CARE HOME ADULTS 18-65
Trefusis 38 Trefusis Road Redruth Cornwall TR15 2JH Lead Inspector
Lowenna Harty Unannounced Inspection 19th October 2005 09:30 Trefusis DS0000009120.V259147.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 Trefusis DS0000009120.V259147.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. Trefusis DS0000009120.V259147.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Trefusis Address 38 Trefusis Road Redruth Cornwall TR15 2JH 01209 219333 01326 371099 enquiries@dcact.eu.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) Spectrum Ms Janet Elizabeth Hurley Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Trefusis DS0000009120.V259147.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 4th April 2005 Brief Description of the Service: Trefusis is a care home providing accommodation and personal care for up to three adults with a learning disability. The home is run by Spectrum, an organisation that provides specialist care in small units to adults who have autistic spectrum conditions. The aim is to provide service users with a homely environment in a local community setting and to enable them to live their lives as normally as possible. Spectrum employs a manager and a team of staff to provide care and support for the service users living in the home. Senior managers from Spectrum’s head office are available to provide additional specialist input as and when it is required. The home is a detached, two-storey building set in its own grounds. There is suitable access for people with disabilities, if required and two of the bedrooms are on the ground floor. The home is situated within easy reach of the town of Redruth with good access to transport and all the facilities of the town. Suitable transport is provided for service users. They all have individual, furnished bedrooms and share a bathroom, which is on the ground floor of the building. The home has a combined kitchen and dining room with a separate laundry area. There are two lounges, one of which doubles as a sleeping in facility for staff. The home has a spacious garden and a lockable office on the first floor of the building. Trefusis DS0000009120.V259147.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection, which took place on 19 October 2005 and lasted for approximately five hours. The purpose of the inspection was to ensure that service users’ needs are properly met, in accordance with good care practices and the laws regulating care homes. The focus is on ensuring that service users’ placements in the home result in good outcomes for them. The inspection focused on an inspection of the premises, examination of care, safety and employment records and discussion with the registered manager. A staff member was interviewed and there were opportunities to observe the daily life of the home and staff interaction with the service users. Because of the small size and nature of the home it was possible to review each of the service users’ records in detail and follow this up with individual interviews with them. They all chose to be accompanied by the home’s manager during the interviews, but stated their views on the care and services provided to them quite freely and openly. The home provides good to the service users placed there, which they confirmed during the interviews. They were particularly satisfied with the range of activities provided to them. There was evidence of noticeable improvement at this inspection, with most of the requirements and recommendations set at the last inspection having been met. What the service does well:
The service users currently living in the home have been there for several years and there have not been any new admissions recently. Admission to the home is dependent on detailed assessments, according to the information available to prospective residents and there is initial assessment information available on each of the service users currently placed there so that staff have
Trefusis DS0000009120.V259147.R01.S.doc Version 5.0 Page 6 some knowledge of their backgrounds and lives prior to their admission to the home. Service users have written, individual care plans that fully address their personal, health and social care needs and properly take into account their cultural backgrounds and religion. These are provided in appropriate formats, reviewed at least six monthly and service users sign up to them to indicate their agreement with them. Their care plans set out clear individual goals for them to achieve in the short, medium and long term so that they are clear about the aims of their placements in the home. Their care plans consider their skills in making choices for themselves and staff work with them individually to help them to decide on their weekly activities, and menu plans for the household. They sign up to individual risk assessments to indicate their agreement to any restrictions placed on them for their own welfare and protection and these are regularly reviewed with them. Service users enjoy busy, active lives in and out of the home. They regularly access a range of local community resources with staff assistance. The home provides transport so that they can attend colleges or voluntary work placements. Service users go out socially with staff, in the local community and are helped to access shops for personal and household shopping. Service users help to maintain their own daily care records, which describe their daily activities and back up their care plans. Service users are informed of their rights and responsibilities as residents of the home through the formal care planning