CARE HOME ADULTS 18-65
Stanfield House 4 Stainburn Road Workington Cumbria CA14 4EA Lead Inspector
Nancy Saich Unannounced Inspection 7 March 2006 9:30 Stanfield House DS0000022602.V281215.R01.S.doc Version 5.1 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Stanfield House DS0000022602.V281215.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Stanfield House DS0000022602.V281215.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Stanfield House Address 4 Stainburn Road Workington Cumbria CA14 4EA 01900 65737 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Turning Point Limited Mr Peter Ditchfield Care Home 12 Category(ies) of Past or present alcohol dependence (12), Past or registration, with number present drug dependence (12) of places Stanfield House DS0000022602.V281215.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 12 people over 18 years of age with past or present alcohol dependency to include people over 18 years of age with past or present drug dependency 20th September 2005 Date of last inspection Brief Description of the Service: Stanfield House is an older property located in a residential area of Workington. It is within walking distance of the town and has good local and national connections. The property has three floors and is unsuitable for people with disabilities. The home takes people between the ages of 18 and 65 who have had problems with substance abuse but who are no longer using drugs or alcohol. The home is only staffed during office hours so residents must be able to function fairly independently. The home is registered to Turning Point, a national charity who run different types of home throughout the country and who have other services for people with problems of addiction. Peter Ditchfield manages the home on their behalf. Further information on Turning Point can be accessed through their website on www.turning-point.co.uk. Stanfield House DS0000022602.V281215.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection of the home conducted by Nancy Saich, the lead inspector for Stanfield House. The visit started at 9.30 a.m and lasted until after 3 p.m. The inspector spoke to all of the seven people in residence either individually or in a group. She also spoke to the three members of the team who were in the home during the day and two members of the area management team. She toured the building and checked on documents and records that backed up what people said to her or what she observed. She also sent questionnaires to the residents and other people involved with the home. Some of the findings of the inspection relate to the responses of the returned questionnaires. What the service does well: What has improved since the last inspection?
The home has improved the way medication is labelled and stored. They have also dealt with some damp problems and have nearly finished an upgrade of the fire alarm system that the inspector and the fire officer had asked them to complete. One or two areas had been redecorated. Turning Point has started to review how the home operates and this review was ongoing on the day of the inspection. Stanfield House DS0000022602.V281215.R01.S.doc Version 5.1 Page 6 What they could do better:
There were some questions raised about whether sometimes the staff admitted people who weren’t ready for the project. The inspector judged that it might be a useful exercise to just look again at the systems used when interviewing new residents. Each person in the home has an individual plan that should show how he or she would work towards recovery. Some of them were out of date or didn’t have enough detail to help with this. There was little evidence to show that staff were aware of some of the more up to date ways of helping people to plan for their futures. There was some feeling amongst the resident group that more could be done to help with things like activities and leisure pursuits. They did query whether this was related to financial issues. They also continued to query how much was available for food. The inspector recommended that these matters be looked at as part of a wider review of the way the home works. The inspector checked medication as a follow up from a visit by the pharmacy inspector. There were still some matters that needed to be looked at again. A further joint visit will be made. The inspector looked around the home and talked to people about the environment. Residents said they would like another shower in the home and that it would be a nice idea to have one room with an ensuite toilet. The inspector was aware that there had been an incident where, due to residents returning to their previous behaviours, the home had been disrupted. Some residents thought that it wouldn’t have happened if there had been staff around more of the time. The behaviour of residents in the home might have been either or both selfharming or related to some form of pressure or even bullying in the group. Turning Point have looked at this incident but need to continue to look at how they will manage such situations. A number of the residents said that they felt that although the staff were very good and caring the home would benefit from more staff so that if people were as one person said “a bit wobbly” they could go to a member of staff at any time of the day or night. This issue of staffing levels has been discussed over the years with Turning Point representatives. The inspector judged that it is the responsibility of the registered person and the registered manager to prove to her that staffing levels meet the needs of residents at all times. There was also a problem in that the staff files showed that some staff had not received supervision or appraisal. There were a number of issues related to the way the home was being managed. There had been some quality assurance work completed but a number of problems were still unresolved and residents were not entirely happy with the quality of the provision. There was no new business or financial plan for the home. The inspector had received some details of the budget after the last inspection but she feels that the future plans for the home need to be more organised and more readily available. Stanfield House DS0000022602.V281215.R01.S.doc Version 5.1 Page 7 Residents questioned what the purpose of the home was and the inspector is aware that Turning Point is looking at the direction the home should go in. This work had started but the company needs to continue to develop this so that residents and staff are sure of what should be happening in Stanfield House. 