Inspection on 16/01/06 for The Chestnuts

This inspection was carried out on 16th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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 19 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Chestnuts 24/05/07

The Chestnuts 13/11/06

The Chestnuts 25/05/06

The Chestnuts 07/06/05

The Chestnuts 30/09/04

The Chestnuts 21/07/04

The Chestnuts 08/03/04

Similar services:

1 Marten Road

Daubeney House

Three Gables

Aldwick House

49 Glendale

The Springs Community

Crossways Community

Belle Vue Country House

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

CARE HOME ADULTS 18-65 The Chestnuts (Welcome House) Watts Avenue (10) Rochester Kent ME1 1RX Lead Inspector Sarah Montgomery Unannounced Inspection 16th January 2006 09:30 The Chestnuts (Welcome House) DS0000028336.V277953.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 The Chestnuts (Welcome House) DS0000028336.V277953.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. The Chestnuts (Welcome House) DS0000028336.V277953.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service The Chestnuts (Welcome House) Address Watts Avenue (10) Rochester Kent ME1 1RX 01634 842084 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) Dr Toqeer Aslam Sharon Edmunds Care Home 15 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (15) of places The Chestnuts (Welcome House) DS0000028336.V277953.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7th June 2005 Brief Description of the Service: The Chestnuts is a registered care home for adults with mental health problems. It has registration for 15. A staff team consisting of a Home manager, Deputy Manager, and a support worker, supports Service users. The home is a large detached property with accommodation over two floors. Communal areas include a large lounge, a dining room and kitchen. The home is close to Rochester town centre and has a selection of local shops and services nearby. The Chestnuts (Welcome House) DS0000028336.V277953.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Sarah Montgomery conducted this unannounced inspection on Monday 16th January 2006. Evidence was gathered by talking with staff and service users, and by reading a selection of documents. What the service does well: What has improved since the last inspection? What they could do better: The inspection process evidenced non-compliance in a number of areas. Most notably; the statement of purpose and service user guide; service user assessment; care planning; risk assessment; staffing numbers; training; and lifestyle opportunities for service users. There was insufficient evidence to suggest that service users needs were correctly identified or met. The Chestnuts (Welcome House) DS0000028336.V277953.R01.S.doc Version 5.1 Page 6 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 Chestnuts (Welcome House) DS0000028336.V277953.R01.S.doc Version 5.1 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 The Chestnuts (Welcome House) DS0000028336.V277953.R01.S.doc Version 5.1 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): 1 and 2. Service users cannot be confident that they have the information they need to make an informed choice about where to live. Service user care may be compromised due to insufficient recording of individual’s aspirations and needs during assessment. EVIDENCE: The service user guide and statement of purpose was inspected. These documents do not provide clarity to service users regarding the purpose of the service, and continue to describe The Chestnuts as a service providing respite, short term and longer-term. Standard 1 clearly states; ‘The registered person produces an up-to-date statement of purpose setting out the aims, objectives and philosophy of the home, its services and facilities, and terms and conditions; and provides each service user with a service users’ guide’. Regulation 6 talks about review of the statement of purpose and service user’s guide and states; ‘The registered person shall keep under review and, where appropriate, revise the statement of purpose and the service users guide’. Information gathered during the inspection indicates that for most service users this home is a long-term placement. There are no systems in place to facilitate service users wishing to gain skills necessary to move into a less dependent placement, and the home cannot evidence documents to support either short-term or respite placements. Prospective service users and their representatives cannot make an informed choice unless they are given clear information about the home. Welcome The Chestnuts (Welcome House) DS0000028336.V277953.R01.S.doc Version 5.1 Page 9 House must decide what service is being offered at the home, and change their statement of purpose and service user guide to reflect a true and up-to-date picture of the purpose of the home. The statement of purpose and service user guide both describe ‘a visitors room and a quiet room with a telephone for private use’. This information is inaccurate as the facilities described are the staff flat which service users do not have access to. Recent pre assessment documentation was read. Information was not complete, and the individual’s aspirations were not recorded. Assessment of need was not thorough enough to be considered effective; in particular, more information is required regarding likely indicators of mental health relapse and the subsequent staff responses. The Chestnuts (Welcome House) DS0000028336.V277953.