Inspection on 19/04/07 for Upperton Gardens

This inspection was carried out on 19th April 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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

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

CARE HOME ADULTS 18-65 Upperton Gardens 44 Upperton Gardens Eastbourne East Sussex BN21 2AQ Lead Inspector Nigel Thompson Key Unannounced Inspection 19th April 2007 10:30 Upperton Gardens DS0000068864.V334608.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Upperton Gardens DS0000068864.V334608.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Upperton Gardens DS0000068864.V334608.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Upperton Gardens Address 44 Upperton Gardens Eastbourne East Sussex BN21 2AQ 01323 439001 01323 439001 enquirifes@arundelcareservices.co.uk 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) Arundel Care Services Ltd Annie Cordeux Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Upperton Gardens DS0000068864.V334608.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The maximum number of service users to be accommodated is six (6) Service users to be aged eighteen (18) to sixty five (65) on admission Service users with a learning disability only to be accommodated, who fall into no other category. Date of last inspection Brief Description of the Service: 44 Upperton Gardens is a large, split level, terraced property in a quiet residential area of Eastbourne, providing accommodation for up to six adults with a learning disability. Service user accommodation, situated on the first and second floors comprise six well-appointed single rooms, two with en-suite facilities, plus a further two bathrooms and toilets. Communal area on the ground floor includes a spacious lounge, dining room and a large kitchen and breakfast room. The secluded rear garden has a lawn, flower borders and a paved patio area. The proprietors and registered providers, Arundel Care Services Ltd. own other similar services in West Sussex. Information about the service, including the Statement of Purpose, Service User’s Guide and CSCI reports is made available to prospective service users or their relatives, on request, as part of the admission process. The current range of fees, as of 19 April 2007, is £1250-£1460. Additional charges are made for hairdressing, chiropody, toiletries, and newspapers/magazines Upperton Gardens DS0000068864.V334608.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key unannounced inspection took place over five hours in April 2007. It was the first inspection to be carried out since the service was registered with the Commission for Social Care Inspection (CSCI) in November 2006. All of the key National Minimum Standards were assessed and found to have been met or partially met and the overall quality of care provided was good. Service users spoken with during the inspection expressed satisfaction with the home, the staff and the service provided. The purpose of this inspection was to monitor care practices at the home and the focus was on the quality of life and outcomes for people who live at the home. On the day of the inspection there were three service users living at the home. The inspection involved a tour of the premises, observation of working practices, examination of the home’s records and discussion with two service users, two members of staff and the Registered Manager. Responses from a CSCI service users’ survey, regarding their views on the home and quality of care provided, now form part of the inspection process and have also been included in this report. What the service does well: Through working closely, sensitively and consistently with service users, staff have developed a sound understanding of their individual care and support needs. Service users are encouraged and supported to make decisions about their lives. Where appropriate and practicable, they are involved and regularly consulted on many aspects of life in the home, including menu planning, colour schemes and activities. The well maintained décor and good quality furniture and furnishings provides a comfortable, pleasant and homely environment for service users. Effective systems are in place for the admission and ongoing care of service users. Comprehensive care plans, developed from thorough pre-admission assessments ensure that an individual’s support needs are met in a structured and consistent manner. Upperton Gardens DS0000068864.V334608.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Upperton Gardens DS0000068864.V334608.R01.S.doc Version 5.2 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 Upperton Gardens DS0000068864.V334608.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3 & 4 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The thorough admission policy and procedure ensures that service users are admitted only on the basis of a full needs assessment, undertaken by people competent to do so. Prospective service users know that the home is able to meet their individual care and support needs. EVIDENCE: Information is available to prospective and existing service users in various formats. The Statement of Purpose and Service User Guide have been thoughtfully and imaginatively produced to a high standard and are both comprehensive and informative. As part of the home’s admission policy and procedure, a detailed ‘Initial Assessment Report’ has been developed and implemented. As well as a useful ‘profile’ of the individual, the assessment report contains information relating to their health, communication, behaviour, personal care needs, daily routine, social interaction and family involvement. Upperton Gardens DS0000068864.V334608.R01.S.doc Version 5.2 Page 9 Relevant documentation, including