Inspection on 14/04/08 for Visions

This inspection was carried out on 14th April 2008.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

Extracts from inspection reports are licensed from CQC, this page was updated on 28/09/2008.

CARE HOME ADULTS 18-65 Visions 48 Nags Head Hill St George Bristol BS5 8LW Lead Inspector Jacqueline Sullivan Key Unannounced Inspection 14th April 2008 09:30 Visions DS0000070426.V362829.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 Visions DS0000070426.V362829.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. Visions DS0000070426.V362829.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Visions Address 48 Nags Head Hill St George Bristol BS5 8LW 0117 9608511 0117 9608511 jennywaring@tiscali.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) Visions (Bristol) Ltd Mrs Jennifer Elizabeth Waring Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Visions DS0000070426.V362829.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care Home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: 2. Learning disability (Code LD) The maximum number of service users who can be accommodated is 4. Date of last inspection First inspection. Brief Description of the Service: Visions is a detached house in a residential area of Bristol. It is on a main road set back via along garden and a series of steps. It is close to local shops and bus routes to the centre of Bristol. The house has been refurbished by the owners to create an attractive home for the residents. It has four available bedrooms for service users. Two of the bedrooms are on the first floor and these have an en-suite bathroom. The two bedrooms on the ground floor have an en-suite toilet and sink. There is a bathroom on this floor for these service users and the staff team. Downstairs there is a kitchen, which leads to the garden. This area is grassed with some decking and paving. There is also a dining room and lounge. The office is on the ground floor. The aim of the service, as detailed in the statement of purpose, is to support young adults with learning difficulties to devlop and achieve independence. The weekly fees at the time of inspection were £890.00. Visions DS0000070426.V362829.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means that the people who use this service experience good quality outcomes. This was the first inspection of the home. The inspection took place over two evenings. Surveys were received from residents, staff members and placing authorities. The purpose of the visit was to establish if the home is meeting the National Minimum Standards and the requirements of the Care Standards Act 2000 and to review the quality of the care provision for the individual’s living in the home. This inspection employed key elements of the national inspection methodology with the objectives of focusing on outcomes for the individual’s. This is evidenced through evaluation of core standards and verification through a surveying and case tracking approach that included talking with and the observation of individuals who live at the home and the views of the manager on duty. An opportunity was taken to view the home and a number of the records relating to the management of the home and plans of care for four of the individuals were reviewed. Residents and staff were also spoken with. What the service does well: The home has a structured admission process based on the homes ability to meet the assessed needs of individuals. Good standards of care and service delivery remain at the home. Those spoken with during the inspection said they were happy and enjoyed life at the home. The staff team at Visions are caring and have developed good relationships with residents at the home; they have a sound understanding of the needs of residents. There is a low staff turnover and residents can therefore be confident that they will receive support from people they know. It was clearly evident that the manager and the staff team are committed to ensuring that all of the needs of individuals at the home are met, this is done through consultation and observation and previous knowledge and an understanding of individuals needs. Visions DS0000070426.V362829.R01.S.doc Version 5.2 Page 6 The manager at Vision has a commitment and drive in wishing to provide a good quality service at the home, ensuring that residents, their relative and staff are consulted. There are clear lines of accountability within the home. 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 Visions DS0000070426.V362829.R01.S.doc Version 5.2 Page 7 contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Visions DS0000070426.V362829.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Visions DS0000070426.V362829.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,4 and 5. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Prospective residents mostly have the information needed to make an informed choice about where to live. This could be further developed to include more detail of the service. Residents also have the opportunity to stay for trial periods. Residents only move into the home after a thorough assessment has taken place. Contracts and agreements ensure that residents mostly know of the terms and conditions of occupancy. These could be further developed to include more detail. EVIDENCE: Residents confirmed and records show that assessments of need have taken place for all residents. Assessments clearly link into care plans and associated risk assessments. Visions DS0000070426.V362829.R01.S.doc Version 5.2 Page 10 The resident questionnaires confirmed that a choice of home was given. The home has produced an up to date service user guide and statement of purpose, which is available to residents. The information in the statement of purpose does not fully meet the standard. For example it does not include the arrangements for consultation with resident or fire