Inspection on 13/07/05 for The Mount

This inspection was carried out on 13th July 2005.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

The Mount 06/04/10

The Mount 26/02/08

The Mount 28/02/07

The Mount 18/01/06

The Mount 21/01/05

The Mount 04/10/04

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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 Mount Faircrouch Lane Wadhurst East Sussex TN5 6PT Lead Inspector Caroline Johnson Announced 13th July 2005 10:15 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 Mount H59-H10 S21251 The Mount V229138 130705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service The Mount Address Faircrouch Lane Wadhurst East Sussex TN5 6PT 01892 782025 01892 782917 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) The Mount Camphill Community Brigitte van Rooij Care Home 39 Category(ies) of Learning Disability (LD), 39 registration, with number of places The Mount H59-H10 S21251 The Mount V229138 130705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. The maximum number of residents to be accommodated is thirty nine 2. On admission residents to be aged sixteen to nineteen years 3. Some of the residents may also have associated mental health problems Date of last inspection 21st January 2005 Brief Description of the Service: The Mount Camphill Community is an independent specialist college that provides further education and training for residential and day students aged 16 to 25. The Community is a registered educational charity providing up to 39 residential places for young people with moderate learning disabilities. The Camphill Movement, founded in 1940, works to create communities in which vulnerable children and adults can learn and work with respect. Camphill is inspired by Christian ideals as articulated by Rudolph Steiner and is based on the acceptance of spiritual uniqueness of each human being, regardless of religious or racial background. The Mount’s training programme extends over 4 years. An educational year is approximately 38 weeks divided into 4 terms, with students returning home or to other placements during the holidays. There are 4 community houses on-site, each with its own character. There are craft workshops for pottery, weaving, woodwork and catering. In the main house, which is a renovated monastery, are classrooms, a library and a community hall. There is a large vegetable garden and orchard, which the students help to maintain and grow produce. There is also a gymnasium on the site. The Mount is staffed by residential co-workers and day staff. The senior co-workers live permanently in The Mount. Most staff take on the role of house co-workers, team leaders and some are also College tutors. The trainee coworkers are volunteers from a wide range of countries and usually work at The Mount for up to one year. The Mount H59-H10 S21251 The Mount V229138 130705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection, the first in the year running from April 1 2005 to March 31 2006. The inspection lasted from 10.15am until 5.30pm. Mr Phil Hale, Regulation Manager, joined the inspection until lunchtime to assist in the tour of the houses. Each of the four houses were seen during the inspection. Three trainee co-workers were interviewed and there was an opportunity to meet with six members of the management team. There was also an opportunity to meet with a number of students in one of the houses and to share a meal with the students in another house. A number of records were examined including pre admission documentation for one student and aims and targets for another two students. Health and safety documentation was also examined and time was spent discussing staff training. The inspection was centred on the care arrangements only and not on the educational facilities. The service is also registered with Ofsted who inspect the educational facilities periodically. What the service does well: What has improved since the last inspection? Within the last year thermostatic valves have been fitted to hot water outlets. In addition the water has been tested for Legionella and there is a detailed risk assessment in place to prevent this occurring. Some of the bedrooms have been repainted. The service has designed a training package for new staff, which has been submitted to OCN (Open College Network) and accepted as an accredited course. Staff report that this course is equivalent to NVQ level 2. By the time trainee co-workers complete their contract they will have completed this course. Staff receive training annually on child and adult protection. As recommended at the last inspection training was provided for staff on epilepsy and the use of invasive medication. The Mount H59-H10 S21251 The Mount V229138 130705 Stage 4.doc Version 1.40 Page 6 There are good systems in place for continually reviewing and auditing the service’s procedures and this is evident in the changes made to procedures following a complaint made to the service. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Mount H59-H10 S21251 The Mount V229138 130705 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection The Mount H59-H10 S21251 The Mount V229138 130705 Stage 4.doc Version 1.40 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 standard(s) 1,2,4,5 The pictorial student handbook provides detailed yet clear information about life at the Mount. The service is continually looking at ways of developing their assessment process for prospective students. A written assessment provided by Connexions would enhance the assessment process. EVIDENCE: There is a very detailed statement of purpose in place. In addition there is student handbook and student charter. The handbook has been produced in pictorial format and clearly describes the service that is provided at The Mount. Terms and Conditions of residence are also issued to parents/carers and to placing authorities. Applications for students need the support of Connexions or Careers Services. Currently Connexions carry out an initial assessment for prospective students and although they provide information to the Mount they do not provide a written assessment. Following a referral, the service is thorough in obtaining as many assessment reports as possible to enable them to assess if they can