Inspection on 07/12/05 for Waymead Short Term Care

This inspection was carried out on 7th December 2005.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 19 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Waymead Short Term Care 08/08/07

Waymead Short Term Care 10/10/06

Waymead Short Term Care 02/05/06

Waymead Short Term Care 02/05/05

Waymead Short Term Care 15/12/04

Waymead Short Term Care 27/07/04

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Dalewood Respite Care

Orchard,The

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Fairways

Treloar College

Pinta

Kestrel House, St Anne`s Opportunity Centre,

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

CARE HOME ADULTS 18-65 Waymead Short Term Care St Anthonys Close Off Binfield Road Bracknell Berkshire RG42 2EB Lead Inspector Jill Chapman Announced Inspection 7th December 2005 01:00 DS0000031646.V256915.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 DS0000031646.V256915.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. DS0000031646.V256915.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Waymead Short Term Care Address St Anthonys Close Off Binfield Road Bracknell Berkshire RG42 2EB 01344 424642 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) dee.lacey@bracknell-forest.gov.uk Bracknell Forest Borough Council Mrs Denise Angela Lacey Care Home 10 Category(ies) of Learning disability (10) registration, with number of places DS0000031646.V256915.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 2nd May 2005 Brief Description of the Service: Waymead Short Term Care Unit provides respite care, for adults with a learning disability. The home can accommodate up to 10 service users per night. The home is registered to take service users who are male or female between the ages of 18-65 years. The service is owned and operated by Bracknell Forest Borough Council. DS0000031646.V256915.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine announced inspection carried out by two inspectors on a weekday afternoon/evening, over a period of six hours. Time was spent following up the requirements from the last inspection report and a number of the key standards were inspected. Some requirements from the last report have been met but some are outstanding or need further work. These will be referred to in the report. Inspectors spent time talking with the Locality Manager, Acting Unit Manager, Assistant Unit Manager and staff on duty. Prior to the inspection, questionnaires were sent to all families and local care managers. Some families gave their views by telephone and one parent gave feedback at the inspection. Some of the communal areas of the home were seen and records were sampled. One inspector joined service users for the evening meal and some were able to give their views about staying at Waymead. Staff helped describe the needs and routines of non-verbal service users. The Pharmacy Inspector will revisit the home in January 2006, to follow up her recommendations from her report dated 19th March 2004. What the service does well: The home provides comfortable accommodation, which is in easy walking distance of Bracknell town centre. There is a good amount of communal space to give service users the opportunity to mix or have personal space. There is a good size games room with a variety of in house activity equipment. Service users were seen to be relaxed and happy. There was a homely and lively atmosphere. Service users like the fact that where possible, they can have the same room at each stay. Staff were attentive to their needs and gave appropriate help with feeding. Service users had choice at the mealtime and some had second or third helpings. Service users know how they can make complaints and these are dealt with properly. DS0000031646.V256915.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? What they could do better: Additional day services offered at Waymead need to be included in the Statement of Purpose. Managers need to make sure there is enough staff time to provide day clients with a proper programme as well as carry out their work for the residential service. Although outcomes for service users are generally good, personal and healthcare support provided to service users is compromised by the poor quality of care plans and record keeping. A system of review is needed. Care plans and risk assessments should be in place to support the use of cot sides and if service users choice is limited to keep them safe. Communication with parents and access to leisure facilities could be improved. There is little evidence of good forward planning. Staff should try to make sure that people who get on well with each other and have similar needs stay in the home at the same time. Care plans should show service users choice about whether they prefer male or female staff to help them with personal care and identify any possible risks. The view of the pharmacy inspector will be sought about whether the arrangements for transporting a service users medication to and from the unit are safe. DS0000031646.V256915.R01.S.doc Version 5.0 Page 7 Alterations to bathrooms are needed to make sure that there is more space to help staff bathe service users safely and protect their privacy More permanent staff are needed to improve consistency of care for service users. The frequency of essential training updates could be improved and training specific to Learning Disability could be considered. (LDAF training.) There have been several management changes and this has delayed work needed to improve the service and help staff work as a team. Some staff practice needs to be improved to provide a better service for the users. Overdue health and safety services could put service users at risk. A Quality Assurance system needs to be developed to enable service users or relatives to give their views of the eservice. 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. DS0000031646.V256915.R01.S.doc Version 5.0 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 DS0000031646.V256915.