Inspection on 29/02/08 for Milton Heights

This is the latest available inspection report for this service, carried out on 29th February 2008.

CSCI found this care home to be providing an Good 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.

Other inspections for this house

Milton Heights 12/01/06

Milton Heights 15/11/05

Milton Heights 14/03/05

Milton Heights 23/11/04

Milton Heights 28/01/04

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

CARE HOME ADULTS 18-65 Milton Heights Milton Abingdon Oxfordshire OX14 4EH Lead Inspector Delia Styles Unannounced Inspection 29th February 2008 14:20 Milton Heights DS0000013110.V358021.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 Milton Heights DS0000013110.V358021.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. Milton Heights DS0000013110.V358021.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Milton Heights Address Milton Abingdon Oxfordshire OX14 4EH 01235 831686 01235 821956 hftmilton@hft.org.uk www.hft.org.uk Home Farm Trust 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) Mrs Emma Pithers Care Home 39 Category(ies) of Learning disability (39), Learning disability over registration, with number 65 years of age (39) of places Milton Heights DS0000013110.V358021.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The total number of services users accommodated at any one time must not exceed 39. 25th May 2006 Date of last inspection Brief Description of the Service: Milton Heights is one of four registered homes in Oxfordshire managed by Home Farm Trust (HFT), a national voluntary organisation that provides care services for people with learning disabilities. There are seven houses and four flats at Milton Heights. These provide accommodation for groups of between three and nine people, with thirty-nine in total. The houses are set in a Close within large grounds. Local facilities in the nearby towns of Abingdon and Didcot are within easy reach and people are supported to access these by use of the house vehicles and public transport. A Day Resource Centre offers activities such as computers, cooking, photography and pottery. There is also a coffee shop and craft store and large organic garden with a greenhouse on site. Milton Heights provides a range of daytime activities, learning and work opportunities for the people who live here and for people living in the community. The fees for this service currently range from £618 to £1000 per week. Milton Heights DS0000013110.V358021.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 the people who use this service experience good quality outcomes. This is what we did when we were at the home. The visit lasted for just over 4 hours on a Friday afternoon. We met 3 people who live at one of the houses and they showed us around so that we could see their rooms. We asked them about what they like about living here. We looked at some of the policies and procedures in the office. Policies are rules about how to do things. Procedures tell people how to follow the rules. We talked to the manager, Emma Pithers, and a Team Leader and other staff about what sort of things the support workers do to help people to go to college and work, and have interesting things to do. Before we visited, Emma sent us lots of information about Milton Heights that told us about how it is run and how people are supported, and about things that are planned to help make things even better – such as service users making DVDs to show what kind of activities and work people do here, and helping more people to go out to work if they want to, We would like to say thank you for helping us to find out what you think about living at Milton Heights. What the service does well: Everyone who lives here has a ‘person centred plan’. This means that staff know each person well and how they like to be supported and the kinds of things they like to do. There are lots of things for people to do and they can choose different activities with the help of the staff in their house. Milton Heights is good at supporting people to go out to work if they want to. Service users get to talk about what they want to happen through meetings with their housemates, key worker, monthly service user meetings and Milton Heights ‘Parliament’. Staff make changes to the way things are run because they listen to what the service users say – such as putting on training courses in first aid for service users and starting a recycling group. Milton Heights DS0000013110.V358021.R01.S.doc Version 5.2 Page 6 The people who live here have their own rooms that are comfortable and clean and where they can choose the colours and furniture they want. There is lots of space outside to go for walks or runs and enjoy the garden. 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. Milton Heights DS0000013110.V358021.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 Milton Heights DS0000013110.V358021.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): 1 and 2 Quality in this outcome area is excellent. People’s individual needs and aspirations are fully assessed with the involvement of the individual and their family and advocates so that they can be confident that the home will support them in their chosen lifestyle. