Inspection on 24/07/06 for The Barn

This inspection was carried out on 24th July 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found 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 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Barn 03/12/07

The Barn 13/03/06

The Barn 04/08/05

The Barn 11/02/05

The Barn 13/08/04

Similar services:

The Vicarage

7 Hyde Road

5 Seafield Road

Trevaylor Manor

12 Orchard Mews

Stallcombe House

Stepping Stones

Cornerstones

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

CARE HOME ADULTS 18-65 Barn (The) Holton Lee East Holton Holton Heath Poole, Dorset BH16 6JN Lead Inspector Sally Wernick Key Unannounced Inspection 24 July 2006 10:00 Barn (The) DS0000026821.V305168.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Barn (The) DS0000026821.V305168.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Barn (The) DS0000026821.V305168.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Barn (The) Address Holton Lee East Holton Holton Heath Poole, Dorset BH16 6JN 01202 631063 01202 631063 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) East Holton Charity Ms Elizabeth Ann Jones Care Home 4 Category(ies) of Physical disability (4) registration, with number of places Barn (The) DS0000026821.V305168.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. One or more Service Users, who will have a physical disability, may also be over the age of 65. 13th March 2006 Date of last inspection Brief Description of the Service: The Barn at Holton Lee offers accommodation for holidays, activities, retreats and relaxation for up to 9 people with a physical disability, although at any one time only 4 will require personal care. Family members, friends or carers can accompany guests and accommodation is provided to support this. The Barn is a modern building set within 350 acres of varied landscape with views towards Poole Harbour. The building is fully wheelchair accessible and designed to meet the needs of people who have a physical disability. The house provides single or double room accommodation. Other facilities include adapted bathroom and toilet including overhead hoist in a shower room, mobile hoists, Apollo bath, alarm call systems and electrically operated beds. Communal areas consist of a resource room fitted with computers with internet access, lounge with TV, a sitting room and a large dining room. As well as the main kitchen where staff prepares the meals there is a guest kitchen for snacks and drinks. During the day service users can use power chairs and scooters to go around the grounds, for bird and deer watching. At extra cost guests can book additional services such as counselling, massage/aromatherapy, reflexology and carriage driving. The home is not particularly close to community resources being in a rural area, however this is in keeping with the expectations of this service. Guests who wish to visit local towns can make taxi arrangements. Barn (The) DS0000026821.V305168.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection visit was unannounced and began at 10:00am on Monday, 24 July 2006. This was a ‘key inspection’ where the homes performance against the key National Minimum Standards was assessed alongside progress in meeting a requirement made at the last inspection. A senior carer assisted the inspector, as did other members of care staff. The registered providers/manager were not present on the day of inspection. Methodology used included a partial tour of the premises, review of records and discussions with guests and staff. The inspector also reviewed the contact sheet for The Barn. Just prior to the inspection The Commission for Social Care also sent questionnaires to the home for them to distribute amongst residents, relatives and visiting professionals. At the time of writing 2 questionnaires had been returned one from a guest another from a local G.P. A Pre-inspection questionnaire was also sent to the manager in order that information could be provided prior to the inspectors site visit. That information where relevant will be included in the main body of this report. What the service does well: At the time of the inspection there were nine guests enjoying respite care at The Barn the inspector was able to talk to seven. Without exception all spoke in glowing terms of the care received one comment card stated, “It is a wonderful place to stay and the staff care is excellent”. The inspector found that in all areas the home is well run and the care and contentment of guests is central to policy and provision. Guests at the Barn all stated that they received the right amount of assistance for their particular emotional and physical needs. Guests reported “nothing is too much trouble for staff at The Barn” and care is taken to provide resources, which cater for individual likes and dislikes. There are good links with other healthcare providers within the community if guests require. Food is described as excellent and there are a number of activities on offer. There is a clear complaints policy and procedure in place and systems to protect guests from harm or abuse. The service is well maintained and is likely to be much improved by a new 10-bed extension with full en-suite facilities. The Barn staff benefit from a structured induction programme. All receive training in equal opportunities and training and development is linked to the charities overall aims as well as service users needs. There is a clear quality Barn (The) DS0000026821.V305168.R01.S.doc Version 5.2 Page 6 assurance system in place and guest views regularly inform decision-making. A range of training, policy and practice protects the Health, safety and welfare of service users and there are good links with the local fire department. Guests return year after year to The Barn and cannot speak highly enough of the service and care they receive. Holton Lee benefits a wide range of individuals and provides a much, needed well-valued community resource. What has improved since the last inspection? 