Inspection on 22/08/05 for The Bungalow

This inspection was carried out on 22nd August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

The Bungalow 14/11/08

The Bungalow 08/09/08

The Bungalow 26/09/06

The Bungalow 07/03/06

The Bungalow 12/11/04

The Bungalow 24/05/04

Similar services:

Insight - Eastchurch

Southfields

Thorndene

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 The Bungalow Dennes Lane Lydd Kent TN29 9PU Lead Inspector Sally Gill Announced 22/08/05 at 09:40hrs 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. The Bungalow 2006 H56-H05 S23184 The Bungalow V233287 220805 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service The Bungalow Address Dennes Lane, Lydd, Kent, TN29 9PU 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) 01797 321612 Parkcare Homes (No 2) Ltd Ms Janet Clayton Registered Care Home 4 Category(ies) of Adults with a Learning Disability 18-65 registration, with number of places The Bungalow 2006 H56-H05 S23184 The Bungalow V233287 220805 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th November 2004 Brief Description of the Service: The Bungalow is registered to provide accommodation for up to 4 adults with a learning disability and admits people with low dependencies. The company Parkcare Homes (No2) Ltd owns the business and the Registered Manager, Mrs Jan Clayton has day-to-day control of the Home. The property is a detached colt bungalow with four single bedrooms one of which has an ensuite shower and two have a wash hand basin fitted. All rooms have a television point. The clients also have the use of a kitchen, utility, lounge/diner, conservatory/workshop, shower room and bathroom. The bungalow has a well-maintained garden with patio and lawn plus an additional area with chickens, geese and ducks. There is a parking area to the front of the bungalow. The Bungalow is situated in a quiet lane on the outskirts of Lydd. The Home has transport available for clients. Within Lydd there is a regular bus service, golf club, pubs and club and a selection of shops. The Bungalow 2006 H56-H05 S23184 The Bungalow V233287 220805 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection, which took place on Monday, 22nd August between 9.40am and 5.10pm. Additional time was spent in preparation and report writing. During the inspection the Inspector spoke to 2 clients both in company and in private. Also, she spoke to the Registered Manager and three support workers. Surveys were received back from all three clients, which indicated that they are satisfied with their care at The Bungalow. The care of one client was case tracked and others looked at in parts. The Inspector examined various records including care plans, risk assessments, client’s finances, menus, the fire safety logbook, Medication Administration Record (MAR) charts and accident reports. A part tour of the building was undertaken including the lounge/diner, shower/toilet, garden and three bedrooms (two by invitation and one is vacant). After discussion during the inspection those that live at The Bungalow will be referred to in this report as clients. What the service does well: The home provides clients with a spacious homely, pleasant, comfortable and clean environment. The emphasis is on outdoor life with clients having responsibilities for the upkeep of the garden and animals. Chickens provide eggs, which are used within the home. The interaction between the staff and clients is good. The staff team is stable. Discussions and observations always highlight the commitment of staff to improve the quality of life for clients. Client comments about their life include “we can say what we want to do and what we want around the house”, “I always have a fantastic day out when I go out”, “you can have a laugh and joke with X (staff member)” and “you can have good fun with staff and sometimes other clients”. The Bungalow 2006 H56-H05 S23184 The Bungalow V233287 220805 Stage 4.doc Version 1.30 Page 6 What has improved since the last inspection? What they could do better: The care needs of one client are impacting quite considerably on other clients and also on staff morale. The home must obtain professional advice; support and guidance to ensure they are able to meet the care needs of the client. Recommendations/requests at client’s reviews must be followed through in a timely manner. Advice and guidance should also be sought from the continence advisor to ensure the home is managing this need appropriately and the client has the best possible quality of life. All clients should have a written structured programme of activities in place. To ensure all clients have opportunities offered. Care plans should be expanded and reflect client’s skills and needs to ensure that all their needs can be met and independence is promoted. Clients should be aware and have access to the records kept about them and have input to their care plans/programmes. The Bungalow 2006 H56-H05 S23184 The Bungalow V233287 220805 Stage 4.doc Version 1.30 Page 7 Clients would benefit from a clear understanding of any house rules and discussions about how they wish to be treated by others within the home and what is expected of them as part of group living. This should help overcome client comments such as “I feel like I’m the only one doing anything”. If goals were broken down into a step-by-step guide for clients and staff it would then allow for all staff to offer cooking/baking opportunities with clients in the structured programme rather only available when one member of staff is on duty. There are shortfalls in the medication system, which could pose a risk to clients. All incidents, which are detrimental to clients and/or staff, must be recorded to enable a clear management of unacceptable behaviours and ensure a quality of life for all clients. 