CARE HOME ADULTS 18-65
The Coach House Trevaylor Manor Newmill Road Nr Gulval, Penzance TR20 8UR Lead Inspector
Stephen Baber Announced 10 August 2005 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 Coach House D52-D04 S63988 The Coach House V231508 10 August 2005.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service The Coach House Address Trevaylor Manor Newmill Road Gulval, Penzance TR20 8UR 01543 414222 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) Swallowcourt Ltd Annette Margaret Reynolds Care Home 9 Category(ies) of Learning disability (9) registration, with number of places The Coach House D52-D04 S63988 The Coach House V231508 10 August 2005.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: No additional Conditions of registration have been made. Date of last inspection First Inspection Brief Description of the Service: The Coach House is a brand new purpose built care home offering ground floor and first floor accommodation for 9 adults with physical and complex needs and who experience a learning disability. The registered provider is Swallowcourt an organisation that provides specialist care for people with special needs and owns three large nursining homes. Mrs Annette Reynolds is the manager and is registered with the Commission. The manager explained the aim of the home is to provide specialist support in a homely environment where residents can experience a quality of life with the support and care of the staff. The home is located in Newmill and is within the curtilege of the grounds of Trevaylor Manor which is registered as a nursing home. The facilities are separate with the home having its own entrance, parking to the front for several cars and beautiful walled gardens which are safe for the residents to use. Penzance town is 2 miles away and a bus service passes the home twice a day.The Coach House shares transport with its sister homes in Penzance . All the residents have their own ensuite bedrooms and special locks have been fitted to give greater privacy if it is required. The home has communal space, including a lounge/dining room, and further conservatory which is much enjoyed by the residents and looks out over the walled gardens. There is a small fully equipped kitchen and additional bathrooms and toilets on each floor.There is a shaft lift that serves the two floors and there are two waking night staff on duty to offer care and attention to the residents .
The Coach House D52-D04 S63988 The Coach House V231508 10 August 2005.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The Coach House was registered under the Care Standards Act 2000 in February 2005. This was the first initial bench mark announced inspection as part of the home’s annual inspection programme on 10 August 2005 commencing at 9.00 am and ending at 18:00 p.m. A pre-inspection questionnaire was completed prior to the inspection and I undertook the following activities whilst at the home: 1. Inspection of records, including assessment information and care plans 2. Discussion with the registered manager of the home on how it operates on a day-to-day basis 3. Inspection of the building 4. Interview with a relative and members of staff 5. Individual discussion with each of the five service users 6. Observation of the daily life of the home. 7. Talked with the visiting doctor for the home. The inspector would like to thank everyone who was involved in this inspection, including the registered manager, staff and residents, for their helpful manner and kind assistance on the day. What the service does well:
Staff demonstrated specific knowledge and skills in order to deliver an individually tailored and comprehensive service to the residents. I observed the staff interacting with the residents and noted how they encouraged the active participation of the residents, which had positive outcomes for them. The management have fully involved the relatives in the admission procedures and the relative confirmed that they were kept fully informed as to what was going on. Each prospective resident and their relative are provided with written information about the home and have the opportunity to visit with family and friends. This helps the person to make an informed choice about the move. Residents are supported to participate in activities of their choice at the care home. Management and staff will be looking at appropriate work and college opportunities for individual residents when people have settled in. The staff team have regular training to improve and update their knowledge and skills. New staff are given a positive introduction about the work of the home and this makes clear the roles and expectations of the care staff in meeting the needs of residents.