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. Barn (The) DS0000026821.V305168.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Barn (The) DS0000026821.V305168.R01.S.doc Version 5.2 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 the following standard(s): 2 Quality in this outcome area is good. This judgement has been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. The particular needs and aspirations of guests are assessed by suitably qualified people, discussed with all parties involved and agreed prior to arrival at The Barn. This means that guests can be confident that the care they receive will be tailored to meet their individual needs. EVIDENCE: Prior to arrival at the Barn guests are asked to complete a requirement form detailing care needs and aspirations during their respite period. In addition care needs assessments are obtained from funding authorities. Three guest files were inspected two of which were detailed and comprehensive. A third held a requirement form but no care plan although paperwork was in place to enable this information to be included. All of the guests were well known to staff as each had previously spent periods of respite at the Barn. Care must be taken however to ensure that up to date qualitative information is available for each guest to reflect their current and changing needs. Barn (The) DS0000026821.V305168.R01.S.doc Version 5.2 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 the following standard(s): 6, 7 & 9. Quality in this outcome area is good. This judgement has been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. Guests at The Barn know their needs and are able to express these well. However these are not always clearly identified in a plan of care, which may result in care not being provided in the manner required. Guests are provided with the assistance and information they need in order that they may make decisions about their own lives. Written risk assessments are in place for minimising the risk of harm to both staff and guests. EVIDENCE: During the inspection nine guests were enjoying respite care at The Barn all of whom when not there live independently within the community. Prior to their arrival they indicate on the guest requirement form specific levels of assistance and support needed during their stay in some cases but not all forms are supplemented by care plans from the funding authorities. Of the three care files reviewed two included “client handling forms” to be used in circumstances Barn (The) DS0000026821.V305168.R01.S.doc Version 5.2 Page 10 where support with movement is required the third file had not yet been completed. Seven of the nine guests were spoken to and without exception was entirely happy with the care they received. Comments included: “Can’t put a value on the excellent care given” “Care can’t be faulted” “Your treated like an individual the staff are excellent” “Staff are considerate and time is taken to meet individual need” It is clear that staff are reliant on verbal instruction from guests, which leads to very positive outcomes in terms of care. The absence of written detailed information however could potentially leave staff and guests vulnerable without good documentation to refer to. All seven guests had only the highest praise for staff however stating that the levels of assistance and care provided were dictated by individual choice and assessed need. Information on resources available at the Barn is kept on both the resource room and in guest rooms. There is a wide range of activities to enjoy and risk assessments are in place to minimise any risk of harm to guests and staff. Guests spoken to choose how to spend their day and receive as much or as little assistance from staff that they require. Barn (The) DS0000026821.V305168.R01.S.doc Version 5.2 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): 12, 13, 15, 16 & 17. Quality in this outcome area is good. This judgement has been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. Guests are provided with a full range of appropriate activities to meet their needs and wishes there are strong community links. Daily routines are flexible, which ensures that guest’s rights and responsibilities are recognised. Meals are varied, nutritious and of good quality. EVIDENCE: There is a wide-range of activities for guests to enjoy at The Barn. A number of adapted motorised vehicles and bikes allow access to the beautiful surrounding areas of Holton Lee. There is a pony and trap available and occasionally organised walks. The resource room includes a computer, which guests can readily access and there are lots of games, jigsaws and books. Each week there is a painting and a stonemasonry workshop and a set time each week where guests can enjoy some spiritual reflection with a local pastor. A number Barn (The) DS0000026821.V305168.R01.S.doc Version 5.2 Page 12 of festivals are planned at Holton Lee during the summer months for visiting groups. Prior to the inspection there had been a music festival and a horse show is planned in the coming weeks which guests are able to attend. There are also various art exhibitions that are hosted at a smaller adjacent barn. Bird Hyde’s are also very accessible. All of the guests spoken to felt that there was more than enough to occupy them at the Barn and there was a good balance between rest and activity. One guest continues to attend the painting workshops when not on respite. All guests spoken to had high praise for the range of activities on offer. Guests are able to bring with them partners, or friends to either care for them or to enjoy a holiday alongside them during their period of respite stay. Family and friends are also able to visit at times which are flexible