precautions. Once this has been reviewed a copy should be sent to the Commission, the residents and their representatives. Consideration should be given to recording on the resident’s files that they have been given this information. All the residents had a contract. However these require some additional work to fully meet the standard. The rent paid by each resident should be included, as should the activities that the residents will have to pay for themselves. For example aromatherapy sessions and phone calls. When the changes have been made the residents should have the opportunity to sign the document again to show they are aware of and have agreed to these changes. Residents have the opportunity to test drive the home to decide if it is the right place for them. One resident said in the survey “I stayed for tea and had an overnight stay. I liked it.” There was some evidence in the resident’s files that a trial took place but this wasn’t available in all the residents’ files. Consideration should be given to recording this information. In the residents questionnaires one resident said, “ I came to visit the house and was given a brochure.” The manager fully demonstrated a clear understanding of the admission process for individuals to the home. The inspector saw that the home holds an initial review shortly after placement at the home, at this meeting the residents and their representatives are present and make their views known, these are recorded and appropriate action is taken. Staff told me that all of those living at the home are treated as individuals, all with different views and values; they were able to give examples of how specific needs are met. The inspector saw that staff have undertaken appropriate training that will equip them with additional skills and knowledge to meet the needs of the residents. Visions DS0000070426.V362829.R01.S.doc Version 5.2 Page 11 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): 6,7,8 and 9.Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are able to make decisions about their own lives and are aware of their assessed needs and associated risk assessments. Residents are encouraged to take appropriate risks and are consulted about the running of the home. EVIDENCE: Four individuals care records were reviewed at this inspection and it was found that the plans in place had been generated from a care management assessment. Information contained within care records included: an individual’s profile containing information about the reason for admission, health care support services involved, next of kin, family contact details and medical history. Each resident also had a pre- admission assessment, risk assessments, records of health professionals visiting, daily records and a care Visions DS0000070426.V362829.R01.S.doc Version 5.2 Page 12 plan. One resident had a detailed Essential lifestyle plan and the staff team were in the process of developing these for the other residents. Minutes from resident’s meetings were available and demonstrate that the residents’ are consulted on many aspects of the home and their lives i.e. planning future activities. There was evidence of residents’ involvement in the day-to-day running of the home. On the first day of inspection one resident was doing her ironing for a holiday she was shortly going on. She said she often does the cooking as she works in a café and enjoys it. One resident took part in her last review. She said that the staff were “supportive.” Throughout the inspection all of the staff on duty were observed helping residents with their needs in a polite way. Staff knocked on resident’s bedroom doors and spoke to residents respectfully. Risk assessments were seen to be in place for activities example use of the lawn mower and going out into the community. However these assessments did not highlight the degree of risk to the resident. The manager said that she is shortly employing consultants from the Royal bank of Scotland to review these assessments and her policies and procedures. Visions DS0000070426.V362829.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,14,15,16 and 17.Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service has a commitment to enabling residents to develop their skills, Including social, emotional, communication, and independent living skills. Residents have the opportunity to develop and maintain personal and family relationships. Residents are able to participate in age, peer and culturally appropriate activities in the community. Residents enjoy a healthy diet. EVIDENCE: Visions DS0000070426.V362829.R01.S.doc Version 5.2 Page 14 It is noted that the menus contain the fridge and freezer temperature recordings. It was seen through case tracking that one resident received professional support and advice on weight control. It was reported that the resident was then able to manage her risk of weight increase. The manager said that the residents decide what food they would like to eat weekly. Then they and the staff shop for these items. The manager said that the residents often have totally different meals as she feels this choice is important. The recording on the menus and discussions with staff members and residents confirmed this took place. Residents eat together and the evening meals seen on both days of inspection were nutritious, well presented and the residents said that they enjoyed them. Residents are able to take part in age, peer and culturally appropriate activities. Activities lists are available in the lounge. Two residents work during the week. One works in a café and the other on a farm. The residents attend either college, walking groups, music therapy and day centres. Two residents go to a local church. Three residents stated that they felt that there was enough to do in the day. At the weekends the male residents tend to go home and the other residents spend time with staff or with friends. Certificates of achievement by the residents were displayed around the house. These included achievements in well-being and creativity and skills development. Visions DS0000070426.V362829.