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. Stanfield House DS0000022602.V281215.R01.S.doc Version 5.1 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Stanfield House DS0000022602.V281215.R01.S.doc Version 5.1 Page 9 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 The home needs to look again at the way they decide on who is admitted to the home to make sure they can care for the person and that they will fit into the resident group. EVIDENCE: Residents felt that there were a lot of people who came to the service who didn’t manage to stay sober or drug free and who then left the home. They queried whether the systems for choosing new residents met the needs of the whole group and whether there might be a different way to assess new residents. The files showed that residents had all had a social work assessment and had visited the home and met the other residents and been interviewed by staff. A new resident said that the assessment process had worked well for him and that he had not been allowed to come to the home until certain conditions had been met. The inspector judged that the way new residents were assessed was suitable but she recommends that when a review of the home is taking place the staff and residents may want to look at the systems in place for admitting new residents. Stanfield House DS0000022602.V281215.R01.S.doc Version 5.1 Page 10 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, Residents individual plans were not detailed enough to help plan for their recovery. EVIDENCE: Residents said they could see their own individual worker (the ‘key worker’) whenever they wanted. Some people saw them once a week and worked on a plan for the way they were to deal with their recovery. The inspector looked at these care plans. She found that the plans lacked in detail and that risk assessments could be stronger. She saw some notes that did show the ‘key workers’ met the residents regularly and that they discussed some very complex and in-depth ways of moving the residents forward. However these things were not being drawn up in detailed care plans. The work would appear to be happening but the residents might benefit from more structure to the format of care planning and perhaps to some new ways of approaching this part of the work. Stanfield House DS0000022602.V281215.R01.S.doc Version 5.1 Page 11 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,17 The home has good arrangements in place but may need to expand opportunities to give higher levels of satisfaction. EVIDENCE: The main focus of the work in the home is in helping people with their personal development. Residents said that they liked the fact that the project wasn’t just about helping people to stop using addictive substances but was also about replacing this behaviour and about strategies for rebuilding lives. This involves residents groups where they can talk about their previous behaviours and choices, individual support and work on things like self-esteem. Residents are encouraged to build on social and learning skills. There are wider opportunities for residents to gain qualifications or complete training. Residents are encouraged to go out to shop and to sports and leisure pursuits. There are groups to help with things like stopping smoking and healthy eating. At the last inspection a number of people did say they wanted more of these activities and that the funding wasn’t adequate for them to do all the things they wanted to do. This was again stated at this visit. The senior management had started to look at this and were planning that residents be involved in budget planning.
Stanfield House DS0000022602.V281215.R01.S.doc Version 5.1 Page 12 The inspector had been sent details of the budget and was not unduly concerned about this but was concerned that residents felt they wanted more say in how the budget was allocated. This is also discussed later in the report. Residents cook for themselves and do qualifications in food safety. Residents said they managed well but one or two people again questioned the amount in the budget for food. One person said he felt the amount didn’t take into account large appetites and another thought that it was hard at this price to make the meals nutritious enough. The staff said this was to be increased in the next financial year. Residents also wondered whether an increase in staffing might also help with giving them more support in activities and in personal development. Stanfield House DS0000022602.V281215.R01.S.doc Version 5.1 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 the following standard(s): 20 The home needs to make sure the arrangements for helping people with medication are made strong enough to protect them from harm. EVIDENCE: This home had a visit from the Commission for Social Care Inspection’s pharmacy inspector and a copy of her report can be obtained from the Penrith Office. The inspector checked on the medication and found that the staff were taking medication out of the original containers so that residents could then take them when there were no staff on duty. The drugs were then in ‘dosette boxes’ that hadn’t been prepared by a pharmacist. This arrangement could mean that mistakes are made. This is classed as ‘secondary dispensing’ and staff would be held responsible for any problems. The management need to deal with this problem that was subject to a requirement from the visit by the pharmacist. The home had developed their policies and procedures on medication but staff felt they had not been able to deal with some aspects of these in relation to how things work in the home. Some of these problems are related to the needs of people who have had difficulty with both prescription and illegal drugs. Some of it related to the fact that the home is only staffed during ‘office hours’.
