Inspection on 22/12/08 for Piper House

This is the latest available inspection report for this service, carried out on 22nd December 2008.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Piper House 24/10/06

Piper House 11/01/06

Piper House 27/06/05

Piper House 31/01/05

Piper House 30/08/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

Extracts from inspection reports are licensed from CQC, this page was updated on 27/02/2009.

CARE HOME ADULTS 18-65 Piper House 2B St Mark`s Road London W11 1RQ Lead Inspector Sheila Lycholit Unannounced Inspection 22 December 2008 10:45 nd Piper House DS0000035201.V373140.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 Piper House DS0000035201.V373140.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. Piper House DS0000035201.V373140.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Piper House Address 2B St Mark`s Road London W11 1RQ 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) 020 7229 7623 MICHAEL.DOWNEY@RBKC.GOV.UK Royal Borough of Kensington & Chelsea Michael Anthony Downey Care Home 12 Category(ies) of Learning disability (12) registration, with number of places Piper House DS0000035201.V373140.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care Home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: 2. Learning disability - Code LD The maximum number of service users who can be accommodated is: 12 17th September 2007 Date of last inspection Brief Description of the Service: Piper House is a residential home for 12 people with learning disabilities, situated in a residential area of North Kensington with good access to transport and other services. The service is provided by the Royal Borough of Kensington and Chelsea. Six service users are accommodated in flat B on the ground floor, which is adapted for people with restricted mobility. Six people, who are more independent, live in flat C on the first floor. Each flat has 6 single bedrooms, a sitting room, kitchen/dining area and bathrooms and lavatories. The main office and a large communal room are on the ground floor. The residents of flat B have access to a garden and patio area. The building is not accessible for wheelchair use above the ground floor. Piper House DS0000035201.V373140.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 assessed as 2 stars. This means that the people who receive this service experience good outcomes. The unannounced visit took place on Monday 22nd December 2008 from 10.45am until 6.30pm. The Manager was on duty, after covering the sleepingin shift the night before, and made himself available throughout the inspection. The Team Leader for Flat B was on duty with 3 staff and there were 2 support workers in Flat C. The Team Leader for Flat C came on duty at 2 pm for the late shift. Some residents were at home, while others were at day services, returning later. Two residents in Flat C went on a planned trip to a West End theatre in the afternoon. There were two vacant places at the time of the inspection, one in each flat. The Manager had completed an annual quality assurance assessment (AQAA) in detail prior to the inspection. The Inspector was shown around the flats by the Team Leaders, meeting with residents and staff. One resident showed the Inspector his room. What the service does well: What has improved since the last inspection? Considerable work has taken place to involve residents further in their care planning, in day to day decision making and in the life of the home, through the increased use of multi-media. Care plans/PCPs are close to completion in flat C for all residents, which are in an accessible format. Imaginative use of photos and illustrations has assisted one resident in keeping to a diet. New contracts have been produced for each resident. Piper House DS0000035201.V373140.R01.S.doc Version 5.2 Page 6 One resident who has expressed a wish to move to more independent accommodation is being supported to transfer to a nearby project. A carefully produced transition plan is in place. The activities programme has developed further, with excellent use made of local services. The use of local advocacy services for residents, both individually and as a group, has become well established. Following a number of medication errors, the medication policy and procedure has been reviewed and a more thorough induction for handling medication implemented for agency and temporary staff. Outline plans for the refurbishment of the building have been commissioned, which will provide residents with more independent and accessible facilities. The proposals are awaiting approval by Elected Members, following which a programme of consultation will be started. 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. Piper House DS0000035201.V373140.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 Piper House DS0000035201.V373140.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 and 5 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. A sound assessment and admission procedure is in place. Clearly designed contracts are available for existing residents. EVIDENCE: Staff were undertaking an assessment of one prospective resident, whose possible admission was at an early stage. A range of background information had been obtained from the Social Worker and previous placement. In addition, records and discussion show that staff were making an assessment as to whether the service was able to meet the prospective resident’s needs and the likely impact of her admission on other residents in the flat. Home visits with the prospective resident and her family had taken place and visits to Piper House were being arranged as part of a planned introduction to the service. Since the last inspection new contracts have been issued to residents, which are in an accessible format. Copies were seen on individual files. Piper House DS0000035201.V373140.