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is looking at ways of improving the Statement of Purpose and Service User Guide information for new service users and their families, through using technology – perhaps a computerised version and a DVD. We discussed the assessment process for two service users who have come to live at Milton Heights since the last inspection. Considerable efforts were taken to adapt the accommodation in one house to make sure that it would suit the person coming to live here and meet their specific needs and preferences. Home Farm Trust (HFT) has introduced a computerised assessment and recording tool – Support, Planning and Review System (SPARS) – to assist staff in the continuous process of assessment of needs and support for service users. Milton Heights DS0000013110.V358021.R01.S.doc Version 5.2 Page 9 Individuals’ assessments reflect the views of the service user, their family and friends and the sponsoring authority, for the type of support that will be needed. Prospective service users involve a number of visits – perhaps an invitation to dinner, overnight stay, or invitation to join the group in an activity - and if appropriate, a trial stay at the home. The views of service users already living in the house and the prospective service user are sought to make sure that they are compatible and feel that the new person will like Home Farm Trust. Milton Heights DS0000013110.V358021.R01.S.doc Version 5.2 Page 10 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): Standards 6, 7 and 9 Quality in this outcome area is good. Individuals are involved in decisions about their lives and play an active role in planning the care and support they receive so that they are in control of their lives and can make informed decisions. Staff support individuals to lead purposeful and independent lives and the person centred care plans accurately reflect the individual’s personal preferences and aspirations. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During this inspection there was a focus on two of the houses on site, and discussion with the Team Manager about supporting people living there. From the evidence seen and comments received, we consider that this service would be able to provide a service to meet the needs of individuals of various religious, racial or cultural needs. Milton Heights DS0000013110.V358021.R01.S.doc Version 5.2 Page 11 All service users have an individual Person Centred Plans (PCP), individual support Plans and/or Life stories, written in a variety of mediums. PCPs includes all aspects of service users’ lives including health, physical, social, emotional, spiritual and intellectual. The service users are at the centre of this process and are encouraged to explore new opportunites and develop skills and interests. Plans are reviewed, monitored and evaluated and updated to reflect changes in the individuals needs or wishes. Examination of one person’s assessment and Person Centred Plan (PCP) showed that this is an in-depth process and that the individual is supported with opportunities to try new leisure activities and meet new people. The main sections of the assessment plans are: Personal profile – a pen picture of the person and their preferred method of communication. Support needed with personal care Keeping healthy Looking after the home and tenancy Employment, College and Day Services Leisure and Hobbies Friendships and relationships Cultural and spiiritual needs Managing money and Dealing with Paperwork Support they will need in decision making Each section has a goal plan and risk assessments. The completed risk assessments cover a wide range of issues. Service users are encouraged to take risks to increase their skills and independence. This is done in a measured way to minimise risk without limiting opportunity. The organisation is currently reviewing the risk assessment process to incorporate the Mental Capacity Act legislation. The aim is to improve service users’ access and understanding of their PCPs by using new technology. For example, they plan to use DVD’s (to replace some of the paper based documents) and have purchased a photo-symbol global license to use so that staff are able to make documents more accessible to service users. Home Farm Trust has employed regional staff to promote and develop the use of ICT and multi media with service users. Service users are encouraged to have an active role in their homes. All are encouraged to get involved with decision making including choice of menus, décor, leisure activities and holidays. Staff support the process but encourage the service users to make the decisions. Service users are involved in a variety of ‘speak out’ groups that give them a voice in decision-making and issues within the wider community. There is a Milton Heights DS0000013110.V358021.R01.S.doc Version 5.2 Page 12 ‘Parliament’ group made up of a representative from each unit and day service users who give feed back between HFT and their units. Service user meetings are held approximately every 6 weeks and everyone is invited to discuss their likes and dislikes, and other topics of interest. One group has decided to taken on recycling for the site and ‘have now educated staff and their peers to become 80 efficient in waste recycling on site’. A service user discussion group has lobbied successfully to have traffic lights installed on the busy road nearby Milton Heights. As a result of service user feedback to their ‘Parliament’, HFT has offered certificated first aid training, organised by St Johns Ambulance, to all service users who wanted to take part. Milton Heights DS0000013110.V358021.