Care Home: The Old Vicarage [Cannington]

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What the care home does well Staff know the needs of residents well and residents are relaxed and content. Individualised person centred care is given. The building is maintained well and accommodation in bedrooms provides a very high standard of personalised space. The service benefits from strong leadership and good managerial organisation. What has improved since the last inspection? At the last inspection in May 2006 one requirement was made regarding adult protection. This requirement was met. Risk assessment processes have been reviewed and improved since the last inspection. Daily activities have been reviewed and re-structured and people have more opportunities for Intensive Interaction for sensory communication. There has been internal redecoration to ground floor communal areas and the purchase of good quality sensory equipment for people to use. What the care home could do better: Some record keeping for health monitoring needs to be better maintained. Staff should ensure that personal records are not left unsupervised and accessible in the home for anyone to view. Some staff require some essential mandatory training updates in order to ensure that high standards of care and protection are maintained. The manager needs to register with the Commission. CARE HOME ADULTS 18-65 The Old Vicarage The Old Vicarage Brook Lane Cannington Bridgwater Somerset TA5 2HP Lead Inspector Judith McGregor-Harper Unannounced Inspection 15th January 2008 09:30 The Old Vicarage DS0000031640.V357686.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 The Old Vicarage DS0000031640.V357686.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. The Old Vicarage DS0000031640.V357686.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Old Vicarage Address 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) The Old Vicarage Brook Lane Cannington Bridgwater Somerset TA5 2HP 01278 653688 Somerset County Council (LD Services) Position Vacant Care Home 8 Category(ies) of Learning disability (8) registration, with number of places The Old Vicarage DS0000031640.V357686.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The bedroom that is below 10 square metres can only be occupied by fully mobile residents. Registered for a total of eight persons with a Learning Disability. Seven of these persons may also have a Physical Disability. 6th May 2006 Date of last inspection Brief Description of the Service: The Old Vicarage is a large two storey building situated in the centre of the village of Cannington. The house is adjacent to the church and is close to a village pub. The home is within walking distance of the local amenities. The town of Bridgwater is five miles away. The Old Vicarage is a home run by Somerset Social Services Community Directorate. The registered manager is Mrs. Deborah Winter. The responsible individual for the service is Mr. David Dick. The Old Vicarage is registered with the Commission for Social Care Inspection to provide care for eight people with learning disabilities and physical disabilities. The home is operated by Somerset Social Services and all people living at the home are funded by Somerset social services. The Old Vicarage DS0000031640.V357686.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over one day between the hours of 09.45 am – 2pm. Eight people were at the home on the day of the inspection. There are currently no vacancies at the home and there have been no admissions since the previous inspection, or indeed for a few years. We were able to see and observe staff interactions with all eight residents. We spoke with four staff on duty. No relatives were visiting the home at the time of the inspection. The manager Mr. McClean was not on duty but his deputy manager was available for part of the inspection process. We would like to thank the duty staff for their time and hospitality shown to the inspector during her visit. The atmosphere at the home was relaxed and informal. Staff carried out their duties in a friendly and professional manner. This focus of this inspection visit was to inspect relevant key standards under the CSCI ‘Inspecting for Better Lives 2’ framework. This focuses on outcomes for service users and measures the quality of the service under four general headings. These are; - excellent, good, adequate and poor. The quality rating for this service is two star. This means that people who use this service experience good quality outcomes. Records examined during the inspection were four care and support plans, eight ‘My Day’ social care plans, written risk assessments, staff training plans and supervision records, recruitment files, medication administration records and maintenance records. On request the home completed an Annual Quality Assurance Assessment (AQAA) and submitted this to the Commission prior to the inspection visit. Surveys were sent to people using the service, relatives, staff and community health care professionals linked to the home. Overall the tone of survey responses received back to the Commission was positive, citing good quality care outcomes for people living at the home. At The Old Vicarage residents all have impairment with speech and language skills. People communicate using other verbal sounds than words such as gesturing, pictures/drawings or Somerset Total Communication signs/symbols. The staff at the home know people living there very well as the staff team is settled. What the service does well: The Old Vicarage DS0000031640.V357686.R01.S.doc Version 5.2 Page 6 Staff know the needs of residents well and residents are relaxed and content. Individualised person centred care is given. The building is maintained well and accommodation in bedrooms provides a very high standard of personalised space. The service benefits from strong leadership and good managerial organisation. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. The Old Vicarage DS0000031640.V357686.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 The Old Vicarage DS0000031640.V357686.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): We inspected Standard 5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at the home have a contract in order to protect their terms and conditions of occupancy. EVIDENCE: Contracts were viewed at the home for the four care and support plans inspected in detail. The Old Vicarage DS0000031640.V357686.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): We inspected Standards 6, 7, 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care and support plans reflect current care needs and care is regularly reviewed. This enables staff to deliver care that meets needs. People are risk assessed for daily activities and safety action plans are in place. The staff team know resident’s needs well and are able to care for residents in a way that provides individualised care. Confidentiality is not always maintained, as attention needs to be given to unsecured care records kept in the home’s lounge. EVIDENCE: Care and support plans for people living at the home are stored in their own rooms. Four were inspected in detail. The information in the plans is detailed and reflects person centred planning. Plans are critically reviewed monthly. Most people at the home are weighed routinely and clear records of weights The Old Vicarage DS0000031640.V357686.R01.S.doc Version 5.2 Page 10 are maintained. In order to demonstrate a person centred approach to routine health screening such as monitoring body weight an individual rationale for regular weights is recommended to be included in the care and support plan. People are unable to participate fully in their care planning process due to their complex disabilities. The home is in the process of producing care summaries to complement the ‘My Day’ summarised plans of daily routines and activities. These documents are written in plain English and are easy to follow. Care plans include clinical and environmental risk assessments. Since the last inspection, as recommended, risk assessments have been completed for the use of lap straps for some wheelchair users to prevent falls from the wheelchairs and baby monitors for listening to service users at night vulnerable to nocturnal epilepsy. Some daily working documents of care records (My Day plans) were stored unsecured in the lounge. Other records were stored discreetly and securely in the lounge or manager’s locked office. The Old Vicarage DS0000031640.V357686.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): We inspected Standards 11, 12, 13, 14, 15, 16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are being encouraged to actively participate in the home’s daily domestic routines to promote structure and purpose to the day. Access the wider local community for leisure and shopping is maintained. Staff give emotional and social support in a kind and professional manner. This adds to the atmosphere of calmness in the home. Meal times are unhurried and staff give individual attention. EVIDENCE: People are supported to manage their bedroom personal space according to ability. Employment or educational opportunities are limited for the people at the home due to their complex physical, emotional or learning disabilities. The Old Vicarage DS0000031640.V357686.R01.S.doc Version 5.2 Page 12 The home is next to the village church. One person chooses to be a member of the local church congregation. People are given the opportunity to access the local and wider community as the home has suitable adapted disabled transport. Outside trips or 1:1 time for leisure is recorded in ‘My Day’ plans. Activities take place in the home on a daily basis and people have part of their contract several ‘quality days’ per year or a short annual holiday, based on individual ability and preference. The management at the home believe that individual quality days currently bring greater reward to people using the service rather than an annual holiday. Since the last inspection the service is using more Intensive Interaction (1:1 sessions in the home using sensory equipment and hands-on therapies to increase communication or sense of wellbeing via sensory interaction). This is individually assessed and helps to meet the communication needs of people with profound learning disabilities. We observed staff on duty interacting with people in a friendly and sensitive manner. People moved freely within the home and approached staff for social interaction on a 1:1 basis and staff gave this attention. People who live at the service tended to interact more with staff than one another. The gardens are spacious and accessible but people living at the home need supervision in the gardens. Meals are provided in the dining room. Most people require supervision or assistance at meal times. We observed staff assisting people to manage lunch. Staff supported people on a 1:1 basis allowing time for the person to enjoy the meal at their own pace. Staff engaged with people by encouraging them to eat in an unhurried way and by talking about things that people liked to do or were going to do in the afternoon. The daily menu is flexible to choice and people were asked to choose what they wanted to eat. Pictures of food were used to assist choices. Meals are cooked on the premises. The kitchen is suitably equipped. Fridge/freezer temperatures are recorded daily and cold stored food in use is labelled with use by date. There is a written cleaning schedule for the kitchen for staff to follow. There are good supplied of fresh fruit and vegetables at the home and this is offered daily. Where people need specialised adapted diets or assistance at mealtimes, information on how to assist the individual is written in their care and support plan. The Old Vicarage DS0000031640.V357686.