and are welcome to stay for meals should they choose. Daily routines although regular are not strictly adhered to. All guests spoken to said that they could choose how to spend their day and that although they chose to go to bed and get up at regular times and take communal meals that this was not expected. All said that their right to privacy, choice and independence were safeguarded. Meals are generally a communal event and are taken in a pleasant dining room. Much of the fresh produce is grown at Holton Lee and care is taken to include organic vegetables in each meal. Food is varied and nutritious and without exception each guest spoken to say the food was “excellent” or “good”. Special dietary needs are well catered for, as are personal likes and dislikes. Barn (The) DS0000026821.V305168.R01.S.doc Version 5.2 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): 18, 19 & 20. Quality in this outcome area is good. This judgement has been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. Staff at the Barn provides personal guidance and support according to individual need and in line with guests preferences and wishes. Policies and procedures relating to the health care needs of service users promote good practice and ensure physical and emotional needs are met. Where possible guests maintain, administer and control their own medication and are generally protected by the home’s policies and procedures. EVIDENCE: Without exception each guest spoken to said that the personal care and support that they receive at the Barn was excellent. Care is delivered in line with individual wishes and in a way that allows guests to feel respected. For all guests their physical and emotional health care needs are established and met prior to their period of respite. Staff at the Barn however continues to contribute to and complement this. If requested guests may access aromatherapy massage and reflexology although there is an additional cost for that service. Guests confirm that they are supported by district nurses during Barn (The) DS0000026821.V305168.R01.S.doc Version 5.2 Page 14 their stay if needed and staff confirm that there are good links with other health care providers. All guests receiving care during this inspection were independent in maintaining, administering and controlling their own medication. Lockable storage is provided and medication brought into the Barn is recorded. Not all staff has received training in the safe handling of medicines however or an assessment of competency from a qualified member of staff. It is also good practice in line with the home’s own policy and procedures to include a risk assessment format for those guests who retain their own medication. Barn (The) DS0000026821.V305168.R01.S.doc Version 5.2 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. Quality in this outcome area is good. This judgement has been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. The Barn has a clear and effective complaints procedure, which enables guests to feel confident that their views are listened to and acted on. Written policies are in place at The Barn to safeguard service users against abuse, neglect and self harm. EVIDENCE: A suitable policy and complaints procedure is in place at The Barn and each guest receives a copy with their welcome pack. There is a formal record of complaints with evidence of review by the registered manager. No complaints have been received during this inspection period. The Barn has an adult protection policy and procedure in place and some staff has received training in this area although not all. Guests spoken to commented on the high levels of sensitivity and respect afforded to them by staff on a day-to-day basis and when delivering individual care. Barn (The) DS0000026821.V305168.R01.S.doc Version 5.2 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 & 30 Quality in this outcome area is good. This judgement has been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. The Barn provides a safe, homely comfortable environment, which is well suited to the needs of the current guests. The Barn is clean and hygienic and promotes safe working practices. EVIDENCE: The accommodation arrangements at The Barn are well suited to the needs of the guests although vast improvements are underway. The charity is currently in the process of building a new 10 bedded fully en-suite facility adjacent to the current accommodation. It is hoped that the new building will be completed during early 2007. The current accommodation continues to offer a well-maintained safe interesting environment with a resource room, which enables access to the, Internet, and a range of information services. The communal sitting room and dining area, provides lovely views of local bird life as well as the surrounding shrub land. There is a good range of up-to–date reading material, games and videos and the premises are accessible to all guests. The Barn is bright and airy and meets the requirements of both the local fire service and environmental health department. Barn (The) DS0000026821.V305168.R01.S.doc Version 5.2 Page 17 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, 34 & 35. Quality in this outcome area is good. This judgement has been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. Guests are supported by a sufficient number of staff that is suitably trained and qualified offering consistency of care at The Barn. However the target of 50 staff with NVQ qualification by 2006 remains ongoing. Proper recruitment procedures ensure that service users are supported and protected. Service users individual and joint needs are met by appropriately trained staff. EVIDENCE: Staff at The Barn has a wide range of qualifications and experience, which makes them well placed to work with all guests. There is a structured induction in place, which provides training in a range of Health