Inspection on 04/10/05 for 19 Wheelwright Road

This inspection was carried out on 4th October 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 29 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

19 Wheelwright Road 30/01/08

19 Wheelwright Road 12/12/06

19 Wheelwright Road 06/04/06

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

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

CARE HOME ADULTS 18-65 Wheelwright Road, 19 Erdington Birmingham West Midlands B24 8PA Lead Inspector Alison Ridge Unannounced Inspection 4th October 2005 11:30 Wheelwright Road, 19 DS0000065018.V256681.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 Wheelwright Road, 19 DS0000065018.V256681.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. Wheelwright Road, 19 DS0000065018.V256681.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Wheelwright Road, 19 Address Erdington Birmingham West Midlands B24 8PA 0121 382 9746 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) Caretech Community Service Limited Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Wheelwright Road, 19 DS0000065018.V256681.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 31 May 2005 Brief Description of the Service: 19 Wheelwright Road is a terraced house located in the Erdington area of Birmingham. The home is registered to provide care and support to three adults under the age of 65 who have a Learning disability. At present the home has two female, and one male service user. All service users have some difficult to manage behaviour, and autism. The home is staffed across the waking day with three staff, and at night a waking night staff and sleep in staff provide support. The home has three single bedrooms. None have ensuite, but all are fitted with a wash hand basin. The home has a bathroom with over bath shower, a communal lounge room, a music room, dining room and kitchen. Laundry facilities are housed in an outhouse at the rear of the property. Service users accommodated at this home all require full mobility as no adapted facilities, or mobility aids are available. The home has a pleasant rear garden; service users and staff have recently been developing this area. The home has no off road parking. Wheelwright Road, 19 DS0000065018.V256681.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Two inspectors undertook this inspection, over the afternoon of one day. The inspectors were pleased to meet with all three of the people who live in the home; they also talked with staff that work in the home, the acting manager, and service manager. The inspectors read records about care, staffing and health and safety. This is a home that inspectors have serious concerns about. What the service does well: What has improved since the last inspection? What they could do better: Opportunities to live an interesting and meaningful life must be made available to the people who live in the home. Wheelwright Road, 19 DS0000065018.V256681.R01.S.doc Version 5.0 Page 6 Activities of people’s choice in the community and at home must be offered on a regular basis. Behaviour management plans and recording must get better to ensure that this area of care is well assessed and planned, and that staff know how to support people. The records must be reviewed to ensure that people are getting the support they need. The number of staff, staff training and support for staff from the management must improve. Regular staff must be recruited, and then trained, and regularly supervised. A Manager must be recruited for the home, and they must apply to register with the CSCI. Health and safety must improve to include plumbing the washing machine in correctly, making sure that fire training and drills are undertaken, and that locks on the doors enable people to escape if there should be a fire. The appearance of the home must improve. Much of the home needs to be redecorated, or needs new carpet or furniture. The home is not homely or comfortable. The decor does not reflect the age, gender or cultural heritage of the people that live there. This must get 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. Wheelwright Road, 19 DS0000065018.V256681.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 Wheelwright Road, 19 DS0000065018.V256681.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): The home has a stable service user group, and there have been no new admissions to the home. The organisation has produced a Statement of Purpose and Service Users Guide. EVIDENCE: The organisation has produced a Statement of Purpose and Service Users Guide. The documents provide a useful insight into the home, but require some further development to fully meet the requirements of such documents. Wheelwright Road, 19 DS0000065018.V256681.