Inspection on 07/11/05 for The Trio House

This inspection was carried out on 7th November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector 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 Trio House 22/06/09

The Trio House 26/06/07

The Trio House 16/05/06

The Trio House 22/06/05

The Trio House 19/02/05

The Trio House 15/09/04

The Trio House 18/03/04

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

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

CARE HOME ADULTS 18-65 Trio House The 15 Abbotsmead Road Belmont Hereford Herefordshire HR2 7SH Lead Inspector Christina Lavelle : Announced Inspection 7th November 2005 01:30 Trio House The DS0000024794.V261315.R01.S.doc Version 5.0 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Trio House The DS0000024794.V261315.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Trio House The DS0000024794.V261315.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Trio House The Address 15 Abbotsmead Road Belmont Hereford Herefordshire HR2 7SH 01432 342416 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) Miss Margaret Clark Stevenson Miss Margaret Clark Stevenson Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Trio House The DS0000024794.V261315.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Residents may also have a physical disability in addition to a learning disability 22nd June 2005 Date of last inspection Brief Description of the Service: The Trio House is home to three adults who need care due to severe learning disabilities. The service users are men aged in their thirties or forties and the home was set up just for them in 2001 when the care home they were living in then was closing. The provider/manager of The Trio House was the manager of their former care home and so they have all known each other for years. The property is a reasonably sized, detached family house situated on a large, new modern housing estate on the outskirts of Hereford city. There are some local shops and facilities nearby, such as a supermarket with a café and a park. The home also has a suitable vehicle for outings into town and further afield. The home has a fairly small and secure garden, which can be reached through the conservatory. Service users all have single bedrooms upstairs. One of the bedrooms has an en-suite toilet and bath and another has an en-suite toilet and shower. There is a separate bathroom and a ground floor cloakroom. The home has a good-sized lounge and a brick built conservatory which has seating and a television etc and so can be used as an extra sitting room. The house also has a kitchen/dining area, utility room, office and staff sleeping-in room. Trio House The DS0000024794.V261315.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine announced inspection carried out in just over three hours on a Monday afternoon in the autumn. The main aim was to review the quality of care service users receive, as shown by their lifestyle at the home. It was also checked whether action had been taken to deal with some issues arising from previous inspections. The following ways were used to assess this service. It was not possible to ask service users’ directly about their care. However time was spent in their company to obtain an impression of how “at home” they appeared and how well they got on with staff. All the service users were at home during the inspection, having been swimming with staff that morning. How the home is run, service users’ care, staffing and health & safety matters were discussed with the provider. A new staff member was asked about their recruitment, training and experience. Comment cards were sent to the home before the inspection for service users’ relatives and professionals involved with their care requesting their views of the home. Unfortunately as none were returned to the Commission their feedback cannot be referred to in this report. Various records relating to service users’ care, the food provided, staffing and how the home is kept safe were checked. The premises were looked around. Information obtained following a complaint made to the Commission about the home was also taken into consideration. An investigation of the concerns raised was carried out under the multi-agency procedures for the Protection of Vulnerable Adults. The outcome was that the complaint was not substantiated. What the service does well: The Trio House provides a secure and very comfortable home for the service users. The home has given them the opportunity to live in an “ordinary” house which has helped them to be part of and accepted within the local community. The house is furnished, equipped, decorated and maintained to a high standard. Service users’ bedrooms are nice and personal and there is enough space in the home for them to be with the others or on their own if they wish. The atmosphere in the home was friendly and relaxed. The three men were clearly very at ease with each other and appeared to relate well to the provider and staff on duty. Good links were maintained with service users’ families. Staff made sure all service users’ personal and health care needs were being met. Staff also enabled service users to participate in a variety of social and leisure activities outside the home to make their lives more active and interesting. It was good that new opportunities were being sought by the home to replace some day services that had been withdrawn recently. Trio House The DS0000024794.V261315.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Trio House The DS0000024794.V261315.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Trio House The DS0000024794.V261315.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1&5 The required information about The Trio House is available for current and prospective service users. To ensure service users’ financial affairs are dealt with appropriately the cost of extras charged by the home should be specified in the relevant documents. All extra costs should be agreed with service users’ families on their behalf and a relative should also sign and hold a copy of the terms & condition statement. EVIDENCE: The home appropriately provides a “Statement of Purpose”, a “Service Users’ Guide” and a “Terms & Conditions of Residence”. There is also a contract agreed between the provider and the local authority for the service provision. As service users would be unable to understand (and so agree and sign) the terms and conditions statement their families should do so and hold a copy on their behalf. Although the home’s document states what the charge covers it should also specify the cost of services and facilities not included in the fee. As the home was set up for the current service users there had not been any referrals or admissions. The Standards relating to assessment and admission procedures for prospective service users were therefore not assessed. It had also not been necessary for the home’s information documents to be made available to prospective service users to help them decide if they would like to live at The Trio house and whether the home could suitably meet their needs. Trio House The DS0000024794.V261315.