Care Home: Botchill House

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What the care home does well One of the good things about Botchill House is that it is out in the country, and residents can go into the garden and the orchard by themselves and without asking anyone, if they feel like it. People can stay in their rooms if they want, or bring their music to the lounges. There are lots of things to do, like art and music, cookery or crafts. The staff take people to the town and to all sorts of other places in the home`s minibus or car. Most people who live at Botchill House have some difficulty with communication. The staff have become good at understanding and finding different ways of helping the residents to express themselves. There is good food, and staff try to find ways that residents will enjoy food that is good for them. What has improved since the last inspection? Two more of the residents` bedrooms had been redecorated, to give them a nice place to live. All the proper checks had been done on new staff, to make sure that they are the right people to work at Botchill House. What the care home could do better: Sometimes there are not enough staff who can drive, so not everyone can go to the places they want. The Managers are trying to put this right, and must keep thinking of ways to attract and keep good staff. Because some residents need to be protected from dangerous places, some rooms in Botchill House are kept locked, and residents who would be safe to use the kitchen independently may not. It would be unsafe at the moment to change this, but if keypads were put on the locked doors there would be less clinking of keys, which is not very homely. Some old medicines were in the medicine cupboard. It should be cleared out regularly, to avoid giving anyone a tablet that is out of date. Sometimes residents do not want to have their bedroom door shut, so the Manager should think of ways to help them keep safe and avoid any risk of smoke if there were a fire. CARE HOME ADULTS 18-65 Botchill House Hennesford Lane Dawlish Devon EX7 0QX Lead Inspector Stella Lindsay Key Inspection (unannounced) 11th October 2007 2:00 Botchill House DS0000003658.V349366.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Botchill House DS0000003658.V349366.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Botchill House DS0000003658.V349366.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Botchill House Address Hennesford Lane Dawlish Devon EX7 0QX 01626 863047 F/P 01626 863047 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) Havencare (Plymouth) Mrs Victoria Hales Care Home 15 Category(ies) of Learning disability (15), Physical disability (15) registration, with number of places Botchill House DS0000003658.V349366.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th April 2006 Brief Description of the Service: Botchill House is registered to provide accommodation with personal care to adults 18 to 65 years of age with learning disabilities and/or physical disabilities. The age range of current residents is from early forties to midfifties. Accommodation is over two floors and all residents have a single bedroom, one bedroom being on the ground floor. Communal areas include two lounges, a dining room and a large activities room. There is no lift, and none of the residents have mobility problems. The building itself is a large detached property standing in its own extensive grounds, which include a garden, patio area and large orchard. There is a sizeable car parking area. The home is located in an attractive rural position about two miles from Dawlish. Current fees range from £627 to £720 per week. Copies of the most recent inspection report are available on request from the office. Botchill House DS0000003658.V349366.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over two days in October 2007. The inspector looked round the whole home, and saw residents enjoying activities in the house and in the garden, and had lunch with some of the residents. The inspector met or was able to see all the residents and had discussions with the Registered Manager and five staff who were on duty. The Manager had sent a lot of information about the home, and some staff and visitors to the home returned questionnaires to the inspector, so that they had a chance to say what they wanted. The inspector has tried to show in this report what it is like for residents who live at Botchill House. She also looked at papers in the office to make sure that the home keeps proper records, and all the health and safety checks have been done. What the service does well: What has improved since the last inspection? Two more of the residents’ bedrooms had been redecorated, to give them a nice place to live. All the proper checks had been done on new staff, to make sure that they are the right people to work at Botchill House. Botchill House DS0000003658.V349366.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Botchill House DS0000003658.V349366.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Botchill House DS0000003658.V349366.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. A prospective new resident’s needs would be assessed prior to his/her admission to the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Statement of Purpose, concisely written, was clear about what the service provides. The most recent inspection report was attached. There has not been an admission since the home opened, when all residents moved together from Langdon Hospital. Haven Care has a suitable procedure for assessing care needs and arranging admissions. Terms and conditions had been provided for each service user. Botchill House DS0000003658.V349366.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 Quality in this outcome area is good. Care planning is systematic and thorough and care plans are updated to reflect changing needs. Residents are supported to take part in a range of activities, with arrangements made to reduce risks. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The files of two residents were examined. Care plans are comprehensive and cover health, recreation, education, and social well being. Night reports and monthly overviews were seen, as well as plans for particular health needs , including epilepsy. Each resident has a keyworker to ensure that they are involved in their care planning and that it is kept up to date. Each resident also has a personal risk assessment within their care plan, with guidelines for staff to avoid risk as far as possible while enabling the person to engage in their preferred activities. A six monthly review is carried out by the Assistant manager, the keyworker and the resident. Professionals and relatives can be invited with the resident’s agreement. One relative returning a survey to the CSCI said that staff at Botchill House are ‘extremely good about keeping (family) informed about Botchill House DS0000003658.V349366.R01.S.doc Version 5.2 Page 10 health problems’, and they had been pleased to attend a meeting in the home. Each review was followed by an action plan, which covered the resident’s needs in respect of health care, personal care and social care. Charts were being kept to record behaviour patterns, in conjunction with the Specialist Support Team. Records were kept of individual attention being given. Person Centred Plans had also been produced for or with all residents, including photos of important people and activities in their lives. These show their likes and dislikes, and any aspirations for the future. Communication boards were used in different ways to meet differing needs. For instance, one board showed a whole month ahead so that the person could see when they would next visit their family, and another had their board displayed in the dining room because they chose not to have it in their own room. Botchill House DS0000003658.V349366.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is good. Residents have opportunities to pursue their particular interests and to engage in activities in the local community, for education and recreation. There is choice and variety in the meals provided and residents are encouraged to eat healthily. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Activities that residents enjoy are identified in their personal care plans. Because of the location of the home, transport is vital to enable residents to engage with people and events in the local community. The home has two vehicles, an estate car and a seven-seater minibus. Residents are supported to join in activities in the local community, including horse riding and swimming, and educational courses offered at the local Community College, as well as educational and social activities in Newton Abbot and Exeter. Staff said that they sometimes have to prioritise, in particular if there are not enough drivers available to transport residents to planned activities. Botchill House DS0000003658.V349366.R01.S.doc Version 5.2 Page 12 Staff provide sessions of music, dancing, relaxation, crafts and cookery within the home. A successful music session took place during this inspection, although some of the expected clientele went on shopping trips, and the group leader adapted the session to the people who stayed. ‘I pick up on what people like’, she said – ‘One resident likes being read to, while another loves music’. A potter has been engaged for series of sessions within the home, which has been popular. Residents were seen to enjoy the large garden, and the ducks that are kept in the orchard. The freedom to come and go through the grounds was seen to be a benefit to residents. One resident is taken regularly to visit their family, while others have relatives to visit them at Botchill House. The home invites relatives to a social event twice a year. Holidays are arranged for residents who can benefit, though the cost is not included in the contract for care, so the resident contributes financially. A staff member said they had found value in taking a resident on a short break, as they had fewer problems with behaviour. ‘He is different on holiday’, they said – ‘less people to argue with’. Residents are not able to have free access to the main kitchen, or to have free access to facilities for making drinks, as some have behaviour that would make this unsafe. At breakfast, flasks of tea and coffee are put out for residents to help themselves, and they come down when they are ready. On the first day of this inspection, staff were preparing apples from the orchard in the locked kitchen, preparatory to making pies in the kitchen area of the activity room, with residents. Lunch on the second day was baked beans and fish fingers. There is not generally a choice offered in the lunch provided, but some residents had lunch out with the Assistant Manager, and residents in turn have the opportunity to go to the shops with a staff member, buy the ingredients, and make the lunch of their choice. There is generally a set meal at tea time, which is the main meal of the day. If necessary, alternatives are made available - sometimes because certain residents are unable to manage chewy food. On Fridays, however, there is a choice of convenience foods or a takeaway. Staff said that they think up different ways of encouraging residents to eat fresh fruit and vegetables. Fresh fruit salad was seen in the fridge. It is given to residents with their cereal for breakfast. Staff make smoothies, and find that salad is eaten if it is chopped into small pieces. Botchill House DS0000003658.V349366.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Quality in this outcome area is good. Personal support is provided by staff in a way that maintains the dignity of the residents. Their health is monitored carefully, and there is a safe medication system. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Residents are supported to choose their own clothes and appearance within the home, while being encouraged to dress appropriately when going out, to protect their dignity. Opaque film had been put on some residents’ bedroom window panes to protect their privacy. The pen picture in respect of each resident in their personal files provides useful information for staff about each of them. Help is provided with personal hygiene in a way that each person can accept, and peoples’ preferred routines are recorded in their care plans so that any new staff may know. Some residents need support to accept medical help when they need it. One person needed professional help in order to have blood samples taken, and now a way of making chiropody is being considered. Professional help has been needed to help deal with some residents’ cravings for drinks or food. Botchill House DS0000003658.V349366.R01.S.doc Version 5.2 Page 14 The home has a good policy and procedure for administering medication. Records were seen to be accurate. No residents are currently assessed as being able to look after their own medicines. Some ‘over the counter’ tablets were in the cupboard, with the agreement of the GP. Some were out of date and needed to be disposed of. During this inspection the Manager discussed with the local pharmacist a better way of organising tablets for residents when they are out of the home. At this time there was no need for regular visits from a District Nurse, for injections or dressings. Some residents had their regular medication changed earlier in the year, and staff had needed to know what differences to notice in their health, well being and behaviour. Medication reviews had been requested by the Manager when there were problems. Havencare provide training for staff in the administration and storage of medicines, side effects to watch for, drug classification, and Controlled Drugs, so that staff will understand the importance of medication for the residents, and be able to promote their good health. The local pharmacy also come to the home to give training on the proper use of their administration system. Botchill House DS0000003658.V349366.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is good. Residents are protected by the understanding that is built up in positive relationships with staff. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There had been one formal complaint since the last inspection, which had been passed to Havencare headquarters as money was needed to improve an area of the garden, in response. Residents were seen to express their views freely within the house. A major focus of the staffs’ effort was seen to be in working out how best to understand and respond to the residents. Training in communication is provided at the organisation’s head office. The home’s written complaint procedure was displayed in the hall produced with symbols to aid understanding. All current residents would need support to use it. No complaint has been made to the Commission for Social Care Inspection since the last inspection. The home had a policy on abuse which included advice on what to do if any allegation of abuse were made. It was advised that the phone number of the Safeguarding Adults Team of the local Social Services be added, so that the person in charge would know immediately who must be informed. Staff and management knew what to do in the event of an allegation being made, and were able to tell me about their NAPPI and POVA training. Measures had been put in place following an injury sustained by a resident earlier in the year, which was considered to have been caused by a fellow Botchill House DS0000003658.V349366.R01.S.doc Version 5.2 Page 16 resident. With advice from the local Mental Health outreach team, and the Specialist Support team, behaviour was being monitored and attention recorded, to promote positive behaviour and ensure the avoidance of further assault. Botchill House DS0000003658.V349366.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,28,30 Quality in this outcome area is good. Botchill House provides a choice and variety of indoor and outdoor spaces. It is maintained in a clean and safe condition. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is set in farmland about two miles inland from Dawlish. The home’s grounds include a small paddock and a large orchard with views across a landscape with farmers at work and horses in fields, which provides continuing interest for some of the residents. Havencare provide a three year rolling maintenance programme. Residents’ bedrooms were seen to be very individual, with solid and attractive furnishings, and much evidence of peoples’ own interests as well as choice of colour schemes. Many had their own shower. One was still in need of refurbishment, and much consideration was being given to achieving this in accordance with the needs and wishes of the occupant. The two lounges at the front of the house were spacious and comfortable, with large screen televisions. Residents listened to their own music. The dining Botchill House DS0000003658.V349366.R01.S.doc Version 5.2 Page 18 room had a laminated floor and a serving hatch from the kitchen. There was room for all, and at lunch residents who were home all came to the dining room. At tea time, some eat in the activity room, for a more peaceful experience. The activity room has equipment for music and artwork, and a kitchenette for supervised cookery sessions. Some rooms in the house were locked to maintain safety of some residents. It might be more homely and convenient to use keypads instead of staff having to seek and carry keys. The kitchen had been refurbished, to provide an improved work area for staff and better hygienic conditions for all. The floor of the store cupboard was being renewed at the time of this inspection. Paint was peeling off the laundry walls, and needed attention to maintain them in an easily washable condition. Toilets had been given good washable wall coatings. Communal toilets needed paper towels and liquid soap for good hygiene. Botchill House DS0000003658.V349366.