Inspection on 08/11/05 for The Gables

This inspection was carried out on 8th November 2005.

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

Other inspections for this house

The Gables 06/08/07

The Gables 13/02/07

The Gables 17/05/06

The Gables 12/07/05

The Gables 17/03/05

The Gables 09/09/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Gables (The) 7 West Moors Road Ferndown Dorset BH22 9SA Lead Inspector Stephanie Omosevwerha Unannounced Inspection 8th November 2005 10:00 Gables (The) DS0000026806.V265137.R01.S.doc Version 5.0 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 Gables (The) DS0000026806.V265137.R01.S.doc Version 5.0 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. Gables (The) DS0000026806.V265137.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Gables (The) Address 7 West Moors Road Ferndown Dorset BH22 9SA 01202 855909 01202 872885 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) H & H Partners Care Home 7 Category(ies) of Learning disability (7) registration, with number of places Gables (The) DS0000026806.V265137.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th July 2005 Brief Description of the Service: The Gables is a registered care home for 7 adults of both sexes between the ages of 18 and 65 years who have a learning disability. It is owned by H & H Partners (Mr and Mrs Habgood). The proprietors have regular contact with the home and the service users. At present there are three service users living at the Gables and the home has also been offering a temporary respite service in some of the vacant rooms. The Gables is situated in a residential area of Ferndown, Dorset. It is a large detached house in keeping with other properties in the vicinity. You approach the property via electric gates, and there are gardens to the front and rear of the home. The property is split into two. One side is The Gables residential home, with the other part of the property being a private Day Centre named Avatar (also owned by H & H partners). Avatar is a separate service and if service users choose to attend Avatar, this requires extra funding and assessment. Accommodation in the residential home consists of a large lounge, dining area, kitchen and an additional small lounge on the first floor. All service users have single rooms with en-suite facilities. There is a supermarket close by, and the town centre of Ferndown is within walking distance. The larger towns of Poole and Bournemouth are accessible by public transport also. The home is not staffed, other than by Management hours, during the hours of 10:00am and 3:30pm. Outside of these hours the home is staffed by two/three members of staff. Gables (The) DS0000026806.V265137.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was an unannounced inspection of the home and took place over approximately 6 hours. It was carried out as part of the planned inspection programme for care homes undertaken by CSCI and to address the requirements and recommendations made at the previous inspection on the 12th July 2005. The proposed manager assisted the inspector throughout the day. The inspector also spent time talking the service users although the extent to which service users were able to give their views on life at the home was limited. Spending time with service users in the communal areas of the home and discussion with one service user who was staying at the home for respite indicated they were satisfied with their care and felt their needs were being met. The inspector had the opportunity to talk to 4 members of staff on duty throughout the day. They told the inspector they enjoyed working in the home. All communal rooms were viewed during the inspection. Various records and documentation was also sampled including staff records, recruitment procedures, health and safety records, financial records and menus. What the service does well: The Gables provides service users with an attractive spacious environment. The home was found to be bright, clean and welcoming. All service users have their own bedrooms with ensuite facilities offering a high degree of personal privacy. Service users are provided with a good variety of home cooked food that is served in pleasant surroundings and residents say they enjoy their meals. Service users choices and preferences are promoted where possible although current residents have limited ability to make informed decisions or give consent to more complex decisions. Service users are treated respectfully and can spend time in the privacy of their rooms or have access to all the communal areas of the home. The home has good links with relatives and liaises regularly with them over service users care needs. More experienced staff in the home demonstrate a good knowledge of service users needs and the aims of the home. Gables (The) DS0000026806.V265137.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Gables (The) DS0000026806.V265137.R01.S.doc Version 5.0 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 Gables (The) DS0000026806.V265137.R01.S.doc Version 5.0 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): The key standard was inspected and met at the previous inspection. The home gave due consideration of its ability to meet service users’ needs, based on professional assessments, prior to agreeing any placement and provided detailed information about service provision. EVIDENCE: See previous report for evidence. Gables (The) DS0000026806.V265137.