Inspection on 24/05/07 for The Chestnuts

This inspection was carried out on 24th May 2007.

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 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 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Chestnuts 13/11/06

The Chestnuts 25/05/06

The Chestnuts 16/01/06

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 Joseph Harris Key Unannounced Inspection 24th May 2007 10:00 The Chestnuts (Welcome House) DS0000028336.V340202.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 The Chestnuts (Welcome House) DS0000028336.V340202.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. The Chestnuts (Welcome House) DS0000028336.V340202.R01.S.doc Version 5.2 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 Post Vacant Care Home 15 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (15) of places The Chestnuts (Welcome House) DS0000028336.V340202.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13th November 2006 Brief Description of the Service: The Chestnuts provides accommodation for up to 15 people with mental health needs. 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 current fees for the service at the time of the visit were £540.00 per week. Information on the Home and the CSCI reports for prospective service users will be detailed in the Statement of Purpose and Service User Guide. The Chestnuts (Welcome House) DS0000028336.V340202.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection process culminated in an unannounced site visit on the 24th May 2007. The visit commenced at 10am and concluded at 4.45pm. During the course of the visit discussion were held with the majority of service users, all staff on duty, the current manager and the acting manager on induction. Conversations were also held with a visiting physiotherapist and the quality assurance manager. A tour of the premises was undertaken and a range of documents and records were examined relating to service users, staff, health and safety and the running of the home. What the service does well: What has improved since the last inspection? A number of issues have been improved upon and developed since the last inspection. The organisation has introduced effective quality monitoring processes. The home has been subject to a thorough redecoration and the home is well appointed and provides a comfortable and conducive atmosphere for the residents. Some work has been completed on service user plans, but there is additional work required to fully update these. An improved pre-admission assessment process was seen to be in use and adhered to. The home has developed a more structured process of risk assessment. Service users now have the opportunity to access a wider range of activities in and out of the home. The Chestnuts (Welcome House) DS0000028336.V340202.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. The Chestnuts (Welcome House) DS0000028336.V340202.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 The Chestnuts (Welcome House) DS0000028336.V340202.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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 and 5. Quality in this outcome area is adequate. Prospective service users needs and aspirations are adequately assessed prior to moving into the home. Information about the home is in the process of being updated. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home management is in the process of developing both a statement of purpose and service users guide. These issues were included in the improvement plan developed by the home with a target date of June 2007. However, draft information had been prepared and was provided on the day of inspection. Three service users files were examined, all of which contained adequate preadmission needs assessments. One file was viewed for a recently referred prospective resident. The senior staff in the home had made efforts to meet with the individual and record issues of need and preference. The assessment process includes visits to the home where there are opportunities to further develop this information. The home receives information from healthcare professionals prior to an individual moving in. In one case it was advised that The Chestnuts (Welcome House) DS0000028336.V340202.R01.S.doc Version 5.2 Page 9 the acting manager requests additional information from a care manager to add to the relatively details provided by Locum Psychiatrist. The home has a contract covering the terms and conditions of residency. This document covers fees, rooms to be occupied and additional charges. The contract is written in a clear and understandable manner and is signed by each service users and/or their representative. The Chestnuts (Welcome House) DS0000028336.V340202.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9. Quality in this outcome area is adequate. Service user’s needs are assessed with further work required to improve this area. Individual risks are assessed and residents supported to take decisions affecting their lives. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Three service user plans were examined during the course of the visit and discussions held with each of the residents concerned. The current manager acknowledged that the home is still in the process of updating the individual plans and this was evident from the varying quality of the plans viewed. One individual plan had been taken directly from the Care Programme Approach (CPA) care plan completed by the care manager and provided little constructive guidance for staff to meet the service user’s needs. However, the other plans examined were more focused and developed by the home using the CPA documents as a reference. The manager was advised to provide The Chestnuts (Welcome House) DS0000028336.V340202.R01.S.doc Version 5.2 Page 11 specific guidance for staff to enable needs to be met in a consistent manner. Refer to requirement 1. The plans are subject to periodic review and there was evidence that the service users had had some involvement in the drawing up of the plan. Service users are supported in making decisions affecting their daily lives and records relating to finances are adequately maintained. The home does not take an appointee role and all finances are either managed by service users or an independent appointee. Where limitations are required these are implemented following discussion with healthcare professionals and the care team. The home has improved risk assessment processes and all files examined contained current and up to date risk assessments. A preliminary risk assessment is completed and where medium or high risks are identified a detailed risk management plan is completed. The assessments are kept under regular review. The Chestnuts (Welcome House) DS0000028336.V340202.