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): 6,7,8,9,10 Care plans and risk assessments do not fully reflect service users needs, or provide staff with clear guidance on how to meet their needs. Care documents are not updated as needs change or incidents occur. Limited opportunities are available for service users to decision make regarding their care and lifestyle. Information in the home is stored securely. EVIDENCE: The plan of one service user was assessed in its entirety, and another was sampled. The plan sampled clearly described the service users needs, but did not clearly describe how the needs were to be met. Vague statements such as, ”To be supported by staff to maintain…” were regularly noted, that do not give specific guidance on how the need is to be met. The plan did not evidence any involvement or consultation with the service user or their representative. The plans only contained information about immediate care needs, and did not include any element of life planning or work towards personal goals. Wheelwright Road, 19 DS0000065018.V256681.R01.S.doc Version 5.0 Page 10 It is recommended that Person Centred planning be offered and developed with service users to address this. The home had no records of house meetings with service users. Evidence regarding how service users had been consulted with on the running of the home was not available. Service users present risks to themselves and others. The way in which these had been assessed and control measures developed was explored. The inspectors identified that control measures in place were not comprehensive, and that known risks had not been well assessed or managed. Restrictions had been placed on one service users access to the community in May 2005 due to the high risk she was assessed to present. It was of serious concern that this restriction remained in place, and that progress towards lifting it had not been made. One risk assessment had been written on in pencil, identifying that staff might be at increased risk from one of the service users. This entry had been made in May 2005, and had not been expanded upon, or subject to review since then. All risk assessments had been drafted in May 2005 and had not been reviewed following critical incidents or changes in the service users needs. The risk assessments were not all consistent regarding the information they contained. Variance in the level of staff support required for the service user differed across the documents. Care practice at the time of inspection was not consistent with that contained in the documents. Control measures such as the support and supervision of service users within the home was not undertaken as identified in the assessment documents. The inspectors concluded that risks were not well assessed or managed, placing other service users, staff and others at risk of harm. The care documents were stored securely in the home. Staff interactions with service users were professional and friendly. No breaches of confidential information were noted during the visit. Wheelwright Road, 19 DS0000065018.V256681.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): 11,12,13,14, Service users do not have opportunities to undertake leisure and developmental activities that are varied, frequent or consistent with their peers. EVIDENCE: Opportunities for leisure and development were assessed for two of the service users over a two-week period. The inspectors considered it positive that support had been obtained from an Occupational therapist regards supporting service users to develop greater skills and independence in the home. The records of engagement in this activity had not been consistently completed. One service user accesses a local college. It was reported that he continues to enjoy this and benefit from it. Opportunities to undertake leisure were identified to be seriously limited. One service user had been out of the home on one occasion in the period sampled, the other service user had been out of the home on one occasion for a healthcare appointment. Wheelwright Road, 19 DS0000065018.V256681.R01.S.doc Version 5.0 Page 12 In house activities that had been recorded included foot-spa, “Playing in the garden”, dancing, personal care, table top activities, TV, “Walking around the corridors” and colouring. These activities are not consistent with the interests of the service users peer group, and do not provide adequate opportunities for exercise, development or relaxation. One service users plan contained a plan of care regarding meeting their religious and cultural needs. This plan identified the need to support the individual with diet, clothing and participation in events and festivals. It was evident support with clothing and food had been provided. No evidence of opportunity to attend events or festivals was available. Wheelwright Road, 19 DS0000065018.V256681.