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, & 9 The home’s care planning system identifies service users’ personal care needs to help staff know the support each of them need. Service users’ plans should cover social needs to ensure these needs are also being met. An appropriate risk assessment process is followed to minimise risks to service users’ safety. It would better ensure the care received by service users’ is as they would wish and in their best interests, if service users’ families and relevant other people were more involved in care planning and in regular reviews of their care needs. It could help to make service users’ care more individual and care staff more involved in care planning if keyworkers were allocated to each service user. EVIDENCE: Two of the service users’ care records were checked. They included their photograph, a description of their personality and background (written in the first person) and a care plan. The plans covered service users’ communication, eating and drinking, ability to maintain a safe environment, their mobility and continence, and detailed the help they need with these relevant areas of need. There was little information however about their family input and social needs, which should be included in their assessment and plan drawn up based on this. Trio House The DS0000024794.V261315.R01.S.doc Version 5.0 Page 10 Staff also made comprehensive daily reports of any activities service users had taken part in, their moods, life events, appointments etc. Communication books were completed for each person by their day services. This all provided a helpful ongoing record of service users’ lives, their condition and behaviour. The home had periodically reviewed service users’ plans and any changes in their needs, the action required from staff and outcomes had been recorded. However, whilst the provider confirmed that service users’ families were kept informed and involved in their relatives’ care, plans should be reviewed with the input of their family and significant other professionals at least six monthly. This would help to ensure that any decisions made about their care are in the individual service users’ best interests and that their rights are maintained. Service users were currently not allocated a keyworker from the staff team. Keyworkers normally take more of a role in care planning and communicating with individual service users, which can help to personalise their care. Some risk assessments had been carried out by the home, most relating to maintaining service users’ safety within their environment. Each individual also had bathing procedures in place. The risk assessments appropriately reflected that they all need a high level of staff supervision for their protection. There were written procedures seen for the restraint of one service user when they used self-injurious behaviour. It must always be made clear through a policy and in care plans that the use of any form of physical intervention must be a last resort. The agreement of relevant professionals and relevant other people must also be obtained and their agreement to the use of specific physical interventions for individuals recorded. Although this information and consent was not available when this matter was discussed with the provider it was confirmed that his behaviour no longer occurred. The service users’ needs should therefore be reassessed and the “restraint” plan removed. Trio House The DS0000024794.V261315.R01.S.doc Version 5.0 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, & 14 Staff facilitated service users to participate in a range of leisure and social activities and to go out in the wider community and mix with other people. It would help to confirm that service users enjoyed their meals if their individual food preferences were recorded in their plans and/or food records. EVIDENCE: Service users attended various day services on weekdays. Although their days had been cut fairly recently by the local authority, the home continued to seek alternatives. One service user now attended another day centre and two of the others a farm project at a local college; both for people with learning disabilities. They all still attended St Owens day service on one day a week. Leisure activities included horse riding and trampolining for the disabled. Other activities pursued included using mainstream services such as swimming at the leisure centre, going to bingo and into town shopping. Outings such as visiting a small breeds farm were arranged using the home’s vehicle. Extra staff were deployed some weekdays to support service users with individual activities, as the home tries not to arrange all their activities on a group basis. Trio House The DS0000024794.V261315.R01.S.doc Version 5.0 Page 12 Service users were at home this afternoon, having been swimming with staff this morning. They all seemed relaxed and comfortable and wandered around the home or sat in the lounge where the television was on, as they wanted to. Staff often accompanied service users out on local walks to the supermarket and park. Although there was limited contact with the home’s immediate neighbours the service users were apparently known and accepted by local children. Staff were aware of the importance of such community integration. Although Standard 17 on food provision was not fully assessed the provider produces a weekly menu, which indicating a reasonable range of wholesome meals. It was confirmed that staff were expected to follow this menu and/or to record any alternatives if and when provided. Food stocks included yoghurts, various cereals and tinned food. Some meals had been cooked and frozen for later that week and although only bananas were seen today the provider said that fresh fruit and vegetables were used more by the home at the weekends. Whilst the provider