DOMICILIARY CARE AGENCY Lifeline Homecare Limited Courtleigh Westbury Leigh Westbury Wiltshire BA13 3TA Lead Inspector Elaine Barber Unannounced Inspection 15th and 18 th September 2008 10:35 Lifeline Homecare Limited DS0000054141.V369875.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 Inspection Report Author CSCI Audience General Public Further copies from 0870 240 7535 (telephone order line) Copyright 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 Internet address www.csci.org.uk Lifeline Homecare Limited DS0000054141.V369875.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 agency are those for Domiciliary Care. 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. Lifeline Homecare Limited DS0000054141.V369875.R01.S.doc Version 5.2 Page 3
SERVICE INFORMATION Name of service Lifeline Homecare Limited Address Courtleigh Westbury Leigh Westbury Wiltshire BA13 3TA Telephone number 01373 823105 Fax number Email address emma@lifelinehomecare.co.uk Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration Mrs Peggy Gifford-Pike Mrs Peggy Gifford-Pike Domiciliary Care Agencies Lifeline Homecare Limited DS0000054141.V369875.R01.S.doc Version 5.2 Page 4
SERVICE INFORMATION Conditions of registration: 1. Large Care Agency 2. To provide a service for the following Older People, People with Dementia, Adults with Mental Health Problems, Adults with Learning Disabilities, Adults with Physical Disabilities, Adults with Sensory Impairment, Adults with Terminal Illness, Adults who are Ill (other than Terminal Illness), Adults who are recovering from Illness, Children with Physical Disabilities, Children with Learning Disabilities, Children with Sensory Impairment, Children who have Terminal Illness, Children who are Ill, Children who have been Ill and supporting Adults with Disability in caring for their Children. Date of last inspection 3rd October 2006 Brief Description of the Service: Lifeline Care Agency is run from an office base in Westbury. There are two office rooms that were well equipped with computers, phones and a fax. There is also a meeting room and training room with equipment, such as a bed and a hoist. The agency is registered for a large number of user groups including children. It provides a service to people in Westbury and surrounding towns and villages. The fees range from 12.85 to 14.49 for an hour and 8.80 to 9.90 for half an hour. Mileage is charged at 32 p per mile. Inspection reports are available form the agency or from the CSCI website www.csci.gov.uk. Lifeline Homecare Limited DS0000054141.V369875.R01.S.doc Version 5.2 Page 5
SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means that people who use this service experience good quality outcomes. We asked the agency to complete an Annual Quality Assurance Assessment (known as the AQAA). This was their own assessment of how well they were performing. It gave us information about what has happened during the last year, and about their plans for the future. We sent surveys to the office to give to people who used the service. We received surveys back from eleven people who use the service and three health professionals. We made a visit to the agency on 15 th September 2008 when they did not know that we were coming. We looked at records, policies and procedures and talked to two of the directors. The manager was on holiday. We visited four people who used the service to obtain their views about the service. The judgements contained in this report have been made from all the evidence gathered during the inspection, including the visit. What the service does well: Each person who used the service was given information about the service so that they could decide whether the agency could meet their needs. The agency obtained information from the social worker and carried out their own assessment before people started to use the service. This meant that each person s needs were assessed so that their needs could be met. Each person had a contract with the agency and the council that paid their fees so that their financial interests were safeguarded. Each person had a care plan. These were clear and detailed and were up to date to ensure that people s needs would be met. People thought that the carers respected their dignity and privacy. People were supported to take their medication so that they could remain in their own homes. The health, safety and welfare of people who used the service and staff were generally promoted by the health and safety policies and practices. Risks to people and to the staff were assessed to ensure that they were kept safe. Lifeline Homecare Limited DS0000054141.V369875.R01.S.doc Version 5.2 Page 6
There was information about protection from abuse and staff received training to ensure that people were protected from abuse, neglect and self harm. People were protected from being cared for by unsuitable staff by the agency's policies and procedures on recruitment and selection. Staff received training in food hygiene, protection of vulnerable adults, medication, first and moving and handling. They had the basic training to meet people s care needs and more than half of the staff were appropriately qualified. Staff received annual appraisals and were supported through supervision by the team leaders. The manager was appropriately qualified and experienced and was supported by a senior management team. This meant that people were receiving a consistent, well planned and well managed service. There was a complaints procedure and people knew how to complain. People were confident that their complaints were listened to, taken seriously and acted upon. There was a quality assurance process and people were asked their views so that the service was run in people's best interests. Areas for development had been identifed and were being addressed. What has improved since the last inspection? One person had