.doc Version 1.40 Page 23 2. 6 3. 4. 5. 6. 7 7 9 9 St Martins Haven 7. 12 8. 18 9. 10. 18 39 place so that staff are fully informed of all risks relating to each service user. It is recommended that more organised activities are offered in the home on an individual and group basis to ensure that service users are given as many structured activity opportunities as possible for personal development and for leisure. It is recommended that visiting professionals be encouraged to make their own entries in the service users care plan to better evidence the multi agency care that service users receive. It is recommended that the manager writes to care coordinators to chase up the minutes from CPA meetings to assist in care planning. It is recommended that the results of satisfaction surveys are summarised and made available to service users and others taking part in surveys in order to evidence that their views underpin self-monitoring, review and development of the home. St Martins Haven G52-G02 S25644 StMartinsHaven V245592 220905 Stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection Ground Floor 46 Loman Street Southwark SE1 0EH National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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