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7. The home has been developing total communication methods designed to make information more accessible to residents and give them opportunities to make choices for themselves whenever possible. EVIDENCE: There was evidence that service users were supported to make decisions about their daily lives. For example the manager had used total communications signs and symbols to give service users choices about evening activities in the home. On the day of the inspection residents could choose whether to go and help with the shopping or go out on a pub trip planned later in the evening. The home also uses picture formats to facilitate residents making choices e.g. pictures of the evening meal were on display. Observation on the day demonstrated service users chose what to do on their return from their daily activities. Some service users enjoyed spending time in the communal facilities whilst other preferred the privacy of their rooms. The inspector spoke to all the service users; however, most were only able to give a very limited verbal feedback. One service user accessing the respite service Gables (The) DS0000026806.V265137.R01.S.doc Version 5.0 Page 10 was able to confirm that he was able to make choices about his daily life, e.g. getting up/going to bed times, making drinks, spending time in his room. The current residents are unable to make an informed decision or give consent to more complex decisions. The manager, therefore, said she regularly liaises with relatives, funding authorities and other relevant professionals about any significant events or changes needed to the service users care plan. All service users need support with managing their finances. 2 residents are supported by their families and one resident is supported by the home. Records and receipts are kept of all incoming and outgoing payments and these were checked and found to be up-to-date and accurate. It was recommended that records were checked and signed by a second member of staff as a point of good practice. Gables (The) DS0000026806.V265137.R01.S.doc Version 5.0 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 15, 16 and 17. The home regularly liaises with families promoting and maintaining service users personal relationships. Service users are able to move independently around the home and their privacy is respected. They are supported and assisted as appropriate to undertake daily routines in the home. The home offers a varied and nutritious diet that the service users enjoy. EVIDENCE: The manager stated family members are welcome to visit the home. All service users have regular contact with their families both at the home and going out for family visits. Service users are also encouraged to make phone calls to their families. In addition, the manager said she regularly liaised with relatives concerning the care of the service users. The manager told the inspector she had also organised a Christmas party to which the residents could invite their families. Service users confirmed they were looking forward to this event. Gables (The) DS0000026806.V265137.R01.S.doc Version 5.0 Page 12 During the inspection, staff were seen interacting with the service users, and it was clear that service users could choose whether to be alone or in company. A service user confirmed their privacy was respected. Service users responsibilities for housekeeping tasks were recorded on their care plan. Most service users need support with domestic tasks and work alongside staff e.g. making their pack lunches for the next day. A sample of weekly menus was viewed. These showed the home was offering a balanced and nutritious diet. Service users likes and dislikes were taken into account and the home provided pictures of the meals available to facilitate service users making choices. The manager said she had now introduced more choice for service users packed lunches to give them more variety. Service users said they liked the food the home provided. Gables (The) DS0000026806.V265137.R01.S.doc Version 5.0 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of these standards were inspected (see below). The home has a good system for monitoring medication records and the audit trail so that discrepancies in the records are picked up. Written procedures need some improvement and staff recording the administration of medicines, including topical products, to protect service users. EVIDENCE: The pharmacist inspector carried out a specialist inspection on the 9th November 2005 to review the arrangements for the recording, handling, safekeeping, administration and disposal of medicines (Standard 20). A separate report containing the findings of this visit is available. The judgement made has been repeated for ease of reference and any requirements and recommendation made at this visit are also included in this report. Gables (The) DS0000026806.V265137.R01.S.doc Version 5.0 Page 14 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): 23. Recent practices have improved ensuring staff are better prepared to safeguard the welfare of service users living in the home and correct procedures are followed for reporting any incidents of concern. EVIDENCE: The home has policies and procedures in place for the protection of vulnerable adults. Staff are asked to read and sign the procedures to evidence they have understood them. In addition training has been arranged with Dorset Social Care & Health training unit to ensure staff are aware of local adult protection procedures. Discussion with members of staff confirmed their understanding of the action they would need to take to report abusive practices and safeguard service users. The home have not always followed the required reporting procedures to the Commission of any incidents in the home. However, recent evidence demonstrates much better communication with the home meeting the requirement to notify the Commission as per Regulation 37 of the Care Homes Regulations 2001. Gables (The) DS0000026806.V265137.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30. The Gables is an attractive home with good quality furnishings and fitments providing a comfortable and homely environment. Systems are in place for preventing the spread infection and staff support service users to maintain a clean and hygienic environment. EVIDENCE: All communal rooms were seen as part of the inspection. It was noted that the requirement to cover exposed wall brackets in the hall had been carried out. On the day of the inspection the home was clean, bright and airy. Furniture and fittings were of good quality and service users expressed satisfaction about their living environment. No further work has been carried out in bedrooms that are currently unoccupied, so there is still the recommendation that these are re-decorated prior to permanent occupation. The home has a policy for infection control. The home was observed to be hygienic and free from offensive odours. The laundry facilities are currently Gables (The) DS0000026806.V265137.R01.S.doc Version 5.0 Page 16 sited in the office so soiled articles are not carried through areas where food is stored or prepared. Hand washing facilities are prominently sited in the kitchen and service users are encouraged to follow good hygiene practices. Gables (The) DS0000026806.V265137.