signed their care plan to show that they had been involved in developing it and were in agreement with it. Their plan was also dated so that it was easy to tell that it was up to date and when it needed to be reviewed. A record sheet had been developed to record what medication people were taking including each medicine, the dose and the time taken so that carers knew which medicines to give people. Each person who took medication had a completed record sheet. We found that one person had a record of when their equipment was due to be serviced and who was responsible for servicing. This would help to ensure that equipment was safe to use for the person and the staff. We made a recommendation at the last inspection about travel time between visits. The managers had made improvements in some areas so that carers were arriving on time. They had identified from the quality assurance process that travel time between visits was still an issue in another area and were working on ways to improve this. What they could do better: Care plans and risk assessments should be dated when they are written to show which information is up to date and when they are due to be reviewed. People should sign their care plans to show that they have been involved in developing them and are in agreement with them. Lifeline Homecare Limited DS0000054141.V369875.R01.S.doc Version 5.2 Page 7
Improvements need to be made to the record keeping when carers administer medication to people or prompt them to take their medication to ensure that people are taking the right medicines at the right time. The medication risk assessments should be more detailed so that carers know how people need help with their medicines and where medicines are stored. When a person uses equipment a record should be kept of who is responsible for servicing and the date when servicing is due to make sure equipment is regularly serviced and is safe to use. 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. Lifeline Homecare Limited DS0000054141.V369875.R01.S.doc Version 5.2 Page 8
DETAILS OF INSPECTOR FINDINGS CONTENTS User Focused Services (Standards 1 6) Personal Care (Standards 7-10) Protection (Standards 11-16) Managers and Staff (Standards 17-21) Organisation and Running of the business (Standards 22-27) Scoring of Outcomes Statutory Requirements Identified During the Inspection Lifeline Homecare Limited DS0000054141.V369875.R01.S.doc Version 5.2 Page 9
User Focused Services The intended outcomes for Standards 1 6 are: 1. Current and potential service users and their relatives have access to comprehensive information, so that they can make informed decisions on whether the agency is able to meet their specific care needs. 2. The care needs requirements of service users and their personal or family carers when appropriate, are individually assessed before they are offered a personal domiciliary care service. 3. Service users, their relatives and representatives know that the agency providing their care service has the skills and competence required to meet their care needs. 4. Each service user has a written individual service contract or equivalent for the provision of care, with the agency, except employment agencies solely introducing workers. 5. Service users and their relatives or representatives know that their personal information is handled appropriately and that their personal confidences are respected. In the case of standards 5.2 and 5.3, these do not apply to employment agencies solely introducing workers. 6. Service users receive a flexible, consistent and reliable personal care service. In the case of standards 6.3 and 6.4 these do not apply to employment agencies solely introducing workers. The Commission considers Standard 2 the key standard to be inspected. JUDGEMENT we looked at outcomes for the following standard(s): 1, 2, 4 Quality in this outcome area is good. People had the information they needed to make an informed decision about whether the agency could meet their needs. People s needs were individually assessed before a service was provided so that their needs could be met. Each person had a contract so that they knew what to expect from the agency. This judgement has been made using available evidence including a visit to this service. EVIDENCE: When we visited the office we looked at the information that was made available to people when they started to use the service. We saw a booklet Lifeline Homecare Limited DS0000054141.V369875.R01.S.doc Version 5.2 Page 10
called Important Information. This included all the information that must be in a statement of purpose. We also saw a Client Information Pack which was a small booklet containing all the information that must be in a service user guide. There was a statement at the front of this booklet to say that it was available in other formats including large print, Braille and other languages. One of the directors told us that both booklets were given to new clients except those people who received the rapid response service. These people had a time-limited service for two weeks and were given the service user guide booklet. The director said that they told these people that they could have the statement of purpose on request. When we visited people in their own homes we found that all four of them had been given both booklets. Four people who completed surveys told us that they had been involved in the decision to use the agency and six said that social services had arranged the care from the agency. We made a recommendation at the last inspection that a summary of the care management assessment should be obtained when social services fund a person s care. This had been partly addressed. One of the directors told us that they do not always receive an assessment from the social worker when they start to provide a service. They said that they receive an order form with information