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 and 7. Service users cannot be sure that their assessed and changing needs and personal goals are reflected in their individual plan. Service users cannot be sure that staff are aware of how to support them to take risks due to insufficient recording. EVIDENCE: A selection of care plans were inspected. It was clear that thought had been given to individual care planning, however, care plans were found to contain insufficient detail. The care plans read presented more as a pen portrait. While they contained some information, this was too brief to enable staff to fully support the service user. Supporting evidence regarding service users on going assessed and changing needs was not in place. Some care plans did contain dates where they had been reviewed, but background evidence in the form of any assessment to assist decision-making pertaining to assessment of changing needs was not available. As already noted, risk assessments were not detailed enough. This leaves service users and staff vulnerable, as key indicators regarding risk (particularly for mental health relapse) are not specific or detailed. The Chestnuts (Welcome House) DS0000028336.V277953.R01.S.doc Version 5.1 Page 11 The vulnerability and risk is further heightened by the fact the home does not hold staff meetings. While the inspector recognises that staff do communicate with each other during the course of the day, it is also apparent by inspection of the staff rota that one member of staff works alone each day from 5pm until 10pm. It is essential for staff meetings to take place regularly to ensure information is shared, and that all staff are fully aware of all current issues including care planning and risk assessment, and have opportunity to share ideas and hold professional discussions which are recorded and actioned. The Chestnuts (Welcome House) DS0000028336.V277953.R01.S.doc Version 5.1 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 the following standard(s): 11 and 16. Service users have opportunities for personal development but cannot be sure there are enough opportunities to learn practical life skills. Service users would benefit from having increased opportunities to promote independence. EVIDENCE: Discussion with the home manager and observations on the day of inspection evidenced that service users are encouraged to maintain independent living skills. Most service users made their own lunch on the day of inspection, and all service users can make drinks. The manager gave the inspector a pen picture of levels of independence for a selection of service users. These levels vary, and support needs were identified in for most. No evidence was presented regarding opportunities for service users to learn practical life skills. The inspector observed that staff positively encourages service users to maintain skills in a range of areas; social, emotional, communication and living skills. However, there is a lack of assessment and of teaching new skills. The Chestnuts (Welcome House) DS0000028336.V277953.R01.S.doc Version 5.1 Page 13 At present, staffing levels are insufficient to meet the needs of service users. The home is registered for 15, and currently has 12 service users. To introduce assessment tools and teaching programmes requires concentrated input from staff, which the rota does not allow. Several service users have requested a front door key. In line with the Welcome House ethos of promoting independence, and National Minimum Standard 16, this request must be fulfilled, and have an accompanying risk assessment. The Chestnuts (Welcome House) DS0000028336.V277953.R01.S.doc Version 5.1 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 the following standard(s): THESE STANDARDS WERE NOT ASSESSED. EVIDENCE: The Chestnuts (Welcome House) DS0000028336.V277953.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 and 23. Service users feel their views are listened to, but would benefit from a formal system which records outcomes of complaints. Service users cannot be sure they are protected from abuse, neglect and selfharm. EVIDENCE: Although the home has a formal complaints policy, the manager has identified that service users feel more comfortable in either talking to staff, or writing complaints in a book which is left in the hallway. Inspection of this book evidenced it is frequently used, and service users have detailed their concerns. When questioned about outcomes of the complaints recorded in the book, the manager gave full explanations of how the issues were responded to and resolved. However, no formal records of outcomes are made. This contravenes Standard 22 and Regulation 22. The manager must ensure that all complaints are responded to in compliance with regulation. The inspector is concerned that service users are not protected from abuse, neglect and self-harm. Indicators of this are insufficient staffing and lack of training. Adult protection training remains an outstanding requirement. Nor have the staff received training in key working skills, mental health, report writing, care planning. It was evident throughout the inspection that service delivery is severely hampered by these factors. The Chestnuts (Welcome House) DS0000028336.V277953.