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1&5 Extra day services need to be properly resourced to make staff have enough time to meet the needs of both the residential and day care service users. Service users have Guest Agreements to help them know their rights and responsibilities when staying at Waymead. EVIDENCE: These standards were not fully inspected on this visit but a requirement to put Contracts (Guest agreements) in place has been met. It was seen that Waymead are offering extra services, which are not included in the aims and objectives of the Unit. These include day care and regular tea visits. The Acting Manager said that the funding arrangements are not in place to support these arrangements currently but that this matter is being reviewed. Staff said that the care arrangements do not enable a proper day care programme to be implemented as well as carry out their work for the residential service. DS0000031646.V256915.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Although outcomes for service users are mostly positive, care plans and risk assessments need further development to make sure all needs and risks are identified and met. Service users are potentially at risk through a lack of proper planning and communication. Staff are in need of training on care planning and risk assessment to help them carry this out effectively. Care plans and risk assessments need to support practice that restricts choice and privacy or restrain service users for safety reasons. EVIDENCE: A requirement was made at the last inspection to make sure that care plans are available and up to date. Care plans were sampled for the service users in situ and those of service users who were seen on the last visit. DS0000031646.V256915.R01.S.doc Version 5.0 Page 11 Staff have made a concerted effort to gather information from residents and relatives to put these in place. Care plans seen are basic and need further development. Although outcomes for service users are mostly positive, there is insufficient information on how to meet the more complex needs. This highlights the need for staff training on care planning to improve the quality and give staff more confidence in the task. A requirement was made at the last inspection to develop a system of ongoing review. This is not yet fully met, care plans seen need to be dated and have a review date set. Care plan files should include a photograph of the service user. It was observed that staff support service users to make choices. In discussion with staff it was found that parents or other professionals are consulted about care issues. Some care practice overrides choice or privacy to protect resident’s health or safety and can involves intrusive or restrictive practice. Written care plans and risk assessments should be in place to support verbal or written guidance, to make sure these issues are regularly reviewed. Risk assessments were sampled for the service users in situ and from last visit. These have begun to be developed and managers acknowledge they are in need of further improvement. Some sampled had insufficient or unclear information on how to reduce risk. This also highlights the need for staff to receive training to help them develop these further. Bathing risk assessments need to address the risk of drowning. Staff also expressed a need to undertake training in care planning and risk assessment to enable them to carry out their role as key workers effectively. DS0000031646.V256915.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 13, 15 & 16. Service users benefit from some access to leisure facilities in the community but this can be restricted due to a lack of drivers or the conflicting needs of the group of service users. Service users can maintain contact with their families when staying at Waymead. Some families are happy with communication between the Unit and home and others feel it could be improved. Service Users appear to feel at home at Waymead but some improvements are needed to fully protect their privacy and dignity. EVIDENCE: It is part of the philosophy of the home that service users are supported to access leisure facilities in the local community. Managers acknowledge that this DS0000031646.V256915.R01.S.doc Version 5.0 Page 13 is an area that needs further development and this is planned for the New Year. Opportunities can be influenced by the lack of drivers in the staff team; a Driver Handyman is employed during weekdays but is not available at weekends. Opportunities can also be limited depending on the mixed needs of the group of service users. This can influence the flexibility of staff to accompany service users in the community. Service users spoken with said they enjoy shopping at the local garage, car boot sales, shopping in town and bowling. Some service users said they were going to the Challenge Club Christmas party that evening. Staff have contact with families about booking arrangements and some service users speak to families on the telephone during their stay at Waymead. Families said they are very grateful for the respite they receive and some are happy with the quality of communication from Waymead staff. Some said they would appreciate more information about activities or meals taken during the stay. One parent suggested that a written ‘Feedback Form’ could improve this. It was seen that service users are free to move about the home as they wish and choose whether to mix with other service users. Staff were seen to interact well with service users and were aware of their needs. It was observed that one service user needed more staff supervision to protect her privacy and dignity at the time when she was changing her clothes and accessing the toilet. Alterations to bathrooms will help preserve service users privacy and dignity. DS0000031646.V256915.