or cannot meet the needs of an individual. This was evident in respect of the records seen in relation to one student admitted to one of the houses. The parents of the student had completed a pre-entry questionnaire. In addition information had been passed on from the previous school and there was an educational report and a psychology report. The Mount H59-H10 S21251 The Mount V229138 130705 Stage 4.doc Version 1.40 Page 9 The service has recently adapted their assessment procedures to ensure that they are even more thorough in requesting information about the individual abilities and needs of prospective students. Following on from the assessment students are invited to spend three days and two nights in the home. The Mount H59-H10 S21251 The Mount V229138 130705 Stage 4.doc Version 1.40 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,8,9 Some of the service’s aims and targets are for individual students are too broad making it difficult to evaluate individual progress. Emphasis should be placed on being more specific about the aims, that is, what it is hoped will be achieved, and how it is to be achieved, including the level of staff assistance required. In order to assist in developing new skills increased opportunities should be arranged for students to plan, shop for, prepare and cook meals. EVIDENCE: Each house keeps records of the aims and targets that are in place for each student. These are reviewed every six months and after each annual review. Some of the aims and targets are very broad and the action to be taken by staff to support students is not always recorded. The co-worker spoken with in one of the houses stated that the aim is that the students would run the house. As part of this process students take it in turn to cook. However, vegetables come from the garden and milk, bread, meat and fish are all delivered to the home. Whilst some opportunities are provided to ensure that students go shopping for food this does not happen on a regular basis. For some students who will move on to more independent living arrangements, this could mean that they would not have developed sufficient skills in this area. The co-workers had already recognised that this is an area where they need to make some changes. The Mount H59-H10 S21251 The Mount V229138 130705 Stage 4.doc Version 1.40 Page 11 The co-worker advised that in relation to meeting one of the student’s wishes she is looking to find a child care course locally for September. Risk assessments are carried out in respect of each student. However, in respect of some of the risk assessments seen the level of risk should be more clearly defined and the action to be taken by staff to reduce the risk of an accident or incident occurring more detailed. In one of the houses visited staff advised that student meetings are held regularly. These meetings are chaired and minuted by the students. It is understood that student meetings are common in each of the houses although some students will require varying levels of support. The Mount H59-H10 S21251 The Mount V229138 130705 Stage 4.doc Version 1.40 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 standard(s) 14,16,17 Students were relaxed during the inspection. There is a lot of structure provided to the working week. Equally there is plenty of leisure time and also time for quiet reflection. Although an inspection was not carried out of day activities, from observations and general conversations with students it was noted that they have opportunities to take part in varied, interesting and fulfilling hobbies and interests. The service needs to make sure that they record the actual meals served to students on a daily basis. EVIDENCE: Students spoken with stated that in their free time they enjoy riding their bikes and playing snooker. Tennis, football and cricket are played informally on the back lawn. There are occasional video evenings. Students spoke about regular outings to places of interest such as to Battle town and to Bewl Reservoir. At the time of inspection five of the students were away on a camping trip. The Mount is a non-denominational Christian community. Emphasis is placed on celebrating the festivals. There is an assembly every morning and grace is said at meal times. Saturday evenings and Sunday mornings are quiet times used for reflection. Students were relaxed during the inspection. They spoke positively about their placements and the support they receive. The Mount H59-H10 S21251 The Mount V229138 130705 Stage 4.doc Version 1.40 Page 13 They were looking forward to an end of term party and some volunteered to take part in the arrangements. When visiting one of the houses a group of students arrived with a coffee table that one of the students had made for the house. Drinks were made immediately and the table was put to use. The student who made the table was quite rightly very proud of his table and all the students shared the joy of his achievement. Emphasis is placed on providing healthy food. Organic vegetables are grown in the gardens and organic bread, biscuits and cakes are supplied from the onsite bakery. Meat and fish are served two or three times a week and there is always a vegetarian alternative. Records were seen in respect of menus in only one of the houses. Records were not always fully completed. As part of the inspection process records showing examples of the meals provided to students were supplied. These records demonstrated that meals served are varied and well balanced. There was also an opportunity to share a meal with some of the students. The meal provided was well presented, nutritious and tasted very good. The Mount H59-H10 S21251 The Mount V229138 130705 Stage 4.doc Version 1.40 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 standard(s) 20 The service should produce a new format for recording homeopathic medication and the person administering the medicine should sign for each medicine administered. EVIDENCE: The arrangements in place for the storage and handling of medication were examined in one of the houses only. A homeopathic doctor plays a key role in maintaining students health in accordance to the whole philosophy and culture of The Mount. All students are registered with a local General Practitioner who is responsible for overseeing