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16, and 17. Quality in this outcome area is adequate. Service users have the opportunity to engage in a flexible lifestyle with regard to individual needs and choices. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users in the home have access to a range of facilities and resources in the local community and within the home. The manager and staff team have looked to develop the range of information available to residents and this process continues, however progress has been made since the last inspection. The Chestnuts has an older client group and a balance of activities needs to be maintained. There are local resources such as The Cabin and the Belfour Centre, which provide drop-in services and work related support. There is also a local college in the vicinity. Some service users choose to attend these activities. An activities person also visits the home engaging in low-level The Chestnuts (Welcome House) DS0000028336.V340202.R01.S.doc Version 5.2 Page 13 activities for some people who find it harder to go out unsupported. She arranges some games, arts and crafts and does the hair and make-up for some residents. One of the service users is an accomplished pianist and another resident plays the guitar. Therefore some sing-alongs also occur. There is an upright piano in the home, which is in need of tuning. Refer to recommendation 1. The home is fairly centrally located and it was reported that the main shopping centre of the town is some 10 minutes walk away. One service user said that she likes to go out, but is not confident going out on her own. She stated that although she goes out with her family she would like there to be more staff so that she could go out at other times as well. The home conducted a consultation exercise asking residents whether they preferred support from male or female staff and any other cultural or preferential requirements with regard to personal care. The home has taken suitable action where required to meet these preferences. Families and friends are welcomed into the home, although it was not possible to meet with any visitors at the time of the inspection visit. Residents stated that their visitors are made to feel welcome and that visiting arrangements are suitably flexible. Service users also confirmed that staff respect their privacy and daily routines. Staff were observed to interact well with service users in a relaxed and informal manner, although there are restrictions on staff time due to necessary routines and low numbers of staff on duty. The home does not have a dedicated cook and all cooking is done by care staff. However, residents were very positive about the quality of the food and there were stocks of fresh and good quality food in the home. Menu records demonstrate that a healthy and balanced diet is provided with a range of choices and meals are taken in a well-appointed and relatively spacious dining room. The Chestnuts (Welcome House) DS0000028336.V340202.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Quality in this outcome area is adequate. Service user’s personal care and healthcare needs are met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users commented that the staff in the home provide the personal support that they require in a way that meets their needs and preferences. Many of the service users require only encouragement and reminders to attend to personal care issues, although the resident group is of an older age in general and attention needs to be paid to the ability of service users to independently attend to the personal care issues. There are suitable aids available such as a fixed bath hoist in the first floor bathroom and a shower room downstairs. The healthcare requirements of residents are met with regular appointments kept with community psychiatric nurses and the Consultant Psychiatrist. Additional healthcare professionals also provide input as required. A physiotherapist was visiting the home at the time of the site visit who stated that the staff are “very supportive” and “follow through her recommendations”. The Chestnuts (Welcome House) DS0000028336.V340202.R01.S.doc Version 5.2 Page 15 She went on to say that she “enjoys visiting the home”. All service users are registered with a local GP and the home maintains clear healthcare records. The home has purchased a new medication cupboard, which is stored in a wellventilated room. The cupboard was reasonably well organised and the administration sheets were up to date. A number of relatively minor medication issues were noted and explained to the manager including ensuring clear information with regard to as required medication and keeping topical and oral medication separate. Staff in the home complete an in-house medication assessment prior to administering medication, however due to frequent lone working and the complexity of some medications with regard to side effects and contra-indications it is required that all staff complete a medication course covering knowledge of medicines, usage and how to recognise problems and basic administration and recording protocols. This training should be provided through an accredited or professional provider. Refer to requirement 2. The Chestnuts (Welcome House) DS0000028336.V340202.