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Although outcomes for service users are generally good, personal and healthcare support provided to service users is potentially compromised by the poor quality of care plans and record keeping. Improvements have been made to the medication system to improve safe practice. EVIDENCE: There was evidence in the care plans and from talking to staff that a number of the current users have complex health and social care needs. However, the quality of recording in care plans was inconsistent. Health issues had been identified but it was not clear in the records how these health issues had been addressed in practice. For example, in one care plan a user was identified in the contact sheets as “not well – advised to see a GP” however, there were no further entries or evidence that the user had indeed sought medical advice and no further record was made in the daily records concerning the users illness. Guidelines and risk assessments varied in their quality of recording and several lacked evidence of review or were only partially completed. There is a need to carry out a full review of the care plans and risk assessments to ensure service user safety and to provide staff with sufficient information on how to meet the needs of users effectively. DS0000031646.V256915.R01.S.doc Version 5.0 Page 15 There is a need to further consider the compatibility of users during their stays. From examination of records and discussion with staff it is evident that some users find it difficult to settle at the home when certain other individuals are staying. An example given to the inspector was that one recent user liked to stay in a quiet peaceful environment but was subjected to noise and invasion of their personal space by another resident. This was observed by staff to cause distress to the user. Service users have the technical aids and other equipment they need to maximise their independence during their stays. Hoists and other moving and handling equipment are deployed throughout the home and staff have been trained to use the equipment safely. Listening monitors are frequently deployed for individual users and there was evidence that consent to use this type of monitoring device had been sought from parents and relatives. The use of cot sides should be supported by an appropriate risk assessment and parental consent should be sought prior to usage. From discussion with staff and management it was clear that there is a need to give further consideration to cross gender care issues in the home and to provide evidence of users expressed choices in relation to this important aspect of care. The medication system has recently been reviewed and as a result is more robust and safer for users. Prior to admission information is sought in writing from users GP’s to ensure the correct dosage of medicines are administered at appropriate times. There is a need to ensure that a photograph is provided of each resident receiving medication to help aid identification. The advice of the pharmacy inspector should be sought to clarify the position in regard to the signing out of the home and transportation of controlled drugs. Staff are required to administer medication by injection and to give rectal suppositories to a number of users. This is a delegated responsibility from the community nursing sisters and it was evident that staff have received the appropriate training they need to carry out these tasks safely and effectively. To aid clarity it would be helpful to keep a list in the medicine room, of those staff deemed competent to carry out such procedures. The Pharmacy Inspector will revisit the home in January 2006, to follow up her recommendations from her report dated 19th March 2004. DS0000031646.V256915.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 Service users know how they can make complaints and these are dealt with properly. EVIDENCE: There is a complaints procedure in place that is accessible to service users. Three complaints have been received and two have been entered in the complaints book and have been dealt with satisfactorily. The third of a more confidential nature should have been logged in the record to show it had been received and to show it is being dealt with elsewhere. DS0000031646.V256915.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): 29 Work is needed to bring some of the bathrooms up to standard and to ensure service users safety, privacy and dignity. EVIDENCE: A requirement was made at the last inspection to notify CSCI of the timescale to carry out the work to the bathrooms, which has been recommended by the Occupational Therapist. This work includes making more space so that service users can be changed in the bathrooms, providing a changing table and an overhead hoist. This requirement has not yet been met however managers said that the funding for this has been agreed. It would be of benefit to users if the shortfall in bathing and showering provision identified by the Occupational Therapist could be addressed at the earliest opportunity to offer users more autonomy and choice in relation to bathing. Details of what work will be carried out and when this is to be started should be forwarded to CSCI. DS0000031646.V256915.R01.S.doc Version 5.0 Page 18 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): 33 & 35 There were sufficient staff deployed to meet service users needs but more permanent staff need to be employed to provide continuity of care. Staff benefit from a variety of suitable training courses to help them meet service users needs. The frequency of core training updates could be improved and consideration could be give to provide LDAF training. EVIDENCE: Although there was sufficient staff on duty at the time of inspection it is evident that the home is dependent on bank and agency staff to cover gaps in the roster. There is a need to recruit to the permanent vacancies to provide continuity of care. From discussion with staff it was clear that staff have clearly defined job roles. Staff are aware of their own limitations and know when it is appropriate to involve someone with more specific expertise. Examination of the staff training files indicated that staff had been appropriately inducted and had received various specialist training courses such as Makaton, the management of challenging behaviours, epilepsy, diabetes, effective communication and dementia care. Participation in these courses enables staff to more effectively meet the needs of the user group. DS0000031646.V256915.R01.S.doc Version 5.0 Page 19 All staff have been offered NVQ (National Vocational Qualification) training and a number of staff have achieved NVQ levels 2, 3, & 4. Consideration should be given to providing the staff team with the opportunity to participate in LDAF (Learning Disability Award Framework training) to further enhance their knowledge and skills in relation to the user group. There is an urgent need to provide staff with refresher training in core skills. In particular there was a shortfall in the number of staff who have recently received first aid, food hygiene and fire safety training, which could pose a risk to the health, & safety of users. DS0000031646.V256915.R01.S.doc Version 5.0 Page 20 