Inspection on 21/06/06 for The Gables (Cambridge) Limited

This inspection was carried out on 21st June 2006.

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 no outstanding requirements from the previous inspection report, but made 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Gables (Cambridge) Limited 02/12/08

The Gables (Cambridge) Limited 04/12/07

The Gables (Cambridge) Limited 21/12/06

The Gables (Cambridge) Limited 18/04/06

The Gables (Cambridge) Limited 20/10/05

The Gables (Cambridge) Limited 08/07/05

The Gables (Cambridge) Limited 29/11/04

The Gables (Cambridge) Limited 02/07/04

The Gables (Cambridge) Limited 05/05/04

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Upaya Ananda

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

CARE HOME ADULTS 18-65 The Gables (Cambridge) Limited 93 Ely Road Littleport Ely Cambridgeshire CB6 1HJ Lead Inspector Andy Green Key Unannounced Inspection 21st & 23rd June 2006 10:00 The Gables (Cambridge) Limited DS0000037198.V302654.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 Gables (Cambridge) Limited DS0000037198.V302654.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 Gables (Cambridge) Limited DS0000037198.V302654.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Gables (Cambridge) Limited Address 93 Ely Road Littleport Ely Cambridgeshire CB6 1HJ 01353 861935 01353 862887 gables@caringhomes.org 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) Gables (Cambridge) Limited Care Home 16 Category(ies) of Dementia (5), Learning disability (16), Physical registration, with number disability (16), Physical disability over 65 years of places of age (1) The Gables (Cambridge) Limited DS0000037198.V302654.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The 5 places in category DE (under 65 years with dementia) are for 5 individuals, each with a primary vulnerability of learning disability The 1 place in category PD(E) (over 65 years with a physical disability) is for 1 named individual whose primary vulnerability is physical disability 18th April 2006 Date of last inspection Brief Description of the Service: The Gables is a registered nursing home providing support and accommodation for up to sixteen adults with a physical and/or learning disability. The home has a respite care facility and has a number of residents using this throughout the year. The home itself is situated on the outskirts of Littleport in Cambridgeshire six miles away from the city of Ely. The current charges for placements in the home ranges from £650 - £1400. The Gables (Cambridge) Limited DS0000037198.V302654.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Andy Green, Regulation Inspector and Sue Pinner, Regulation Manager conducted an unannounced key inspection on 21st June 2006 in response to concerns raised about care practices in the home. They met with the Operations Manager, care staff and service users to gather views regarding the services offered in the home. A number of records were inspected including care plans, training records and activities records, medication administration records. A tour of the building was also undertaken. The inspection continued on 23rd June 2006. What the service does well: What has improved since the last inspection? What they could do better: Care plans need to give considerably more guidance to ensure that staff can appropriately assist service users with agreed care and support procedures. Recording in care plans and reviews needs to be in more detail to monitor service users needs and their social development needs. As service users have complex communication needs, specific aids and training needs should be researched and implemented, as there is a distinct lack of knowledge. This should include current good practice guidelines. The carpet in the small lounge remains in need of replacement along with the carpets in a number of service users bedrooms. Communal areas in the home need upgrading to give a more appropriate décor and furnishings to reflect the age group of service users. The Gables (Cambridge) Limited DS0000037198.V302654.R01.S.doc Version 5.2 Page 6 Corridors, upstairs shower room and WC need refurbishment as they are deteriorating and need new fittings. An audit regarding décor and furnishings in the communal areas of the home must be undertaken and appropriate work with timescales must be actioned. A greater choice for individual service users, and frequency of meaningful activities need to be provided to reflect their age and individual preferences. Training related to the service users specific care and support needs must be implemented. The current staff-training programme remains inadequate due partly to the reliance on videos at training sessions. Trained nursing staff also need to update their knowledge and clinical practice, as discussions with trained staff during the inspection did not evidence adequate competence. 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 Gables (Cambridge) Limited DS0000037198.V302654.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 Gables (Cambridge) Limited DS0000037198.V302654.