process and their service users’ guides. These set them out clearly, including expectations that they will help with household tasks and cooking to develop their skills and independence. Service users’ healthcare needs are properly met. They are helped to access a range of local NHS healthcare providers, including specialist services, according to their individual needs. They are encouraged to maintain healthy lifestyles through sensible eating plans and exercise. Service users are informed of their rights to make formal complaints about the care and services provided to them and all stated that they would be able to talk to someone if they were unhappy with any aspect of their lives in the home. They are encouraged to state their views, which are listened to and respected. The home is a normal, domestic property in a residential neighbourhood with good access to the local community. It provides service users with a comfortable, safe and homely environment with sufficient personal and communal space. It is generally well maintained, tastefully furnished and well decorated. It was clean and tidy throughout at the time of the unannounced inspection. The home’s staff team is currently quite stable. All of them are either suitably qualified to work in the home or are in the process of working towards achieving the formal qualifications they need. The registered manager ensures that staff are well supported and provided with formal supervision individually and as a team so that they can properly meet the individual service users’ needs. The home’s manager is registered with the Commission and demonstrates competence and good leadership of the staff team. She undertakes training on a regular basis to update her own knowledge and skills. Trefusis DS0000009120.V259147.R01.S.doc Version 5.0 Page 7 Service users are consulted on the quality of the services provided to them through the care planning process and formal questionnaires that are provided to them on a monthly basis. They appeared to have easy and open relationships with the staff who were working with them at the time of the inspection, who encouraged them to state their views and opinions in positive ways. They all indicated that they are satisfied with most aspects of the service provided to them during interviews in the course of the inspection. There are clear, written policies and procedures to guide staff on how to work with service users. These are readily accessible to them and a staff member interviewed at the time of the inspection indicated their knowledge of key policies and procedures to ensure service users’ welfare and safety. Records necessary to communicate important information to staff and service users are held securely and confidentially in the home. Personal records are accessible to service users if they wish to see them. The records that were reviewed at the inspection appeared to be clear, accurate and up-to-date. There are suitable systems in place to ensure that service users and staff working in the home are kept safe, including staff training, written policies and procedures, regular safety equipment tests and checks and written fire safety and environmental risk assessments. What has improved since the last inspection?
There are new systems for medicines management in the home with improved storage facilities and improved records to reduce the risk of harm to service users through medication errors. The new guidance for staff, which is in the process of being completed, now addresses service users’ abilities to manage their own medication, depending on their individual risk assessments. There is improved information to guide staff on what to do should they suspect a service user has been or is at risk of neglect, self-harm or abuse, including copies of the multi-agency procedures for the protection of vulnerable adults from abuse from each of the placing authorities. The registered manager has booked to attend local multi-agency training in the near future, so that she will be able to inform staff on how different agencies such as the police and social services work together to protect vulnerable adults in the local area. The home’s bathroom has been redecorated and no longer smells of damp. There are now paper towels and anti-bacterial soaps to encourage good hand washing to prevent the spread of infections in the home. All of the service users have undertaken training in basic food hygiene as they take responsibility for much of the food preparation in the home. There is written evidence that all staff have been trained in the home’s fire safety procedures.
Trefusis DS0000009120.V259147.R01.S.doc Version 5.0 Page 8 Spectrum has invested in a new computerised record system to ensure that all records relating to staff recruitment are now available for inspection, to show that staff are selected on the basis of their suitability to work with service users. Records show that staff recruitment and selection is fair, safe and effective, for the welfare and protection of the service users. There is improved evidence that staff have the training they need to work effectively with service users and records show that there is always someone qualified in the provision of emergency first aid on duty in the home. The registered manager has now drawn up a staff training plan for the home to ensure that training is prioritised and staff duty rotas can be drawn up to ensure there is an appropriate mix of trained and skilled staff on duty at all times. What they could do better: Please contact the provider for advice of actions taken in response to this inspection.
