CARE HOME ADULTS 18-65
The Orchards 140/142 Birkrig Skelmersdale Lancashire WN8 9HY Lead Inspector
Val Turley Unannounced Inspection 23rd May 2007 09:30 The Orchards DS0000005979.V334249.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 Orchards DS0000005979.V334249.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 Orchards DS0000005979.V334249.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service The Orchards Address 140/142 Birkrig Skelmersdale Lancashire WN8 9HY 01695 726118 01257 450630 dawaking@talk21.com 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) Dawaking Care Ltd Mrs Lesley Ferguson Care Home 7 Category(ies) of Learning disability (7) registration, with number of places The Orchards DS0000005979.V334249.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. A maximum of seven service users requiring personal care who fall into the category of LD - Learning Disability. The registered provider must, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. Staffing must be provided to meet the dependency needs of the service users at all times and will comply with any guidelines which may be issued through the Commission for Social Care Inspection regarding staffing levels in care homes. 16th March 2006 Date of last inspection Brief Description of the Service: The Orchards is a large end terraced house comprising of two properties in the Digmoor area of Skelmersdale. It is close to local shops and amenities. The home has been extended and adapted to provide long term care for seven people all of whom have a learning disability. People are accommodated in single rooms situated on three floors. The home is able to accommodate a person with a physical disability as it provides ramps to the front and rear of the home, a ground floor bedroom and a ground floor shower room. There is a separate kitchen, dining room and two lounges. A well-maintained garden can be accessed through the dining room. The Orchards DS0000005979.V334249.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an inspection that took place over a fourteen-month period and culminated in a site visit to the home over one day in April 2007 by one regulatory inspector. The inspection involved discussion with people living at the home, discussion with staff, observation of staff supporting residents and an examination of records, policies and procedures. Information was also provided through a preinspection questionnaire completed by the provider, through surveys completed and returned by 6 of the people living at the home, 3 by relatives and 1 by an advocate. As part of the inspection, the inspector used ‘case tracking’ as a means of assessing some of the National Minimum Standards. This process enabled the inspector to focus on one of the people living at the home. Records relating to that individuals were inspected and discussion took place with people who were present in the home on the day of the site visit. What the service does well:
The Orchards has a clear view of how to best support the people living there. This begins even before the person moves into the home. The home works with them, relatives and any involved health and social care professionals to ensure as far as possible that the home is able to provide the support that the person needs. Wherever possible service people are encouraged to become involved in the development of their care plans and these are reviewed at least on a monthly basis to make sure that the people are receiving the right support. Risk assessments were linked to the care plans. These are in place to help make sure that people are kept as safe as possible when involved in activities both inside and outside the home. The home also works with the people living there to help them to each develop a person centred plan. This process encourages and supports individuals to identify their likes and dislikes and any goals or ambitions they may have. The plans are very personal to each of the residents and are presented in ways that they are able to understand them more easily. Sometimes this includes the use of pictures and colours. Included in the plans are people’s preferred daily routines, meals and activities. People are able to make decisions about the way the home is run and great efforts are made to ensure that they are able to make choices and decisions
The Orchards DS0000005979.V334249.R01.S.doc Version 5.2 Page 6 about their own lifestyles. Where this is not possible, advocates provide additional support for people. The residents have monthly meetings when they are able to discuss the running of the home and plan any activities they might like to get involved in. A person living at the home wrote ‘all the staff listen and help me when I need help’. One person returned a completed survey form writing that their relative is ‘allowed the freedom to live their own life’. Another wrote that the home ‘gives choice to people’ and that they ‘give care and attention at all times’ The people living at the home are supported to get involved in a range of leisure and work activities including working at a charity shop, attendance at college and day centres and the use of leisure centres, local shops and pubs. Contact with families and friends is encouraged and visitors are made welcome in the home. A resident wrote ‘I enjoy going out with other people in the house and having my own friends’. The home is clean, well maintained, decorated and furnished and provides a pleasant environment for both the people living at the home and the support staff working there. People are able to personalise their bedrooms to reflect their interests and hobbies. The staff respect the privacy of the residents and always knock before going into their rooms. The people living at the home decide their own menus and are able to take their personal likes and dislikes into account when doing this. The staff support them if they have any specific dietary needs. Mealtimes are relaxed and unhurried with assistance being offered sensitively. The support staff work with the people living at the home to make sure that their health needs are met. Health action plans have been developed to help identify and manage any health concerns as well as maintain a record of any routine health appointments. A range of health and social care professionals are involved in the home providing additional support and guidance. The home has good policies and procedures in place should any concerns or complaints be made