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is adequate. Service users views are listened to and they are protected from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users spoken to said that they knew how to complain within the home. Service users explained that they would report any concerns to the manager and then to the registered provider though were not sure where to go after this. A copy of the complaints procedure was on display, which incorporated all the necessary details. One complaint had been made since the time of the last inspection and this has been dealt with appropriately. It was reported that there are no current adult protection issues open with regard to the home. There are good policies and procedures in place in respect of abuse awareness and reporting. Staff appeared clear what to do if they suspected abuse having occurred, although the only training in this area currently provided to staff is through an induction video. It was reported that a manager within the organisation has completed a trained trainers course in adult protection issues and this training is due to be provided to all staff in the near future. Refer to recommendation 2. The Chestnuts (Welcome House) DS0000028336.V340202.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30. Quality in this outcome area is good. The premises are homely, comfortable and provide a pleasant environment meeting the collective and individual needs of service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has been redecorated throughout since the last inspection and the environment is homely, comfortable and conducive to the needs of the service users. All communal areas of the home were appropriately furnished, bright and well-ventilated. The home, in preparation for the smoking ban, has provided a covered outdoor area for smokers. There is an L-shaped patio around the rear of the home, which is well maintained and a lowered garden that is in need of some attention. With the permission of service users a number of bedrooms were viewed which were all suitable for the needs of the individuals and residents confirmed that they liked their rooms and that they The Chestnuts (Welcome House) DS0000028336.V340202.R01.S.doc Version 5.2 Page 18 are appropriately equipped. The home reportedly meets the requirements of local fire and environmental health departments. The home was clean and hygienic with no offensive odours. There is a domestic style kitchen, which is well equipped and a separate laundry area, which although suitable for the needs of the home, would benefit from new flooring to promote improved infection control. Appropriate measures have been taken with regard to infection control and the storage of hazardous substances. It was reported that the services and fittings meet with the Water Supply Regulations 1999. The Chestnuts (Welcome House) DS0000028336.V340202.R01.S.doc Version 5.2 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 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34 and 35. Quality in this outcome area is poor. There are insufficient staff on duty at periods during the week and staff training needs updating. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Two care staff were on duty at the time of the inspection and both members of staff demonstrated a good understanding of the individual needs of service users and of the collective needs of the home. The staff team is, with exception of the manager, relatively inexperienced and the longest serving member of the care staff has worked in the home for around 6 months. Two members of the team have been enrolled on NVQ courses and the third member of staff is due to be enrolled in the near future. Refer to recommendation 3. The home operates with a minimal staff team, which is an area that requires attention. Duty rotas were examined for two weeks. The rotas demonstrated that in addition to the manager who works from 9-6 Monday – Friday there are only 3 care workers covering the home on a 24-hour basis. An activities coThe Chestnuts (Welcome House) DS0000028336.V340202.R01.S.doc Version 5.2 Page 20 ordinator comes into the home on a part-time basis for 4 hours 3-4 days per week. There are at least 2 staff on duty throughout the daytime during the working week, but frequently only 1 staff member after 6pm. The staffing levels at weekends are of particular concern with the rotas showing that only one member of staff is duty throughout Saturday and Sunday, which includes cooking and cleaning duties and administering all medications including controlled drugs. On one day a single member of staff was required to work alone throughout a 24-hour period including a sleep-in shift. Whilst the sleepin shift does not constitute working hours, this offers no break for the staff member from 8am until 10pm. Additionally there is no flexibility for staff to support service users out of the home and presents a health and safety risk. A number of staff have left over recent months and it was reported that the home is looking to recruit staff, which should be considered a matter of priority. One staff member has only worked in the home for 2 weeks, but is required to work alone for lengthy periods. According to department of health guidance a there should be a minimum of 6.67 FTE staff and total duty hours of 266.83 per week. The current rotas demonstrate that there is a staff team of 4 FTE carers and total establishment hours of between 160 and 176 hours per week. Refer to requirement 2. 