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 and 21.Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents can expect to receive the personal support they require and have their medical needs met by the staff team. The residents can expect their physical and emotional needs to be met and their wishes to be followed in the event of their death. EVIDENCE: All of those living at the home are registered with a general practitioner. There was a record of visits to the GP and these were up to date and sufficiently detailed. The inspector also saw evidence to confirm that individuals are well supported with their primary healthcare needs such as optician, diet and chiropody To find out if medication practices in the Home were safe, the practices and procedures for administration, and storage of medication were checked. These were satisfactory. The medication administration record was clearly written and signed appropriately. There was a record of medication entering and leaving the premises. Visions DS0000070426.V362829.R01.S.doc Version 5.2 Page 16 There was a photograph of resident and a medication profile. There was a medication policy and sixteen other associated policies included: medication error; resident’s taking medicines to clubs/work; medication disposal and changing medication. In the questionnaires one resident said, “ I enjoy having control of my finances which I have never experienced before and with support I manage fine. I also like the fact that I choose what I do in my life i.e. college courses, clubs I attend. “ A statement was available on the majority of resident’s files about their wishes in the event of their death. The manager said that the other statements not available are with relatives and in the process of being completed. Visions DS0000070426.V362829.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents are protected by the homes policies and procedures. They can be confident that the staff team will listen to their views. EVIDENCE: One resident stated in the questionnaires “We went through the complaints procedure just to ensure that I fully understand. I fully understand now.” In relation to the staff teams listening and acting on what the residents say, a resident said” They deal with everything straight away”. All the residents who completed the questionnaires or spoke with me stated that knew how to complain and were confident that the staff team would sort out any problems they may have. There was a system in place to record complaints The staff team have either had POVA training or are awaiting refresher courses. The policies and procedures were known to the staff. The manager was aware of the need to inform the Commission of any protection issue if the need arose. All the residents spoken with confirmed that they felt safe in the home. They were able to give examples of how the staff team listened to their views. For example one resident wanted her scooter from a former placement but had not been able to get it. A member of staff said that if her social worker was not able to pick it up then she would. Visions DS0000070426.V362829.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): 24,25,26,27,28 and30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents live in a clean, comfortable and homely house that is decorated to a high standard. Their bedrooms are personalised and suit their lifestyles. The bathrooms provided privacy and were clean. EVIDENCE: The house has been newly furnished by the manager to a high standard. It presents as homely, clean and is well maintained. There is a lounge and kitchen next to the dining area. The colours chosen for these rooms are designed to be relaxing. The lounge and dining areas are well equipped and comfortable. The residents were seen moving freely around these areas talking to staff members and each other. Upstairs there are two bedrooms with en- suite bathrooms. Again these are decorated to a high standard. Downstairs there are two bedrooms, each with a Visions DS0000070426.V362829.R01.S.doc Version 5.2 Page 19 separate toilet and sink. The bathroom downstairs is shared with the staff members. A handrail is available to assist the residents. The residents confirmed that they were involved in the choice of décor and each bedroom seen was personalised. Downstairs there are an additional two bedrooms with toilets and washbasins. The downstairs bathroom is used by these residents and the staff team. The bathrooms were clean and hygienic. Two residents who spoke with me said they liked their rooms and the house itself. The garden at the rear of the house has been landscaped by the owner and has a lawn and a decked sitting area. The garden outside has a series of steps so there is no wheel chair access. A handrail is available for the residents. Visions DS0000070426.V362829.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): 31,32,33,34,35 and 36. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents are supported by an experienced and trained staff team who are knowledgeable about their needs. The staff team were clear about their roles and the residents are protected by robust recruitment practices. The frequency of staff supervision for bank staff must be improved to ensure that the staff team are working consistently. EVIDENCE: The staff team consist of the manager/owner, a senior support worker, a support worker and four regular bank staff. A key worker system is in place and the staff members on duty at the time of the inspection were able to demonstrate a sound knowledge of the residents needs. Each individual has a key worker to support them with the manager being involved with the overall monitoring of individual care. It was clear that staff have developed relationships with individuals and have worked together with them and others in order to identify the needs of residents and then support the person appropriately. There was information in individual care plans that Visions DS0000070426.V362829.R01.S.doc Version 5.2 Page 21 provided information to guide staff to the appropriate level of support that individuals require. Regular staff meetings are held at the home and appropriate subjects are covered in respect of the service provided at the home and in line with the needs of those living at the home. The staff files were well ordered and contained the required information. Staff training certificates were available on the staff files seen. These included training in manual handling, first aid, infection control, the protection of vulnerable adults and the mental capacity act. One staff member holds the NVQ 3 in care and another the NVQ4. Three members of the bank staff either have the NVQ or are working towards the qualification. The recruitment procedures were seen to meet the standard. However they could be further developed by the introduction of telephoning referees after they have supplied a staff reference. The manager stated that she will ensure this is completed in the future. Supervision of the substantive staff by the manager was taking place. These were detailed and frequent. However the bank staff did not receive staff supervision at the required frequency. Three bank staff members had not had supervision for several months. The manager said she would ensure that these staff would be regularly supervised from now on. Visions DS0000070426.V362829.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, 38, 40,41,42 and 43. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager has a strong sense of leadership and direction and is committed in providing a good quality of life for those living at Visions. The health, safety and wellbeing of those living at the home is well managed. There are robust record keeping, policies and procedures in place. However the records of monthly visits to assess the conduct of the home must be available at the home so that the staff team can monitor and develop their care for the residents. EVIDENCE: Mrs Jennifer Elizabeth Waring recently underwent the ‘fit person’s’ process and was deemed competent by the Commission to undertake the role of registered manager. Mrs Waring has many years experience in management the caring profession, and achieved the NVQ level 4 in care during her career. Visions DS0000070426.V362829.R01.S.doc Version 5.2 Page 23 Her continual professional development includes achievement in the following subjects: • • • NVQ Level 4 Registered Managers Award NVQ Assessor Award During a fit-person-interview held on 20/9/07 conducted by Helen Taylor and throughout the inspection Mrs Waring was able to demonstrate a good understanding of the requirements of the registered manager post. Mrs Waring also demonstrated a good awareness of legislation that guides practice in a care home. Throughout the inspection she demonstrated a commitment to the provision of good quality individualised care packages in the home The homes extensive policies and procedures were seen to meet the standard. These are signed by staff members to show they have read and understood them. The manager stated that monthly monitoring visits to assess the conduct of the home take place. However there were no copies of the report available in the home nor were they being sent to the Commission. These report are a useful tool for the staff team to evaluate their care of the residents and develop their practice. Therefore a requirement has been made that these are available in the home. Throughout the inspection demonstrated a commitment to the provision of good quality individualised care packages in the home. The inspector observed many occasions when spent time with the residents, she was supporting and reassuring. She has high visibility in the home and gives strong leadership and direction. She encourages openness and discussion and is regarded as someone who listens. Regular residents and staff meeting are held at the home and provide an opportunity for open discussion, to raise concerns, ideas and suggestions and to plan for the future. Visions DS0000070426.V362829.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 2 2 3 3 X 4 3 5 2 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 3 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 2 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 3 2 3 X 3 3 3 3 Visions DS0000070426.V362829.R01.S.doc Version 5.2 Page 25 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. 2. 3. Standard YA5 YA36 YA1 Regulation 5 (c) 18 (2) 4 (1) Requirement The registered person must ensure that the resident’s contracts are reviewed. The registered person must ensure that the bank staff have regular staff supervision. The registered person must ensure that the statement of purpose is reviewed so that it contains all the elements of schedule one. A copy then be sent to the Commission. The registered person must ensure that risk assessments are available about the residents ability to self medicate. The registered person must ensure that there is recorded evidence that monthly visits to assess the conduct of the home take place. Timescale for action 01/08/08 01/06/08 01/08/08 4. YA20 13 (c) 01/06/08 5. YA37 26 (1) 01/06/08 Visions DS0000070426.V362829.R01.S.doc Version 5.2 Page 26 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 YA9 YA34 Good Practice Recommendations The risk assessments are reviewed to detail the degree of risk to the residents. Telephone enquires are made by the manager following receipt of a staff reference. Visions DS0000070426.V362829.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA 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. 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