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the home. Prospective service users have access to information, and can make an informed choice regarding the home’s services. EVIDENCE: There have been no additions or updates to either the Statement of Purpose or Service Users Guide. The Acting Manager stated that both of these documents would be updated in the forthcoming months to ensure that accurate information is documented to reflect services the home provides. A copy of the care management assessment was contained in the care plans seen during the inspection. There were 13 service users in residence on the days of inspection. The Gables (Cambridge) Limited DS0000037198.V302654.R01.S.doc Version 5.2 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): 6,7,8,9,10 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to the home. Care provided at the home is of a basic standard only. Care plans are in place but need improving to ensure that the home can meet each individual service user’s assessed needs. EVIDENCE: Four service user care plans were seen. Care plans do not provide sufficient detailed guidance to ensure that staff can meet the assessed needs of the service users. Although care plans are reviewed regularly there is insufficient space to record information to show where care or needs have changed. The majority of care plans had “no change” recorded in the review sections. Care plans tracked showed that residents are being weighed regularly and where required food and fluid intake is monitored. There was also evidence of reviews, risk assessments, and healthcare audits. Daily notes are also recorded. However the care planning process needs to be improved to ensure that care and support is being adequately delivered. The Gables (Cambridge) Limited DS0000037198.V302654.R01.S.doc Version 5.2 Page 10 As recommended in the report of the inspection carried out on 18th April 2006, a social profile for each service user needs to be implemented in a creative manner to give staff a deeper understanding of the person’s life history, photographs, key life events, preferences and dislikes. In one care plan it was recorded that the service user should have daily physiotherapy sessions but “no therapy, bed rest only” had been recorded on several occasions with no reason for this. When the nurse in charge of the shift was asked why these sessions had not occurred she was unable to give a reason. A notice on the wall in the staff office gave clear guidelines to remind staff to complete and record the daily physio session. A nurse leading another shift was also unable to give reasons why the physio session had not been given whilst she was on duty. This is unacceptable especially as the nurses were leading the shifts and were responsible for the agreed care procedures to be undertaken. The information regarding guidelines for dealing with epileptic seizures on a service users care plan gave insufficient detail regarding assistance that should be given. This potentially places the service user at risk. There was insufficient information on how to communicate with service users with reduced verbal communication. Staff spoken to during the inspection stated that there were no pictorial or other communication aids in place. When asked how they were able to ascertain the preferences of service users eg, choosing clothes to wear during the day they replied that they would make the choice for the service user by choosing something from the wardrobe. There was no indication as to how the service users would be involved in making choices and no evidence to show that service users or their representatives were involved in the care planning process. Each care plan contained a document entitled “Infringement of Rights”. There was no explanation as to the use of this document and staff were not able to give a reason for the document or how it should be used. This document was not filled in for any of the care plans seen. The acting manager should undertake an audit of all care plans to ensure that there is sufficient and appropriate information which is being accurately recorded so that service users assessed needs are safely being met. The majority of service users met during the inspection were unable to communicate their views of the home. One of the service users did however say that there had been some improvements in the food and in activities since a new manager and activities co-ordinator had been appointed. The Gables (Cambridge) Limited DS0000037198.V302654.R01.S.doc Version 5.2 Page 11 It was also noted that there was little in the way of meaningful conversation occurring when staff were assisting service users. On one occasion when a service user was being hoisted it was noticed that the procedure was undertaken silently by the carers with virtually no reassurance or explanation offered. On another occasion a member of staff was observed to approach a service user who was in a wheelchair and move her to a new location without speaking to her to explain her actions. The Gables (Cambridge) Limited DS0000037198.V302654.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15,16,17 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to the home. Service users have limited access to activities in the home and wider community. Consequently a wider range of age appropriate activities need to be provide EVIDENCE: The staff stated that activities include mostly board games, day trips, TV, shopping, aromatherapy and massage. There is a small gardening project in development but it was not clear how service users would be assisted to take part. Some of the service users also attend a local day service. On the first day of inspection three service users were on a day trip to Sandringham during the day with two staff including the newly appointed activities co-ordinator. However, it was observed during the inspection that there continues to be little in the way of meaningful activity with most of the service users sitting passively in the lounges. This was also observed during the last inspection of the home. The Gables (Cambridge) Limited DS0000037198.V302654.R01.S.doc Version 5.2 Page 13 The activities co-ordinator is enthusiastically arranging a number of day trips including garden centres, wildlife parks, seaside resorts and shopping trips. Usually three service users go on the trip with two staff depending on the mobility requirements of service users. Apart from those on the day trip it was observed that during both days of inspection the atmosphere in the home did not reflect the fact that younger adults lived there, it was quiet and uninspiring and there was little staff interaction with service users. Consequently a