the Initial Assessment Report, relating to two people recently admitted to the home was examined and found to be comprehensive and generally well maintained. The manager confirmed that she is always directly involved in the assessment and admission process for prospective service users. Following discussion with the manager, it is recommended that the assessment report be dated and amended to contain details of the service/organisation. Prospective service users and their relatives are encouraged to visit the home and have the opportunity to look around and meet with members of staff and existing residents. The manager confirmed that new service users undergo a flexible trial period at the home, during which time their suitability and compatibility are assessed and it is established whether their identified care and support needs are able to be met. One service user, spoken with during the inspection, commented positively about his experience of moving into the home: ‘I chose my room and I’m very happy with it. I like it here!’ Upperton Gardens DS0000068864.V334608.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Comprehensive care plans enable staff to meet the assessed support needs of service users in a structured and consistent manner. Systems for consultation and participation are effective. Service users are treated with respect and encouraged and enabled to make decisions about their day-to-day living. EVIDENCE: Each service user has two key-workers, who share responsibility for supporting the individual. Satisfactory care plans have been developed for each service user and are clearly linked to their assessed needs. The care plan is formulated by the key-workers and manager, who confirmed that the service user or family member, as appropriate, have the opportunity to be involved both in developing and reviewing the plan. Upperton Gardens DS0000068864.V334608.R01.S.doc Version 5.2 Page 11 However this was not evident from certain plans examined. Following discussion with the manager it is recommended that, where practicable, individual care plans be signed by the service user or a representative on their behalf, to confirm understanding and agreement with the content of the plan or any changes made. The manager emphasised the importance of staff developing close working relationships with individual service users, often in a one to one situation, and being aware of sometimes very subtle changes in their mood, condition or circumstances. Staff spoken to during the inspection confirmed that, despite the variable and limited verbal communication of some service users, effective and regular interaction and consultation takes place constantly throughout the home. This was evident from direct observation of staff supporting service users in a professional, sensitive and respectful manner. Personal and environmental risk assessments are in place as well as a daily ‘report book’ for each service user. Guidelines for staff have also been developed, however it was noted that in certain cases these could be made more specific. In one care plan examined, details of the support and action to be taken by staff included the rather ambiguous instruction: ‘Staff to teach………skills he has not yet developed’. The manager confirmed that service users are encouraged and supported to make decisions about their day-to-day living and there was evidence of effective consultation systems being in place. Individuals are clearly consulted regarding many aspects of their day-to-day living, including menu planning and choosing both individual and collective social, recreational and leisure activities. Upperton Gardens DS0000068864.V334608.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Service users are enabled and supported to maintain contact with family and friends as they wish and effective links with the community enrich their social and educational opportunities. Service users benefit from appropriate recreational and leisure activities and menus that are balanced and nutritious, reflecting their individual likes and preferences. EVIDENCE: The manager confirmed that, where appropriate, service users’ family links are supported, however not all service users have regular family contact. Community participation is evidently a focus in the home. Sufficient numbers of staff help ensure that service users are enabled and supported to visit local shops, cafes and other amenities. Upperton Gardens DS0000068864.V334608.R01.S.doc Version 5.2 Page 13 The recreational and leisure interests of service users are identified and recorded in their individual care plan and individuals are clearly supported to access activities and facilities, reflecting their individual needs, preferences and abilities. In individual care plans that were examined there was evidence of a ‘flexible’ weekly programme of activities, including cookery and day services. One service user evidently attends a local college five days a week and enjoys a full programme of educational and recreational activities. However it was noted that in one file the activity plan had not been updated since 19.03.2007. Menus are developed weekly and are varied, balanced and nutritious and based on service users’ identified likes and preferences. An alternative to the main meal is always available. A member of staff, spoken with during the inspection, confirmed that service users’ likes and dislikes are recorded and they are regularly consulted regarding menu planning. She added that two service users are supported in the kitchen to assist staff with meal preparation. This was evidenced by one service user, spoken with during the inspection: ‘The food is good here and they ask us what we like’. Upperton Gardens DS0000068864.V334608.