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. The Bungalow 2006 H56-H05 S23184 The Bungalow V233287 220805 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection The Bungalow 2006 H56-H05 S23184 The Bungalow V233287 220805 Stage 4.doc Version 1.30 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 standard(s) 3 and 5 The home does not currently demonstrate that it can fully meet the needs and aspirations of all individuals admitted to the home. All clients have an individual written contract in place with the home. EVIDENCE: The behaviours of one client are impacting quite considerably on other clients to the point the majority of the inspection was discussing this concern with both other clients and also staff. A referral to the local Community Learning Disability Team (CLDT), which was agreed in April, has been delayed although not by the home. The home must obtain professional advice; support and guidance to ensure they are able to meet the care needs of the client and that his needs do not have a negative impact on other clients. The registered manager stated that all clients now have an written individual contract in place. The Bungalow 2006 H56-H05 S23184 The Bungalow V233287 220805 Stage 4.doc Version 1.30 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 standard(s) 6, 7, 8, 9 and 10 Improvements should be made to ensure that clients know their assessed needs and goals are reflected in their care plan. Clients are consulted and are able to make decisions about day-to-day life. Risks are managed in a way that does not limit individual development. EVIDENCE: Regular reviews are held however the recommendations/requests made must be followed through in a timely manner. A review held in April still has outstanding recommendations/requests. Care plans did not cover all areas of standard 2.3, which they should. They should also reflect client’s skills and needs to ensure that their needs are met and also that staff adopt a consistent approach to promote independence wherever possible. Clients commented that they were not involved with the review of their care plans and had been told in the past that they were “not allowed to see their IPP (individual personal plans)”. They should be aware of all records kept about them and have involvement in their care plans/programmes. The Bungalow 2006 H56-H05 S23184 The Bungalow V233287 220805 Stage 4.doc Version 1.30 Page 11 All clients should have a written structured programme of activities in place, which they have agreed and is kept under review. If they were to maintain a copy perhaps this would help in the motivation of undertaking activities together with a consistent approach from staff. This will ensure they have opportunities offered and any refusals should be recorded. The Inspector saw some very good recording against goals and also some poor. It is suggested that the goal is broken down into a step-by-step guide for clients and staff. This would then allow for all staff to offer cooking opportunities with clients in the structured programme rather only available when one member of staff is on duty. A key worker system is in place and all clients are aware of their key worker and what is their role. Restrictions on choice are recorded. Clients confirmed that they are consulted on and participate in day-to-day life at the home. Appropriate risk assessments are in place, which are kept under review. The Bungalow 2006 H56-H05 S23184 The Bungalow V233287 220805 Stage 4.doc Version 1.30 Page 12 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 standard(s) 11, 12, 13, 14, 15, 16 and 17 Clients have opportunities for personal development. Clients are able to choose a variety of appropriate activities and leisure activities and get out into the wider community. Family contact is encouraged and supported. Work should be undertaken to ensure the rights and responsibilities for all clients. Clients enjoy a variety of meals. EVIDENCE: All clients have the opportunity for personal development however some are more motivated than others in using these opportunities. The home used to have an agreed rota where clients all participated in daily household tasks such as helping prepare the evening meal, washing and drying up, staff said that this is no longer in place because some clients refuse to do their share and some do more than their share both of which eventually leads to confrontation between clients. The Inspectors feels that clients and staff would benefit from a clear understanding of any house rules and these discussions should include how The Bungalow 2006 H56-H05 S23184 The Bungalow V233287 220805 Stage 4.doc Version 1.30 Page 13 they wish to be treated by others within the home and what is expected of them as part of group living. Once discussed and agreed this should be reinforced day to day to ensure that clients do not “feel like I’m the only one doing anything”. One Care Manager had stated that one client did not appear to have any structure to his day to aid this as previously stated all clients should have a copy of structured programme of activities in place, which is kept under review/developed. This will ensure they are offered opportunities any refusals should be recorded. Clients talked about involvement in the local community and also a variety of leisure activities they had enjoyed including a recent holiday. Goal planning to aid development and recording has been discussed previously but this would then allow for all staff to offer cooking/baking opportunities with clients as part of their structured programme rather only available when one member of staff is on duty. Staff talked of the achievement of one client since moving to the home (although not evidenced by records) despite a lack of motivation. Clients and staff also talked about the new college term and course, which were booked or being planned. At present staff morale is low and the Inspector feels that as a result consistency in their approach to motivate clients compared to previous inspection has declined. Clients and staff talked of family contact and visits, which