requirement has been made regarding the provision of suitable and age appropriate activities for service users. A variety of meals are provided to meet the assessed needs of service and drinks and snacks are available throughout the day. The acting manager stated that the food budget has been reviewed and increased so that better quality products are now being purchased. The cook confirmed that she was now able to provide better quality meals and more home cooked meals. One service user confirmed that the quality of food had improved. The lunch observed appeared to be of good quality and nutritious. However, during lunch it was observed that a member of staff was assisting a service user with her meal but was clearly overloading the spoon making it difficult for the service user to take the amount of food in her mouth. The staff member attempted to give the service user the food on at least three occasions until a smaller amount of food was offered which she then took. The Gables (Cambridge) Limited DS0000037198.V302654.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the home. Service users receive appropriate health and personal care to meet their assessed needs together with support in taking prescribed medication. EVIDENCE: All service users are registered with a GP and the senior staff member stated that any health problems are dealt with appropriately and recorded in care plans. Staff accompany service users to hospital and GP appointments as required. The service user files seen showed that health care services are available to ensure that service users receive health care from a variety of professionals. It was noted however on one care plan that other service users names were documented when a GP had made a visit to the home. A variety of healthcare professionals remain in contact with service users including a speech therapist, OT, and a chiropodist. Observations throughout the day showed that the communication between staff and service users is of a limited nature so it was not clear whether all care procedures were agreed or understood by service users. The Gables (Cambridge) Limited DS0000037198.V302654.R01.S.doc Version 5.2 Page 15 As mentioned previously in this report the lack of agreed physio sessions for one of the service users is of great concern especially as there were no reasons given as to why these sessions had not occurred. The administration records for individual service users medication were inspected and found to be accurate. It was noted that a blind had been put on the window in the medication room to aid security but it did not seem to work and either needs to be repaired or replaced. The Gables (Cambridge) Limited DS0000037198.V302654.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the home. The home has a satisfactory complaints process to make sure that service users have their complaints or concerns listened to and acted upon properly. EVIDENCE: The home has a complaints procedure including agreed timescales to make sure that all complaints are investigated and actioned appropriately. The home has not received any complaints since the last inspection. The home has a satisfactory policy in place, in line with the Local Authority policies, to make sure that service users are protected from abuse. However a number of concerns have been raised about care practices in the home, which has instigated an investigation under the Protection of Vulnerable Adults. The Gables (Cambridge) Limited DS0000037198.V302654.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26,27,28,29,30 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to the home. The environment is not suitable for the needs of those living in the home, as it does not reflect the age group of most service users. There is a need to improve the décor and furnishings and fittings and equipment provided in the home. EVIDENCE: The environment is clean and tidy. However, the communal areas are not decorated and furnished in a suitable manner to reflect the age group of service users in the home. Individual service user bedrooms were in reasonable decorative order and personalised. However, a number of bedroom carpets are showing signs of wear and should be replaced. The acting manager stated that a new carpet had been ordered for the front lounge and was due to be laid in the forthcoming week. She agreed to confirm with CSCI when this had been done. The acting manager stated that an audit regarding carpets, décor and furnishings is to be undertaken and a priority list would be actioned The Gables (Cambridge) Limited DS0000037198.V302654.R01.S.doc Version 5.2 Page 18 accordingly. She stated that a copy of the maintenance audit including timescales for work to be carried out would be sent to CSCI. A number of doors and areas of paintwork in the corridors remain scuffed and damaged and attention needs to be given to these areas as it gives the home an unkempt appearance. The kitchen was clean and hygienic. The upstairs shower room is in need of complete renovation as its condition is unacceptable including: • • • • • • A new radiator cover New shower tray. New and appropriate coverings for the pipe work should be installed. The ramp leading into the shower tray needs to be replaced, as it is currently a painted wooden ramp that is showing signs of deterioration. The window does not have appropriate cover and a curtain or blind should be purchased for this purpose. Adequate and appropriate cover for the storage cupboard in the room needs to be installed as there is currently a curtain pulled across the opening. The upstairs WC also requires attention, as it did not have: • • • • • A suitable window cover, Toilet roll holder, Working paper towel dispenser, Door lock A lampshade. Appropriate fire escape signage has been added to the front door indicating that it is fire exit. The home has a very well landscaped garden to the rear and service users would benefit from more access to this area instead of only using the courtyard near to the main lounge. The Gables (Cambridge) Limited DS0000037198.V302654.