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Staff have developed close and positive relationships with service users and demonstrate an awareness and sound understanding of their individual care and support needs. Service users are protected by clear and comprehensive policies and procedures in place for the control and safe administration of medication. EVIDENCE: As previously documented staff have developed close working relationships with individual service users, often in a one to one situation. In accordance with their personal care plan, service users are fully supported and enabled, as far as practicable, to exercise control over their lives and maintain maximum levels of independence and individuality. During the inspection, service users were observed being supported in a sensitive, professional and respectful manner by members of staff. Upperton Gardens DS0000068864.V334608.R01.S.doc Version 5.2 Page 15 Documentary evidence was in place to demonstrate that the health and emotional care needs of service users continue to be met within the home. All service users are registered with local GPs and have access to other health care professionals, including district nurses, physiotherapists and dentists, as required. It was noted, in care plans that were examined, that all appointments with, or visits by, health care professionals are recorded. Up to date and detailed policies and procedures relating to the control, storage, administration and recording of medication are in place. Medicines are stored and recorded appropriately. The home uses a monitored dosage system (MDS) for the administration of prescribed medicines and a local pharmacist continues to carry out quarterly monitoring visit. The manager confirmed that all staff responsible for administering medication have received appropriate training and are individually assessed and authorised to do so. This was confirmed through discussions with staff and supported by training records examined. Upperton Gardens DS0000068864.V334608.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The home’s complaints procedure ensures that service users and staff feel able to express any concerns, confident that they will be listened to and acted upon. Service users are protected, through policies and procedures relating to abuse and adult protection. EVIDENCE: The organisation has produced a complaints policy and procedure, as part of the Statement of Purpose and Service User Guide. Following discussion with the manager, it is recommended that the procedure be service specific and amended with updated contact details for the CSCI. Service users and members of staff, spoken with during the inspection, confirmed that they would have no hesitation in speaking to the manager or making a complaint if necessary and each person was confident that they would be listened to. However it was noted that there is currently no accessible complaints procedure in place, for the benefit of service users’ relatives or other visitors to the home. Upperton Gardens DS0000068864.V334608.R01.S.doc Version 5.2 Page 17 The organisation has produced detailed policies and procedures relating to adult protection and abuse, including a whistle blowing policy. In line with other policies and procedures, the abuse policy has a ‘Staff compliance’ form, which each member of staff is expected to sign to confirm that they have read and understood the relevant document. The manager confirmed that staff have undertaken specific adult protection training, in accordance with the multi agency guidelines for the protection of vulnerable adults. This was supported through discussions with members of staff during the inspection and evidenced through individual training records. Upperton Gardens DS0000068864.V334608.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 28, 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The service is accessible, safe and clean and is clearly suitable for its stated purpose. Service users benefit from pleasant accommodation that is comfortable, well maintained and furnished and decorated to a satisfactory standard. EVIDENCE: During my ‘guided tour’ of the building, including service user accommodation and spacious communal areas, it was evident that the premises have been decorated to a high specification and, with good quality furniture and furnishings, provide a comfortable, pleasant and homely environment for service users. Upperton Gardens DS0000068864.V334608.R01.S.doc Version 5.2 Page 19 Service user accommodation, situated on the first and second floors comprise six well-appointed single rooms, two with en-suite facilities, plus a further two bathrooms and toilets. Communal area on the ground floor includes a large comfortable lounge, dining room and a spacious kitchen and breakfast room. The secluded rear garden has a lawn, flower borders and a paved patio area. The manager confirmed that independence is promoted within the home, as far as is practicable, and this is evident from the personalising of service users’ rooms, which clearly reflects individual tastes, preferences and interests. Infection control procedures are in place and clearly adhered to and levels of cleanliness were found to be high throughout. Upperton Gardens DS0000068864.V334608.R01.S.doc Version 5.2 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 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 & 36 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. There is always sufficient trained and competent staff on duty to meet the assessed needs of the service users. Service users are protected by satisfactory staff recruitment policies, procedures and documentation. EVIDENCE: There is evidently sufficient staff on duty at all times to meet the current assessed