Trefusis DS0000009120.V259147.R01.S.doc Version 5.0 Page 9 The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Trefusis DS0000009120.V259147.R01.S.doc Version 5.0 Page 10 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 Trefusis DS0000009120.V259147.R01.S.doc Version 5.0 Page 11 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): 2 Admission to the home is on the basis of a detailed assessment of prospective service users’ needs to ensure that it will be suitable for them. EVIDENCE: There have been no new admissions to the home for several years and current service users are very familiar with the services provided to them there. There is detailed assessment information available on each of them, on their personal files in the home and the home’s statement of purpose states that admission is on the basis of a formal assessment process. Trefusis DS0000009120.V259147.R01.S.doc Version 5.0 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 the following standard(s): 6&7 Service users have detailed care plans and are aware of the aims of their placements in the home. They are assisted to make decisions about their lives to develop their skills and independence. EVIDENCE: Detailed written care plans for each service user are held on their personal files. These are prepared in ways that are accessible to them and address their individual personal, health and social care needs. Service users sign up to their care plans as evidence of their participation and agreement with them. Their care plans set out their immediate needs, needs to be met within the next six months and their long term aims. Care plans address service users’ religious and cultural needs and backgrounds appropriately. Service users’ care plans consider their skills in making independent choices. Staff work with them individually to help them to choose their activities for each week and to decide on menu plans for the household. Any necessary restrictions on them, to ensure their safety, are included in detailed written risk assessments to which they have signed their agreement. Care plans and risk assessments are formally reviewed at least six monthly. Trefusis DS0000009120.V259147.R01.S.doc Version 5.0 Page 13 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): 13 & 16 Service users regularly access a variety of local community resources to develop their skills and independence. They are made aware of their rights and responsibilities in relation to their placements in the home. EVIDENCE: Service users regularly access a wide range of community resources and there are daily care records, which they help to prepare, to provide evidence of this. They go out with staff individually and together and transport is provided to enable them to access local community facilities. All of them indicated that they are satisfied with the activities provided to them, which include attendance at local colleges or voluntary work. Service users participate in developing their individual care plans and risk assessments, which clearly set out the purpose of their placements in the home, including expectations that they participate in household tasks to develop their skills and confidence. They are provided with service users guides, in suitable formats to ensure that they are aware of their rights and responsibilities, copies of which are held on their individual files. Trefusis DS0000009120.V259147.R01.S.doc Version 5.0 Page 14 Trefusis DS0000009120.V259147.R01.S.doc Version 5.0 Page 15 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): 19 & 20 Service users access a range of local healthcare providers to ensure their physical and emotional health needs are met. Arrangements to ensure the safe management of their medication require further improvement. EVIDENCE: Service users physical and emotional healthcare needs are addressed in their individual care plans. There are separate medical files for each of them, with details of regular healthcare checks and their access to a range of local NHS healthcare providers according to their individual needs. The home’s systems for managing service users’ medication have been improved since the previous inspection. The home has improved storage facilities to ensure that medicines are held safely and securely in the home. There are new systems for the safe administration, record keeping and disposal of medicines, which reduce the risks of errors. The written guidance for staff is in the process of being updated and Spectrum is in the process of setting up improved training for staff in the safe handling of medicines, which they all need to complete. Trefusis DS0000009120.V259147.R01.S.doc Version 5.0 Page 16 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Service users are helped to express their views, which staff respect and act upon. Some improvements are needed to ensure that they are fully protected from abuse, neglect and self-harm. EVIDENCE: Service users are regularly consulted on matters that affect them and they have all been provided with copies of the home’s formal complaints procedure, which is contained in their service users’ guides. They all said that they would know who to talk to if they were unhappy about any aspect of their care, during interviews at the time of the inspection. There is evidence in the home that staff are recruited on the basis of their suitability to work with vulnerable adults. They undergo training on the protection of vulnerable adults from abuse as part of their induction, prior to starting work in the home. All of the service users said that they feel safe and that they are well cared for by the home’s staff. The home’s registered manager has booked to attend local multi-agency training on the protection of vulnerable adults from abuse and there are copies of the placing authorities multi-agency procedures in the home. Spectrum’s internal procedures still need to be reviewed and updated and a copy of the local multi-agency procedures needs to be obtained for the home to ensure that staff have clear written guidance on the action they should take if they suspect a service user has been or is at risk of abuse. Trefusis DS0000009120.V259147.R01.S.doc Version 5.0 Page 17 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 The home is generally homely and safe, but requires some improvement to make it more pleasant for service users. Some improvements are required to ensure that the environment is kept clean and hygienic. EVIDENCE: The home provides service users with a homely, domestic-style environment, which is part of the local community. It is well furnished and tastefully decorated throughout. It is generally well maintained and there are suitable systems in place to make it safe for service users and staff but at the time of the inspection there was a noticeable smell of damp in two of the bedrooms. The source of this needs to be identified and the odour eradicated to ensure that service users have pleasant private space in the home. The home was clean and tidy throughout at the time of the unannounced inspection. Duty rotas indicated that there are staff on duty, during times in which food is handled, who have training in basic food hygiene. Service users undertake most of the food preparation in the home and have undertaken training in basic food hygiene. There are detailed written procedures to guide staff on the prevention of infection and staff and service users have suitable facilities to ensure good hand washing to prevent the risk of infection
