Inspection on 11/11/05 for Westmead

This inspection was carried out on 11th November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 7 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Westmead 03/11/09

Westmead 05/06/08

Westmead 07/06/07

Westmead 20/06/06

Westmead 16/06/05

Westmead 03/03/05

Westmead 17/06/04

Similar services:

The Vicarage

7 Hyde Road

5 Seafield Road

Trevaylor Manor

12 Orchard Mews

Stallcombe House

Stepping Stones

Cornerstones

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

CARE HOME ADULTS 18-65 Westmead Leonard Cheshire Saunton Road Braunton Devon EX33 1HD Lead Inspector Dee McEvoy Unannounced Inspection 11th November 2005 10:00 Westmead DS0000022129.V265505.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 Westmead DS0000022129.V265505.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. Westmead DS0000022129.V265505.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Westmead Address Leonard Cheshire Saunton Road Braunton Devon EX33 1HD 01271 815195 01271 814501 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) Leonard Cheshire Mrs Caroline Brennan Care Home 18 Category(ies) of Physical disability (18) registration, with number of places Westmead DS0000022129.V265505.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16th June 2005 Brief Description of the Service: Westmead provides accommodation and 24-hour care for eighteen adults with physical and learning disabilities under the ownership of the Leonard Cheshire Foundation. Although their age category ranges from nineteen to sixty-five, the majority of service users are under 40 years. The home is an older property and has been adapted for wheelchair users throughout. All bedrooms are single occupancy and are situated on the ground floor, some with direct outdoor access. Westmead is located in Braunton, a large village offering shops, banks, pubs and other amenities. The home is within easy reach of local beaches. Barnstaple is 5 miles away. The home has specially adapted vehicles available to service users, enabling them to enjoy trips. Overnight accommodation is available for visiting relatives and friends. Westmead DS0000022129.V265505.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was the second inspection of the current year and was undertaken over the course of one day. The national minimum standards, which met the standard required at the previous inspection, were not inspected on this occasion. During the course of the day the inspector met with the majority of residents at home and spoke with 5 in some depth, six staff members were interviewed including the locum manager. No relatives were available to speak with during this unannounced inspection but one regular visitor was spoken with. The inspector toured the premises and inspected a number of records including residents’ care plans and associated records and staff records. There have been several changes within the home since the last inspection; the registered manager has left and a locum manager from Leonard Cheshire is covering the post. A new manager has been appointed and will take up the post in January 2006. This position will be formalised once the manager has completed the registration process with the Commission. 15 new staff have been recruited including team leaders, care staff and a training co-ordinator. Residents spoken with were generally positive about the changes and described an improvement in the atmosphere, one resident said, “ The new staff are settling in OK and getting to know us”. What the service does well: What has improved since the last inspection? All residents now have regular access to a physiotherapist, who is based at the home 15 hours a week. Individual assessments are being undertaken and handling and positioning plans are being developed to ensure that residents’ needs are met. 2 members of staff are nominated to complete a physio assistant programme with Plymouth University. Westmead DS0000022129.V265505.R01.S.doc Version 5.0 Page 6 The management of residents’ finances has improved with residents being supported to take control of individual bank accounts. Several areas of the home have been refurbished and repaired; the exterior of the home and some internal communal areas such as the dining room and sitting room have been redecorated. The roof is being repaired and windows and doors are being replaced or renewed where necessary. There is an ongoing programme of refurbishment and improvement of the environment. The home has successfully recruited a number of permanent staff after a period of difficulties. Staffing levels and the general morale have improved. Residents and some long serving employees were happy with the changes and the improvement in morale. A space has been identified within the building to provide staff with a designated staff room. 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. Westmead DS0000022129.V265505.R01.S.doc Version 5.0 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 Westmead DS0000022129.V265505.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Admissions to the home appear to be well managed ensuring that care needs can be met. EVIDENCE: Three residents were case tracked. Residents are admitted through the care management process and the referring professional completes an assessment of need prior to the resident moving into the home. The home has its own assessment format, which is thorough and is completed by the manager, team leaders and other health professionals such as physiotherapist and speech and language therapist; Leonard Cheshire staff in other parts of the country will assess prospective residents’ needs if living ‘out of county’. The residents’ files inspected had been reviewed recently. The inspector was told that all residents’ needs are being reviewed using the comprehensive assessment tool. Westmead DS0000022129.V265505.R01.S.doc Version 5.0 Page 9 