care and support needs of the service users. The rota indicated that there is a minimum of three staff employed mornings and evenings, with one waking member of staff and one person sleeping in each night. Following discussion with the manager it is recommended that the rota be amended to include the designation of each member of staff. The manager clearly recognises the importance of a skilled and competent workforce. A training matrix has been developed and implemented and it was noted that all new staff receive comprehensive induction and foundation Upperton Gardens DS0000068864.V334608.R01.S.doc Version 5.2 Page 21 training, the ‘Common Induction Standard’, which is compatible with Skills for Care (Formerly TOPSS). In addition to this programme, appropriate core skills training is provided, including first aid, moving and handling, food hygiene and fire safety. This was confirmed through discussions with staff and supported by training records examined: ‘There is plenty of opportunity for training here.’ In accordance with company policy, the manager confirmed that formal supervision is provided for all care staff on a regular basis. Through direct observation and discussions with members of staff, it is evident that the manager also operates an ‘open door’ policy, with staff feeling confident and able to discuss any issues at anytime. The home evidently operates thorough and robust recruitment procedures, to ensure the protection of service users. Individual files that were examined, relating to recently appointed members of staff, were found to be well maintained, containing all relevant and necessary information, including two satisfactory references, proof of identity and satisfactory Criminal Record Bureau (CRB) and Protection of Vulnerable Adults (POVA) disclosures. Upperton Gardens DS0000068864.V334608.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 41 & 42 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Service users benefit from a competent and experienced manager and are protected by satisfactory health and safety procedures. Their best interests are safeguarded by adequate and effective quality monitoring systems. EVIDENCE: The newly registered manager has been in her current post since the home opened in November 2006. She has relevant experience of managing services for adults with learning disabilities and has obtained the National Vocational Qualification (NVQ) level 4 in Management and Care. Upperton Gardens DS0000068864.V334608.R01.S.doc Version 5.2 Page 23 From direct observation and through discussions with service users and members of staff, it is evident that the manager demonstrates a clear and positive sense of leadership and direction. She is conscientious, motivated and approachable. The home operates effective quality monitoring systems, including satisfaction questionnaires for service users, their relatives, advocates and other visitors to the home. Monthly Regulation 26 visits are undertaken by the directors of Arundel Care Services, who maintain regular contact with the home and it is clear that their support, knowledge and relevant experience underpins the new service. Following risk assessments, the manager confirmed that the home maintains responsibility for service users’ personal monies. It was noted that individual balances are checked on a regular basis and all financial transactions are recorded. The manager confirmed that the health, safety and welfare of service users and staff is of paramount importance within the home. Staff training is provided in many aspects of safe working practices, including moving and handling; food hygiene; fire safety and first aid. All staff training is recorded. COSHH assessments and guidelines are in place. Regular fire drills are undertaken and recorded. Temperature regulators are fitted to all hot water outlets, accessible to service users. All accidents, incidents and injuries are recorded and reported, as required. Upperton Gardens DS0000068864.V334608.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 3 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 X 27 X 28 3 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 X 3 X 3 3 X Upperton Gardens DS0000068864.V334608.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? N/A STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard YA2 YA6 Good Practice Recommendations It is recommended that the needs assessment report be signed, dated and amended to contain details of the service/organisation. It is recommended that, where practicable, individual care plans be signed by the service user or a representative on their behalf, to confirm understanding and agreement with the content of the plan or any changes made. It is recommended that guidelines for staff, regarding their actions, support and interventions, contained in service users’ care plans, be reviewed and made more specific. It is recommended that activity plans be regularly monitored to ensure that information is accurate and up to date. It is recommended that the current complaints procedure be service specific and amended with updated contact details for the CSCI. It should also be accessible for the benefit of service users’ relatives and other visitors to the home. DS0000068864.V334608.R01.S.doc Version 5.2 Page 26 3. 4. 5. YA6 YA12 YA22 Upperton Gardens 6. YA33 It is recommended that the duty rota be amended to include the designation of each member of staff. Upperton Gardens DS0000068864.V334608.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © 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 Upperton Gardens DS0000068864.V334608.R01.S.doc Version 5.2 Page 28 - 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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