about the care package to be provided. The amount of information provided depended upon the council purchasing the care, and some were more detailed than others. The director told us that the team leaders carry out their own assessments before care is provided. The team leaders will phone the social worker to request information as part of their assessment. We looked at four people s care plans in the office. We saw that the people had had assessments of their needs as part of their care plans. When we visited four people we saw that each of them had a copy of this information at home. When we looked at the personal files we saw that three out of the four people had individual service contracts with one council and the agency while the other person had a contract with another council and the agency. Lifeline Homecare Limited DS0000054141.V369875.R01.S.doc Version 5.2 Page 11
Personal Care The intended outcomes for Standard 7 10 are: 7. The care needs, wishes, preferences and personal goals for each individual service user are recorded in their personal service user plan, except for employment agencies solely introducing workers. 8. Service users feel that they are treated with respect and valued as a person, and their right to privacy is upheld. 9. Service users are assisted to make their own decisions and control their own lives and are supported in maintaining their independence. 10. The agency s policy and procedures on medication and health related activities protect service users and assists them to maintain responsibility for their own medication and to remain in their own home, even if they are unable to administer their medication themselves. In the case of standards 10.8 and 10.9, these do not apply to employment agencies solely introducing workers. The Commission considers Standards 8 and 10 the key standards to be inspected. JUDGEMENT we looked at outcomes for the following standard(s): 7, 8, 10 Quality in this outcome area is generally good. Each person s care needs, wishes and personal goals were recorded in their personal plan to ensure that their needs were met. People felt that they were treated with respect and that their dignity and privacy were upheld. The policy and procedures about medication assisted people to maintain responsibility for their own medication and assisted them to remain in their own homes. However improvements need to be made to recording to make sure that people have the right medicines at the right time. This judgement has been made using available evidence including a visit to this service. EVIDENCE: We looked at four care plans when we were in the office. We saw that these were very clear and easy to understand. They provided detailed information about the care to be given and tasks to be completed at each visit. They Lifeline Homecare Limited DS0000054141.V369875.R01.S.doc Version 5.2 Page 12
included the objective of the service and the outcome that the person wanted to achieve. We made a recommendation at the last inspection that care plans should be dated when they are written to show which information is up to date. The care plans in the office were not signed or dated. When we visited people at home we saw that they each had a copy of their care plan in their home. Three of these were not signed or dated. One of these people told us that their care plan had been reviewed recently because their needs had changed. The fourth person had signed their care plan to show that they had been involved in developing it and were in agreement with it. The plan was also dated so that it was easy to tell that it was up to date and when it needed to be reviewed. Nine people who completed surveys said that they had a copy of their care plan. Two other people said that they had not but one said that their needs kept changing. Four said that the carers always did the things that were detailed in their care plan, five said that they usually did and two said they sometimes did. These two people said that carers came at different times and did not stick to the same time. Six people said that the service always took into account and respected their individual needs and three said that they usually did. Two people said the service sometimes took into account and respected their individual needs. One of these said that the timing of meals was important because of a health problem and one said Don t think they realise I am 95. We discussed this with the directors who said that they would look into this. Two health professionals who completed surveys said that people s health care needs were always met and one said they were usually met. This person said I have always found Lifeline to be always striving to meet the ever changing needs of patients. The agency directors had conducted their own survey as part of their quality assurance process. They had a good response to the survey and people said that their dignity and privacy was respected. When we visited people at home they told us that the carers were always polite and respectful and care was always given in privacy. Eight people who completed the surveys that we sent them said that the carers always respected their privacy and dignity and two said that they usually did. One said that they sometimes did, I have a whole army of different people including two men. One is really respectful and a perfect gentleman, but the other never really listens and does not make me feel respected. We discussed this with the directors who said that they would address this with the member of staff concerned. Three health professionals who completed surveys said that the agency always respected people s privacy and dignity. When we looked at the care plans we saw that two of the people had help with their medication. Both of the people had medication risk assessments. One of these included how the medication was given and where it was stored. The other just said carer to give medication but gave no details about how this was to be done or where the medication was stored. We made a requirement Lifeline Homecare Limited DS0000054141.V369875.R01.S.doc Version 5.2 Page 13