and Safety topics and all staff receive equal opportunities training. Training and development are linked to the Barn’s aims and to service users needs. NVQ training remains ongoing although the requirement that 50 of the staff team are trained to at least NVQ level 2 may not be achieved by the end of 2006. Three staff files were reviewed and staff spoken to. All confirmed that they had the opportunity for regular training and were well supported by the registered manager. Proper recruitment procedures are adhered to and files evidenced that all relevant documentation is in place to ensure the safety and well being of guests. Barn (The) DS0000026821.V305168.R01.S.doc Version 5.2 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 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, 40, 42 & 43. Quality in this outcome area is good. This judgement has been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. The home benefits from an experienced manager and staff team whose roles and responsibilities are clearly defined. Guests are asked to make their views known and to have regular input into policy and practice. Comprehensive policies are in place to ensure the safety and wellbeing of guests. The Barn follows good practices that promote and safeguard the health, safety and welfare of service users. Guests benefit from generally accountable management of the service. Barn (The) DS0000026821.V305168.R01.S.doc Version 5.2 Page 19 EVIDENCE: The Registered manager holds the Registered Managers award and NVQ 4 in care. Ms Jones is an NVQ assessor and there is evidence that she continues to keep her knowledge and skills updated by attending regular training courses. Following their stay all guests are asked to complete an evaluation form, which is reviewed both by the registered manager and the director. Any areas of concern are followed up as a result of this by letter and results are incorporated into the charity’s strategic yearly review. Family members also complete evaluations although at the current time care managers and other stakeholders are not included in the quality assurance programme. There is a five-year management plan in place and the views of guests strongly influence, decision making. For example the decision to undertake the new build has been made following comments from guests who benefit from the current provision and who has expressed a preference for en-suite facilities. In line with a recommendation made at the previous inspection The Barn has in place comprehensive policies and procedures to protect the safety and wellbeing of all guests. All staff has received training in moving and handling, fire safety, first aid, food hygiene and infection control. There is clear evidence that all electrical and gas systems are well maintained and that regular servicing of the lift, and hoists takes place. The Barn has a good relationship with the local fire station who take part in staged evacuations with guests and staff and who provide advice on maintaining equipment. Fire records demonstrate that regular drills take place and the content and duration of the training is recorded. At the current time not all staff members sign to say they have received that training it is preferred good practice that they do so. It is clear given the feedback from guests that investment in the quality and provision of service continues to be of paramount importance to the manager and registered providers. In line with previous recommendations however reports on the quality of provision made by the providers are not forwarded to the commission for social care. These reports monitor all standards of care and contribute to ensuring good conduct of the service. This recommendation will therefore be repeated. Barn (The) DS0000026821.V305168.R01.S.doc Version 5.2 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 Standard No Score 1 X 2 3 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 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 2 33 x 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 x 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x 3 X 3 3 X 3 2 Barn (The) DS0000026821.V305168.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? Yes 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. Standard Regulation Requirement 50 of care staff must be qualified to at least NVQ level 2 and qualifications gained by the extended date of 2006. (Ongoing from previous inspection within attached timescale). Timescale for action 1. YA32 18 31/12/06 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 YA9 Good Practice Recommendations Comprehensive, detailed information should be included in care plans to ensure that staff have sufficient knowledge to meet service user needs. Individual risk assessments should be signed by both staff and service user to demonstrate consultation has taken place and is understood. Where service users self medicate this should be considered in a risk assessment format. All staff involved in the handling of medication should also receive appropriate training or an assessment of competency from a suitably qualified person. It is good practice for all staff to receive up to date accredited training in the protection of vulnerable adults. The record of staff fire instruction should contain DS0000026821.V305168.R01.S.doc Version 5.2 Page 22 3. YA20 4. 5. Barn (The) YA23 YA42 6. YA43 signatures of all staff that has received that training. Reports made by the person visiting the home on behalf of the Registered Provider must be made available to the Commission. Greater care should therefore be taken to ensure that all such reports are made available. (Repeated at this inspection). Barn (The) DS0000026821.V305168.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Barn (The) DS0000026821.V305168.R01.S.doc Version 5.2 Page 24 - 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!