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 Quality in this outcome area is excellent. People who live here are able to make choices about their life style and are supported to develop their skills and interests, so they enjoy a full and stimulating lifestyle. This judgement has been made using available evidence including a visit to this service. EVIDENCE: From information in the AQAA document, discussion with staff and observation on the day of the inspection it is evident that people living here are offered a wide range of choices about how they wish to spend their day. Service users have contributed ideas about what they would like day services to provide and the programme has been changed in response to peoples’ suggestions – for example discontinuing some less popular activities and starting a Ballroom Dancing Course and DVD group. Milton Heights DS0000013110.V358021.R01.S.doc Version 5.2 Page 14 Service users attend sessions they choose at day services and staff support them to attend non-day services based activities of their choice throughout the week, weekend and evenings. The information on activities and trips out to individual places of interest that people have requested, is put out in userfriendly formats with pictorial aids. The home has minibuses that can be used to transport people to local clubs and facilities, but some service users use public transport independently (subject to careful risk assessment). Several service users have elderly parents and staff drive service users to and from their family to maintain contact. Service users who wish to have paid work are supported to find a job. Some are introduced through an agency that supports them until they are able to work unaided, and others apply for work with staff support. Currently 12 individuals have found paid employment, 4 people work on a voluntary basis and 2 people have begun ‘micro-enterprises’ – selling their own art and craft work. A further 17 service users are able to have unpaid work experience through working in the coffee shop which is open to the public. HFT hope to expand the coffee shop work experience by getting it accredited as a training resource that will help service users gain experience that will help them get paid employment. Service users are supported to maintain a health balanced diet (they are given opportunities to shop and choose the meals that they eat). Vegetables are organically grown in the gardens. Food diaries are kept to record what people choose to eat. Milton Heights recently held a ‘Good Health/Healthy Eating Day at which service users were invited to sample food and drink, take part in games and quizzes and visit stalls, all with a healthy eating/good health theme. This involved local dentists, doctors, shops, hospitals, schools and other care professionals who gave visual aids, information and prizes. Milton Heights DS0000013110.V358021.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Quality in this outcome area is good. The people who live here receive the personal, physical and emotional support to the level they need and that meets their preferences. Service users are encouraged to manage their own healthcare and medication and are supported to access any NHS healthcare services needed, so that they stay healthy and well. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The service uses a ‘key worker’ system. The key worker is responsible for ensuring that service users’ support plans are kept up to date and ensures that all staff are aware of service users particular likes and needs and are aware of any changes. All aspects of personal care and support and health needs are incorporated into the support plan. This ensures that each individual is able to receive support in the way they wish. The support plan of a service user with considerable needs was looked at. It is very detailed and shows that the individual and their family had been very involved in drawing up the plan. Family members work in partnership with staff to ensure there is good communication and continuity of care for the individual when they go home for visits. Milton Heights DS0000013110.V358021.R01.S.doc Version 5.2 Page 16 Service users access local medical and health care facilities and are supported to do so. Specialist support , such as learning disability nurses, psychologists and psychiatrists are accessed when appropriate for the individual. All service users attend regular appointments to opticians, dentist and chiropodists as needed. Staff encourage service users to understand their health needs and to monitor their own health. A ‘well woman’ course, that informs and educates service users about female health issues is offered through day services. The manager said that they plan to develop ‘health action plans’ for each service user who would liked one and staff will have training about the impact of the Mental Capacity Act in relation to service users’ rights and decision making about their care. End of life plans will also be made, involving families and guardians, to clearly document service users’ wishes in the event of illness and death. They also plan to do more work around supporting service users and staff to deal with the illness or death of a service user. The service continues to anticipate the changing needs of service users and to work with local Primary Care Trusts (PCTs) and GPs to raise awareness of learning disabilities and voicing service users’ rights to all health services. Staff have had training about Ageing and Dementia, Mental Health Awareness and Autism. HFT has its own ‘Valuing Ageing’ network and service user representatives from Milton Heights are involved in this. Examination of a sample of the medication administration record (MAR) sheets showed that service users had taken their correct medication and the records are up to date. Staff sign the MAR charts after checking with the service user and/or supervising them when they take their medication. The house has clearly written policies and procedures about the storage and administration of medication. There are also printed information sheets with the MAR charts to inform staff about the purpose of each person’s medication. Staff training schedules and the sample of individual staff records seen showed that staff receive training from the supplying pharmacist and also from an external training organisation about safe management of medication. Milton Heights DS0000013110.V358021.