at the last inspection that when carers assist people to take their medication a record must be made of each item of medication taken, the dose and the time taken. This had been partly addressed. Each of these people had a record sheet to record each medicine that they took, the dose and the time that they took it. They each had another sheet for carers to sign to confirm that medication had been given as per the record sheet. In the office records we saw that aspirin had been added to the record of medication taken by one person with no explanation. There were some gaps in their administration records. When we visited this person at home we found that they had a record of all the medicines that they took with the dose and time taken. All these medicines were stored in a dosette box. One of the carers had added aspirin to the list of medicines with an explanation that this had been advised by a GP. The addition had been dated and signed. This person s medication administration records were fairly well recorded although there were a few gaps at tea time visits and no explanation was given about why medication might not have been taken. The second person whom we visited had a list of all the medicines they took with the dose and the time, including two as required medicines. The medication record sheets were well recorded and there were no gaps. Carers were also recording meds given on the daily record sheets. There was no separate record of as required medicines so it appeared from the record that as required medicines were being given on every occasion that medicines were given. It would be good practice to record as required medicines separately so that it is clear when they were being given. Lifeline Homecare Limited DS0000054141.V369875.R01.S.doc Version 5.2 Page 14
Protection The intended outcomes for Standards 11-16 are: 11. The health, safety and welfare of service users and care and support staff is promoted and protected, except for employment agencies solely introducing workers. 12. The risk of accidents and harm happening to Service Users and staff in the provision of the personal care, is minimised, except for employment agencies solely introducing workers. 13. The money and property of service users is protected at all times whilst providing the care service, except for employment agencies solely introducing workers. 14. Service users are protected from abuse, neglect and self-harm, except for employment agencies solely introducing workers. 15. Service users are protected and are safe in their home, except for employment agencies solely introducing workers. 16. The health, rights and best interests of service users are safeguarded by maintaining a record of key events and activities undertaken in the home in relation to the provision of personal care, except for employment agencies solely introducing workers. The Commission considers Standards 11, 12 and 14 the key standards to be inspected at least once. JUDGEMENT we looked at outcomes for the following standard(s): 11, 12, 14 Quality in this outcome area is good. The health, safety and welfare of the people who used the service and the staff were promoted by the health and safety policy and procedures. Risks of accidents and harm to people who used the service and the staff were minimised. People were protected from abuse, neglect and self harm by the policy and procedures about abuse This judgement has been made using available evidence including a visit to this service. Lifeline Homecare Limited DS0000054141.V369875.R01.S.doc Version 5.2 Page 15
EVIDENCE: There were policies in the staff handbook about health and safety, infection control, food storage, Control and Substances Hazardous to Health (COSHH), dealing with emergencies, safe use of equipment and lone working. The agency had moved offices since the last inspection and one of the directors had conducted a health and safety risk assessment. Protective clothing was provided in the form of gloves and aprons. Staff received training about health and safety, first aid, food hygiene and manual handling. When we read four personal files we noted that each person had a risk assessment, which included any risks to the person and risks to the carers. Each person also had a safe systems of work assessment which identified whether the person had any moving and handling needs and whether two carers were required. When we visited these people we found that they had copies of these assessments in their homes. None of these assessments was signed or dated. We made a recommendation at the last inspection that it would be good practice to record the dates when equipment needs servicing and who is responsible for servicing to ensure people s safety. This had been partly addressed. Two people had equipment and one of these had information about servicing in their care plan. There were policies about protection of vulnerable adults and protection of children in the staff handbook. There were copies of the multi-agency procedures for three local authority areas. Staff were given booklets about these procedures. When we looked at the training records we saw that staff had training about protection of vulnerable adults. The directors told us that there had been six vulnerable adults referrals since the last inspection. These had all been referred to the relevant social services department and had all been investigated using the multi-agency procedures. Lifeline Homecare Limited DS0000054141.V369875.R01.S.doc Version 5.2 Page 16
