CARE HOME ADULTS 18-65
The Willows Halvarras Park Halvarras Road Playing Place Truro TR3 6HE Lead Inspector
Lowenna Harty Announced 12 July 2005 09:30 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 Willows D52-D04 S9122 The Willows V229450 120705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service The Willows Address Halvarras Park Halvarras Road Playing Place Truro Cornwall TR3 6HE 01872 865588 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) Spectrum Miss Diedre Kent, Acting Manager Care Home 3 Category(ies) of Learning Disability (3) registration, with number of places The Willows D52-D04 S9122 The Willows V229450 120705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: There are no conditions of registration additional to those listed above. Date of last inspection 10 March 2005 Brief Description of the Service: The Willows is a home providing personal care and accommodation for up to three adults with a learning disability. The registered provider is Spectrum, an organisation that provides specialist care in small units for people with autism. The aim is to provide them with specialist support in a domestic style environment. There is a manager in charge of the home on a day-to-day basis. A team of care staff assists them. Senior managers from within the organisation are available to provide specialist support and assistance where necessary. The home is located in the village of Playing Place, close to the city of Truro. There is reasonable access to public transport and the home has its own vehicles to assist service users to access the local community. The home is a single storey building, set in its own grounds and is set off the main road. There are three single bedrooms for use by the service users. The home has a combined lounge and dining room, a kitchen, separate laundry room and two bathrooms. There is a lockable office, which also functions as a sleeping in room for staff at night. The home has a large garden and some offstreet parking space. There have been some adaptations, with the provision of grab rails to assist people with specific physical disabilities to access the building. The Willows D52-D04 S9122 The Willows V229450 120705 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 as part of the home’s annual inspection programme, which took place on 12 July 2005. The inspection lasted for approximately four and a half hours and consisted of the following activities: 1. Inspection of records, including assessment information and care plans 2. Discussion with the registered manager on how the home operates on a day-to-day basis 3. Inspection of the premises 4. Interview with a member of staff 5. Interviews with both of the service users currently in the home with assistance from staff and in the communal areas of the home. 6. Input from relatives of both the service users, who supplied the commission with information prior to the inspection. This indicated that they are satisfied that service users are well cared for in the home. 7. Observation of the daily life of the home with particular regard for the interaction between staff and service users. Overall the home provides service users with a good standard of care but there are specific issues around essential aspects of staff training that have not been well managed, and which the Commission is taking up with Spectrum to ensure that there is a real improvement for the protection of the service users living in the home. The inspector would like to thank the registered manager, staff, relatives and service users for their kind assistance in the conduct of this inspection. What the service does well:
Before they move in, there is good information about the home to help service users and their representatives decide if it is likely to be suitable for them. Admission is based on a detailed assessment so that staff are aware of their backgrounds and their needs. This information is used to develop detailed written care plans and risk assessments for service users, that consider their individual goals and are reviewed every six months. This helps them to develop their skills and independence in safe ways.
The Willows D52-D04 S9122 The Willows V229450 120705 Stage 4.doc Version 1.40 Page 6 Service users are helped to access a broad range of activities in the local community for their enjoyment and to help them to develop their skills and abilities. This includes attendance at a local college during term times. Their religious and cultural needs are taken into account and met appropriately. They are encouraged to maintain positive relationships with their families and regularly have contact with relatives. Staff help them to maintain their personal appearances so that they are smart and fashionably dressed and are able to fit in as part of the local community when they go out. Service users are helped and encouraged to make their views known to the home’s manager through their care plan reviews and satisfaction questionnaires, which are attached to the home’s service users’ guide. This also informs them of how they can make a formal complaint, should they wish to so. Their accommodation is comfortable, homely and well situated for access to the local community. Service users have individual bedrooms and plenty of communal space, so they have a choice of places in which to spend their time when they are at home. Important safety checks and tests are undertaken to ensure the home is safe. This includes proper risk assessments, including a fire safety risk assessment. The home’s manager is in the process of being registered with the Commission. She is in day-to-day charge of the home and has made improvements to it since the previous inspection. Spectrum has a clear philosophy of care, which is communicated to service users and their representatives in the home’s statement of purpose and service users’ guide. All new staff are made aware of it during induction training they undertake at Spectrum’s head offices before they start work in the home. Staff have regular, formal supervision with the home’s manager, with records kept. There are also regular staff meetings to ensure that important information affecting the lives of the service users is passed on to them. Both the service users appeared to be happy and well looked after at the inspection and this was confirmed during interviews held with them. A staff member said they had noticed real improvements for them both recently and gave examples of this. Comments returned from relatives