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): THESE STANDARDS WERE NOT INSPECTED. EVIDENCE: The Chestnuts (Welcome House) DS0000028336.V277953.R01.S.doc Version 5.1 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): 33, 34, 35 and 36. Service users are not supported by an effective staff team. Service users cannot be sure that staff supporting them are appropriately trained or well supported. Service users can be confident they are protected by the home’s recruitment policy and practices. EVIDENCE: The current staffing hours allocated to The Chestnuts are 22 hours per day Monday to Friday, and 14 hours per day Saturday and Sunday. A total of 138 hours per week. The home is registered for 15 service users. Figures from the Residential Forum for this number of service users in a registered care home providing support to service users with mental health issues are 314.46 per week. The home currently has 3 vacancies. Figures from the residential forum for 12 service users are 255.38. The home is running a deficit of 176 hours per week (or, taking into account the three vacancies, 117 hours per week). This deficit is unacceptable. Evidence gathered from the inspection not only demonstrates that service user’s needs are not being met, but also indicates that the Welcome House mission statement ‘To promote independence through supporting and encouraging our service users to lead as normal life as possible and to reach their full potential’ is not, and cannot be fulfilled with the substantial gaps in staff numbers. The Chestnuts (Welcome House) DS0000028336.V277953.R01.S.doc Version 5.1 Page 18 Staff do not receive adequate training. Again, this is in direct conflict to statements made in the Welcome House business plan which states; ‘Staff morale is being improved in an effort to prevent the high turnover of staff. This will be achieved through on-going training’. Staff have received little or no training. This is particularly worrying considering the diverse needs of the service user group. The training needs of all staff must be addressed, and accredited training must be undertaken. To compound this shortfall, staff are not paid when they attend training courses. This leads to low staff motivation regarding attending training, identifying their own training needs, and being proactive in making sure their training needs are addressed. Significant shortfalls in training, inadequate staffing numbers, and total absence of staff meetings indicate that there are not systems in place to show that staff and service users are valued. The manager informed the inspector that staff are supervised monthly. Records of these supervisions were not inspected. Staff files inspected demonstrated significant improvements in this area. All files now comply with Schedule 2. The Chestnuts (Welcome House) DS0000028336.V277953.R01.S.doc Version 5.1 Page 19 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 and 43. Service users benefit from having a manager who is committed to excellence in service delivery, but cannot be sure that this is achieved because of overall shortfalls in management of the service. EVIDENCE: The manager demonstrated a commitment to providing care and support to service users at the home. She is knowledgeable about their needs, and is competent in working within recognised systems and guidelines. Evidenced gathered during the inspection indicated that service delivery is compromised because of insufficient staffing, and inadequately trained staff. Service users are not receiving adequate care or support to lead valued and fulfilling lives. Staff evidently work hard, but do not receive adequate support to enable them to fulfil requirements in Regulation or to fulfil the terms of the Welcome House business plan. Shortfalls in staff numbers and staff training must be rectified. Without an adequate staff team who are suitably trained, the home will not be in a The Chestnuts (Welcome House) DS0000028336.V277953.R01.S.doc Version 5.1 Page 20 position to properly support individual service users in line with National Minimum Standards and Care Home Regulations. The Chestnuts (Welcome House) DS0000028336.V277953.R01.S.doc Version 5.1 Page 21 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 1 2 1 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 1 23 1 ENVIRONMENT Standard No Score 24 X 25 X 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 X 33 1 34 3 35 1 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 X X 1 X LIFESTYLES Standard No Score 11 1 12 X 13 X 14 X 15 X 16 2 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X X X 2 X X X X X 1 The Chestnuts (Welcome House) DS0000028336.V277953.R01.S.doc Version 5.1 Page 22 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 YA1 Regulation 4(1)a,b,c Requirement Timescale for action 31/03/06 2 YA1 4(2) 3 YA1 4(3)(a) 4(3)(b) The registered person shall compile in relation to the care home a written statement (in these Regulations referred to as “the statement of purpose”) which shall consist of – (a) a statement of the aims and objectives of the care home; (b) a statement as to the facilities and services which are to be provided by the registered person for service users; and a statement as to the matters listed in Schedule 1. The registered person shall 31/03/06 supply a copy of the statement of purpose to the Commission and shall make a copy of it available on request for inspection by every service user and any representative of a service user. Nothing in regulation 16(1) or 31/03/06 23(1) shall require or authorise the registered person to contravene, or not to comply with – DS0000028336.V277953.R01.S.doc Version 5.1 The Chestnuts (Welcome House) Page 23 4 YA1 5(1)a,b,c, d,e,f 5 YA1 5(2) 6 YA1 5(3) any other provision of these Regulations; or the conditions for the time being in force in relation to the registration of the registered person under Part 2 of the Act. The registered person shall produce a written guide to the care home (in these Regulations referred to as “the service user’s guide”) which shall include – (a) a summary of the statement of purpose. (b) The terms and conditions in respect of accommodation to be provided for service users, including as to the amount and method of payment of fees; (c) A standard form of contract for the provision of services and facilities by the registered provider to service users; (d) The most recent inspection report; (e) A summary of the complaints procedure established under regulation 22; The address and telephone number of the Commission. The registered person shall supply a copy of the service user’s guide to the Commission and each service user. Where a