Managers and Staff The intended outcomes for Standards 17-21 are: 17. The well-being, health and security of services users is protected by the agency s policies and procedures on recruitment and selection of staff. 18. Service users benefit from clarity of staff roles and responsibilities, except for employment agencies solely introducing workers. 19. Service users know that staff are appropriately trained to meet their personal care needs, except for employment agencies solely introducing workers. 20. The personal care of service users is provided by qualified and competent staff, except for employment agencies solely introducing workers. 21. Service users know and benefit from having staff who are supervised and whose performance is appraised regularly, except for employment agencies solely introducing workers. The Commission considers Standards 17, 19 and 21 the key standards to be inspected. JUDGEMENT we looked at outcomes for the following standard(s): 17, 19, 20, 21 Quality in this outcome area is good. People s well-being, safety and security were protected by the agency s policies and practices on recruitment and selection of staff. People and their carers knew that the staff were appropriately trained and qualified to meet their needs. People benefited from having staff who were supported and supervised. This judgement has been made using available evidence including a visit to this service. EVIDENCE: We looked at the recruitment records of four staff. At the last inspection we made a recommendation that the declaration made by staff that they have no convictions should include convictions that are spent. The directors told us in the AQAA that they had changed the application form to include spent Lifeline Homecare Limited DS0000054141.V369875.R01.S.doc Version 5.2 Page 17
convictions. We saw that each of the four new staff had completed an application form. This included a declaration that they had no convictions including spent convictions. The forms also contained a health declaration and any gaps in employment history were recorded on the form. Two of the staff started to work with people on their own after two written references, a Criminal Record Bureau (CRB) check, Protection of Vulnerable Adults (POVA) check and Protection of Children Act (POCA) check. One member of staff had two written references and a POVA first check before they started to work with people. As required by the Domiciliary Care Agency regulations a member of staff was available to supervise them and people had been informed that their CRB check had not yet been received. A record was kept of the feedback from clients about their performance. The fourth member of staff had not yet started work. Two written references and a POVA first check had already been obtained for them and they were due to start work with people the following week. The directors told us that there were forty five carers. Thirty three of these had a National Vocational Qualification (NVQ) at level 2 or above. Six staff were working towards an NVQ, two of these were working towards NVQ 3 and four towards NVQ 2. The directors said that staff normally started NVQ 2 after they had completed their probationary period. Three senior staff were NVQ assessors and the senior team leader had just completed NVQ level 4. We saw that there was a training plan and a computer programme was used to track when training updates were due. When we looked at the training records we saw that the new staff completed the skills for care common induction standards. They also completed training in food hygiene, manual handling, protection of vulnerable adults and administration of medication. Training was also available about understanding dementia and stroke awareness. One of the people whom we visited said that the carers were well trained. We spoke to one of the senior team leaders who told us that staff have monthly observations of their practice, annual personal development plan meetings, and supervision meetings every three months. They said that staff have more frequent observations during their first few months of work and the team leaders obtain feedback from clients on the telephone about carers practice. We looked at six staff files and saw that new staff had frequent observations of their practice by the team leaders and notes were kept of their observations. Other staff had observations approximately once a month. Each staff member had an annual personal development plan. There were records of meetings with the team leaders. Lifeline Homecare Limited DS0000054141.V369875.R01.S.doc Version 5.2 Page 18
Organisation and Running of the Business The intended outcomes for Standards 22 27 are: 22. Service users receive a consistent, well managed and planned service. 23. The continuity of the service provided to service users is safeguarded by the accounting and financial procedures of the agency. 24. The rights and best interests of service users are safeguarded by the agency keeping accurate and up-to-date records. 25. The service user s rights, health, and best interests are safeguarded by robust policies and procedures which are consistently implemented and constantly monitored by the agency. 26. Service users and their relatives or representatives are confident that their complaints will be listened to, taken seriously and acted upon. 27. The service is run in the best interests of its service users. The Commission considers Standards 22 and 26 the key standards to be inspected at least once. JUDGEMENT we looked at outcomes for the following standard(s): 22, 26, 27 Quality in this outcome area is good. Overall, people received a consistent, well planned and well managed service. Areas for development had been identified and were being addressed. People and their relatives were confident that their complaints would be listened to, taken seriously and acted upon. The service was run in the best interests of the people who used the service. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The agency had moved to a new office in Westbury. There were two office rooms that were well equipped with computers, phones and a fax. There was also a meeting room and training room. There was a management structure including the manager, deputy, training manager, a co-ordinator and accounts manager. There were four team leaders and forty five care staff. The manager was appropriately qualified and experienced.6 Lifeline Homecare Limited DS0000054141.V369875.R01.S.doc Version 5.2 Page 19