included “Staff are doing a superb job.” “ I could not speak highly enough of the work and effort.” There were no negative comments at all. What has improved since the last inspection? The Willows D52-D04 S9122 The Willows V229450 120705 Stage 4.doc Version 1.40 Page 7 Information provided to service users has been updated and improved so that they are better informed about the arrangements in place for the funding of their placements in the home. The service users’ guide, which also functions as a statement of their terms and conditions, has been translated into pictorial versions. This provides them with more useful information than before. There is now assessment information for all service users in the home to inform staff of their backgrounds and how they can best support and help them, which is an improvement on the previous inspection, where it was missing in respect of one service user who had been recently admitted to the home. They also all have written care plans now. The home’s manager has drawn up a written policy for the home to guide staff on how to manage service users’ personal finances, in situations where they need assistance, to ensure that there is a clear audit trail when they handle service users’ money. She has done this in advance of Spectrum’s review of all its policies and procedures, to ensure that staff have the guidance they need in the meantime. Circumstances in the home have changed so that it is now entirely free of unpleasant odours. There is guidance and equipment in place, suitable for the needs of the service users currently there to ensure that most aspects of good hygiene are maintained in the home. Information held about staff has greatly improved, to show that service users benefit from fair, safe and effective staff recruitment and selection. Staff supervision records are being improved and there is now a template in place for the home’s annual development plan, which the manager is in the process of drawing up for this year. What they could do better:
The main area of concern identified at this inspection relates to staff training, particularly in relation to essential aspects of health and safety such as basic food hygiene and first aid. Duty records showed that there have been occasions when staff have been left in charge of the home who do not have the training they need to ensure that service users are fully protected from food transmitted infections and that staff would know what to do in an emergency. This is compounded by the fact that only the home’s manager appears to have undertaken training in sign language, which is one of the forms of communication used by service users and there are times when she is not at the home. Staff need to have training in basic sign language to ensure that
The Willows D52-D04 S9122 The Willows V229450 120705 Stage 4.doc Version 1.40 Page 8 they can communicate effectively with service users, particularly in the case of emergencies. Spectrum has been formally notified of the need to improve essential staff training in this home on several previous occasions and the Commission is currently considering options for further action to ensure that it makes the necessary improvements to fully protect service users. Service users would benefit from having their care plans translated into formats that they are able to understand more easily, similar to the home’s service users’ guide. They also need to be provided with access to specialist support to ensure they are getting as much help as possible to help them maintain and develop their communication skills. Formal arrangements for protecting service users from abuse would benefit from improvement. This includes providing staff with up-to-date written information, particularly on how different agencies such as social services and the police work together to protect vulnerable adults. In addition, the home’s manager should undertake local multi-agency training so that she is fully informed of the steps to take should it be suspected that a service user is being abused. Service users would benefit from having locks on their bedroom doors of a type that can be opened by staff in an emergency to give them a higher degree of privacy. Whilst the home was mainly clean and tidy at the time of the inspection, a shower tray was in need of proper cleaning as it had become stained around the edges. 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 Willows D52-D04 S9122 The Willows V229450 120705 Stage 4.doc Version 1.40 Page 9 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 Willows D52-D04 S9122 The Willows V229450 120705 Stage 4.doc Version 1.40 Page 10 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) 1,2,3 & 5 Service users are provided with good information to help them to decide if the home is suitable to meet their needs. Their individual needs are assessed so that they can be confident that the home is suitable for them. They all have statements of the terms and conditions of their placement in the home so they are informed of their rights and obligations. EVIDENCE: The home’s service users’ guide has been updated and now provides clear information to service users on how their placements in the home are funded so that they are better informed of their rights in this respect. The document also serves as a statement of the terms and conditions of their placement in the home and is provided to them in translated formats, which they can access directly. Copies are sent to their families and representatives and signed by them as evidence of their agreement with the contents. Current service users have detailed written assessments, which provide staff working with them with information on their backgrounds and needs prior to their admission to the home and can be used to inform the care planning process. A staff member interviewed at the time of the inspection said that the service users currently in the home get on very well together. Another is undergoing assessment for