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35,36 Quality in this outcome area is good. There is a good core of experienced staff but the home has difficulty in recruiting new staff. The recruitment process is sound and the training provided has improved. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A rota was supplied which showed that there are generally four Support staff available during the day, and the Manager and housekeeper are often additional. The numbers vary, and can be increased to meet particular needs including planned activities, assessed needs for individual attention, and support to attend health care, educational, and recreational activities and appointments. There is sometimes difficulty in providing enough drivers. At these times the Senior in charge of co-ordinating staff duties has to prioritise between different residents’ planned activities, which is not ideal. The managers were taking steps to enable more of the staff to be able to drive. There are normally two carers during the evening after 7pm, but a third is employed when needed for activities outside the home. There are two staff at night, one awake and one sleeping in. Havencare has a robust recruitment policy and procedure. The files of two recently appointed staff were examined. All the checks necessary for Botchill House DS0000003658.V349366.R01.S.doc Version 5.2 Page 20 protection of residents from potential harm had been carried out, and all documents required by the regulations were held. Each member of staff receive a copy of the codes of conduct and practice set out by the G.S.C.C. The Manager said that they had been continually trying to recruit, but still had vacancies for Support staff that they had not been able to fill. Havencare should continue their efforts to make these posts attractive to suitable applicants. A monthly arrangement had been agreed with the agency that supplies temporary staff to the home, to enable a regular worker to come to Botchill to help maintain some consistency for the home. Staff felt that training had improved over the past year. A Training Manager had been appointed by Havencare, resulting in ‘more structured courses that don’t get cancelled.’ All staff have to complete the common induction standards, introduced by skills for care. Havencare has its own induction program, and staff are also required to complete the learning disability framework foundation cource within eighteen weeks. There is a concise induction programme written for Agency workers, to give them essential information. Havencare is a registered assessment centre accredited with City and Guilds to award NVQs and VRQ for the care, social care and learning disability awards framework. Staff had continued to make progress with NVQ achievement and LDAF training. All staff have five supervisions and an individual performance review per year, in order to give feedback on performance, and give an opportunity to discuss any anxieties. Identification of staff training needs is included. Records were seen which showed that a variety of issues were duscussed with relation to staff performance and resident care, and actions to be taken were agreed. The Manager delegtes this duty to the Deputy and Assistant Managers. Botchill House DS0000003658.V349366.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 Quality in this outcome area is good. The home has an experienced manager and there is support and supervision from head office staff. Health and safety arrangements are satisfactory. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager has been a qualified learning disability nurse since 1992. She has been in a managerial role within a range of learning disability services for many years. She is currently undertaking the NVQ registered manager award, and the Standard will be fully met when this is completed. She is an Internal Verifier for NVQ training, and delivers staff training for Haven Care. Monthly auditing visits are conducted on behalf of Havencare, with reports supplied to the CSCI. These show that staff and residents are included in the Botchill House DS0000003658.V349366.R01.S.doc Version 5.2 Page 22 discussions and that senior management are involved with all major issues within the home. Havencare recognition with Investors in People’ was reviewed and maintained in March 2007. The Fire log book was examined. The fire alarm system had been serviced professionally in December 2006 and June 2007. Risk assessments had been carried out in April 2007. Professional fire safety training had been provided in March 2007, attended by all except one staff member, who had attended training at a different home within the organisation. Fire doors were seen to be in good order throughout the home. One resident was seen to peg open their own bedroom door, which could place them in potential danger. The Manager should make arrangements for this risk to be minimised. Accident and incident reports showed that referrals to specialists had been made appropriately. Botchill House DS0000003658.V349366.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 X 27 X 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 2 X 3 X X 3 X Botchill House DS0000003658.V349366.R01.S.doc Version 5.2 Page 24 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. Refer to Standard YA20 YA23 YA28 YA42 Good Practice Recommendations The medicine cupboard should be checked periodically, and any out-of-date preparations disposed of. The policy on dealing with abuse should include the contact number of the Safeguarding Adults team. The use of keypad locks for internal doors should be considered. The Registered Manager should consider ways to encourage each service user to keep safe within their fire door. Botchill House DS0000003658.V349366.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Botchill House DS0000003658.V349366.R01.S.doc Version 5.2 Page 26 - 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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