about the home. The home has good policies and procedures in place that help to protect both residents and support staff as far as possible with training also being provided in respect of this. The staff team are carefully selected and recruited with all of the necessary checks being made to help make sure that people are kept safe. New staff feel well supported and the manager is seen to be both approachable and supportive of staff. The staff team as a whole have a good range of skills and qualifications and are knowledgeable about the needs of the people living at the home. A range of training opportunities had been provided for them and over 50 of the team had achieved a nationally recognised qualification in care. The staff were seen to be sensitive in the support they offered people and the residents were relaxed in their presence. The Orchards DS0000005979.V334249.R01.S.doc Version 5.2 Page 7 One person living at the home wrote ‘I love living there. The staff are nice and so is the manager’. The registered manager of the home is very experienced in her role and has achieved a NVQ level 4 in care and management. She is aware of the need to keep her skills updated and has undertaken any necessary training. She has a good overview of the needs of the needs of the people living at the home, the staff team and the home in general and benefits from a good support network within the company. The home has a number of quality assurance checks in place and these help to make sure that the home is run safely and with the best interests of the resident in mind. All systems and equipment are serviced and maintained appropriately. Staff receive training in health and safety issues and this is backed up by detailed policies and procedures in respect of health and safety issues. 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. The summary of this inspection report can be made available in other formats on request. The Orchards DS0000005979.V334249.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Orchards DS0000005979.V334249.R01.S.doc Version 5.2 Page 9 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The pre-admission process was in sufficient detail to ensure that prospective residents support needs are fully assessed before admission. EVIDENCE: The care of one person was tracked during the site visit to the home. By doing this it was possible to look at the work the home had undertaken before that person was admitted to the home. The information on the file showed that the home had worked with the person, the care manager and relatives and that they had collected detailed information about the individuals care needs. The staff at the home had also undertaken their own assessment to help them decide if they were able to give the person the help and support that was needed. The Orchards DS0000005979.V334249.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 and 9 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. People living at the home were supported to take responsible risks based on good information and enabled them to work towards a more independent lifestyle. EVIDENCE: The file of the person whose care was tracked during the site visit contained a very detailed care plan and included information for staff as to how best to support her on a daily basis. Risks were identified within the care plan and risk assessments were in the process of being developed. It was recognised that these were changing as the resident settled into the home. The Orchards DS0000005979.V334249.R01.S.doc Version 5.2 Page 11 The people living at the home had signed their care plans where they were able to, to show that they agreed with it and they were involved in the development of their care plans as far as this was possible. To make sure that the care plans met the needs of the people living at the home, they were reviewed whenever it was necessary and at least once a month by the staff and where possible with the individual resident. They were reviewed formally every six months and this review involved other health and social care professionals involved in providing support to the individual residents. Risk assessments were linked to the care plans. These were in place to help make sure that the people living at the home were kept as safe as possible when involved in activities both inside and outside the home. The home encouraged and supported people to make decisions and choices about their support needs and lifestyle. During the course of the visit to the home, support staff were heard to ask people what they would like to do and provided them with support and guidance to enable them to make decisions. An advocate was involved in the home, working with individuals, helping them to make decisions and choices or helping to making informed decisions on their behalf. People were also encouraged and supported to attend a local independent advocacy group where they had opportunities to discuss any concerns. One care plan examined included guidance on how to support one of the residents to make decisions. The home had a key worker system in place; they gave individual support to the people living at the home, helping them to make decisions and choices. The home had also introduced Person Centred Planning for most of the people living at the home. This process encouraged and supported individuals to identify their likes and dislikes and any goals or ambitions they may have. The plans were very personal and were presented in ways that the residents were able to understand more easily. Sometimes this included the use of pictures and colours. The home had plans to extend the Person Centred Planning for each person, enabling them to decide on their preferred lifestyle. The Orchards DS0000005979.V334249.R01.S.doc Version 5.2 Page 12 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 and 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The daily routines in the home promoted the independence of the people living at the home, encouraging and supporting them to make safe choices and decisions and become involved in valued and worthwhile activities. EVIDENCE: From evidence on the files of people living at the home and from discussion with them and support staff, it was clear that people were supported to become involved in a range of activities that they as individuals valued. These included work at a charity shop, horse riding, attendance at college and day centres. People were supported to