The Willows D52-D04 S9122 The Willows V229450 120705 Stage 4.doc Version 1.40 Page 11 admission to the home from another Spectrum home. They have visited the home on several occasions and had opportunities to meet the service users to ensure they are compatible and the home will meet their ongoing needs. The Willows D52-D04 S9122 The Willows V229450 120705 Stage 4.doc Version 1.40 Page 12 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, 7 & 9 Service users have written care plans but these could be improved for their benefit. They should be provided with more assistance to make decisions about their lives. They are able to take risks to develop their skills and independence. EVIDENCE: Service users have detailed written care plans that address all aspects of their personal, social and healthcare needs and set out personal goals for them. These are reviewed every six months. They should be provided with copies of the key aspects of their care plans in translated formats so that they can access the information directly for themselves. Their care plans and risk consider their decision-making abilities and this is reflected in the home’s daily care records. Any restrictions necessary for their own or other people’s protection are recorded in their risk assessments. Service users were given choices at the time of the inspection that provided a clear demonstration of how they are helped to make decisions about their day-to-day activities. The home’s manager described how the service users communicate and they need to be provided with access to specialist assessments to ensure they are able to maximise their skills in this respect. At the time of the inspection, there was
The Willows D52-D04 S9122 The Willows V229450 120705 Stage 4.doc Version 1.40 Page 13 only evidence that the home’s manager had undertaken specialist communication training in sign language and service users are often left alone with staff who have not had this. Requirements in respect of staff training have been re-notified on several previous occasions. They have not been in this report because the Commission is currently considering options with regard to enforcement action to ensure compliance. The Willows D52-D04 S9122 The Willows V229450 120705 Stage 4.doc Version 1.40 Page 14 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) 12, 13 &15 Service users access appropriate activities and the local community in ways that benefit them. They have appropriate relationships with people outside of the home. EVIDENCE: Service users’ care plans consider their needs and preferences with regard to the activities they are involved in on a day-to-day basis and set individual goals for them to develop their skills and independence appropriately. They do activities separately and together and there are daily records to provide evidence that they undertake a broad range of activities, in accordance with the home’s statement of purpose. Their care plans consider their religious and cultural needs and their day-to-day activities reflect this. They go out of the home with staff regularly, and attend a local college during the term time. There are records of their regular visits to and contact with their families. Their care plans consider issues around developing relationships and Spectrum’s senior managers provide staff with guidance and support as necessary, to protect service users.
The Willows D52-D04 S9122 The Willows V229450 120705 Stage 4.doc Version 1.40 Page 15 The Willows D52-D04 S9122 The Willows V229450 120705 Stage 4.doc Version 1.40 Page 16 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) 18 Service users receive the personal support they need. EVIDENCE: Service users’ care plans and daily records provide evidence that they receive appropriate support to maintain and develop their personal care skills. They have sufficient and suitable bathroom facilities and staff are available to provide them with any assistance they need, which was observed at the time of the inspection. Both appeared smart and fashionably dressed at the time of the inspection. The Willows D52-D04 S9122 The Willows V229450 120705 Stage 4.doc Version 1.40 Page 17 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 Service users’ views are listened to and acted upon. Some improvements are needed to protect service users from abuse, neglect and self-harm. EVIDENCE: The home has a written complaints procedure that is contained in the home’s service users’ guide and service users have signed to say that they have received this in translated formats that they can understand. Their preferences and views are considered as part of the care planning process and service users indicated that they are satisfied with the services provided to them during interviews at the inspection. Spectrum is in the process of updating all the written policies and procedures for staff and the internal procedures in respect of the protection of vulnerable adults from abuse need to be updated and amended. The home’s manager should obtain copies of the local authority multi-agency guidelines for the protection of vulnerable adults for each of the service users’ placing authorities and attend local multi-agency training so that she is fully informed on what action she should take in response to allegations of abuse. Records on staff working in the home have much improved since the last inspection and demonstrate that staff are recruited in fair, safe and effective ways for the benefit and protection of service users. The home’s manager has updated the home’s written policies in respect of managing service users’ personal finances, pending a review of them by Spectrum, to ensure there is a clear audit trail and protection for service users when their personal money is managed or handled by staff. The Willows D52-D04 S9122 The Willows V229450 120705 Stage 4.doc Version 1.40 Page 18 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 & 30 Service users live in a homely and comfortable environment but improvements are needed to improve hygiene and privacy for their protection and welfare. EVIDENCE: A visual inspection of the premises and inspection of safety records showed that the home is comfortable and spacious. Service users benefit from individual bedrooms but they are not provided with locks that have facilities for staff to over-ride them in an emergency. These should be provided to enhance their privacy, unless there are clearly stated reasons as to why this would be against their best interests in their risk assessments. There have been improvements to ensure that service users are protected from the risk of infection. Staff now have ready access to appropriate equipment in this respect and service users also use it. The home was entirely free of unpleasant odours at this inspection and appeared mainly clean and tidy, although a shower tray was in need of cleaning. There are written fire safety and environmental risk assessments in place to protect service users. Evidence that staff who prepare, cook and serve food have all have basic food hygiene training is lacking and there had been occasions when staff without training in the provision of basic