2 staff recruitment and personnel files were examined, which provided evidence that all pre-employment checks are satisfactorily carried out. Information on file included CRB and POVA checks, two written references, proof of identity and completed application forms amongst other documents. None of the care staff in the home, with the exception of the manager, have worked in the home for more than 6 months. However, with the exception of induction training and induction videos there has been little progress in respect of mandatory training for any of the care staff members. It was reported that the organisation is in the process of putting managers of other homes through a range of train the trainer courses. It is essential that all care staff in the home complete suitable mandatory training courses in topics including first aid, fire safety, manual handling and food hygiene within their first six months of employment. This is particularly apposite with the fact that staff spend periods of time working alone and that there is an inexperienced staff team. Refer to recommendation 4. All staff have been given a package of induction training, however the home and organisation should consider introducing a competency based assessment format in line with the Skills for Care Common Induction Standards. Refer to recommendation 5. The Chestnuts (Welcome House) DS0000028336.V340202.R01.S.doc Version 5.2 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 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42. Quality in this outcome area is adequate. The conduct and management of the home is satisfactory and an accountable management structure is in place. Effective quality assurance measures have been introduced. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The current manager has been in post following the departed of the registered manager some 6 months ago. However, with the manager in post due to retire over the coming weeks an Acting Manager was on induction during the time of the visit with a view to taking temporary charge until a full-time manager can be appointed. It is essential for this home that a manager is appointed who will be put forward for registration to provide clear leadership and stability The Chestnuts (Welcome House) DS0000028336.V340202.R01.S.doc Version 5.2 Page 22 following a period of significant change and upheaval. The present manager has acquitted herself well in light of the challenges that she has faced. The acting manager who is due to take charge also demonstrated a clear understanding of the needs of the home, but acknowledged that there will be a limited amount of change and progress that will be able to be made in the time she will be in post. Refer to requirement 4. The organisation has worked hard to introduce effective quality assurance processes over the past year. There is a quality assurance manager who visits the home on a monthly basis to complete monitoring visits. Whilst these have continued to be developed and become a more meaningful process, there are issues raised through this inspection that could have been identified through the monitoring visits and addressed. A series of questionnaires have been sent out to service users, staff, professionals and relatives and the information collated within an annual report. This is a significant achievement and the quality assurance manager and staff recognised the benefits of completing this process. It is important to ensure that the quality monitoring in all areas continues to grow and develop throughout the coming months and years. The majority of health and safety documentation was up to date and in place, although further work is required with regard to the electrical wiring certificate. This is in date, but 3 issues that require urgent attention. There was no evidence in the home to demonstrate that these issues have been addressed. Refer to requirement 5. The home also needs to ensure fire safety records are kept up to date in relation to fire training and drills. As previously stated there are potential shortfalls with regard to mandatory training issues. The Chestnuts (Welcome House) DS0000028336.V340202.R01.S.doc Version 5.2 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 Standard No Score 1 3 2 3 3 X 4 X 5 3 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 1 34 3 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 2 X 3 X X 2 X The Chestnuts (Welcome House) DS0000028336.V340202.R01.S.doc Version 5.2 Page 24 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. 1. Standard YA6 Regulation 15 (1) Requirement Timescale for action 01/08/07 2. YA20 18(1)(c) 3. YA33 18(1)(a) To ensure that all service user plans are reviewed and updated providing clear guidance for staff to meet individual needs. All staff must complete 01/07/07 suitable training in medication issues and administration from a professional source prior to administering medication. To ensure that suitable 01/07/07 numbers of staff are on duty at all times to ensure the health and safety of all people in the home with particular reference to staffing at weekends and evenings and ensuring flexibility to enable staff to support service users outside the home. (Outstanding requirement from the previous 3 inspections. Time scale of 28/02/07 not met) The Chestnuts (Welcome House) DS0000028336.V340202.R01.S.doc Version 5.2 Page 25 4. YA37 8, 9 5. YA42 13(4)(a) To appoint a manager who 01/08/07 will be put forward for registration with the Commission for Social Care Inspection. To provide evidence that 01/07/07 all electrical wiring work has been completed as per NICIEC electrical wiring certificate. 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 4 5 6 Refer to Standard YA14 YA14 YA23 YA32 YA35 YA35 Good Practice Recommendations To continue to develop and offer a range of activities with available staff support where required. To tune to the piano. To ensure that all staff receive appropriate and detailed adult protection and abuse awareness training. To ensure that care staff continue to work towards National Vocational Qualifications in Care at level 2 or above. To ensure that all staff receive suitable mandatory training courses within the first 6 months of employment. To introduce a competency based induction programme in line with the Skills for Care Common Induction Standards. The Chestnuts (Welcome House) DS0000028336.V340202.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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.V340202.R01.S.doc Version 5.2 Page 27 - 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!