also confirmed that the intent was to encourage a healthy diet clearly fresh food stuffs should be provided whenever possible to ensure service users’ receive a balanced diet. There was no reference to service users’ food preferences and any special dietary requirements in their needs assessment or plans. Whilst they may not be able to say what they like and dislike clearly staff and their families must get to know what they prefer and this should be reflected in their food intake. Trio House The DS0000024794.V261315.R01.S.doc Version 5.0 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 & 19 Appropriate arrangements were made to ensure that the personal and health care needs of service users were met. EVIDENCE: Service users were very dependant on staff for all their personal care needs. Daily records were kept showing the assistance given to service users by staff to maintain good hygiene and to manage their continence. Service users were seen today to be appropriately dressed, clean and well presented. Staff kept records of various checks they carried out for service users (such as their weight) and of their mood and behaviour. This is one way of monitoring their physical and emotional state to identify issues and so promote their good health. Body charts were also available and used to record injuries etc and how they occurred (if known) which is very necessary for service users’ safety and protection, especially as they would be unable to explain what happened. Care records showed that appropriate input was sought from health care and other professionals, such as GPs, Dentists and “Well-Man” clinics. Two service users had regular Psychiatric appointments to review their condition, behaviour and/or medication. Trio House The DS0000024794.V261315.R01.S.doc Version 5.0 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 23 Service users would be better protected if staff were clearer about their responsibilities in respect of the abuse or neglect of service users and knew about the local multi-agency procedures for Protection of Vulnerable Adults. EVIDENCE: The home had a copy of the multi-agency procedures for the Protection of Vulnerable Adults, although a newish staff member was not yet familiar with them. All staff in Herefordshire care homes should attend a training session taken by the local Adult Protection co-ordinator to ensure they understand their responsibility to report any incidence or suspicion of abuse or neglect of service users and how, whom and where to make a referral when necessary. The Commission had received an anonymous complaint about the home since the last inspection. Strategy meetings were subsequently held to discuss the concerns raised, under the auspices of the multi-agency procedures for the Protection of Vulnerable Adults. The provider was invited to attend one of the meetings bringing records to show how service users’ money was being spent on their behalf by the home. This confirmed that appropriate financial records were being maintained by the home and that any service users’ money spent was known to and had been agreed by their parents. The outcome was therefore that the concerns raised by the complainant were not substantiated. In view that service users have severe learning disabilities the extent to which they can manage their own lives and financial affairs is very limited. It is appropriate therefore that their families consent to and are able to check any money spent on their behalf by the home as well as the charge made for their care and accommodation. The manager said that families are sent an annual statement of all their cash spent and receipts for expenditure are also kept. Trio House The DS0000024794.V261315.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 The Trio House provides a clean, safe, very homely and comfortable home for service users and the accommodation is suitable for their needs. Satisfactory arrangements were in place for the maintenance of good hygiene. EVIDENCE: The house was found to be warm, clean and tidy and was maintained to a good standard of repair, furnishings and décor. The home is suitable for service users and provides a very homely and comfortable environment, which fits in well with the local community. Policies and procedures relating to infection control were available to staff. Disposable gloves, clinical waste bags and antibacterial wash were seen and staff confirmed they were all used as a means of ensuring good hygiene, which is an essential part of infection control. Trio House The DS0000024794.V261315.R01.S.doc Version 5.0 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34 & 35 Suitable staffing levels were being maintained. However the effectiveness of the staff team would improve if there was a lower staff turnover and if staff had achieved a qualification in care and received accredited induction training. It would ensure that only suitable people work at the home when aspects of the home’s recruitment procedures are improved. EVIDENCE: Staff rotas showed the home deployed at least two staff during the day and three staff on some weekdays when individual activities were planned. During the night one staff member slept in at the home on call. Taking into account staff also cover household, laundry tasks and cooking these levels appeared to be appropriate to meet service users’ personal needs and facilitate activities. Three staff had left the home since the last inspection and two new staff been appointed, leaving some vacant hours which staff were covering. This reflects a relatively high staff turnover within a small staff team, which has also been identified in previous inspections. An unstable staff team does not promote consistency of care and ensure staff get to know service users and their needs well. It is recommended therefore that the provider is proactive in introducing a system to monitor possible reasons for this staff turnover. This could include reviewing the home’s recruitment procedures and conducting exit interviews (that are recorded) with a view to reducing staff turnover in future. Trio House The DS0000024794.V261315.R01.S.doc Version 5.0 Page 17 A recently appointed staff member was spoken with who had previous experience working in care. They said they had undertaken all the mandatory health and safety training, although their certificates were still at their previous place of employment and so this training had not been verified as is expected. In respect of their recruitment this staff member