Trefusis DS0000009120.V259147.R01.S.doc Version 5.0 Page 18 spreading. Training for staff on infection control is not currently included in the home’s training calendar and this should be provided to them. Trefusis DS0000009120.V259147.R01.S.doc Version 5.0 Page 19 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 & 36 Staff are competent and suitably qualified to work with service users. They are recruited on the basis of procedures and practices that are fair, safe and effective. Staff have good access to training to ensure they can meet service users’ needs and undergo regular, formal supervision to ensure they are supported to work with service users effectively. EVIDENCE: Three of the home’s team of seven staff are qualified to NVQ level 2. The remainder are in the process of undertaking training to achieve qualification at this level. The home’s recruitment policy ensures that staff are employed on the basis of equal opportunities and their suitability to work with vulnerable adults. Recruitment records demonstrate that they are appointed on the basis of written applications, formal interviews, the provision of satisfactory references and checks with the CRB. There is a training calendar and staff-training plan for the home. Staffing rotas indicate that staff with a broad skills and training mix are on duty at all times to ensure that service users’ needs are properly met. Staff indicated that they have good access to paid training. All staff left in charge of the home have undertaken training in the provision of emergency aid. Trefusis DS0000009120.V259147.R01.S.doc Version 5.0 Page 20 There are records of formal 1:1 staff supervision, drawn up by the registered manager. This takes place with each of them on a regular basis. Staff meetings are held on alternate months, with records kept and staff meet regularly, more informally, to ensure that there is a clear hand-over of information at each shift. Trefusis DS0000009120.V259147.R01.S.doc Version 5.0 Page 21 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 40, 41 & 42 The home is well run, for the benefit of the service users. Their views are taken into account but should be more clearly linked into the home’s development plans. There are clear written policies and procedures to guide staff on how to work effectively and appropriately with service users. Suitable records are maintained to protect service users’ best interests and there are suitable arrangements to ensure the home is safe for them. EVIDENCE: The home’s manager is registered with the Commission. She is experienced in working with Spectrum and familiar with the needs of the service users. She undertakes regular training to update her knowledge and skills so as to provide effective management and leadership to the staff team. Service users’ views are considered in the formal care planning process, which takes place with them individually at least six monthly. They are asked to give their opinions on the quality of the services provided to them each month and records are kept of this. There is currently no annual development plan for the Trefusis DS0000009120.V259147.R01.S.doc Version 5.0 Page 22 home and this should be drawn up, with reference to the service users’ individual and collective needs. There are clear, written policies and procedures to guide staff in their day-today work with service users. These are held on a file in the office and readily accessible to them. A staff member interviewed at the time of the inspection indicated that they are familiar with key procedures relating to ensuring the welfare and best interests of the service users. Records required by law to ensure service users’ protection and welfare are safely stored in the home. They are accessible to service users, who assist in their preparation and sign up to key documents that affect their lives. Records inspected appeared to be clear, accurate and up-to-date. All new staff undergo induction training at Spectrum’s head office before starting work in the home as well as in-house induction when they commence work directly with service users. Key aspects of ensuring their and service users’ health and safety are addressed at this stage, backed up with good access to further training and/or written guidance. There are records of staff training in fire safety and the home’s fire safety risk assessment is complete. The registered manager has undertaken a comprehensive environmental risk assessment for the home to ensure that it is safe for service users, staff and visitors. Trefusis DS0000009120.V259147.R01.S.doc Version 5.0 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 X 3 X X X Standard No 22 23 Score 3 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 X X X Standard No 24 25 26 27 28 29 30
STAFFING Score 2 X X X X X 2 LIFESTYLES Standard No Score 11 X 12 X 13 3 14 X 15 X 16 3 17 Standard No 31 32 33 34 35 36 Score X 3 X 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Trefusis Score X 3 2 X Standard No 37 38 39 40 41 42 43 Score 3 X 2 3 3 3 X DS0000009120.V259147.R01.S.doc Version 5.0 Page 24 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA20 Regulation 13(2) Requirement The home’s written policies for the safe management of medication must be completed, signed and dated. All staff undertaking management of service users’ medication must undergo training in the safe handling of medicines. The source of damp in service users’ bedrooms must be identified and the cause eradicated. Timescale for action 01/04/06 2. YA24 12(2)(b) 01/04/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA23 Good Practice Recommendations The home should obtain copies of the local multi-agency procedures for the protection of vulnerable adults from abuse. The home’s internal procedures in this respect should be reviewed and updated. Staff should be provided with training in infection control. The registered manager should prepare an annual development plan for the home on the basis of service
DS0000009120.V259147.R01.S.doc Version 5.0 Page 25 2. 3. YA30 YA39 Trefusis users’ needs and preferences. Trefusis DS0000009120.V259147.R01.S.doc Version 5.0 Page 26 Commission for Social Care Inspection St Austell Office 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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