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Inspection on 26/11/08 for Lilliputs Farmhouse

Also see our care home review for Lilliputs Farmhouse for more information

This is the latest available inspection report for this service, carried out on 26th November 2008.

CSCI found this care home to be providing an Excellent service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Lilliputs Farmhouse Lilliputs Farmhouse Wingletye Lane Hornchurch Essex RM11 3BL three star excellent service The quality rating for this care home is: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Jackie Date Date: 2 6 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Internet address www.csci.org.uk Information about the care home Name of care home: Address: Lilliputs Farmhouse Lilliputs Farmhouse Wingletye Lane Hornchurch Essex RM11 3BL 01708620949 TBA info@cmg-corporate.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Care Management Group Ltd Name of registered manager (if applicable) Mr David Ward Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 6 0 care home 6 learning disability Additional conditions: Date of last inspection 0 9 0 1 2 0 0 7 A bit about the care home Lilliputs Farmhouse is a care home for six adults who have learning disabilities.It is in Hornchurch and shares the site with three homes for children with learning disabilities. All four homes are owned and run by Care Management Group (CMG), a private company. The Farmhouse is a 17th Century listed building and is decorated and furnished to a good standard. The six single bedrooms are all large, with two on the ground floor and four on the upper floor. People have ensuite facilities or their own bathroom. The lounge, quiet room, kitchen, dining room, laundry and small office are on the ground floor. There is also a large conservatory with access to the garden. People have free access to an activity centre on the site, which has a swimming pool, gym, soft play area and well equipped teaching rooms for such things as art, cookery and music. The home has its own car and can use a shared minibus. People living at Lilliputs have busy lives and as well as using the onsite facilities they also go to day centres, college and other community activities. Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing C onduct and management of the home How we did our inspection: This is what the inspector did when they were at the care home The last inspection of this service was on 9th January 2007. This inspection was unannounced and took place over eight hours. This was a key inspection and all of the key inspection standards were tested. Staff were asked about the care that people using the service received and were observed carrying out their duties. People using the service were asked to give their views on the service and their experience of living in the home. All of the shared areas and bedrooms were seen. Staff, care and other records were checked. The inspector was joined for part of the visit by an Expert by Experience who was accompanied by a support worker. The Expert by Experience had a look around the home and spent time talking to staff and the people living there. He then gave feedback to the manager. Comments from his report have been included in this report. Feedback questionnaires were sent to people who use the service, staff, social workers and health care professionals. Feedback was received from all of the people living at Lilliputs and five staff. A relative also provided verbal feedback. Services are now required to complete an AQAA (Annual Quality Assurance Assessment) and the completed form was received in October 2008. Information providing in this document also formed part of the overall inspection. The inspector would like to thank the people living at Lilliputs, the staff and the expert by experience for their input during the inspection. What the care home does well Feedback received about the service at Lilliputs was very positive. People living there said, I like staying in this home and have the choice of things to do and places to go. I do not want any changes and would like to continue living here. A relative said, were absolutely delighted with the service, our daughter has a full life. A healthcare professional said, staff show dedication, professionalism and a positive attitude. Excellent work. The expert by experience said, the residents are in a relaxed environment where there are choices, independence, dignity and respect. Staff members are helpful, nice, friendly and supportive. They speak nicely to residents. This is a lovely residential home and is highly commended. People living at Lilliputs are supported to be part of the local community and activities are flexible and varied to suit the differing needs of people that live there, together with their religious cultural and social preferences. People living at Lilliputs receive good personal and healthcare support. Staff work closely with other professionals to support people in whatever way they need. The home is very well managed and organised and is run in the best interests of those living there. People are supported by a fairly stable staff team that know them well and that work together to provide a good consistent service. What has got better from the last inspection What the care home could do better The service continues to grow and develop and staff support people to be as independent as possible. Staff are committed to this and are aware of improvements that they intend to make. If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Jackie Date Caledonia House 223 Pentonville Road London N1 9NG 0207 239 0330 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line - 0870 240 7535 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The Statement of Purpose and Service User Guide provides people with all the information they need to make an informed choice about whether they wish to live in the home. The assessments completed by the home mean that staff have detailed information to enable them to determine whether or not the home can meet a persons needs. Evidence: Standards 1, 2, 3, 4 & 5 were tested. There is a Statement of Purpose and a Service Users Guide. The Service User Guide is available in an user-friendly format using symbols and pictures to assist people to understand it. All of the people living in the home moved in when it first opened approximately five years ago and have lived together ever since. Therefore there has not been any new admissions since the last inspection. The organisation does have a comprehensive assessment process that would be used in the event of any new person wishing to move into the home. The files seen contained detailed assessment information that was gathered when people first moved in. They also contained information about how people were supported to move into the home and this included visits and structured transition. Therefore the service obtained the necessary information about an individuals needs before they offered a service to them. Additionally people received information that helped them to decide if they wanted to use the service. Each person has a contract/terms and conditions of residence and copies of these were Evidence: seen in individual files. Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People living at Lilliputs are involved, as far as they are able, in developing and reviewing their care plans and these provide staff with the information they need to meet individual needs. The risk assessments are appropriate and people are supported to take risks according to their needs and to have the opportunity to try things and develop their skills as safely as possible. People are encouraged and supported to be involved in decisions about what they do and what happens in their home. Their opinions are valued and listened to. Evidence: Standards 6, 7, 8, 9 in 10 were tested. Each person has a care plan and these contain information about them and the support they need. The records of three people were checked. Some people had signed their care plans, others were not able to do this. Plans are used on a daily basis to assist staff and to ensure that peoples needs and wishes are complied with. Care plans are regularly reviewed and updated. Key workers have monthly meetings with people who use the service. The outcomes of these meetings are recorded and give clear information about what has been discussed and what has been agreed. They also contain information about how things have been explained to people and how feedback has been sought. For example using symbols, vocal sounds and in one case a digital photo frame. The files contained pen portraits of each person, what they did, their likes and dislikes. All of the necessary areas were covered. The information in the care Evidence: plans is very clear and detailed and easy to follow. Any new member of staff would easily be able to support an individual using the information in the plans. The information shows that staff have a good knowledge of peoples individual needs and of how to meet them. The staff team are gradually changing the format of the care plans into PCPs (Person Centred Plans). In the care plans that have already been changed the information is available in a more user-friendly format with photographs and pictorial representations. Daily notes are kept for each person. This includes what they have done and how they have been. Risk assessments are in place. These identify risks to people and indicate ways in which the risk can be reduced to enable people to be supported as safely as possible. The risk assessments seen were up-to-date and covered areas that were relevant to each individual and the activities that they do. Peoples records and other information are securely stored in the office and staff are aware of issues of confidentiality. Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People are encouraged to be as independent as possible, to take part in activities and be part of the community and this exceeds minimum standards. People are supported to keep in contact with relatives and visitors are made welcome at the home. People have meals that they have chosen, like, and that meet their needs and preferences. Evidence: Standards. 11, 12, 13, 14, 15, 16 and 17 were tested. People living at Lilliputs have planned and scheduled activities and this includes evening activities. Each person has an individual activity chart. These are displayed in their bedrooms and are in a picture format to help each person to understand them. The organisation also has a day centre on the same site as the residential home and people living at Lilliputs have access to all the facilities there. This includes a sensory room, a soft room, a gym and a swimming pool. People can also do arts and crafts and music there. One person said that he went to college to do music, computers and english. Another person said that she enjoyed her activities and that she liked college. A third person told the expert by experience that he likes staying in this home, he has a choice of things to do and places to go. He also said that he used taxis or buses when he went out. One person talked about a holiday in Blackpool and another about Evidence: holiday in Spain. There are lots of photographs around the home of activities and holidays and celebrations. A member of staff said, there are a good range of activities, holidays and trips. A relative said, my daughter does lots of things, she goes to the day centre and also has a great programme of activities when shes not there. I feel that she leads a full life. People are supported to meet their cultural and religious needs if they so wish. One person does not practise their religion and this is clearly recorded. Another person is supported to go to church each Sunday to meet his family and then to go to his family home for dinner. Celebrations are organised for birthdays, Christmas, Easter, Halloween and any other relevant event. Families and friends are invited to these and again there are pictures around the home of these events. A relative said, there is good communication with the home and we have a good rapport with the staff team. The expert by experience said, the staff members are helpful, nice and friendly and we were warmly welcomed. Residents meetings are held and minutes show that people are involved in decisions about developments in the home. The expert by experience said that when he was interviewing one person the member of staff did not respond on their behalf but prompted them to help them answer. People are also supported to help with the day-to-day running of the home and to develop their skills as far as possible. There are photographs of people doing things in the home such as making tea, doing the ironing and making toast. One person offered to make a cup of tea when she came home from college and later helped a member of staff to cook the evening meal. Individual plans give information about mealtimes. This includes what people can do, for example prepare a drink or a simple snack. Also what food people like. For example one person likes ring biscuits but doesnt like currants or raisins. Records are kept of what a person has had to eat and the record seen showed a variety of food including fruit and vegetables. The expert by experience said that residents are in a relaxed environment where there are choices, independence, dignity and respect. Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People who use the service receive personal care that meets their needs and preferences. People who use the service are supported to receive the health care that they need and to remain as healthy as possible. Evidence: Standard 18, 19 and 20 were tested. People who live at Lilliputs all need support with their personal care and information about this can be found in individual care plans. Everybody was clean and smartly dressed and their personal hygiene guidelines were in place. These include what the person likes, what the person can do and what support they need. For example, one person has a shower in the morning but enjoys a bath occasionally. Another person needs to be reminded to put on deodorant. Care plans also stress that people should be encouraged to choose their own clothing and be supported and guided to dress appropriately. There is a mixed staff team and people are usually able to have same gender support with personal care. Each person is registered with the local GP and receives specialist input as and when required. This includes input from a speech therapist, physiotherapist and community nurses. Feedback was seen from a challenging behaviour nurse and this congratulated the staff team on the work that they had done with one person living there. Care plans contain sections on oral hygiene and each person has a completed my health booklet. Each person has a medical file and this includes a record of any medical appointments and their outcome. This confirmed visits to the psychiatrist, doctor, dentist and optician. The staff team take this file when they support people for any medical Evidence: appointments so that they have all the information needed and can answer any questions quickly. Good records are kept of any health issues. Records are kept of seizures and when appropriate, bowel movements. Due to complex behaviour some people do at times have unexplained bruises or grazes. These are all clearly documented and the manager reads and signs all of the records relating to these. It is recommended that the manager includes more information on the record sheets to clarify why he is satisfied that these unexplained marks are not any cause for concern. The manager and deputy were able to verbally tell us this but it does need to be recorded. There are policies and procedures for handling and recording medication. Medication is stored in an appropriate locked metal trolley which is chained to the wall. None of the people living at the home are able to self medicate and medication is administered by staff that have been trained to do this. Staff authorised to administer medication have received training from the pharmacist and in addition to this the manager and deputy assess staffs capability in this area. Most medication is administered via a monitored dosage system. In the medication trolley there are separate shelves for each persons medication. The medication records were all up to date and appropriately completed. The staff team have received updated epilepsy training and have also been trained to administer rectal Valium and Buccal Midazolam as some people living at the home are prescribed these for severe epilepsy. There are protocols in place for when and how they should be administered. Therefore the systems for the administration and recording of medication are robust and do safeguard people living at the home. Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People living at Lilliputs are safeguarded by the working practices at the home and by the support of the staff team. Evidence: Standards 22 and 23 were tested. There is a user-friendly complaints procedure on display at the home and this has photographs and symbols. Information on how to make a complaint is readily available. This includes a simple guide showing pictures and symbols in the service user guide, with a copy in each persons file. There is also a complaints procedure giving details of the companys commitment to take complaints seriously and to respond within set timescales. There had not been any recorded complaints. The expert by experience observed that the staff speak nicely to residents. He also stated that residents are in a relaxed environment where there are choices, independence, dignity and respect. A relative said, my daughter always goes back to the home happily. If there was anything wrong she could and would tell me. All staff have received safeguarding training and there is a policy and procedure with regard to this. Staff spoken to were aware of safeguarding issues and the organisation had developed an easy read say no to abuse guide. This explains in simple terms what abuse is and who can help. This is due to be distributed and explained to people in the very near future. None of the people living at Lilliputs are able to manage their own finances. Some peoples finances are dealt with by a corporate appointee from the organisation. Other people are supported by their families. One person has got a bank account and he goes with staff to withdraw cash. Records are kept of financial transactions and receipts are obtained as far as possible. The cash held for three people was checked and these were found to be correct. The are two safes at the home. One can only be accessed by the manager or deputy and this contains the bulk of peoples monies. There is another safe where small amounts of cash are kept for each person so that Evidence: staff can access these when needed. There was evidence that the manager or deputy checks the cash held. In addition a sample of finances are checked as part of the monthly monitoring visits and also a representative from the organisation has carried out a financial audit. Therefore systems are in place to safeguard peoples finances. Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People live in a clean and comfortable home and has lots of facilities and that is suitable for their needs. Evidence: Standards 24, 25, 26, 27, 28 and 30 were tested. Lilliputs farmhouse is a 17th-century listed building set in extensive grounds. There are six single bedrooms, some of which are on the ground floor. People living there either have ensuite facilities or their own bathroom. Everywhere was clean and appropriately decorated with good-quality furniture. All of the bedrooms were different and personalised to suit the individuals likes and choices. One person told the expert that he chose his bedroom decoration. In the bedrooms there are TVs, computers and one person has a keyboard that he likes to play. There is a large conservatory, lounge, dining room, kitchen and laundry area. There is also a large garden with a trampoline, swings and garden furniture. The expert by experience said that this is a lovely residential home situated on farmland. He also said that the environment is generally neat and tidy and the garden is well tended. On the same site there is a day centre which people have access to. The day centre has a gym, swimming pool, music room, sensory room and soft play area. There is not a lift in the home and although some people use wheelchairs when out in the community they are able to move around the home with support from staff. Those with mobility problems have ground floor bedrooms. The expert by experience observed that the signpost leading to the home was not informative or large enough and advised that this should be looked into. Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People who live at Lilliputs are supported by a consistent staff team who know them well and who are committed to provide a very good quality service that meets individual needs. People who use the service are supported and protected by the recruitment practices of the service. Staff have the opportunity collectively and individually to discuss their own development or any problems and developments within the service and feel supported by the manager. Evidence: Standards 31, 32, 33, 34, 35 and 36 were tested. From the rota and discussions with staff it was evident that people are supported by a regular staff team that know them well. A relative said that there is a stable staff team and that the family have a good rapport with staff. Most of the staff team have completed NVQ level 2 or above. Records are kept of staff training and show that staff receive the training needed to meet the needs of people living at Lilliputs. This training included induction, health and safety, fire, first aid, food hygiene, protection of vulnerable adults, sexuality, moving and handling and medication. Staff have also received specialised training to enable them to administer the appropriate medication when people have severe seizures. A member of staff said that staff are catered for in terms of training. Records also confirm that staff have regular supervision and appraisal and that staff meetings are held. Staff confirmed that they had regular supervision and also the opportunity to discuss any concerns with the management team. A member of the bank staff said that he also gets access to training and supervision and that the frequency of supervision increased when he was working at the home more regularly. Staff therefore have an opportunity individually and Evidence: collectively to discuss issues, concerns and the development of the service. There are usually four staff on duty between 7 a.m. and 7 p.m. and this includes oneto-one support for two people. At night there are two waking staff. At weekends some people go home so there are usually less staff on duty. All of the staff spoken to said that they felt there was sufficient staff on duty to meet peoples needs. They also said that there was a good staff team. Staff files seen contained the required information to demonstrate that staff had been appropriately recruited. This included application forms, appropriate references, interview questions and details of CRB (Criminal Records Bureau) and POVA (Protection of Vulnerable Adults) checks. Feedback received was very positive about the staff team. A relative said that staff do a fantastic job, not only looking after her daughter but encouraging her to realise her full potential. Feedback from a health care professional was that staff do excellent work, they show dedication, professionalism and a positive attitude. The expert by experience said that staff are doing a brilliant job. He also said that staff are helpful, nice, friendly and supportive and that they speak nicely to residents. Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People living at Lilliputs benefit from a service that is very well managed and organised and where their opinions are sought and acted upon as far as possible. They live in a safe home. Evidence: Standard 37, 38, 39 and 42 were tested. The registered manager holds the RMA (Registered Managers Award) and NVQ level 4 in care. He has many years experience in both public service and the care field. In addition the deputy manager holds NVQ level 3 in care and also has many years experience in all aspects of care work. Therefore the management team are appropriately qualified and experienced to manage this service. From discussions, records, feedback and observations on the day, it was very evident that staff and the people living at Lilliputs are very involved in decisions about what happens at the home and that the manager listens and values their input. The quality of the service provided is monitored by the manager and deputy and also by the organisation. A representative of the organisation visits the home regularly and carries out monitoring visits and then writes a report. In these reports appropriate issues had been identified and addressed. Financial audits also take place. Monthly residents meetings are held and also key workers meet people monthly. Information from these meetings is used to plan and develop the service. Feedback from staff was that they get a lot of support and that the manager and deputy are always around for advice and support. A member of staff said that the deputy and manager are very approachable and easy to talk to. Another member of staff said that management is excellent. Other staff said that the manager is approachable and gives praise and Evidence: encouragement to staff. The manager provides an excellent role model to staff and is aware of issues of equality and diversity, human rights and person centered thinking. Record-keeping is of a high standard and the working practices in the home are safe. A variety of methods of communication are used to support people to express their views as far as they are able. The expert by experience said that Lilliputs is highly commended. The necessary health and safety checks are carried out and records are kept of these checks. These records were up-to-date and accurate. A safe environment is provided to the people living there. Are there any outstanding requirements from the last inspection? Yes  No  Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No Standard Regulation Requirement Timescale for action Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No Standard Regulation Description Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set No Standard Regulation Description Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 19 It is recommended that the manager includes more detailed information in incident/accident reports to clarify why he is satisfied that any injuries however minor are accidental or self inflicted. This will help to demonstrate that people are robustly safeguarded. Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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