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. People who use the service are able to express their concerns and know how to complain. The practices and procedures of the home and the organisation protect service users from abuse and exploitation. This judgement has been made using available evidence including a visit to this service. EVIDENCE: HFT has clear polices and procedures for complaints and ‘whistle blowing’ which have been made accessible to service users and staff by providing and explaining it in a user friendly format. The AQAA states that staff receive regular training in adult safeguarding issues (‘Abuse Awareness’) and this was verified from the sample of staff training records looked at. HFT has sound financial management systems in place that protect service users from financial exploitation or abuse. Managers receive training in all aspects of this and are monitored and supervised via area managers. HFT has internal audit inspections every year with detailed action plans which are implemented. The Team Manager for the house visited explained the safeguards and checks in place to make sure that any money and store/cash cards held on behalf of service users are acounted for. In conversation with service users and staff, it was apparent that service users are supported in their decision making and choices about how they spend their Milton Heights DS0000013110.V358021.R01.S.doc Version 5.2 Page 18 money – for example, saving up for their next holiday or visiting craft sales to buy items to add to their model collection. Service users have regular meetings, ‘speak out’ groups and are encouraged to say when theings are not right or they have any concerns. Each service user has a key worker who gets to know them very well and who is alert to pick up on any changes in their mood or behaviour that may indicate that they have a problem. The range of reported complaints showed that service users are confident in raising concerns and that these are fully investigated. Families are also encouraged to share any concerns or complaints and these are responded to by either the unit manager or the service manager. HFT regularly monitors complaints and how they are managed through their quality management and auditing tools. The manager provided a summary of the complaints and compliments received by the organisation from January 2007 to 2008. We discussed how the home has responded to the 9 complaints listed. There was evidence that complaints have been appropriately dealt with and resolved satisfactorily. No complainant has contacted the Commission with information concerning a complaint made to the service since the last inspection and we consider that the provider has met the regulations in relation to complaints. Milton Heights DS0000013110.V358021.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is good. The people who live here have safe, clean, well-maintained and comfortable homes that suit their individual lifestyles and preferences. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During this inspection two of the six independent houses were visited. A more detailed tour of one house included looking at two service users’ bedrooms (with their permission). It was evident that HFT works hard to make sure that people have a comfortable, clean and well-maintained home to live in. The ground floor lounge of one of the houses visited has been altered and a ground floor room with new en-suite bathroom installed to meet the needs of a service user who has come to live here since the last inspection. There were plans to replace a first floor toilet. Milton Heights DS0000013110.V358021.R01.S.doc Version 5.2 Page 20 Work was underway doing similar upgrading and improvements in other houses on the site. One has had a stair lift installed so that a service user with physical disability can access the first floor of their house. There is a two-year rotational decorating system and each person is involved in choosing the colour and layout of their bedroom and communal areas to suit their personal preferences. Service users are involved in keeping their houses clean and tidy in as much as they are able to, and have an agreed cleaning rota and staff support to maintain a good standard. Staff ensure that key safety checks, such fridge and freezer temperatures and hot water temperatures, are done and that perishable food is stored correctly and disposed of when ‘use by’ dates expire. Approved contractors carry out general repair and maintenance work. The manager stated in the AQAA that there are sometimes delays in getting maintenance work done because external contractors wait until there is a substantial amount of work to be undertaken, rather than doing jobs piecemeal in different houses. HFT is looking at ways of improving the process of maintenance and repairs. Milton Heights DS0000013110.V358021.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 Quality in this outcome area is good Support workers are appropriately trained and employed in sufficient numbers to support the people living here in a way that allows for flexibility and fits in with service users’ individual lifestyles. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A staff training matrix and record of supervision dates evidenced that there is a good programme of training and development in place for staff. The manager confirmed that all new staff have an induction pack that meets the Skills for Care (national approved training body) standards. Each staff member has an individual training plan that is developed and monitored through supervision and annual appraisal system. HFT has designed a ‘professional passport’ setting out what is expected within each person’s role through the use of a ‘capability’ matrix. Staff are offered the opportunity of completing a National Vocational Qualification (NVQ) once they have successfully completed their induction and probation. There are 52 permanent support staff and 29 relief support staff; Milton Heights DS0000013110.V358021.R01.S.doc Version 5.2 Page 22 34 out of the total of 81 have NVQ Level 2 or above and a further 7 are working towards an NVQ qualification. This means that the home should soon achieve the expected 50 percentage of staff who have an NVQ Level 2. One full time and 4 part-time staff have left since the last inspection - a low staff turn over. Stability in staffing numbers and skills means that service users and staff are able to build up a good rapport and there is continuity of support and development of new training programmes linked with service users’ changing needs. Staffing shift patterns are flexible so that staff are available to support service users in the different activities they want to do – for example, going out to evening and night clubs and day service staff running evening and weekend sessions. We looked at the recruitment and training files for 2 recently appointed support staff. These showed that the recruitment procedure is thorough and that the required pre-employment checks, references and selection process safeguard service users from unsuitable workers. The manager said that their plans for improvement include getting service users further involved in the recruitment and training of staff. Some service users have had training in interviewing and recruitment and the questions they want to ask have been incorporated into the interview schedule used for new staff. Service users also give their views about new staff members’ qualities/skills over their 6-month probation period and then annually as part of their annual appraisal. The homes own record of compliments included 4 from families of service users, praising the staff for their standard of care and support. For example, how well staff have supported a service user’s transition from family to residential care and are continuing to support that individual in further changes and independent living. Milton Heights DS0000013110.V358021.R01.S.doc Version 5.2 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Quality in this outcome area is good. The service is well managed by a competent person and a staff team who listen and act on the views of service users, so that all work together to improve the quality of life for the people living here. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager has the required qualifications and experience, is highly competent to run the home and meet its stated aims and objectives. The manager has sound knowledge of both strategic, and financial planning and review, and manages the service efficiently. The manager is visionary in her approach to the service and is able to demonstrate through formal qualification, experience and ability that she is highly competent in the following areas: care of people with a learning disability and older people with Milton Heights DS0000013110.V358021.R01.S.doc Version 5.2 Page 24 a learning disability, quality assurance systems, equal opportunity issues, development and implementation of the services policies and procedures, good people skills, strong leadership of staff (which leads to confident workers), responds to need and provides an excellent role model. She has a strong ethos of being open and transparent in all areas of running of the home and is aware of current developments both nationally and by CSCI and plans the service accordingly. Although one registration, Milton Heights comprises six houses and four flats. Each house has a dedicated Team Manager and staff team. The Team Managers, deputy manager (on sick leave at the time of the inspection) and manager meet together fortnightly to make sure that everyone is kept informed about the running of the service. Team Managers have undertaken the Registered Managers Award and so have a good understanding of, and ability to manage the service in the absence of the registered manager. A review of the registration and registered manager’s role has been requested by HFT and the Commission will consider their proposal to have more than one ‘registered’ manager on site. An HFT service manager does monthly ‘Regulation 26’ provider visits to get service users’ views about their homes and any improvements they would like. HFT has recently reviewed its quality assurance (QA) system – ‘to be more person-centred’ using key quality of life indicators that indicate how well it is meeting peoples needs through: ‘Care, Consultation, Communication, Opportunity, Respect and Empowerment’. In addition, HFT carries out an indepth quality review of a particular individual takes place – there are two of these per service each year. There was evidence that the organisation has comprehensive policies and guidelines in place to ensure the safety ad wellbeing of residents. The annual audit and report of each service carried out by HFT’s Health and Safety manager highlights actions and recommendations that are to be carried out. The requirement made at the last inspection in relation to carrying out health and safety requirements (made in HFT’s last health and safety audit) has been met. Milton Heights DS0000013110.V358021.R01.S.doc Version 5.2 Page 25 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 3 2 4 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 4 13 3 14 X 15 4 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Milton Heights DS0000013110.V358021.R01.S.doc Version 5.2 Page 26 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Milton Heights DS0000013110.V358021.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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. 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