all generic prescribed medication and health concerns. There were some gaps in the recording of medication administered to students. There are appropriate arrangements in place for the storage of medication. The Mount H59-H10 S21251 The Mount V229138 130705 Stage 4.doc Version 1.40 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22,23 The service had reviewed and made some appropriate changes to their procedures following a recent complaint. The policy on restraint needs to be amended and the use of restraint clearly defined. EVIDENCE: The service has a detailed complaint procedure in place. The procedure is also included in the students’ handbook. Since the last inspection there had been one complaint made to the service. The complaint was partly substantiated. Staff spoken with acknowledged that could have handled aspects of the complaint better. Following the complaint the service has revised their crisis intervention guidelines so that should a similar incident occur in the home it would be handled better. The guidelines make reference to the Registered Home’s Act 1984 and this needs to be changed to the Care Standards Act and associated Regulations, in particular Regulation 37. It was also highlighted that when incidents occur were there is likely to be a conflict of interest it is always better to request that someone independent of the service investigates the matter. An external company provides training for staff on adult and child protection on an annual basis. There is a procedure in place in respect of adult protection and prevention of abuse. The procedure should be amended to include reference to the steps that would be taken by the service and by Social Services should an allegation of abuse be made. There is restraint procedure in place that allows use of restraint in extreme circumstances. However, the management team advised that they have no recollection of ever needing to restrain a student. The service’s policy on restraint should be amended to provide further clarification on when and if it should be used. The Mount H59-H10 S21251 The Mount V229138 130705 Stage 4.doc Version 1.40 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,25,27,28,30 Each of the houses are well decorated and all accommodation seen was comfortable and homely in design. The plans to make one of the toilet facilities, wheelchair accessible and to turn one of the rooms into an internet cafe and library will enhance the environment even further. The service takes the fire safety arrangements of the Community seriously but there is still a need to ensure that there is a fire safety risk assessment in place. EVIDENCE: There are four houses in the Community: the Mount House, the White House, St John’s House and Soltane. A tour of each of the houses was undertaken as part of the inspection. Students are encouraged to personalise their individual rooms. Some of the double rooms are used for single occupation to comply with Regulations in terms of single to double ratios. All areas seen during the inspection were clean. In the Mount House there are plans to make two of the toilets into one wheelchair accessible toilet facility. Over the summer months there are also plans to turn one of the rooms into an internet café and student library. The house exceeds the standards in terms of provision of communal space. In addition there are extensive grounds that are used regularly by the students. The Mount H59-H10 S21251 The Mount V229138 130705 Stage 4.doc Version 1.40 Page 17 Staff receive annual training in fire safety. The service is making arrangements to have a fire safety risk assessment carried out. Since the last inspection, door releases have been fitted on all corridor doors and in other areas assessed as high risk. The Mount H59-H10 S21251 The Mount V229138 130705 Stage 4.doc Version 1.40 Page 18 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) 32,33,35,36 Two of the management team have worked extremely hard to develop their training package for trainee co-workers. The list of subjects covered is extensive and ensures that by the time the trainees leave at the end of their contracted year they have a very good understanding of the needs of people with learning disabilities. There is still a need to formalist appraisal (supervision) sessions for all care staff and to keep a written record of the outcome. EVIDENCE: Long-term senior co-workers live on site alongside the students. They are supported in this role by short-term (voluntary) trainee co-workers, who also live on site. The trainee co-workers usually come from a wide range of countries and are contracted to work for a year. They start in post four days before the autumn term. During this time they begin their induction process. Each trainee co-worker has a mentor who is generally someone not living in the same house. They have one day off a week. The service has designed a training package for new staff, which has been submitted to OCN (Open College Network) and accepted as an accredited course. Staff advised that the course is equivalent to NVQ level two. By the time trainee co-workers complete their one-year contract they will have completed the course. Unfortunately this means that at the start of each year the home is not meeting the standard in terms of 50 of the staff team having NVQ level two or equivalent. The Mount H59-H10 S21251 The Mount V229138 130705 Stage 4.doc Version 1.40 Page 19 The training package is extensive and in addition to training on core subjects such as first aid, food hygiene, health and safety and fire safety, trainee coworkers also learn about some of the more common conditions associated with people with learning disabilities. Strong emphasis is also placed on learning about the history of Camphill, eurythmy, and youth guidance and to the routines and way of life at The Mount. As recommended at the last inspection, training has been provided for staff on epilepsy and on the administration of invasive medication. There is a system in place of peer appraisal whereby co-workers appraise each other’s work. The service is working on extending this so that all staff receive regular appraisal of their work. At present there are no written records kept of the appraisals carried out. The Mount H59-H10 S21251 The Mount V229138 