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&9 There is a clear care planning system in place, which needs to be fully implemented if needs are to be met; attention is needed to ensure that environmental and situational risks are minimised. EVIDENCE: The home is starting to use a more person centred approach to care planning. When fully implemented residents will have copies of their ‘Individual Service Plan’ (ISP) documents in their bedrooms. The three plans seen on this occasion were comprehensive and highlighted the areas of support needed and the action that staff should take to meet these needs. The plans looked at had improved since the last inspection and contained personal preferences and relevant histories, such as preferred name, foods and times for getting up and special family and friends. Preferred activities were also recorded. The care plans examined had been reviewed recently and a cycle for regular reviews was being established. Several residents were aware of their care plans and key worker. Manual handling plans had been completed by the physiotherapist and were comprehensive. Some excellent guidance was available with regards to individual postural needs, which ensured that residents were as comfortable as Westmead DS0000022129.V265505.R01.S.doc Version 5.0 Page 10 possible at all times. Although environmental and situational risk assessments were available, the use of bed rails had not been risk assessed and consent had not been recorded in two files. Staff showed a clear understanding of residents’ needs and their methods of communication. A staff member assisted the inspector when communicating with one resident; a warm and respectful approach was observed towards the resident. One resident told the inspector, “I love the staff here”. Westmead DS0000022129.V265505.R01.S.doc Version 5.0 Page 11 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, 14, 16 & 17 Activities are generally well organised with the residents and staff developing more things to do in the evenings and at weekends. Links with the local community are good supporting and enhancing residents’ social and educational opportunities. The review of the dining room and mealtimes has facilitated less ‘stressful’ mealtimes. EVIDENCE: Residents are supported to enjoy leisure and educational activities; on the day of the inspection 4 residents were at college and 3 were spending time at a local club for young adults. Residents also make use of local shops, cinemas and pubs. Several residents enjoy the local carnivals and other community activities. Residents are also encouraged to continue with or develop new hobbies; one resident told the inspector about a new interest which staff had “supported 100 !” The development of evening and weekend activities was discussed with the acting manager and a few of the residents. Residents were generally positive about the recent changes and felt that they were being listened to. An Westmead DS0000022129.V265505.R01.S.doc Version 5.0 Page 12 independent living support worker, employed for 20-hours a week, enables residents to develop their independent living skills, which one resident particularly appreciated. Many residents enjoy the IT room; a support worker is on hand to assist residents with using equipment and programmes as well as correspondence and college work. The manager is hoping to extend the hours the IT room is available to residents to include weekends. An activities space has been created in the large sitting room on the first floor with plans for music and art sessions to be offered to residents. Residents have shown an interest in the PAT scheme, where animals visit the home, and the manager is following this up. A number of other in-house activities are planned for evenings including themed nights, which will provide different foods and an opportunity to invite guests to dine. Residents were invited to consider ideas for the Christmas party and are encouraged to express ideas for the continued development and improvement of activities at regular residents’ meetings; this will be monitored at future inspections. Preferences with regard to daily routines are recorded and routines appeared to be flexible taking the residents’ wishes into account, for example the timing of the main meal was the decision of the residents. Since the last inspection the dining room has been moved to the ground floor and a ‘hot trolley’ provided to try to ease the difficulties experienced at meal times. Residents spoken with had been consulted and were happy with the changes. Several residents require assistance at mealtimes and this had proved difficult; the new arrangements, including the timing of the main meal, appears to have eased some of the difficulties and can allow meals to be ‘staggered’ where needed to ensure that residents have individual attention. One staff member was assisting two residents at breakfast but the inspector was told that 4 staff members were out with other residents and on occasion the ratio was not ideal. Several residents received individual attention at lunchtime. Westmead DS0000022129.V265505.R01.S.doc Version 5.0 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 20 The health needs of residents are met with evidence of good multi-disciplinary working taking place on a regular basis and the management of medicines is improving. EVIDENCE: Residents spoken with were happy with the care they received overall. Since the last inspection the home has secured the services of physiotherapist for 15 hours a week. The physio has assessed each resident and one training session has been provided for staff to ensure that residents’ positioning is correct. Access to hydrotherapy is planned for February 2006. A ‘seating’ clinic, planned for November, will re-assess residents current wheel chairs to make sure they meet their needs. Several residents have been or will soon be reassessed by a speech and language therapist