attend local churches and make use of local facilities including shops, pubs and leisure centres. The Orchards DS0000005979.V334249.R01.S.doc Version 5.2 Page 13 From information on resident’s files and from discussion with people living at the home and their support staff, it was clear that contact with families and friends was encouraged and supported. Bedrooms were personalised and reflected the hobbies and interests of the people they belonged to. Staff were observed to knock on bedroom doors before entering the room. People had unrestricted access to all the communal parts of the house except the kitchen. This was kept locked for reasons of safety although those people who could use the kitchen safely could get a key from the member of staff on duty. The people living at the home met on a regular basis to discuss and decide on menus. Individual likes and dislikes were taken into account in the planning. On the day of the site visit there was much discussion about what to have for lunch and a decision was reached taking into account what the staff on duty cooked best. Lunchtime was relaxed and unhurried with help being given sensitively to those people who needed it. Individuals living at the home had their weights recorded on a regular basis as a means of monitoring their general well being. The home had a lively atmosphere with the people living there being given the confidence and opportunities to influence the running of the home and make decisions about their individual lifestyles. The Orchards DS0000005979.V334249.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The support staff had a good knowledge of individual residents preferences and personal and health care needs and provided support sensitively and in accordance with their wishes. EVIDENCE: The care plans for each of the people living at the home outlined their specific health and personal care needs providing the staff with good guidance and information on how best to support people. The home had also developed health action plans for each of them and helped to identify and manage any health concerns as well as maintain a record of routine health appointments Records showed that there was involvement of a number of health care professionals in the home. These included an occupational therapist, chiropodist, an optician and a behavioural specialist. People were supported to attend GP and outpatient appointments. Discussion with people living at the
The Orchards DS0000005979.V334249.R01.S.doc Version 5.2 Page 15 home, support staff and the manager confirmed the involvement of these professionals. The support staff were aware of individuals preferred routines in terms of bed times, baths, meals etc and these details were included in both the care plans and in the individual person centred plans. A recent pharmacy inspection at the home had highlighted a number of areas where the home needed to improve on its management of medication. It was recognised that some of these concerns and bad practices had developed during the managers recent period of sick leave from the home. At the time of the site visit, the manager had returned to work on a part time basis and had already, in conjunction with the proprietor, started to act upon the concerns raised. The homes medication policy had been reviewed and updated, providing staff with best practice information and guidance. The manager had worked with the staff team to introduce changes. Records and recording had been improved and these provided a clearer picture of the way medication was managed and administered within the home. The improvements made helped to ensure that the people living at the home received the correct medication and remained healthy. The manager undertook spot checks to make sure that support staff were following the correct procedures when administering medication and a monthly audit of medication had just been introduced to help stop errors being made. Additional training had been planned for all staff administering medication to help ensure that poor practices were prevented. The manager recognised that there was a need to make more improvements in the way the medication was managed, these included the need to make information and guidance in care plans clear when residents self medicate and the need to ensure that a persons refusal to take medication is recorded correctly. The Orchards DS0000005979.V334249.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home had good policies and procedures in place in order to protect the people living at the home. EVIDENCE: The home had detailed policies and procedures in place in order to protect people living at the home as far as possible. Staff received training in the protection of vulnerable adults and the people living at the home who completed a survey said that they knew how to make a complaint. The homes complaints policy and protection of vulnerable adults policy had also been given to the residents in a format that they would find easier to understand. Most people living at the home were able to communicate with staff and were heard to discuss with staff any concerns that they might have. Strategies were in place to manage any challenging behaviour presented by the people living at the home and the home involved relevant health and social care professionals to provide additional guidance and support. The homes approach was strengthened by the homes policies and procedures. The home had clear policies and procedures in place to support people to manage their finances. Their monies were handled as safely as possible. Staff were observed signing money out for the residents and providing receipts for purchases. Records were well made and maintained.
The Orchards DS0000005979.V334249.R01.S.doc Version 5.2 Page 17 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home was clean and comfortable and provided a pleasant and safe environment for both the people living at the home and their support staff. EVIDENCE: The Orchards provided a clean, homely and practical environment for both the people living there and the staff working there. Bedrooms had been personalised by the people living there and there was evidence that the staff had worked with individuals and supported them to do this. The home had a pleasant and safe patio area to the rear of the house that was enjoyed by the residents in the better weather. The kitchen and laundry were both clean and well equipped to meet the needs of the residents.