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): We inspected Standards 18, 19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Personal support for residents is individual and sensitive to needs ensuring good care and health support for service users. Some record keeping for health needs must improve so that an accurate assessment of daily fluid intake is maintained. Management of medication is safe with clear systems and protocols in place. EVIDENCE: All people at the home need personal care support. Several people need two staff to assist with these tasks. Five people use wheelchairs. Suitable equipment is available in the home to assist staff. Community health care professionals are involved in the overall care management of residents on a continuing basis. Specialist community health care professionals also consult on health care matters for individual people. Records of professional visits/advice were entered into personal care and support plans. The Old Vicarage DS0000031640.V357686.R01.S.doc Version 5.2 Page 14 Care plans reflected that health needs were anticipated and acted upon. Health issues that were not anticipated were also managed appropriately and effectively. Medication reviews were booked for people at the home for the first week in February 2008. Some care and support plans indicated that fluid intake needs to be monitored for some service users and a rationale is now included. Daily records of fluid intake were poorly maintained for the last 2 months. No person living in the home is able to manage his or her own medication. Staff administer medication. Medication records for the month were examined and the records were managed well. The home has a system of asking staff to sign to say that they have read the home’s policies and procedures in the administration of medicine and two staff supervise one another in medication administration. Medicines are stored securely in individuals’ rooms. There is a folder detailing medicines prescribed and the effects of the medicines and expected therapeutic benefits of the medicines. There are clear guidelines for the use of emergency first aid medicines such as in the case of epileptic seizures. The home is not currently storing cold medicines but has a secure system in place should the needs arise. The management is recording clinical supervisions of medication administrations by staff. This is good practice. Training was provided to staff from the prescribing pharmacy on the 4/07/07. The Old Vicarage DS0000031640.V357686.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): We inspected Standards 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is an open atmosphere in the home for the raising of concerns and there have been no complaints received at the home since the last inspection. People are risk assessed for self-harm or neglect and staff have received good training in adult protection legislation. EVIDENCE: The home has a complaints procedure. It is not displayed prominently in the home, as there is risk of this being taken or destroyed by residents. On viewing the home’s complaint log there have been no complaints raised to the home since 2004. The Commission has not received any concerns or complaints made about the service since the last inspection. Polices and procedures are available in the home for the protection of vulnerable adults. The policy is the multi-agency protocol for Somerset in the Protection of Vulnerable Adults. Staff have received training in the protection of vulnerable people and the home is currently undertaking work to assess people’s capacity under the criteria of the Mental Capacity Act to assist in making meaningful life choices. The Old Vicarage DS0000031640.V357686.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): We inspected Standards 24, 25, 26, 27, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Old Vicarage is a character property providing clean and pleasant accommodation for the people living there. Bedrooms are personalised and attractive, decorated to an excellent standard. EVIDENCE: The physical premises were inspected. Communal areas are spacious and accessible for independently mobile or wheelchair using residents. The home was clean to a good domestic standard on the day of the inspection. The carpets were clean and the ground floor corridors and communal lounges have been redecorated since the last inspection. Each person living at the home has a single bedroom. They are spacious, meeting individual physical needs, are personalised very attractively and have equipment installed to meet handling needs of individuals. Sensory equipment is also provided in bedrooms. The Old Vicarage DS0000031640.V357686.R01.S.doc Version 5.2 Page 17 Bathrooms are sufficient to meet people’s care needs. There is a shower room and a large disability equipped bathroom. Residents are also able to listed to music of their choice whilst bathing as a sound system speakers have been wired into the bathroom (a safe distance from wet areas). Access to the laundry is not convenient for wheelchair users but people can assist with folding their laundry if it is taken to the lounges. The washing machine was temporarily out of order on the day of the inspection, but contingency arrangements were in place to launder at a nearby home owned by Social Services. The Old Vicarage DS0000031640.V357686.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): We inspected Standards 32, 33, 34, 35 and 36. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staff carry out their roles in a caring and sensitive manner. Some staff require training updates in mandatory areas so that people get skilled support. Staffing levels are generally good but lower staffing levels in the afternoon could impact upon community access for people who use wheelchairs. EVIDENCE: There are three part time staff vacancies and a few vacant shifts that are covered by relief staff. The home is now works with a minimum of four staff during the mornings, which provides appropriate staffing support for the physical and emotional dependency levels of residents. The minimum staffing level in the afternoon is three. At night there is one waking staff member and one sleeping-in night staff member on duty. Duty rosters inspected showed The Old Vicarage DS0000031640.V357686.R01.S.doc Version 5.2 Page 19 that staffing levels often exceed minimum levels to allow of ‘My Day’ activities or 1:1 Intensive Interaction sessions. There has been one new member of the care staff employed since the last inspection. Their recruitment practice was carried out appropriately. Training staff to achieve a minimum level of NVQ level 2 in care is slow. 3 out of the 8 permanent care staff have achieved this qualification. Individual staff training records were inspected. The management has collated an assessment of where there are gaps in mandatory training update requirements. This includes staff requiring training updates in first aid, food hygiene and fire training. Arrangements must be made for staff to attend updates in mandatory training. During the inspection the deputy manager confirmed that staff were to receive a session in fire safety within the next working week. Staff have also been booked on a practical training refresher update in supporting people with eating and drinking in February 2008. On the day of the inspection most of the regular staff team were on a team training away day on the subject of meeting equality and diversity needs of people within the service. Written staff supervision records were in good order and staff are regularly supervised. Staff meetings are also held on average quarterly and minutes of the last two staff meetings were read. The Old Vicarage DS0000031640.V357686.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): We inspected Standards 37, 39, 40 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The standard of the home management is good and personal safety is risk assessed. Quality assurance processes are both formal and informal and the management have a clear focus on where the strengths and weaknesses within their service provision lie so that further improvements can take place. EVIDENCE: The manager is Mr. McClean. He is an experienced manager. He needs to apply to the Commission to be the registered manager. The current registration certificate was not held or displayed in the home. The Old Vicarage DS0000031640.V357686.R01.S.doc Version 5.2 Page 21 Health and safety equipment servicing information was inspected and was up to date. The fire system in the home was serviced on the 11/01/08. The home has now also complied with recommendation of the fire authority on improving fire safety protocols in the home, as stated in a letter from the fire authority outlining what needed to be improved upon in the building, dated the 16/01/07. On the day of the inspection the passenger lift was serviced. The home notifies the CSCI of reportable significant events in the home via the Regulation 37 reporting process. The service is run by the County Council Social Services, who provide their own insurance for The Old Vicarage. The home uses both Council generic and service specific policies and procedures. The service completed an AQAA as required by the Commission. The information in the AQAA was tested by evidencing against strengths and weaknesses identified by the home. The information provided in the AQAA as an accurate description of services provided. There are three first aid boxes in the home. They did not seem to have been checked for some time. It is recommended that a list of contents be supplied for each box and a system introduced in the home for regularly checking the contents and re-stocking as appropriate. The Old Vicarage DS0000031640.V357686.R01.S.doc Version 5.2 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 Standard No Score 1 N/A 2 N/A 3 N/A 4 N/A 5 3 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 4 27 3 28 4 29 3 30 3 STAFFING Standard No Score 31 X 32 2 33 2 34 3 35 1 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 2 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 3 X 2 X 3 3 X 2 X The Old Vicarage DS0000031640.V357686.R01.S.doc Version 5.2 Page 23 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA19 Regulation 12 (1) (b) Requirement Where care and support plans indicate that fluid intake needs to be monitored then accurate daily records must be maintained. Timescale for action 01/03/08 2. YA35 18 (1) (c ) Arrangements must be made for (i) all staff to receive updates in statutory training. * Fire safety. * Food handling. * First aid. * Moving and handling. 8 (1) (a) The responsible person must apply to the CSCI to register a manager at the service. 01/03/08 3. YA37 01/03/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations The Old Vicarage DS0000031640.V357686.R01.S.doc Version 5.2 Page 24 1. 2. YA6 YA10 It is recommended that a rationale for weight recording be included in a person’s care and support plan. It is recommended that staff be reminded to ensure that personal information be stored appropriately in communal lounges so that confidentiality is not breeched. The registered person should take action to ensure that 50 of care staff achieves a minimum of an NVQ level 2 in care. The minimum staffing level provision of 3 in the afternoon should be reviewed to assess whether an increase in staffing levels would provide greater scope for wheelchair users to access the community in the afternoons. The registration certificate for the home should be displayed in a prominent position in the home. First aid boxes should be checked regularly and if necessary re-stocked. 3. YA32 4. YA33 5. 6. YA37 YA42 The Old Vicarage DS0000031640.V357686.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Taunton Local Office Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 The Old Vicarage DS0000031640.V357686.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. 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