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): 18,19,20 Personal care and healthcare needs are generally well planned and met. Medication management is good. Service users challenging behaviour is not well planned for, or effectively recorded and evaluated. EVIDENCE: All three of the service users had been supported to undertake personal care on the day of inspection. This was offered during the visit to the home, as the service users required it. The plan of care regarding meeting personal care needs was individual for each service user, but did not evidence how the contents of the care plan had been decided upon, or that the contents were the known preference of the service user. The plan contained some vague statements that did not fully detail or direct staff regarding the level of support or assistance required. The inspectors could not establish that the service provided at the home was consistent with the level of service users need. The inspectors drew the service managers and acting managers attention to the need to ensure that the service is staffed and resourced in such a way that needs are met by the home with the support of the wider care team. Wheelwright Road, 19 DS0000065018.V256681.R01.S.doc Version 5.0 Page 14 At present staff at the home rely greatly on the wider care team to initiate care developments. The records of healthcare appointments showed that service users had been supported to access all the required appointments and follow up. The plan for physical health care needs such as diabetes were detailed, and gave clear guidance on how the needs were to be met. The plan did not evidence that liaison had occurred with the appropriate professionals to complete the plan. The service users accommodated have some difficult to manage behaviours. The way in which these had been assessed, planned and recorded was found to require further work. The behaviour plan contained detailed information about the presentation of challenging behaviour. This had been complied in May 2005, and had not been subject to review since that time. The guidelines did not provide clear guidance on how to use distraction or signpost the reader to other relevant documents including the PRN Medicine protocol. The guidelines remain reactive, and do not contain proactive strategies regarding managing behaviour. The home had a generic physical intervention plan; this was not specific to each service user. The daily notes contained evidence of incidents that had occurred in the home, which had not been reported on the homes internal system or to the CSCI. It was not evident from the records made that the management plan had been utilised or followed. Two-service users weight was assessed. It was not evident that the plan to assist in the reduction and management of weight was being effective. The inspectors identified opportunities for exercise were limited, and that foods available were not all low fat, or healthy option products. Medication management was assessed. The system was generally robust, and evidence that service users were receiving the right medication at the right time was available. It was required that creams be used or discarded within 28 days of opening. One medication was not being used by the home as directed on the MAR sheet. It was required the original FP10 prescription be obtained and it confirmed how this medication is to be used. Confirmation of the action taken is to be provided to the CSCI. Wheelwright Road, 19 DS0000065018.V256681.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): 22,23 Service users behaviour places them at risk of harm. Support and plans are not proactive, and service users are placed at risk of harm. EVIDENCE: The inspectors read of a compliment paid to the home regarding the personal development of one of the service users accommodated. At the time of inspection the provider was investigating a complaint made about the management arrangements at the home. It has been requested that a copy of the homes complaint procedure and adult protection procedure be forwarded to the CSCI. The home has previously been issued with a regulation 43 notice regarding service users safety and management of risks. While documentation underpinning risks to service users has improved, further development is required to ensure staff work in a pro-active way, and that control measures in place are robust and adhered to. Records of incidents in the home continue to identify that service users are placed at actual or potential harm on a regular basis. Copies of the Complaints policy, Adult Protection policy, and the Managing Abuse policy were assessed. The information contained in the Managing abuse policy is not consistent with the Birmingham Multi Agency Guidelines, and does not instruct the reader to inform Social Care and Health for a Strategy meeting or discussion prior to an investigation commencing. The procedure does not prompt the reader to ensure the immediate safety or welfare of the service user at risk of harm. The policy must be reviewed to ensure these amendments are made. Wheelwright Road, 19 DS0000065018.V256681.