The Coach House D52-D04 S63988 The Coach House V231508 10 August 2005.doc Version 1.40 Page 6 Due to the high dependency and complex needs of the residents it was difficult to hold a meaningful conversation but I could see from their expressions and behaviours that they were well cared for and comfortable. Management and staff are committed to providing a good standard of health care to the residents and also work closely with all professionals to provide a high level of service. What has improved since the last inspection? What they could do better:
Management were well prepared for the inspection and looked at it as a positive experience for the benefit of the home. With the help of the learning disability manager and managing director, they have prepared the foundation on which they intend to build on all the good work that has been established so far. Throughout the company there is a structure of support with ancillary staff, domestics, training managers, accountants, maintenance personnel, support and activities assistants which provide monitoring and back up. Through their human resources, recruitment and selection, policies and procedures and training the company are improving their reputation in the eyes of the customers, stakeholders and the wider community. However the company are looking to providing a corporate approach throughout its entire homes. At present there is some fragmentation due to the fact that this consistency of approach is not common throughout the company. The policies
The Coach House D52-D04 S63988 The Coach House V231508 10 August 2005.doc Version 1.40 Page 7 and procedures inspected on the day of the inspection showed that this is not yet in place and policies and procedures to enable staff to do their jobs well and to protect and safeguard the well being of require review and updating to reflect this consistency of approach throughout the company. The identity of The Coach House must be established within this framework by personalising and establishing their own identity through everything they do. The current arrangements to assess risk management and control need to be developed and the records about the management of risk and control require improvement. This will make sure that staff are fully informed of the action needed to minimise potential risks to residents and their wellbeing. Arrangements are in place to protect residents against abuse. The procedure the staff are required to take if they have concerns about abuse could be written more clearly. This will also make sure that residents and staff’s wellbeing are not compromised. 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 Coach House D52-D04 S63988 The Coach House V231508 10 August 2005.doc Version 1.40 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 Coach House D52-D04 S63988 The Coach House V231508 10 August 2005.doc Version 1.40 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) 1,2,3,4and 5. Prospective residents are provided with written information about the home and are able to visit and spend time in the home before they make a decision about living there. This helps the person to make an informed choice about where they wish to live. Management assess each prospective resident to ensure that their individual aspirations and needs are being met but the record of the assessment needs to be improved with the involvement of the resident and their relatives or representatives. Each resident has an individual contract but further work is required to establish that the contract is in a format /language appropriate to each resident needs. EVIDENCE: A suitable statement of purpose and services users guide has been established and is made available to prospective residents to help make an informed choice about moving to the home. The statement of purpose and service user guide requires updating to reflect current information. The relative I spoke with said that he and his son read the information before making the decision about where he wanted to live. Prospective residents are assessed before moving to the home and the management and staff work closely with social workers and health professional to ensure that the needs and aspirations of the resident is going to be met. The assessment did not evidence that appropriate communication methods or the resident or their representative participated in this process. Prospective
The Coach House D52-D04 S63988 The Coach House V231508 10 August 2005.doc Version 1.40 Page 10 residents are able to visit the care home and the arrangements for this are flexible with overnight stays if requested. This helps the resident make an informed choice about the move. Contracts have been issued to each resident but because of the lack of numerous and literacy skills these should be in a format or language appropriate to individual requirements. The Coach House D52-D04 S63988 The Coach House V231508 10 August 2005.doc Version 1.40 Page 11 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 Each resident has a care plan with staff knowing their assessed and changing needs, which is reflected in the individual plan. The plans should be drawn up with the involvement of the resident and their family and be in a format the resident can understand. The arrangements to manage and assess risk need to be improved and the more able residents should be given training about their personal safety to avoid limiting their preferred choice. . Staff will then be provided with the information they require to satisfactorily meet the needs of residents. The home has devised its own confidentiality policy and procedure which is made available to staff. Training for all staff should be undertaken so that staff respect and handle information in accordance with the company’s written policies and procedures. EVIDENCE: All of the residents have written care plans that will be subject to regular review. These plans provided a clear picture of the individual needs and reflect the work and support the residents receive from the staff and management. Management explained that residents and their representatives will be invited to attend reviews and will be encouraged to sign care plans as evidence of