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,35,36 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the home. Mandatory training is provided for care staff but there is little in the way of client specific training. However it is recommended that training methods are reviewed as the reliance on training through video presentations is not adequate. EVIDENCE: The manager stated that training in the home is being reviewed to ensure that both mandatory and client specific training is in place. Staff files confirmed that they had received training mainly in mandatory sessions eg food hygiene, health and safety; COSHH, infection control, POVA, epilepsy and NVQ training have been undertaken. However the majority of this training has been delivered through video presentations. Reliance on such training is inadequate. Staff spoken to stated that after each video session they complete a question & answer sheet but they were not told if they had answered questions correctly or not. Considering the complex needs of the service users there is clearly a skill gap regarding the staff’s knowledge of individual clinical conditions and the communication needs that clients may have. Care staff need in depth training The Gables (Cambridge) Limited DS0000037198.V302654.R01.S.doc Version 5.2 Page 20 in the diverse conditions represented in the service user group in order to ensure that they can meet the service user’s needs. The inspectors were also concerned about the lack of training that nurses receive regarding updating their clinical practice. The nurse on duty, on the first day of inspection, stated that she had attended a course regarding MRSA but could give no further examples of any clinical updates. It was recommended at the last inspection that the home should not rely on video methods. Staff spoken to stated that they had received supervision but this was infrequent. The Gables (Cambridge) Limited DS0000037198.V302654.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,38,39,42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the home. The home has been well managed in the short time that the acting manager has been in charge of the home. EVIDENCE: The manager was registered in May 2006. He has since resigned. The home is currently managed by one of the organisation’s project managers until a new person is appointed to the post of manager in the home. An application to register the new manager with the Commission for Social Care Inspection will need to be submitted. The inspectors expressed their concern that the home is again without a registered manager. However it was clear from discussions with the acting manager, during the first day of inspection, that she is both experienced and skilled and has already implemented a number of changes in the home. These include increasing the food budgets, shift patterns, trained staff meetings, maintenance audits and residents meetings. The Gables (Cambridge) Limited DS0000037198.V302654.R01.S.doc Version 5.2 Page 22 The staff spoken to during the day were clear about the management arrangements in the home and they were complimentary about the acting manager who they described as both supportive and approachable. Records of weekly fire alarm and emergency lights testing were seen and found to be accurate. Service contracts are also in place to ensure that equipment and services in the home are maintained regularly. The Gables (Cambridge) Limited DS0000037198.V302654.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 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 2 ENVIRONMENT Standard No Score 24 2 25 3 26 2 27 2 28 1 29 3 30 3 STAFFING Standard No Score 31 1 32 1 33 2 34 X 35 1 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 1 1 2 2 LIFESTYLES Standard No Score 11 X 12 1 13 2 14 2 15 2 16 2 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 2 3 X 2 2 2 X X 3 X The Gables (Cambridge) Limited DS0000037198.V302654.R01.S.doc Version 5.2 Page 24 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA6 Regulation 15(1)(2) (c)(d) Requirement The provider must ensure that the care plan is written in sufficient detail to ensure that care staff have clear guidance regarding the care and support needs of individual service users. The provider must ensure that the care plan is reviewed giving clear recorded details of individual progress or changes in service users care and support. Suitable activities must be provided to meet the individual needs of service users. The provider must ensure that the home is well maintained and areas of furniture and paintwork are renewed or replaced. Carpets in the lounge and a number of service user bedrooms must be replaced The upstairs shower room and WC must be upgraded to provide suitable and safe facilities for service users The registered provider must ensure that all staff receive adequate training to ensure that they can meet the assessed DS0000037198.V302654.R01.S.doc Timescale for action 31/08/06 2. YA6 15(2)(b) 31/08/06 3. 4. YA14 YA24 16(2)(n) 23(2)(b) 31/08/06 31/08/06 5. 6. YA24 YA27 23(2)(b) 23(2)(d) 31/07/06 31/08/06 7. YA32 18(1)(a) (c) 31/08/06 The Gables (Cambridge) Limited Version 5.2 Page 25 needs of service users. 8. YA37 8(2) An application to register a manager for the home must be made to CSCI 30/11/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations The Gables (Cambridge) Limited DS0000037198.V302654.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Cambridgeshire & Peterborough Area Office CPC1 Capital Park Fulbourn Cambridge CB1 5XE National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI The Gables (Cambridge) Limited DS0000037198.V302654.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. 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