130705 Stage 4.doc Version 1.40 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 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) 37,38,42 Although there is a registered manager in post the management team share the responsibilities of this task. This works effectively as there are clear lines of communication in place. However, the registered manager is still required to undertake study to NVQ level four or its equivalent. There are appropriate systems in place to ensure the health and safety of students and staff. EVIDENCE: A large management team runs the Mount. Each member of the team has specific roles and responsibilities. One of the management team is the registered manager of the Service. Two of the management team are studying for NVQ level three but there is no one trained to level four. A number of the management team have other professional qualifications. Trainee co-workers spoken with stated that they were well supported in their roles within the home. They stated that their `work is appreciated’ and that there is a `good team spirit’. They find the management team approachable and would not hesitate to raise any issues or discuss new ideas with them. The Mount H59-H10 S21251 The Mount V229138 130705 Stage 4.doc Version 1.40 Page 21 As part of the inspection process comment cards are sent from the Commission to the service for distribution to relatives of the students. Although comment cards were not returned, nine relatives took the opportunity to respond in writing highlighting their views of the Mount and the care provided. One of the letters was in relation to the complaint referred to in standard 22. The service has responded to the complaint made to them. Eight of the letters were from parents of students. Every one of the eight letters praised the staff team for their dedication and stated that their sons/daughters had grown in selfconfidence and self esteem since joining the Community. Comments also refer to students being `ready to face adult life by the time they leave the Mount’. Hot water accessible to students is regulated to a safe temperature and there is regular monitoring to ensure that temperatures remain safe. It was agreed that contact would be made with the manufacturer for advice regarding the frequency of servicing the valves that regulate the water temperatures. Within the last year the water has been tested for Legionella and there are good procedures in place to prevent this occurring. Portable appliance testing has also been carried out within the last year. There is a health and safety meeting weekly to discuss any work required to be carried out. The maintenance person keeps a diary of all work undertaken. Health and safety risk assessments are also carried out and reviewed at regular intervals. The Mount H59-H10 S21251 The Mount V229138 130705 Stage 4.doc Version 1.40 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 3 3 x 3 3 Standard No 22 23 ENVIRONMENT Score 2 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 2 x 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 3 3 3 x 3 Standard No 11 12 13 14 15 16 17 x x x 3 x 3 2 Standard No 31 32 33 34 35 36 Score x 2 3 x 3 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Mount Score x x 2 x Standard No 37 38 39 40 41 42 43 Score 2 3 x x x 3 x H59-H10 S21251 The Mount V229138 130705 Stage 4.doc Version 1.40 Page 23 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 6 Regulation 15(1) Requirement Aims and targets set for each student must be more specific in detailing what is to be achieved and the action to be taken by staff to support this. Individual risk assessssments must be more detailed in describing the level of the perceived risk and the action to be taken by staff to minimise the risk of an accident/incident occuring. Records must be kept of the actual meals served. A fire risk assessment must be carried out. All care staff must receive supervision (appraisal) at least six times a year and a written record must be kept of the outcome. The registered manager must enrol on an NVQ level four course or its equivalent. Timescale for action 31 October 2005 2. 9 13(4) 31 October 2005 3. 4. 5. 17 24 36 17(2) schedule 4 para.13 23(4)(a) 18(2) 30 September 2005 30 September 2005 31 October 2005 6. 37 9(2)(b)(i) 31 December 2005 The Mount H59-H10 S21251 The Mount V229138 130705 Stage 4.doc Version 1.40 Page 24 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. Refer to Standard 6 8 20 Good Practice Recommendations Daily records should record all progress made by students in achieving their individaul aims and targets. Students should be given more opportunities to participate in food shopping in order to develop their skills in this area. The format used for recording all homeopathic medication should be redesigned to allow for each medicine to be signed for individually. There should be no gaps in recordings unless medication is prescribed on an as required basis. In respect of the services crisis intervention guideleines, the document needs to refer to the Care Standards Act. In addition it should also state that if it is considered that there could be a conflict of interest it is always best to arrange for someone independent of the service to carry out an investigation. The servcie should include within their adult protection procedures a flow chart detailing the action that would be taken following an allegation of abuse. The restraint procedure should be amended to reflect that restraint should only be used if it has been a multidisciplinary decision and there are clear guidelines in place for the individual concerned. Only staff that have received training on restraint should be involved in restraint. A percentage of the permanent staff should train to NVQ level two or its equivalent so that the service can meet the standard throughout the academic year. 4. 22 5. 6. 23 23 7. 32 The Mount H59-H10 S21251 The Mount V229138 130705 Stage 4.doc Version 1.40 Page 25 Commission for Social Care Inspection Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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 Mount H59-H10 S21251 The Mount V229138 130705 Stage 4.doc Version 1.40 Page 26 - 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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