The Willows D52-D04 S9122 The Willows V229450 120705 Stage 4.doc Version 1.40 Page 19 first aid had been left in charge of the home overnight, according to the records of staff on duty. Requirements in respect of staff training have been re-notified on several previous occasions. They have not been in this report because the Commission is currently considering options with regard to enforcement action to ensure compliance. The Willows D52-D04 S9122 The Willows V229450 120705 Stage 4.doc Version 1.40 Page 20 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) 35 & 36 Staff training needs to improve to protect the welfare of service users. Staff are supported and supervised for the benefit of service users but this could be improved. EVIDENCE: The inspection focused on a detailed analysis of staff training based on the records available in the home. The home’s manager has now drawn up a whole team-training plan, which clearly indicates what training staff have done and what they need. Staff training and duty records indicated that there were occasions when the home was left in the charge of staff who had not undergone training in key areas of health and safety such as basic food hygiene and first aid and service users had been left in the charge of staff who had not undergone formal training in basic sign language. Requirements in respect of staff training have been re-notified on several previous occasions. They have not been in this report because the Commission is currently considering options with regard to enforcement action to ensure compliance. There are records to suggest that staff are provided with regular, formal supervision and the standard formats for this have been improved. There are records of staff meetings available. The Willows D52-D04 S9122 The Willows V229450 120705 Stage 4.doc Version 1.40 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 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) 38, 39, 41 & 42 With the exception of staff training, the home is well managed, for the benefit of service users. Their views are taken to account in the home’s annual development plan. Their interests are well accounted for by the home’s record keeping. Improvements are needed to ensure service users’ health, safety and welfare. EVIDENCE: The home’s current manager is in the process of undergoing registration with the Commission. The ethos of the organisation is communicated to service users and their representatives in the home’s statement of purpose and service users’ guide. It is communicated to new staff as part of a four-day induction programme that they undertake at Spectrum’s head offices, prior to taking up their posts in the home. The home’s service users’ guides, which have been translated into pictorial versions, now have satisfaction questionnaires that are given to service users, to seek their views on the service. These have also been sent to their relatives and representatives. Comments received back are
The Willows D52-D04 S9122 The Willows V229450 120705 Stage 4.doc Version 1.40 Page 22 all very positive. The home’s manager has drawn up a template to form the basis of the home’s annual development plan and is in the process of completing it for this year. Record keeping in the home, with particular regard to records on staffing has been greatly improved for the protection of service users. There are good records to suggest that most aspects of health and safety in the home are well attended to. There are written risk assessments in respect of the home’s general environment and fire safety. There are records of appropriate tests and checks and all staff receive training in fire safety. As previously stated in this report, records of staff training and duty rotas provided evidence that the home and/ or service users have been left in the charge of staff without key training in aspects of health and safety at times and the Commission is currently considering enforcement options to ensure compliance with previously set requirements. The Willows D52-D04 S9122 The Willows V229450 120705 Stage 4.doc Version 1.40 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 x 3 Standard No 22 23
ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10
LIFESTYLES Score 2 2 x 3 x
Score Standard No 24 25 26 27 28 29 30
STAFFING Score 2 x x x x x 2 Standard No 11 12 13 14 15 16 17 x 3 3 x 3 x x Standard No 31 32 33 34 35 36 Score x x x x 1 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
The Willows Score 3 x x x Standard No 37 38 39 40 41 42 43 Score x 3 3 x 3 1 x D52-D04 S9122 The Willows V229450 120705 Stage 4.doc Version 1.40 Page 24 Are there any outstanding requirements from the last inspection? YES- these relate to staff training and are the subject of current enforcement action. 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, 7 Regulation 12(1) 12(2) 12(3) 13(1)(b) Requirement There must be full evidence in the home that service users have been given access to specialist services to assist them to develop their communication skills to enable them to fully participate in making decisions about the care and services provided to them. Timescale for action 01/11/05 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 6 23 Good Practice Recommendations Service users care plans should be available to them in translated formats. The homes internal policies and procedures for the protection of vulnerable adults from harm and abuse should be updated and amended. Staff should have ready access to the multi-agency policies and procedures of all the local authorities placing service users in the home. The homes manager should attend multi-agency training in the protection of vulnerable adults from abuse. Service users should be provided with locks on their
D52-D04 S9122 The Willows V229450 120705 Stage 4.doc Version 1.40 Page 25 3. 24 The Willows 4. 30 bedroom doors with facilities for staff to over-ride them in an emergency, unless there are clear reasons stated in their individual risk assessments that this would not be in their best interests. The shower tray should be thoroughly cleaned The Willows D52-D04 S9122 The Willows V229450 120705 Stage 4.doc Version 1.40 Page 26 Commission for Social Care Inspection John Keay House Tregonissey Road St Austell Cornwall PL25 4AD National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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