Stanfield House DS0000022602.V281215.R01.S.doc Version 5.1 Page 14 The inspector decided that she would extend two of the requirements made by the pharmacy inspector. These issues need to be looked at again by both the lead inspector and the pharmacy inspector and this will be discussed with the manager. Stanfield House DS0000022602.V281215.R01.S.doc Version 5.1 Page 15 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 The inspector judged that Turning Point need to look at how they support and help residents to deal with any problems in the house. EVIDENCE: Individual bedrooms had copies of the complaints procedure and residents said the staff would listen to any concerns they had. They also said that a representative of the company came to the home every month and they could if they wanted talk to them about worries. However a number of residents said (either verbally or in questionnaires) that there had been things worrying them in the home that they had not disclosed. The inspector felt concerned that some months before residents had been drinking and using drugs and none of the residents felt they could tell the staff due to fear that they would be branded as an informant or “grass”. They did said that when staff did find out they stressed that residents must tell them of any problems. The inspector judged that this might also have had an impact on Standard 23 as there was evidence that residents had been engaged in self-harming behaviour and that there might have been some bullying going on in the home. The inspector had already asked the manager and his manager to look at these things that led to an event in the home that affected the well being of the residents. This was completed but the inspector also feels that more work needs done on complaints and protection and that this needs to be looked at along with the issues of staffing discussed later in this report. Stanfield House DS0000022602.V281215.R01.S.doc Version 5.1 Page 16 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 The house is comfortable and meets the needs of the residents but the company need to look at the bathroom facilities. EVIDENCE: The inspector toured all areas of the building and asked residents their opinions of the environment. The feeling was that the home was comfortable and well decorated. Residents only stay for a short period of time but many of them had personalised their rooms. The home appeared to be generally well maintained and the fire alarm and fire door problems at the last inspection had been dealt with. Some redecorating had been undertaken. One of the bedrooms on the top floor had been damp and this had been dealt with. The plasterwork seemed a little loose under the new wallpaper. Staff agreed to keep an eye on this problem in case the damp returned. The home has two bathrooms and one toilet. There are no ensuite facilities. At times there are more men than women and residents though it would be nice if there was at least one room with an ensuite toilet. Turning Point has costed this work and an upgrade of the top floor bathroom to include a shower. It is recommended that these things be progressed as soon as possible for the comfort and dignity of residents.
Stanfield House DS0000022602.V281215.R01.S.doc Version 5.1 Page 17 There are two double rooms but staff try to have these as single occupancy where possible. The home was clean and tidy on the day of the inspection. Stanfield House DS0000022602.V281215.R01.S.doc Version 5.1 Page 18 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,33,34,36 The staffing arrangements in this home are not flexible enough to meet the needs of a changing group of residents. EVIDENCE: The manager, two full and one part time support worker staff this home. On the day of the inspection there were only seven people in the home. One full time member of staff was not at work and expected to be absent for more than a few days. In the last inspection report the inspector asked that a contingency plan be in place for just such an event. This plan did not seem to have kicked in when the absence started. However there was some evidence to show that senior management were dealing with the problem. The inspector is prepared to give turning Point management more time to deal with this. Residents said on the day that the staffing was just about acceptable. They were unaware of this unplanned absence so did not comment on the team being down by one person. They said that in previous months there hadn’t been enough staff to meet the needs of individuals or of the group as a whole. A number of people thought that the home needed to have more staff on duty – especially when new residents come to the home or when there are some tensions in the group of people who share the home. Currently the staff are only in the home from 9 to 5 on weekdays. At weekends, at night and in the evening three people are ‘on call’ from home. Residents though that there needed to be more staff who could work flexible hours especially into the
Stanfield House DS0000022602.V281215.R01.S.doc Version 5.1 Page 19 evening and some people also felt that things would be better if someone slept in the house overnight. The staff who work in the home were given a lot of praise by the residents. They said they were polite and respectful and “always give us our own space”. No one had any problems with the staff and felt they did a good job but that they were “stretched to the limit and just cant give some people enough support…” One or two people felt that this was often the case with new residents who really needed a lot of support at any time of the day. The residents also said that they did use the ‘on call’ system if they needed to but that there were times when they just needed to talk to someone and felt that if they did this to the ‘on-call’ person they were disturbing someone who had already worked a long day. The inspector checked on the recruitment of one new team member who had only become a permanent member of the team at the start of February. All the necessary checks had taken place so that this worker was the right kind of person to be trusted with the sensitive and confidential nature of the work. The staff team had received suitable training and there was a lot of evidence and opinions to show that they were capable and caring people. However there was also a lot of evidence to show that the size of the team did have an effect on their capacity to deal with the way they were able to respond to the residents needs. The team is now quite well balanced in terms of gender and in qualifications and competence. However when one person is absent from the team the competence and qualification balance is changed drastically. It is possible that