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35. Instability in staffing in the home has led to inconsistencies in the staff team that have had a detrimental impact on the service users care. The home needs to be more rigorous in obtaining information when employing staff to ensure that service users are well protected by thorough recruitment procedures. The home was working hard to address the training needs of the staff team and courses had been arranged to ensure staff were aware of safe working practices including the protection of vulnerable adults. EVIDENCE: The Gables has experienced some turnover of staff members over the past year. This followed a period of instability of the home when the registered providers decided to close or sell the home in the summer of 2004. This decision was reversed in late 2004. The home has managed to recruit some new staff and currently employs 5 members of staff. Two members of staff who work at the day service also work regular shifts in the home. The manager stated that the home has 2 agency staff that they use on a regular basis that know both the way the home works and the service users living there. Gables (The) DS0000026806.V265137.R01.S.doc Version 5.0 Page 18 The skill mix of staff was variable with some staff having previous knowledge and experience; other members of staff had limited experience. There was evidence that the inexperience of some members of staff was having an impact on service users care and examples of this included a vulnerable service user gaining access to a cleaning fluid and medication not being given at the correct time on 2 occasions. The proposed manager had taken measures to address this and staff had accessed training, been supported in staff meetings and supervisions, and risk assessments and procedures had been tightened up with staff signing to evidence they had read and understood these. The home needs to continue to ensure staff working in the home achieve satisfactory standards to ensure the health and welfare of service users. Discussion with 4 members of staff further evidenced the difference in the skill mix. Whilst some staff were able to demonstrate a good knowledge and understanding of the service users they worked with, other staff found it difficult to answer questions relating to practices in the home. All staff said they enjoyed working in the home and felt it was a good working environment. The home is currently not achieving the target of having 50 of staff qualified with NVQ level 2 or above as only one member of staff has completed NVQ level 2, another member of staff was working towards NVQ2 and other staff are still completing their induction/foundation stages. The home’s recruitment procedure was seen. This was thorough and included job descriptions, applications forms, standard interview formats that involved informal observation and feedback from residents. A sample of 3 staff files was viewed. These contained proof of the person’s identity, CRB checks and evidence of qualifications achieved. However, it was noted that 2 written references had not been received prior to staff being employed as required for all person’s working in a care home. The manager stated that a verbal reference had been obtained but there was no written evidence to confirm this. It was also recommended that any gaps in employment were explored at interview. All staff had contracts specifying their terms and conditions and were subject to a probationary period. There was evidence that the home was trying to address the training needs of the staff team and most staff were booked on courses in manual handling, food hygiene, first aid and health and safety. They had also recently completed fire training and handling medication courses. Some of the more established members of staff had completed courses relevant to the aims of the home and the needs of the service users e.g. epilepsy, autism and Makaton. Staff confirmed they had undertaken training courses and certificates of qualifications held were observed on staff files. The proposed manager said most staff were currently undertaking the LDAF induction and foundation courses. All new staff complete an in house induction and the proposed manager showed the inspector the format that is used. This included general information, safety information, policies and procedures, employment Gables (The) DS0000026806.V265137.R01.S.doc Version 5.0 Page 19 details, role and responsibilities, communication and recording, support and supervision, professional development, financial and medication procedures. Staff were also made aware of the GSCC standards of conduct and practice. Gables (The) DS0000026806.V265137.R01.S.doc Version 5.0 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42. The home does not have a registered manager and an immediate requirement was made for a valid application to be submitted to the Commission without further delay. Service users and their representatives need to be consulted about their views of the service to inform an annual development plan designed to monitor and improve the quality of service provided by the home. Health and safety matters were generally well managed in the home although records need to be maintained to show regular testing and training in fire safety is carried out. EVIDENCE: A valid application to register the proposed manager had failed to be submitted to the Commission as required at the previous inspection resulting in an immediate requirement being made. Gables (The) DS0000026806.V265137.R01.S.doc Version 5.0 Page 21 The proposed manager had begun to look at Quality