is supported by staff. One client was on a short break to home at the time of the inspection. Clients commented that they are happy with the food and the menu reflected a variety of meals are available although adequate the emphasis is not necessarily on the healthy option. The Bungalow 2006 H56-H05 S23184 The Bungalow V233287 220805 Stage 4.doc Version 1.30 Page 14 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, 19 and 20 The medication system potentially places the clients at risk. There is no clear care planning system in place to ensure clients are supported maximise their health, independence, dignity and control over their lives. EVIDENCE: Care plans do not reflect any personal care needs or preferences. The manager stated that clients are independent however the needs and preferences should still be recorded to ensure a consistent approach by staff and to aid independence. One staff member talked about a continence problem and how staff was addressing this however this is not recorded or monitored to aid improvement. The home should seek specialist advice and guidance from the continence advisor to ensure the home is managing this appropriately and the client has the best possible quality of life. As discussed previously the behaviours of one client are having an impact on others and a referral for specialist support is required to help the home manage this behaviour so it does not negatively impact on others. The Inspector viewed the medication system and found the following shortfalls. All PRN medication must have written instruction to staff. All sections of the PRN template must be completed and the level of authorisation should be The Bungalow 2006 H56-H05 S23184 The Bungalow V233287 220805 Stage 4.doc Version 1.30 Page 15 added. There should be evidence that a doctor has authorised any homely remedies used for clients to ensure they can be taken with their current medication. A review of current medication should be undertaken to ensure the prescription information is up to date and relevant those, which are not, should be referred back to the doctor. The home should access printed MAR charts where possible. All medicines taken in and out of the home including home visits must be recorded with quantities. All staff administering medication should follow the homes medication procedure. Any checks that are undertaken by the manager on competency of staff should be recorded. The Bungalow 2006 H56-H05 S23184 The Bungalow V233287 220805 Stage 4.doc Version 1.30 Page 16 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 standard(s) 22 and 23 Clients feel that any complaints they had would be listened to and acted upon. Improvements must be made to ensure clients are protected from abuse. EVIDENCE: Clients commented that if they had any complaints they felt comfortable in approaching staff and felt they would be listened to and actions would be taken. The Inspector viewed records of incidents recorded on ABC charts however in discussion with staff it was apparent that not all incidents have been reported/recorded. All incidents, which are detrimental to clients and/or staff, must be recorded to enable a clear management strategy to address any unacceptable behaviour and ensure protection for both clients and staff. Although staff has undertaken adult protection training in discussion they were not aware of the route to report abuse outside of the company. The whistle blowing policy was displayed within the home however this did not have the correct details of the Commission or Social Services but an incorrect muddle of the two. This should be addressed and management should ensure that staff do know the route should they wish to disclosure outside of the company. Staff have undertaken NVCI training and the manager stated that the refresher which is planned has been increased from one to two days. The Bungalow 2006 H56-H05 S23184 The Bungalow V233287 220805 Stage 4.doc Version 1.30 Page 17 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, 25, 26, 28 and 30 Clients live in an environment, which is well maintained, safe, comfortable, and homely and suits their needs. There should be a written policy and procedure for handling clinical waste to ensure hygiene and clients dignity. EVIDENCE: On the day of the inspection the home was clean and well maintained providing a homely and comfortable environment. The gardens are as always looking pleasant and well kept. Since the last inspection the lounge/diner has been redecorated and a new lounge suite purchased as well as a dining room table and chairs. The large third bedroom has been made into two bedrooms each with wash hand basin. An electric shower has been installed over the bath at the request of clients. The Bungalow 2006 H56-H05 S23184 The Bungalow V233287 220805 Stage 4.doc Version 1.30 Page 18 Staff discussed concerns regarding the washing of soiled laundry given the washing machine is situated in the kitchen. There should be written procedures for staff to follow to ensure hygiene is maintained as well as the dignity of clients. The Bungalow 2006 H56-H05 S23184 The Bungalow V233287 220805 Stage 4.doc Version 1.30 Page 19 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33 and 35 Clients benefit from a competent, trained and qualified staff team who are clear about their roles and responsibilities and are deployed in sufficient numbers to meet the needs of clients. EVIDENCE: There is two staff on duty from 7am – 10pm and one wake night 9.30pm – 7.30am and one member of staff sleeping in. This is in addition to the manager. No new staff have been employed since the last inspection. Two staff has obtained an NVQ qualification at level 2 or above and another three are on going which will meet the 50 target. The company have just introduced a new induction and foundation-training programme, which is to TOPSS specification and linked to LDAF. The Inspector is pleased to see this is competency based. The interaction