said they had appropriately completed an application form and been interviewed. It was confirmed that a CRB/POVA check had been taken up and they had given two referees. The CRB check and references were seen and were satisfactory, albeit that one reference was brief and uninformative. The provider explained it was often difficult to obtain written references from previous employers as is required. Care services must now also obtain a full employment history and explore any gaps, in employment, which had not been carried out for this staff member. The induction of new staff comprised them working 5 or 6 shadow shifts with staff. The provider also went through the home’s fire safety and other health & safety procedures, service users’ needs and day-to-day routines with them. A basic induction checklist had been produced for the home, which was then completed. However the Standard specifies learning disabilities services should use Learning Disability Award Framework (LDAF) accredited training to provide underpinning knowledge. This training is a structured induction and foundation training for all new staff to be received within six months of new appointments. None of the current staff team had an NVQ qualification, which is now expected of staff in care homes. Three staff had started NVQ which should be completed as soon as possible to ensure at least half the staff team become qualified. Although staff support and supervision was not fully assessed the provider said staff meetings were held regularly. Also that monthly individual supervision sessions were arranged with new staff as part of their induction and trial period and three monthly sessions for permanent staff. Trio House The DS0000024794.V261315.R01.S.doc Version 5.0 Page 18 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): EVIDENCE: These Standards were not assessed in full; however the management arrangements had not changed. The provider/manager had achieved an NVQ level 4 in care but still needed to complete additional units to obtain NVQ 4 in management, as is now expected of care home managers. The provider is reminded that a quality assurance and monitoring system needs to be developed for the home. This must involve obtaining the views of service users’ families and other stakeholders to plan for and show continual improvements in the service. This must then result in periodic reports that are made available to the Commission and other interested parties. There were no health and safety hazards identified and the following indicated that due attention was paid to safeguard service users and staff: • • Cleaning equipment was kept locked in the utility room All staff participated in a fire drill in June. DS0000024794.V261315.R01.S.doc Version 5.0 Page 19 Trio House The • • • • • Tests had been carried out on portable electrical equipment. Fridge and freezer temperatures were taken and recorded. Monthly health and safety checks were undertaken on various aspects of the premises. The fire safety equipment and system had been serviced annually. A gas services safety check was carried out periodically. Trio House The DS0000024794.V261315.R01.S.doc Version 5.0 Page 20 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 2 X X X 2 Standard No 22 23 Score X 1 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 2 X 2 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X X X X 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X 1 2 1 1 X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Trio House The Score 3 3 X X Standard No 37 38 39 40 41 42 43 Score X X X X X X X DS0000024794.V261315.R01.S.doc Version 5.0 Page 21 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENT This section sets out the actions, which must be taken so that the registered person 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 YA23 Regulation 13(6) Requirement Timescale for action 31/12/05 2 YA34 19 3 4 YA32 YA35 18 18 It must be ensured that all staff receive instruction to ensure they are clear about and understand their responsibility in respect of the protection of service users. This must include the multi-agency procedures for Protection of Vulnerable Adults. The information and documents 31/12/05 outlined in Schedule 2 must all be obtained for staff employed at the home. In addition a full employment history must be obtained, with evidence that any gaps have been explored. The programme of NVQ training 31/03/06 for staff must continue to ensure that staff are suitably qualified. New staff must undertake an 31/01/06 accredited (LDAF) induction programme. Trio House The DS0000024794.V261315.R01.S.doc Version 5.0 Page 22 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider to consider carrying out. No. 1 Refer to Standard YA5 Good Practice Recommendations The service users guide and terms & conditions documents for the home should include the cost of any extra charges made to service users that are not covered by the fee. These extras should be agreed with and the terms & conditions statement signed by the service users’ family and a copy held by them on their behalf. Service users’ plans should be drawn up, agreed and reviewed at least six monthly with the involvement of their families and relevant other people. Their input should be recorded in the plans. keyworkers should be allocated to each service user from the staff team and their involvement in that individual’s care planning increased. Interventions needed from staff to deal with service users’ behaviour that could cause self-harm should be reassessed and a suitable management plan put in place if necessary, with the agreement of relevant professionals and others. Service users’ plans should reflect the extent each person can make decisions and choices in their lives. If they are not able to do so other relevant people should be involved in making decisions on their behalf and this input should be recorded and in what circumstances. A system should be introduced to monitor staff turnover, at the home, which could include reviewing the home’s recruitment procedures and conducting exit interviews. 2 YA6 3 4 YA6 YA6 5 YA7 6 YA33 Trio House The DS0000024794.V261315.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Hereford Office 178 Widemarsh St Hereford Herefordshire HR4 9HN 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 Trio House The DS0000024794.V261315.R01.S.doc Version 5.0 Page 24 - 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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