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): 24,25,26,27,28,30 The premises of 19 Wheelwright Road require urgent work to the décor and presentation. At present a comfortable, safe and homely environment is not being offered. EVIDENCE: The inspectors observed all the communal areas of the home, and one service users bedroom. Some redecoration of the home had occurred since the last inspection. The presentation of the home was poor. It was largely devoid of personal items. It did not feel welcoming or homely. The hallway, stairs and landing require urgent redecoration. Damage to the plasterwork, wallpaper and décor was evident in this area. The lounge curtains were not to be securely hung, and hanging down. It has been recommended that at use of Kylie pads on chairs be reviewed, and ways of meeting continence needs that protects service users dignity be obtained. West Midlands Fire service visited the home in response to concerns raised by the CSCI regarding exiting the building in the event of a fire. Requirements they made regarding fitting suitable locks on external doors are as yet unmet. Wheelwright Road, 19 DS0000065018.V256681.R01.S.doc Version 5.0 Page 17 One service users bedroom was inspected. This was personalised. The quality of furniture and flooring in the room was of concern. Financial records identified that the service user had also spent personal money on bedclothes and towels, and it was required this expenditure be reimbursed. It was positive to observe that locks on service users bedrooms doors had been replaced with a lock that does not impede freedom of movement. The first floor bathroom was observed to be functional. The room was not well presented and it has been required that attention be given to improve the appearance of the room. The home was clean in the areas inspected. Good standards of food hygiene were observed in the kitchen. Records of food core temperatures, and of the fridge and freezer have been maintained. Protective clothing was available for staff. It has been required that the plumbing of the washing machine be reviewed to ensure disposal of sluice water is in accordance with the Water Regulations. Wheelwright Road, 19 DS0000065018.V256681.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): 32,33,34,36 Staff recruitment practice is good. The number of and supervision of staff does not ensure service users needs are well or consistently met. Staff are not all skilled in the specific needs of the service users accommodated. EVIDENCE: The home is carrying a number of staff vacancies. These are largely being met by a consistent group of agency staff. During the inspection positive interactions between staff and service users were observed. It was reported that training in mandatory subjects has recently been provided to all staff. It was not possible to evidence that training in fire safety had been delivered. Inspectors raised concern about staff working alone at night, who have not undertaken training in challenging behaviour or in the communication needs of the service users accommodated. It has been required that this be reviewed. Inspectors raised concern at the number of staff provided on duty, as this is not adequate to meet service users needs out of the home. Wheelwright Road, 19 DS0000065018.V256681.R01.S.doc Version 5.0 Page 19 Risk assessments and staff support ratios identify that staff in addition to those provided are required to enable service users to undertake an active and meaningful life. Three staff files inspected identified that robust recruitment practices are in place. Records of supervision showed that the quality of supervision undertaken with staff was detailed and balanced, but that the frequency with which supervisions are undertaken must increase. Wheelwright Road, 19 DS0000065018.V256681.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): 37,38, 42 The home has no registered manager. Temporary arrangements do not ensure positive outcomes for service users are regularly achieved. EVIDENCE: The home is without a registered manager. This has been the case for over three years, and is a matter of serious concern to the CSCI. An acting manager is in place, over seeing the day-to-day operations of the home. The inspection did not identify that the management of the home is ensuring positive outcomes for service users, and this must be addressed with haste. Records of servicing and routine testing of the fire alarm, electricity, gas and hot water had been undertaken as required. It has been required that fire drill be undertaken, and that evidence of or provision of fire safety training be provided to all staff. Wheelwright Road, 19 DS0000065018.V256681.R01.S.doc Version 5.0 Page 21 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 X X X X Standard No 22 23 Score 2 1 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 1 X 1 1 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 1 1 2 2 X X 1 LIFESTYLES Standard No Score 11 2 12 1 13 1 14 1 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X X 1 3 X 1 CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Wheelwright Road, 19 Score 2 2 2 X Standard No 37 38 39 40 41 42 43 Score 1 X X X 2 1 X DS0000065018.V256681.R01.S.doc Version 5.0 Page 22 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 YA19YA6 Regulation 12(1) Requirement Unmet from