between the staff and clients is good. The staff team is stable. Discussions and observations always highlight the commitment of staff to improve the quality of life for clients although as previously mentioned the motivation/morale of some team members has taken a dip, which is disappointing. The Bungalow 2006 H56-H05 S23184 The Bungalow V233287 220805 Stage 4.doc Version 1.30 Page 20 See next section for core training. Five staff is also trained sexual awareness for clients. The Bungalow 2006 H56-H05 S23184 The Bungalow V233287 220805 Stage 4.doc Version 1.30 Page 21 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, 40, EVIDENCE: The manager continues to study for her RMA NVQ level 4. The manager stated that the recommendation to include professionals in the quality assurance system remains outstanding. However the views of clients and their families are sought and fed to head office. As previously stated the home should have a written procedure for staff to follow regarding the washing of soiled laundry given the washing machine is situated in the kitchen. The procedure should ensure hygiene is maintained as well as the dignity of clients. The whistle blowing policy requires review. The Bungalow 2006 H56-H05 S23184 The Bungalow V233287 220805 Stage 4.doc Version 1.30 Page 22 As also previously stated clients should be aware and have access to their records and be involved in the development of care plans/programmes. Individual records are maintained securely. Accidents are recorded appropriately. All staff are trained in manual handling, fire safety, first aid, food hygiene and health and safety. Two staff are trained in infection control and one in fire marshall. The fire safety logbook evidenced all appropriate checks to timescales. A valid periodical electrical wiring certificate was seen. The Bungalow 2006 H56-H05 S23184 The Bungalow V233287 220805 Stage 4.doc Version 1.30 Page 23 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 x 2 x 3 Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 3 3 2 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 x 2 Standard No 11 12 13 14 15 16 17 2 3 3 3 3 2 3 Standard No 31 32 33 34 35 36 Score 3 3 3 x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Bungalow Score 2 2 2 x Standard No 37 38 39 40 41 42 43 Score x x 2 2 2 3 x 2006 H56-H05 S23184 The Bungalow V233287 220805 Stage 4.doc Version 1.30 Page 24 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 3 Regulation 13 Requirement The home must obtain professional advice; support and guidance to ensure they are able to meet the care needs of clients and these needs do not have a negative impact on other clients Clients should be aware of all records kept about them, have involvement and access All PRN medication must have written instruction to staff. All sections of the PRN template must be completed and the level of authorisation should be added (by 30/08/05). There should be evidence that a doctor has authorised any homely remedies used for clients to ensure they can be taken with their current medication (by 22/09/05). A review of current medication should be undertaken to ensure the prescription information is up to date and relevant those, which are not, should be referred back to the doctor (by 22/09/05). The home should access printed MAR charts where possible (by 2006 H56-H05 S23184 The Bungalow V233287 220805 Stage 4.doc Timescale for action 16th October 2005 2. 3. 10 20 15 13 30th August 2005 22nd September 2005 The Bungalow Version 1.30 Page 25 4. 23 17 Sch 3 22/09/05). All medicines taken in and out of the home including home visits must be recorded with quantities (by 30/08/05). All staff administering medication should follow the homes medication procedure (by 23/08/05). Any checks that are undertaken by the manager on competency of staff should be recorded (by 30/08/05). All incidents, which are 24th August detrimental to clients and/or 2005 staff, must be recorded to enable a clear management strategy to address any unacceptable behaviour and ensure protection for both clients and staff 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. 3. Refer to Standard 6 6 6 Good Practice Recommendations Recommendations and requests made at reviews must be followed through in a timely manner Care plans should cover all areas of standard 2.3 Care plans should reflect all client’s skills and needs to ensure that all their needs are met and that staff adopt a consistent approach to promote independence wherever possible Clients should be involved with the review of their care plans/programmes which should be evidenced Clients should have a written structured programme of activities in place, which they have agreed and is kept under review and able to have a copy Goals are broken down into a step-by-step guides for clients and staff Clients should have a clear understanding of any house rules and these discussions should include how they wish to be treated by others within the home and what is expected of them as part of group living. 2006 H56-H05 S23184 The Bungalow V233287 220805 Stage 4.doc Version 1.30 Page 26 4. 5. 6. 7. 6 6 6 16 The Bungalow 8. 9. 10. 11. 18 23 30 39 The home should seek specialist advice and guidance from the continence advisor The whistle blowing policy should be review to reflect the correct outside route to whistleblow There should be written procedures for staff to follow to ensure hygiene is maintained as well as the dignity of clients Expand QA to include professionals involved in the home (brought forward from previous inspections) The Bungalow 2006 H56-H05 S23184 The Bungalow V233287 220805 Stage 4.doc Version 1.30 Page 27 Commission for Social Care Inspection 11th Floor, International House Dover Place Ashford, Kent TN23 1HU 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 The Bungalow 2006 H56-H05 S23184 The Bungalow V233287 220805 Stage 4.doc Version 1.30 Page 28 - 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!