to review any swallowing difficulties and the like. Regular weights had been recorded for two of the residents case tracked as risks had been identified; a steady improvement was noted for one, the other was stable. Ensuring residents have the sufficient dietary intake is a challenge with some residents and staff may benefit from training in this area (Refer to standard 35). Since the last inspection simple guidelines have been developed to direct staff for the administration of rectal diazepam. The inspector was told that these guidelines would be developed further and that staff expected to administer Westmead DS0000022129.V265505.R01.S.doc Version 5.0 Page 14 such medicines were to receive training for this delegated nursing task, in line with the Foundations own procedures. The home is working closely with G.Ps and district nurses to provide the necessary training, which was booked for later in the month. Alternative medicines were also being explored with medical staff. The inspector was told that a regular reviewing system of staff competence to administer medicines is starting with Boots training and will be supported by up-dates and assessments, and policies and procedures. Westmead DS0000022129.V265505.R01.S.doc Version 5.0 Page 15 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): 23 The handling of residents’ finances has improved. EVIDENCE: The arrangements for dealing with residents’ money have been reviewed since the last inspection, with the majority of residents or their family managing their finances now. Residents have been assisted to set up bank accounts and encouraged to take more responsibility for managing their own affairs. Secure storage is provided in each room and a system for ensuring robust accounting is in place. One account was audited; two people signed all transactions and totals were accurate. The home’s administrator said that the new accounts were working well but she was aware of ‘weaknesses’ in the system, which would be monitored. Westmead DS0000022129.V265505.R01.S.doc Version 5.0 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 27, 29 & 30 Improvements have been made to the exterior and interior of the home, ensuring that residents enjoy a homely and comfortable environment, however residents would benefit from improved bathing facilities. EVIDENCE: The roof of the home is being repaired, and windows and doors are being replaced or renewed where necessary. The exterior of the building is being repainted in the original colours, as requested by the residents. The building will be restored to its former elegance when this work is completed. Internal areas have also been redecorated, including the dining area and sitting room. Residents have been asked to choose colours for the redecoration of the entrance and hallways. When asked what they thought of the improvements one resident said, “ absolutely fantastic!” All residents spoken with were happy about the improvements at the home. As previously reported, six of the bedrooms have en-suite facilities however only one is currently usable. As a result, 17 residents use three bathrooms; this is not ideal. Since the last inspection the acting manager has obtained quotes for refurbishing en-suite facilities to ensure individual residents’ independence, privacy and dignity are meet. Once completed these facilities will improve the general bathing amenities. Westmead DS0000022129.V265505.R01.S.doc Version 5.0 Page 17 On the day of inspection the home was clean, hygienic and free from offensive odours. The laundry facilities were clean and well organised. Disposable protective items, such as gloves, are available for staff. Westmead DS0000022129.V265505.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): 32, 33, 34 & 35 Progress has been made to address staff absence and shortages and residents are now receiving more consistent care. The procedures for recruiting new staff are good and offer protection to residents. The home has an active approach to training, however in order to ensure all staff have the skills to provide the appropriate care, future training should reflect residents’ individual needs. EVIDENCE: There have been several staff changes since the last inspection. 15 new staff have been recruited including a new manager, team leaders, care staff and a training co-ordinator. Some residents commented on the changes, one said, “There is a damn good staff team”; another said about the new staff, “We are getting to know each other”. On the day of the inspection 8 care staff were on duty, including a team leader; four staff members had accompanied residents to various activities. New working rotas are in place providing at least 6 staff members for an early shift and five for late shifts including a team leader per shift. On the whole residents spoken with were happy with the new staffing arrangements. New staff felt supported and were enjoying their role, while long serving staff were ‘feeling positive’ about the changes. Westmead DS0000022129.V265505.R01.S.doc Version 5.0 Page 19 The home operates a thorough recruitment process, three staff files were inspected for new staff; all contained the necessary information. The home has always been keen to develop training opportunities for staff, and has a dedicated training and development officer newly in post. With the changes to the staff team, many new staff require a range of training to ensure that residents needs are met and safe working practices are maintained (Refer to standard 42 for mandatory training). The future development of training and training records was discussed with the locum manager and training officer. Training identified as being relevant and useful to staff and reflective of residents’ needs included epilepsy, swallowing dysfunctions & nutritional needs. Two new staff said their induction had been valuable and that they were settling into their new posts. The inspector was told that 9 staff are being supported to complete NVQ level 2 or 3. Two members of staff are nominated to complete a physio assistant programme with Plymouth University. Westmead DS0000022129.V265505.