We made a recommendation at the last inspection that the travel time between visits should be looked at to ensure that staff arrive on time and stay the full length of time. The two directors told us that this was more of an issue in Somerset as there were recruiting difficulties in Somerset. They told us that a team leader had been promoted and was helping the manager with the scheduling. Both directors said that the Wiltshire area had improved but it was still an issue in Somerset. The agency had sent surveys to staff as part of their quality assurance process. Three staff said in their surveys that travel time was still an issue. We visited four people from the Wiltshire area. They all said that the service was well run and carers usually came on time and stayed the correct length of time. However, one relative said that the carers occasionally came 40 to 45 minutes early and they found this inconvenient. Three people who completed the survey forms that we sent them said that the carers always stayed the agreed length of time. Four people said that they usually did and three people said that they sometimes did. One of the people who said sometimes told us that carers dash off because they have to be somewhere else and the roads are very congested in the mornings, the other said that it depended on the carer. The directors told us that the call monitoring system logged when a carer arrived at a visit and when they left. It was possible to monitor how long carers spent with a person and ensure they spent the correct amount of time. There was a complaints procedure and a complaints log, which detailed the name of the complainant, nature and date of the complaint, the response to the complaint and whether there was a verbal response. There had been two complaints since the last inspection. The records showed that these had been dealt with appropriately. Positive comments and compliments were also recorded. The people whom were visited had information about how to make a complaint and knew to phone the office if they had a problem. Nine out of the eleven people who completed comment cards knew how to make a complaint. The directors told us that they sent out quality monitoring letters once a year to people who used the service. Letters were sent out in March 2008 and a good response was received. We saw a report of the findings in graph format. People expressed a high level of satisfaction. Areas for development were identified including travel times between visits and notification to people of any changes. One of the people whom we visited said that people in the office had asked their views. The others had only received care for a few weeks so had not had chance to receive surveys. Lifeline Homecare Limited DS0000054141.V369875.R01.S.doc Version 5.2 Page 20
SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Domiciliary Care have been met and uses the following scale. 4 Standard Exceeded (Commendable) 3 Standard Met (No Shortfalls) 2 Standard Almost Met (Minor Shortfalls) 1 Standard Not Met (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 User Focused Services Managers and Staff Standard No Score Standard No Score 1 3 17 3 2 3 18 X 3 X 19 3 4 3 20 4 5 X 21 3 6 X Personal Care Organisation And Running Of The Business Standard No Score Standard No Score 7 3 22 3 8 3 23 X 9 X 24 X 10 2 25 X Protection Standard No Score 11 3 12 3 13 X 14 3 15 X 16 x 26 3 27 3 Lifeline Homecare Limited DS0000054141.V369875.R01.S.doc Version 5.2 Page 21
Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Domiciliary Care Regulations 2002 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action 1. DO10 14 (7) The registered person shall make arrangements for the recording, handling, safe keeping, safe administration and disposal of medicines used in the course of the provision of personal care to service users. 15/09/08 When carers assist people to take their medication they must make a record of each item of medication taken, the dose and the time taken. This was partly met on this inspection so has been carried forward from the last inspection. Lifeline Homecare Limited DS0000054141.V369875.R01.S.doc Version 5.2 Page 22
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 Good Practice Recommendations Standard 1. DO7 Care plans should be dated when they are written to show which information is up to date. 2. DO7 People should sign their care plans to show that they have been involved in developing them and are in agreement with them. 3. DO10 The medication risk assessments should be more detailed so that carers know how people need help with their medicines and where medicines are stored. 4. DO10 It would be good practice to record as required medication separately from regular medication so that it is clear which medicines are being given at which time. 5. DO12 It would be good practice to record the dates when equipment needs servicing and who is responsible for servicing to ensure people s safety. 6. DO12 Risk assessments should be signed by the person who develops them and dated so that it is clear that the information is up to date and it is easy to tell when they are due to be reviewed. Lifeline Homecare Limited DS0000054141.V369875.R01.S.doc Version 5.2 Page 23
Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA 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 Lifeline Homecare Limited DS0000054141.V369875.R01.S.doc Version 5.2 Page 24