The Coach House D52-D04 S63988 The Coach House V231508 10 August 2005.doc Version 1.40 Page 12 their agreement with the care to be offered. Care plans detailed individual goals for residents, with a view to ensuring that they are encouraged to develop their skills and independence in a way that is safe and realistic. Individual care plans considered individual skills and how the management and staff can assist in enabling residents to make decisions for themselves and how these can be developed. I observed the residents making clear choices about what they wished to do and noted that staffing ratios were high so that needs can be met. The registered manager is currently considering ways in which key aspects of residents care plans can be translated into formats that can understood by some of the residents. Progress in respect of this will be reviewed at the next inspection. The manager has complied a policy on confidentiality but there needs to be evidence provided that staff have received training in this area of their responsibility as well governing the sharing of information with other interested parties. There are some arrangements in place to take account of risk to residents and the records indicate that certain risks are considered and steps are taken to promote the resident’s well-being and welfare. The company will be looking at the risk managements and controls in the coming months to establish it’s corporate identity. The Coach House D52-D04 S63988 The Coach House V231508 10 August 2005.doc Version 1.40 Page 13 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) 11,12,13,14,15,16,17. Staff support residents to develop and maintain social emotional, communication and independent living skills and residents with physical and complex multiple disabilities are offered specialist interventions and opportunities by trained and caring staff. Opportunities to take part in a variety of activities in and out of the home are reflected in the care plans. Residents engage in activities in the local community and family contact is encouraged. Meals offer a varied diet and reflect the choice and preference of the people living at the home EVIDENCE: Residents care plans and daily records evidence how they are encouraged to develop their skills and independence and they have individual goals clearly set out. Full use is made of the mini bus but consideration should be made to transport that is disabled friendly. This was noticeable on the day of the inspection when the transport was not available and a substantial amount of money had to be paid for a private taxi. Clubs are attended in the community
The Coach House D52-D04 S63988 The Coach House V231508 10 August 2005.doc Version 1.40 Page 14 and the manager explained that some residents enjoyed shopping at the local supermarket. Management are also assessing residents for future opportunities in a range of activities, including attendance at a local college. Resident’s interests are recorded and they are provided with opportunities to spend their leisure time in ways they enjoy. Family contact and involvement is encouraged and some of the residents spend time away from the home on family visits and overnight stays. Residents nutritional needs are kept under review to including risk factors associated with low weight, obesity, and eating and drinking disorders. Apart from two residents it was difficult for other residents to comment on the catering arrangements but the two I spoke with said that they enjoy the meals very much. I observed mealtimes and noted that they were unhurried and taken in the conservatory overlooking the garden. Staff spend time with some residents ensuring that they enjoy their meals. At present the main lunchtime meal comes from the main kitchen, which serves the nursing home. Management will have to review the current arrangements when some residents are out of the home in the daytime. The kitchen is domestic in size with appliances to assist the staff. It is also recommended that staff have training in Basic Food Hygiene and that a probe is purchased to test the temperature of the meal when given to the residents. The Coach House D52-D04 S63988 The Coach House V231508 10 August 2005.doc Version 1.40 Page 15 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) 18,19,20,21. Personal and healthcare needs of residents are appropriately met. Policies, procedures and practices regarding medication are appropriate ensuring any risk to residents is minimised apart from full and accurate recordings on the MARS sheets. Policies and procedures on ageing and dying have been made available to staff so that residents and their relatives can be assured that if you become ill their comfort and dignity and the wishes of residents will be respected. EVIDENCE: Resident’s records contain appropriate information outlining how residents physical and emotional health care needs are met. There is also suitable records regarding visits to/from GP’s and other healthcare professionals. I talked with the doctor who was visiting a resident and he thought residents get a good service. The manager explained how the staff would receive ongoing training to increase their understanding of how staff can respect residents preferences, and expert knowledge, about their individual personal needs when providing support including intimate personal care. There is a medication policy, which has been devised by the manager for the home but this is an area that should have the corporate approach. The policy and procedure should also detail homely remedies and drug error policy and
The Coach House D52-D04 S63988 The Coach House V231508 10 August 2005.doc Version 1.40 Page 16 procedure. The storage of medication is appropriate but all staff should sign the MARS sheets when dispensing medication to the residents. There is no evidence that staff have received appropriate training regarding medication and the manager said this will be given high priority in the coming months. The manager who is an experienced nurse explained that relatives and residents would be involved in planning for and dealing with growing older terminal illness and death. The Coach House D52-D04 S63988 The Coach House V231508 10 August 2005.doc Version 1.40 Page 17 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. Complaints are handled appropriately and relatives and residents can be confident that any concerns are taken seriously and acted upon. Staff are given access to a policy and procedure to protect residents from abuse. There are measures in place to protect vulnerable service users from abuse but these should be strengthened and improved. This could be improved by giving the staff some clearer guidance about the action they take to keep residents safe. EVIDENCE: The home has policies and procedures for dealing with complaints and to protect residents from abuse. The policy about complaints details the types of complaints that can be made and the timescales for their resolution. Relative and staff said they would know how to complain should they need to. The Adult Protection Procedures must provide staff with clearer guidance about the action they are required to take should an allegation of abuse be made. The manger should also obtain copies of local multi-agency procedures and those of the various placing authorities in respect of residents who may be placed there from out of county in the future. Staff have received some training as part of their induction training but a more robust training and access to external, multi-agency training must be given to ensure that residents are safeguarded from harm. The Coach House D52-D04 S63988 The Coach House V231508 10 August 2005.doc Version 1.40 Page 18 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) 24,25,26,27,28,29 and 30 The Coach House provides high standard of accommodation that meets individual preferences and needs and is accessible to community facilities and services and is maintained to high standards both internally and externally. EVIDENCE: There are eight bedrooms with full ensuite rooms provided. Rooms can be locked and furnishings, fittings and