The Orchards DS0000005979.V334249.R01.S.doc Version 5.2 Page 18 The people living at the home and the staff supporting them were observed to take a pride and an interest in the home. There were plans in place for a new garden area following the building work that took place last year. The home has demonstrated a willingness to use the space available to them flexibly and creatively and there were plans to relocate the office and develop an additional communal area. The home was well maintained with any repairs and redecoration being undertaken as needed. In addition to this there was a refurbishment schedule in place to help ensure that furnishings and equipment were replaced on a regular basis. There were regular safety checks on the environment and the home was also able to call on the services of a maintenance man for urgent repairs. The Orchards DS0000005979.V334249.R01.S.doc Version 5.2 Page 19 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34 and 35 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home selects and trains staff appropriately to ensure that the people living at the home receive the support that they need. EVIDENCE: During the site visit the file of a recently appointed member of staff was examined. The file showed that the home had followed all of its procedures and all of the necessary checks and references were in place before the member of staff started to work in the home. The staff spoken to said that the support that was provided by the staff team and the manager was valued and appreciated. The staff team as a whole had a good range of skills and qualifications. A range of training opportunities had been provided for them and over 50 of the team had achieved a nationally recognised qualification in care. Staff were given opportunities within supervision to discuss their professional
The Orchards DS0000005979.V334249.R01.S.doc Version 5.2 Page 20 development and additional training was planned to broaden the skills base of the staff team. It was recommended that the details on the homes training matrix include dates of training undertaken to enable the need for refresher training to be more easily recognised and planned. The staff team met on a monthly basis when they were given opportunities to discuss any concerns or ideas that they may have about the way in which the home was run and also to discuss any specific issues in relation to the individual residents. During the site visit the people living at the home were observed to be relaxed in the company of the staff. The staff on duty were sensitive in their approach. It was clear that they had a good knowledge of the residents support needs and respected their individual needs and preferences. The Orchards DS0000005979.V334249.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 and 42 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home is well managed, providing a safe and relevant service for the service users. EVIDENCE: The registered manager of the home was very experienced in her role and had achieved a NVQ level 4 in care and management. She was aware of the need to keep her skills updated and undertook all necessary mandatory training. The manager had a good overview of the needs of the needs of the people living at the home, the staff team and the home in general.
The Orchards DS0000005979.V334249.R01.S.doc Version 5.2 Page 22 The manager had a good support network. The proprietor of the home and the company’s general manager called in on an almost daily basis to provide support and guidance. She also had regular contact with other managers within the company providing each other with additional support. The manager said she appreciated the support that she received from her employers, colleagues and health and social care professionals who were involved in the home. The home had a number of quality monitoring systems in place. There were regular internal checks on the homes documentation including care plans and risk assessments and also on the environment. These helped to ensure the safety and well being of both the residents and the staff team. The homes policies and procedures were reviewed and updated as necessary to reflect any changes in legislation and good practice. The home had achieved the Investors in People Award which is quality assurance award accredited by an outside body. The home was also a member of the British Quality Foundation, which provides support to businesses enabling them to improve their performance. The home undertook annual surveys of the views of the people living at the home, their families and friends and any involved professionals. A survey had been produced in a format that the residents could understand more easily. The most recent survey undertaken in December 2006 had not highlighted any major criticisms although an action plan had been put into place to address any concerns raised. People living at the home met every 1-2 months and were given opportunities to influence the way the home was run. There was evidence that the home was run as safely as possible with all systems and equipment being serviced and maintained appropriately. Staff received training in health and safety issues and this was backed up by detailed policies and procedures in respect of health and safety issues. Accidents and incidents were recorded in such a way that the manager could identify any patterns or emerging trends. The Orchards DS0000005979.V334249.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 X 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 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 X 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X The Orchards DS0000005979.V334249.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. Standard Regulation Requirement Timescale for action 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 YA20 YA20 Good Practice Recommendations Care plans for residents self-medicating should be reviewed and updated to ensure that they reflect current practice. Where necessary the manager should discuss with people living at the home the implications for refusal to take medication and the staff team should adopt a common approach when recording a service users refusal to take medication. The dates of training undertaken by individual members of staff should be included in the training matrix to enable future training needs to be more easily identified. 3 YA35 The Orchards DS0000005979.V334249.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Lancashire Area Office Unit 1 Tustin Court Portway Preston PR2 2YQ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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