last inspection. Appropriate behaviour management plans that contain individual proactive strategies must be developed. Unmet from last inspection. A user-friendly format for maintaining service users records must be developed. Care documents must contain clear guidance on how care needs are to be met. Unmet from last inspection. Evidence of consultation with service users or their representatives must be available in the service users plans. Risk assessments must contain consistent information, and practice must be consistent with the assessment documents. Restrictions made on service users must be kept under review, and action taken to DS0000065018.V256681.R01.S.doc Timescale for action 01/12/05 2. YA6 17(1) 01/01/06 3 4 YA6 YA8YA6 12(1)(a) &15 12(2)(3) 01/01/06 01/01/06 5 YA9 13(4)(a-c) 31/10/05 6 YA9 13(4)(a-c) 31/10/05 Wheelwright Road, 19 Version 5.0 Page 23 7 YA9 13(4)(a-c) 8 YA11 12(1)(a) 9 YA14 16(2)(m-n) 10 YA14 12(2) & 16(2)(m-n) 11 YA16 12(4)(a-b) 12 13 YA19 YA19 12(1)(a) & 18(1)(a) 12(1)(a) & 13(1)(b) 14 YA19 12(1)(a) 15 16 YA20 YA23 13(2) 13(6) minimise the impact these have. Unmet from last inspection. Risk assessments that reflect current risks and practice must be available in the home. Unmet from last inspection. Staff must be trained in the communication needs of all service users. Unmet from last inspection. A choice of interesting and varied activities both in the home and community must be available for service users each day. Unmet from last inspection. Evidence of how activities have been decided upon must be available. Service users must be offered opportunity to maintain and develop their spiritual and cultural beliefs. The home must be resourced and staffed to meet service users needs. Incidents of challenging behaviour must be fully recorded, and reported. Review of these records must be undertaken to direct and inform care practice. Service users must be supported to achieve and maintain a healthy weight. Plans must be kept under review for effectiveness. Creams must be used or discarded with 28 days of being opened. The provider must ensure all reasonable action measures DS0000065018.V256681.R01.S.doc 31/10/05 01/01/06 30/11/05 30/11/05 30/11/05 01/01/06 30/11/05 31/10/05 31/10/05 31/10/05 Page 24 Wheelwright Road, 19 Version 5.0 17 YA24 23(2)(b)(d) 18 YA24 23(2)(b)(d) 19 YA24 12(4)(a) 20 YA26 23(2)(b)(d) 21 22 YA27 YA28 23(2)(b)(d) 23(2)(b) 23 YA33 18(1)(a) 24 YA33 18(1)(a) & 18(1)(c) 25 YA36 18(2) are undertaken to protect service users from abuse, neglect and self-harm. Unmet from last inspection. The hall, stairs and landing must be repaired, redecorated and re-carpeted. Unmet from last inspection. Refurbishment of the communal areas must be undertaken, in a style consistent with service users age, gender, cultural heritage and behaviours. . Incontinence protection that maintains the dignity of the service user must be provided. Bedroom furniture and flooring must be audited and broken or absent items repaired, replaced or provided. The first floor bathroom must be redecorated and suitable window covering provided. Consideration must be given to landscaping and planting the garden to provide a more attractive recreational area for service users. The number of staff on duty must be adequate to meet service users assessed needs and enable access into the community. Staff working alone at night must have suitable skills and experience. This must be underpinned with a risk assessment. Unmet from last inspection. Supervision must take place at least six times a year. These must be formal and DS0000065018.V256681.R01.S.doc 01/01/06 01/01/06 31/10/05 01/12/05 01/01/06 01/04/06 30/11/05 31/10/05 30/11/05 Wheelwright Road, 19 Version 5.0 Page 25 26 YA37 27 YA42 minutes taken and a record given to the member of staff. 8,9 Unmet from last inspection. A suitably completed and qualified care manager must be appointed, and application for registration made. 23(4)(b)(c)(iii) Unmet from last inspection. Fire exits must be reviewed with West Midlands Fire service, and identified action undertaken. 01/12/06 31/10/05 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 YA6 YA12 Good Practice Recommendations It is recommended that Person Centred Planning be undertaken with service users to address peoples changing needs and aspirations. It is recommended that household activities be included in the service users upport plans, so that progress made and the effectiveness of the strategy can be monitored and evaluated. It is recommended that the activity plan in All About Me be utilised as a means of planning activities and allocating staff resources. 3 YA12 Wheelwright Road, 19 DS0000065018.V256681.R01.S.doc Version 5.0 Page 26 Commission for Social Care Inspection Birmingham Office 1st Floor Ladywood House 45-46 Stephenson Street Birmingham B2 4UZ 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 Wheelwright Road, 19 DS0000065018.V256681.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. 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