adaptations are of a good quality. I noted some rooms could be more personalised but was given explanation by the management that they work very closely with the relatives and the rooms meet the needs of the occupants. I also noted that a storage facility is needed as all storage is in one bedroom and looks untidy. Also a view from the fire officer should be taken about storing materials in one area. It would also benefit some rooms if net curtains were purchased to give more privacy to the residents that could be overlooked. There is a brand new shaft lift that serves ground to first floor and other adaptations to meet the needs of residents. The Coach House D52-D04 S63988 The Coach House V231508 10 August 2005.doc Version 1.40 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) 31,32,33,34,35 and 36 Staff roles and responsibilities are clear but whilst they have access to a range of training courses it is difficult to determine what training they have actually done and what they need. Evidence to support fair, safe and effective recruitment and selection of staff in the home is in place but key information is still lacking. Staff are supported, supervised and appraised by the manager and resident’s benefit from well supported and supervised staff. Staff morale is good and staffing ratios are high to meet the complex needs of the residents. EVIDENCE: Staff are provided with clear written job descriptions and person specifications. The company are committed to equal opportunities and this is reflected in the recruitment procedure but as evidenced from the staff files key information is still missing. 50 of the staff group hold a mixture of H.N.D and NVQ level 2 and 3.Staff-training portfolios need to be updated and organised into a system that can be verified, checked, monitored and reviewed by the manager. The manager also needs to be mindful of the guidance given by the CRB regarding POVA first checks and the retention of the disclosures. There is two staff on night duty and high staffing ratios to meet the needs of the residents
The Coach House D52-D04 S63988 The Coach House V231508 10 August 2005.doc Version 1.40 Page 20 throughout the day. The staff commented they felt well supported and informed by the management. The staff are also positive about the way they work as a team and support each other. The company need to review areas of recruitment and selection, training and development and documentation so that consistency of approach will be the common thread going through all of its homes. The next inspection will identify the areas that have improved. The Coach House D52-D04 S63988 The Coach House V231508 10 August 2005.doc Version 1.40 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) 37,38,39,40,41,42,43. There is leadership, guidance and direction to staff to ensure residents receive high standard of service and care. There are arrangements in place to protect and promote the health, safety and welfare of service users but improvements are needed in line with the corporate approach. EVIDENCE: The manager has over 30years experience in nursing, care and management. Obviously her experience is extremely important and a very substantial and fundamental factor when considering the role she plays in supporting, supervising and offering guidance to the staff. Staff and the relative made very positive comments about how good the communication is and that staff were clear about what was expected of them. In the area of health and safety there needs to be a lot of consolidation to bring everything together in line with the corporate approach which is the desired option for the company. Due to the newness of the home and everyone and thing still settling in a better overview
The Coach House D52-D04 S63988 The Coach House V231508 10 August 2005.doc Version 1.40 Page 22 can be gleaned at the next inspection. In the meantime every effort must be made to establish the bigger picture with the documentation in each establishment common throughout the company. This will ensure a consistency of approach and ensure your management systems provide for effective monitoring and reporting. The Coach House D52-D04 S63988 The Coach House V231508 10 August 2005.doc Version 1.40 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 3 3 3 3 2 Standard No 22 23
ENVIRONMENT Score 3 1 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10
LIFESTYLES Score 3 3 3 2 2
Score Standard No 24 25 26 27 28 29 30
STAFFING Score 3 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score 3 3 3 2 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
The Coach House Score 3 3 2 2 Standard No 37 38 39 40 41 42 43 Score 3 3 2 2 2 2 3 D52-D04 S63988 The Coach House V231508 10 August 2005.doc Version 1.40 Page 24 First Inspection 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 9 Regulation 13 Requirement Risk assessmement and risk management arrangements must be put in place when any situation arises that could compromise the health and well being of residents. More robust systems for the protection of residents from abuse must be introduced into the home including updated policies and procedures, ensuring copies of multi-agency protocols and procedures are available for each placing authority and the provision of access to multi-agency training by staff. A review of the recruitment and selection procedures must take place to ensure all details required by regulation are in place. A review of Health and Safety policies and procedures must be implemented to ensure risk management and operational controls are in place in line with the corporate approach Timescale for action 30th December 2005 2. 23 12(1)(a) 30th December 2005 3. 29 Sch 2 reg 19 30th December 2005 30th Dec2005 4. 38 12and 13 The Coach House D52-D04 S63988 The Coach House V231508 10 August 2005.doc Version 1.40 Page 25 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. Refer to Standard 1 2 5 17 Good Practice Recommendations The statement of purpose and service user guide should be updated. Assessments should be shared and signed by the prospective resident or their relative so that agreement can be reached. Contract should be made available in a format or language that can be understood. A probe should be purchased to test the tempersaure of the meals and a review of the dining arrangements should take place when educational and occupational activities are engaged in by the residents. A policy and procedure on drug error and homely remedies should be written up and all staff should sign the MARS`sheet after dispensing medication to the residents. Training should also be made available for the staff. Storage facilities and net curtains should be purchased for the residents. Staff training portfolios should detail all the training undertaken and be organised into a system that can be verified, checked and monitored. 5. 20 6. 7. 24 32 The Coach House D52-D04 S63988 The Coach House V231508 10 August 2005.doc Version 1.40 Page 26 Commission for Social Care Inspection John Keay House Tregonissey Road St Austell PL25 4AD National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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