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 & 42 There appears to be a lack of management direction and staff feel leaderless. Managers have identified that some staff practice needs improvement. The absence of a consistent management overview has contributed to shortfalls in the training of staff and some health and safety systems and potentially puts service users at risk. There is no Quality Assurance system in place to seek the views of service users or parents. EVIDENCE: The Registered Manager has been on long-term sick leave for extended periods in 2004 and 2005 and there have been several Acting Managers looking after the home. Although the Acting Managers are experienced in the field of learning disability, the changing arrangements and other commitments have not helped them to resolve some of the long-term problems in the home. The Service Manager has said that a Strategic Review of the Learning Disability DS0000031646.V256915.R01.S.doc Version 5.0 Page 21 Service and a Management Review are underway. Managers have identified that some staff practice needs improvement. From discussion with staff, management and in response to service user surveys it is clear that staff of the home lack clear consistent leadership and as a result effective teamwork has been compromised. Staff appear to be working in a disjointed fashion sometimes ringing families for support when a crisis occurs rather than approaching management for advice and guidance. This has led to some families feeling that communication is poor; that staff are overstretched and lack clarity of direction. For some families this has led to a general loss of confidence in the service. There is no in house Quality Assurance System in place at present, which would give service users and families the opportunity to express their views about the service. The Bracknell Forest Partnership Board Quality Assurance Framework for Learning Disability is being developed across the authority. The Locality Manager said that the Waymead Quality Assurance System would eventually be developed from that. Health and safety records were sampled and some were up to date. Some shortfalls were identified, the hot water mixing valves and boiler services are overdue and the PAT testing is due. Fire safety training for staff was last carried out in 2003 and should be six monthly. DS0000031646.V256915.R01.S.doc Version 5.0 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 x x x 3 Standard No 22 23 Score 2 x ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 1 1 x 1 x Standard No 24 25 26 27 28 29 30 STAFFING Score x x x x x 2 x LIFESTYLES Standard No Score 11 x 12 x 13 2 14 x 15 2 16 2 17 Standard No 31 32 33 34 35 36 Score x x 2 x 2 x CONDUCT AND MANAGEMENT OF THE HOME x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 2 2 x Standard No 37 38 39 40 41 42 43 Score 1 x 1 x x 2 x DS0000031646.V256915.R01.S.doc Version 5.0 Page 23 yes 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 YA29 Regulation 23(n) Requirement The registered persons should notify CSCI of their plans to address the shortfalls in the bathrooms, which have been identified by the Occupational Therapist, and give a timescale, to carry out this work. Outstanding timescale 02/08/05 Care plans should be available and up to date. These need further development. Outstanding timescale 02/08/05 Staff should have Care Planning training 3 YA9 13(4)c Risk assessments should be available and up to date. These need further development. Outstanding timescale 02/08/05 Staff should have Risk Assessment training A system needs to be developed to enable ongoing review of care plans. Outstanding timescale 02/08/05 DS0000031646.V256915.R01.S.doc Timescale for action 07/02/06 2 YA6 15 07/02/06 07/02/06 4 YA6 15 07/02/06 Version 5.0 Page 24 5 YA13 20 6 YA7 15 13 (4)c 15 13(4)c 15 17(1)a Schedule3 13(4)c 7 8 9 YA7 YA9YA6 YA41 Recommendations made by the Pharmacy Inspector to improve the medication system should be carried out. To be followed up by the Pharmacy Inspector Written care plans and risk assessments should be in place to support practice that overrides choice or privacy. Written care plans and risk assessments should be in place to support the use of cot sides. Cross gender care plans and risk assessments should be developed. Care plan files should include a photograph of the service user. Bathing risk assessments need to address the risk of drowning. The additional services provided need review to make sure they are properly resourced and should be included in the Statement of Purpose. Fire safety training for staff should be carried out at least twice a year. Carry out the following services Hot water mixing valves Gas boiler PAT electrical testing Staff should have up to date training in First aid, Staff should have up to date training in food hygiene The advice of the pharmacy inspector should be sought to clarify the position in regard to transportation of controlled drugs and the signing out of the DS0000031646.V256915.R01.S.doc 07/02/06 07/02/06 07/02/06 07/02/06 07/02/06 10 YA9 07/02/06 11 YA1 4 07/02/06 12 YA42 23 07/02/06 13 YA42 13(4)c 07/02/06 14 15 16 YA42 YA42 YA20 13(4)c 16(j) 13(2) 07/02/06 07/02/06 07/02/06 Version 5.0 Page 25 home of controlled medication. 17 YA37 9 That the Local Authority ensures adequate management cover in the absence of the qualified manager to ensure the home to meets its stated purpose, aims and objectives. Vacant staff posts need to be filled to provide continuity of care. 07/02/06 18 YA33 18(1) a 07/02/06 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 2 Refer to Standard YA18 YA33 Good Practice Recommendations Develop a system to plan admissions to ensure where possible the compatibility of service users during their stays. Consideration should be given to providing the staff team with the opportunity to participate in LDAF (learning disability award accredited framework training) to further enhance their knowledge and skills in relation to the user group. DS0000031646.V256915.R01.S.doc Version 5.0 Page 26 Commission for Social Care Inspection Berkshire Office 2nd Floor 1015 Arlington Business Park Theale, Berks RG7 4SA National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI DS0000031646.V256915.R01.S.doc Version 5.0 Page 27 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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