Assurance systems; however, there is still an outstanding requirement to produce a development plan for the service, seeking views from friends/family and other interested parties. There is a further requirement for the responsible individual to carry out regular monthly monitoring visits. Although the manager told the inspector initial visits had been carried out no reports were available. It was recommended that a simplified format be designed to facilitate completing the report, which then need to be sent to the Commission. Records showed that the home was meeting the requirements of other agencies such as Dorset Fire and Rescue Service and Environmental Health Department. Certificates were in place demonstrating that equipment and facilities were regularly serviced and maintained. A written health and safety risk assessment and fire risk assessment for the home have been completed. The manager confirmed her awareness of relevant legislation and certificates were in place showing staff had attended various training courses in safe working practices. Although the manager stated that fire training was carried out on a regular basis, the records did not reflect this. The home needs to ensure that accurate records relating to fire training are kept, i.e. 6 monthly for day staff and 3 monthly for night staff. The home also needs to keep accurate records of regular alarm tests. Gables (The) DS0000026806.V265137.R01.S.doc Version 5.0 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X X X X X Standard No 22 23 Score X 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X 3 X X X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X X X X 3 LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X 1 X 1 3 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Gables (The) Score X X 2 X Standard No 37 38 39 40 41 42 43 Score 1 X 1 X X 2 X DS0000026806.V265137.R01.S.doc Version 5.0 Page 23 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 YA20 Regulation 13 (2) Requirement The manager must ensure that staff who give medicines are competent to follow the homes procedures for the administration of medicines so that they are given as prescribed, and the administration, or reason for non-administration, is accurately recorded. The registered provider must ensure staff working in the home achieve satisfactory standards to ensure the health and welfare of service users. The registered provider also needs to identify strategies towards increasing the number of care staff qualified to NVQ level 2 and above to meet the targets set out in the National Minimum Standards. The registered provider must obtain all the information in respect of care workers in the home identified in Schedule 2 of the Care Homes Regulations 2001. Specifically 2 written references. DS0000026806.V265137.R01.S.doc Timescale for action 30/11/05 2. YA33 18 31/12/05 3. YA34 19 31/12/05 Gables (The) Version 5.0 Page 24 4. YA37 9 5. YA39 24 6. YA39 26 7. YA42 23 The proposed manager must submit a valid application and fee for registration with Commission. This was required at the last inspection with a timescale of 01/09/05. The registered providers must introduce an effective Quality Assurance System and produce a development plan for the service, seeking views from friends/family and other interested parties, on how the service is performing. This requirement is brought forward from the inspection reports dated the 13/08/02 & 29/09/04. The responsible individual for the home must visit and report each month on the standard of care being provided in the home, and forward a copy of the report to the Commission. The report must detail the observations, and interviews with service users and staff. This requirement is brought forward from the inspection report dated 13/08/02 & 29/09/04. The registered provider must ensure that all records concerning fire training are upto-date, i.e. 6 monthly for day staff and 3 monthly for night staff. Records for testing the fire alarm should also be kept up-todate. 22/11/05 31/03/06 31/03/06 31/12/05 Gables (The) DS0000026806.V265137.R01.S.doc Version 5.0 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. Refer to Standard YA7 YA14 Good Practice Recommendations It is recommended that service users financial records are checked and signed by a second member of staff. It is recommended that further consultation is undertaken with residents to increase the choice/provision of social and community activities. This recommendation is carried forward from the inspection dated 12/07/05. The medication policy should be updated with the recommended additions. The doctor should be asked to include full directions for medicines labelled “as directed”. When medicines are handwritten on the MAR chart a second competent person should check the details are accurate and countersign. Details of any medicine sensitivity or ‘none known’ should be included on the MAR chart. It is recommended that the rooms currently being used to provide respite care are re-decorated to make good minor repairs needed to the paintwork prior to permanent occupation. There is also a filing cabinet in one of the rooms which would need to be removed prior to a service user moving in. This recommendation is carried forward from the inspection dated 12/07/05. It is recommended that staffing hours are reviewed to ensure they meet the recommendations of the Department of Health and do not potentially restrict service users choice/access to the home during day time hours. This recommendation is carried forward from the inspection dated 12/07/05. It is recommended that any gaps in employment are explored at interview with prospective members of staff. It is recommended that a simplified form be devised for carrying out monitoring visits by the responsible individual to facilitate recording. 3. 4. 5. YA20 YA20 YA20 6. YA24 7. YA33 8. 9. YA34 YA39 Gables (The) DS0000026806.V265137.R01.S.doc Version 5.0 Page 26 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Gables (The) DS0000026806.V265137.R01.S.doc Version 5.0 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. 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