the absence of a key member of staff lead to some of the problems that occurred in the home at the end of 2005. This is such a small team that any change can have a really dangerous impact on the way the home functions. With a small team who deal with very intense and complex residents there is a need for all the staff to have close personal supervision so that they can talk through the support they are giving to the residents. Staff said that they did talk together and support each other. There was written evidence that this had happened in February but for one member of staff this had only been recorded once in twelve months and this person had not had an annual appraisal. The inspector was told that the manager had regular supervision but she did not look at this on the day. These one-to-one meetings need to be held regularly. Details of these need to be recorded so that there is evidence of staff development and a record showing that the support given to residents is discussed, planned and given suitable consideration Stanfield House DS0000022602.V281215.R01.S.doc Version 5.1 Page 20 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39,43 This home has some failings that relate to the way its staffed and the way things are arranged and these are having an impact on the residents care. EVIDENCE: A key member of staff had been out of the home on two separate occasions during the past year. There was evidence to show that this had given other members of the team more work to do and had created some stress and lack of motivation. The staff felt unsure of how things were to move forward in the home. Residents and staff alike were unsure of future planning for the home. The home didn’t have a new business or financial plan. Some auditing of quality matters had been undertaken but no quality improvement plan was in place that would address issues residents had. The inspector judged that outcomes of questionnaires ought to also be considered along with individual and group concerns that were discussed in group meetings. A number of issues were waiting to be dealt with and this didn’t make residents feel confident that their views were listened to. Stanfield House DS0000022602.V281215.R01.S.doc Version 5.1 Page 21 Senior management of the company had started to work with the manager and the staff about how they saw the home moving forward. There was evidence to show that the residents were going to be involved with this project. The residents said they felt that the home was not sure whether they were running a project for people who were really ready to do the work for themselves or whether they were going to take people who were still in early stages of recovery. They thought that if the philosophy were to change then the staffing and other arrangements also needed to change. The inspector agreed with their opinions and requires Turning Point to complete this exercise and come up with concrete plans for moving things forward in the home. Stanfield House DS0000022602.V281215.R01.S.doc Version 5.1 Page 22 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 X 2 2 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 2 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 2 33 2 34 3 35 X 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 X X X X LIFESTYLES Standard No Score 11 3 12 2 13 X 14 X 15 X 16 X 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X 1 X 2 X 2 X X X 2 Stanfield House DS0000022602.V281215.R01.S.doc Version 5.1 Page 23 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA6 Regulation 15 Requirement Timescale for action 30/04/06 2. YA20 13(2) The care plans for every resident need to be more detailed, cover all needs and be up to date. To review policies and procedures for medicines 30/04/06 handling to reflect local practice. To clarify systems in place for self-medication. (This is an outstanding requirement that has been extended) The system of self-medication requires review to include ongoing risk assessments and supply of medicines in appropriate containers that are labelled to the standard expected from a dispensing pharmacist (This is an outstanding requirement that has been extended) Medicines must be kept in their original container and supplies must not be mixed. (This is an outstanding requirement)
DS0000022602.V281215.R01.S.doc 3. YA20 13(2) 30/04/06 4. YA20 13(2) 01/01/06 Stanfield House Version 5.1 Page 24 5. YA23 13 (6) 6. YA33 18(1) (a) 7. 8. YA36 YA37 18 (2) 24 (2) and (3) 9. YA39 24 (1) 10. YA43 25 The registered person must look at how the home deals with potential or actual bullying or self-harm. It is required that the registered person proves to the inspector that there are always enough staff in the home to make sure residents are protected and that care is enhanced. It is required that all staff receive supervision and appraisal on a regular basis. Turning Point must review the way the home is currently operating and send a copy of their action plan to the inspector by the due date Turning Point must make sure that further quality monitoring is undertaken in a response to the issues raised in this inspection and to issues raised by the residents. The registered person must prepare a business and financial plan for the next financial year. 30/04/06 30/04/06 30/04/06 30/04/06 30/04/06 30/04/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard YA2 YA6 Good Practice Recommendations It is recommended that Turning Point review their arrangements for making assessments and for admitting new residents. It is recommended that the staff team be given the opportunity to look at up to date research on person centred care planning and on planning specifically structured for rehabilitation and addiction.
DS0000022602.V281215.R01.S.doc Version 5.1 Page 25 Stanfield House 3. YA12 4. 5. YA17 YA22 6. YA24 7. YA32 It is recommended that as part of a wider review Turning Point look at extending the availability of activities, employment and training and look at ways to fund these things. It is recommended that as part of a wider review Turning Point looks at how the food budget is managed. As part of a wider review Turning Point need to look at how they encourage residents to talk to staff about concerns and complaint relating to how the resident group functions. It is recommended that Turning Point progress their plans for a new shower as part of the refurbishment of the upstairs bathroom and the installation of an ensuite to one of the double rooms. It is recommended that Turning Point consider skills mix when they undertake a review of the future planning in the home. Stanfield House DS0000022602.V281215.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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