local authority has made arrangements for the provision of accommodation, nursing or personal care to the service user at the care home, the registered person shall supply to the service user a copy of the agreement specifying the arrangements DS0000028336.V277953.R01.S.doc (a) 31/03/06 31/03/06 31/03/06 The Chestnuts (Welcome House) Version 5.1 Page 24 made. 7 YA1 6(a) 6(b) The registered person shall – 31/03/06 (a) keep under review and, where appropriate, revise the statement of purpose and the service user’s guide; and notify the Commission and service users of any such revision within 28 days. The registered person shall not 28/02/06 provided accommodation to a service user at the care home unless, so far as it shall have been practicable to do so – (a) needs of the service user have been assessed by a suitably qualified or suitably trained person; (b) the registered person has obtained a copy of the assessment; there has been appropriate consultation regarding the assessment with the service user or a representative of the service user; 28/02/06 The registered person shall ensure that the assessment of the service user’s needs is – (a) kept under review; and (b) revised at any time when it is necessary to do so having regard to any change of circumstances. The registered person shall not provided accommodation to a service user at the care home unless, so far as it shall have been practicable to do so – (d) the registered person has confirmed in writing to the service user that having regard to the assessment the care home is suitable for the The Chestnuts (Welcome House) DS0000028336.V277953.R01.S.doc Version 5.1 Page 25 8 YA2 14(1)a,b,c 9 YA2 14(2)a,b,d 10 YA6 15(1) 11 YA6 15(2)a,b, c,d 12 YA6 12(1)(a) 12(1)(b) 13 YA9 13(4)(b) 13(4)(c) purpose of meeting the service user’s needs in respect of his health and welfare. Unless it is impracticable to carry out such consultation, the registered person shall, after consultation with the service user, or a representative of his, prepare a written plan (“the service user’s plan”) as to how the service user’s needs in respect of his health and welfare are to be met. The registered person shall – (a) make the service user’s plan available to the service user; (b) keep the service user’s plan under review; (c) where appropriate and, unless it is impracticable to carry out such consultation, after consultation with the service user or a representative of his, revise the service user’s plan; and notify the service user of any such revision. The registered person shall ensure that the care home is conducted so as – (a) to promote and make proper provision for the health and welfare of service users; to make proper provision for the care, and where appropriate, treatment, education and supervision of service users. The registered person shall ensure that – (b)any activities in which service users participate are so far as reasonably practicable free from DS0000028336.V277953.R01.S.doc 28/02/06 28/02/06 28/02/06 28/02/06 The Chestnuts (Welcome House) Version 5.1 Page 26 14 YA11 12(1)(b) 15 YA22 22(3)(4) (8) 16 YA23 16(2)(c) 17 YA33 18(1)(a) avoidable risks; and unnecessary risks to the health or safety of service users are identified and so far as possible eliminated. The registered person shall ensure that the care home is conducted so as – (b) to make proper provision for the care and, where appropriate, treatment, education and supervision of service users. The registered person shall ensure that any complaint made under the complaints procedure is fully investigated. The registered person shall, with 28 days after the date on which the complaint is made, or such shorter period as may be reasonable in the circumstances, inform the person who made the complaint of the action (if any) that is to be taken. The registered person shall supply to the Commission at its request a statement containing a summary of the complaints made during the preceding twelve months and the action that was taken in response. The registered person shall make suitable arrangements, by training staff or by other measures, to prevent service users being harmed or suffering abuse or being placed at risk of harm or abuse. The registered person shall, having regard to the size of the care home, the statement of purpose and the number and needs of service users – (a) ensure that at all times suitably qualified, competent and experienced persons are working at the care home in DS0000028336.V277953.R01.S.doc 28/02/06 28/02/06 28/02/06 28/02/06 The Chestnuts (Welcome House) Version 5.1 Page 27 18 YA35 18(1)c(i) 18(1)c(ii) 19 YA43 10(1) such numbers as are appropriate for the health and welfare of service users. The registered person shall, having regard to the size of the care home, the statement of purpose and the number and needs of service users – (c)ensure that the persons employed by the registered person to work at the care home receive – (i) training appropriate to the work they are to perform; and suitable assistance, including time off, for the purpose of obtaining further qualifications appropriate to such work. The registered provider and the registered manager shall, having regard to the size of the care home, the statement of purpose, and the number and needs of the service users, carry on or manage the home (as the case may be) with sufficient care, competence and skill. 28/02/06 28/02/06 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 Refer to Standard YA16 Good Practice Recommendations Service users are offered a key to the front door of the home. The Chestnuts (Welcome House) DS0000028336.V277953.R01.S.doc Version 5.1 Page 28 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Chestnuts (Welcome House) DS0000028336.V277953.R01.S.doc Version 5.1 Page 29 - 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!