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 Residents and staff benefit from the experience and positive approach of the locum Manager. Residents are involved in the running of the home, with evidence that their views are sought and acted on. Some health and safety issues need to be addressed to ensure the residents and staff are protected from hazards. EVIDENCE: The registered manager resigned earlier in the year and a locum manager, from the Leonard Cheshire Foundation, currently fills the post. The acting manager has overseen the home in a positive way during this transition period; residents and staff were happy with changes and said that morale had improved. A new manager has been appointed and will take up this position in January 2006. Regular residents’ and relatives’ meetings are held at different times to encourage attendance; minutes are available. Several residents said that the meetings were “very useful” and allowed people to bring ideas and share Westmead DS0000022129.V265505.R01.S.doc Version 5.0 Page 21 information. The residents have elected a chair person/representative for a newly established residents’ committee. The acting manager told the inspector that a full audit of the home would be undertaken in March/April 2005 in line with Leonard Cheshire quality assurance programme. CSCI receives monthly internal reports on the performance of the home. A recent Devon Fire & Rescue report identified several areas, which need to be addressed in order to maintain fire safety. Records showed that many staff required mandatory training including first aid, food hygiene, infection control, and health and safety. Some dates had been booked for staff to attend the necessary training. A Health and Safety committee has been established, which reviews accidents in the home and addresses issues such as training and new policies and procedures. A quarterly Health and Safety audit is to be undertaken to monitor progress. Minutes for the last meeting were looked at. A recent Environmental Health inspection reported good standards in the home. Westmead DS0000022129.V265505.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 X 3 X X X Standard No 22 23 Score X 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 X X 1 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X 2 X 2 3 LIFESTYLES Standard No Score 11 X 12 X 13 3 14 3 15 X 16 3 17 Standard No 31 32 33 34 35 36 Score X 3 2 3 2 X CONDUCT AND MANAGEMENT OF THE HOME 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Westmead Score X 3 1 X Standard No 37 38 39 40 41 42 43 Score 3 X 2 X X 1 X DS0000022129.V265505.R01.S.doc Version 5.0 Page 23 Are there any outstanding requirements from the last inspection? YES 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 YA9 Regulation 13 (4)(c) Requirement The registered person shall ensure that unnecessary risks to the health and safety of residents are identified and so far as possible eliminated (Risk assessments must identify behavioural and environmental risks, with clear actions to reduce risks. This includes choking risks and the use of bed rails.) (Previous timescale of 28/7/05 not met). All staff administering rectal diazepam must be trained and assessed as competent by the nurse delegating the task. (Previous timescale of 01/08/05 not met) Timescale for action 09/12/05 2. YA20 13 (2) 09/12/05 3. YA27YA29 23 (2) (n) The registered provider shall 30/12/05 ensure that suitable adaptations are made, and such support, equipment and facilities as may be required are provided for residents (This refers to the need to review the bathing facilities, including en-suite, to ensure that residents’ assessed needs are met and that facilities offer sufficient personal privacy and DS0000022129.V265505.R01.S.doc Version 5.0 Page 24 Westmead 4. YA42 23 (4) 5. YA42 13 (4) independence) (Previous timescale of 30/12/05 not expired) The registered person shall after 23/12/05 consultation with the fire authority - take adequate precautions against the risk of fire. The registered person shall make 31/01/05 suitable arrangements for the training of staff in first aid. The registered person shall ensure that the persons employed to work at the care home receive - training appropriate to the work they are to perform. (This refers to food hygiene, infection control, and health and safety training) 31/01/05 6. YA42 18 (1) (c) (i) 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. 3. Refer to Standard YA6 YA17 YA20 Good Practice Recommendations It is recommended that the review of all residents’ care continues using the comprehensive ISP documents It is recommended that mealtimes be monitored to ensure that sufficient staff are available at mealtimes to ensure individual needs and preferences are met. It is recommended that the competence of staff administering medication be reviewed at least twice a year as part of the regular supervision process. It is recommended that staffing levels be regularly reviewed to reflect residents’ changing needs. It is recommended that a training and development plan be established to ensure that staff training reflects the residents’ needs and the aims of the home. It is recommended that the home supply a copy of quality assurance reviews to the Commission, and make a copy DS0000022129.V265505.R01.S.doc Version 5.0 Page 25 4. 5. 6. YA33 YA35 YA39 Westmead available to residents. Westmead DS0000022129.V265505.R01.S.doc Version 5.0 Page 26 Commission for Social Care Inspection Exeter Suites 1 & 7 Renslade House Bonhay Road Exeter EX4 3AY 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 Westmead DS0000022129.V265505.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. 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