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Considerable progress has been made in developing more accessible formats for care plans/PCPs. Residents receive good support to make decisions and choices and to take part in the life of the home. EVIDENCE: The individual files for 2 residents in flat B and pictorial care plans/PCPs and risk assessments for all residents in flat C were looked at. Daily notes for all residents in flat B were also seen. Each of the resident’s files in flat B contained copies of recent reviews, including detailed notes prepared by staff for the meetings. Recording of reviews is of a good standard, in particular the resident’s participation in the review is noted in detail. Review decisions are recorded in a partially accessible format. The Manager explained that multi media are used to support residents to participate in their review, for example DVDs. Staff in flat C have developed PCPs using photos, symbols and illustrations. These are completed for 3 out of the 5 residents, with the remaining 2 plans Piper House DS0000035201.V373140.R01.S.doc Version 5.2 Page 10 partially completed. The completed plans illustrate residents’ lifestyles and aspirations, as well as providing information about personal care, medication, activities and contact with friends and relatives. Discussion with staff and records show that residents are supported to make decisions about their lives, with the involvement of families, friends and advocacy services where necessary. For example one resident had just returned from a successful weekend at more independent accommodation nearby. He is in the process of trying out the new living arrangements, having consistently expressed a wish to move elsewhere. The advocacy service, as well as Piper House staff, are assisting him with the transition. Regular meetings are held in each flat, at which residents choose the menus and discuss other issues affecting the group. In addition, residents take part in quality review meetings, with the involvement of the advocacy service. A schedule for the meetings and agendas are displayed in an accessible format in the reception area. Risk assessments seen were up to date and were generally comprehensive. No risk assessments were available regarding residents being left alone in the flats, which staff confirmed can occasionally happen for relatively short periods. Risk assessments should indicate how the resident would summon assistance, if left alone. Piper House DS0000035201.V373140.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16 and 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are supported to take part in a wide range of community based activities in line with their interests. Friendships are well supported and good relationships are maintained with families and carers. A programme of healthy eating is encouraged. EVIDENCE: Records, including care plans, and photos on file and around the building show that all residents participate in a variety of social, leisure and community based activities. The majority of residents take part in some aspects of the programme operated by the Borough’s day centre, which is across the road. Some activities are on site, while others take place at a variety of venues in West London. A photographic record of residents participating in workshops, visits to places of interest and in leisure pursuits compiled by Scope’s staff were seen on file. One resident works at a café project in Chelsea and another assists one day a week at one of the Council offices. Access to a local gym has encouraged some residents to become more active. Piper House DS0000035201.V373140.R01.S.doc Version 5.2 Page 12 All residents have an annual holiday, with staff support. Holidays are arranged individually or in a small group, according to residents’ wishes. Residents regularly go to the cinema and to the theatre, as well as visiting the local pubs and cafes in North Kensington. Two residents were going to see The Sound of Music in the West End on the day of the inspection. Records and discussion with staff confirm that residents are encouraged to try new activities and to attempt to fulfil long-held ambitions. One resident has recently won a prize in a photographic competition, which has encouraged him to continue with this new interest. Good communication is maintained with relatives and friends, including those who live abroad and are only able to visit infrequently. Friendships are supported in line with residents’ perceived wishes and appropriate boundaries established where residents are unable to clearly assert themselves. Staff, with the encouragement of the Community Matron, have been encouraging a programme of healthy eating and increased physical activity. Good use has been made of pictorial images to support one resident in reducing his intake of ‘junk’ food. Staff report that he has lost weight and gained more confidence as a result of participating in the agreement to limit unhealthy food and drinks. Menus are decided by residents at their meeting in each flat and menus displayed in a pictorial format. The evening meal was being prepared from fresh ingredients in flat C on the day of the inspection. Staff were supporting residents with the cooking. Fresh fruit and vegetables were available. Where there are concerns, residents’ weight is checked monthly and recorded. Staff in flat B have received training in the prevention of choking, after one resident was noticed to be having difficulty in swallowing. Up to date guidance provided by the Speech and Language therapist regarding support with eating and drinking for this resident is on file. Piper House DS0000035201.V373140.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 and 21 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Staff have detailed knowledge of residents’ personal care needs. Health care is given a high priority, with good relationships established with health care colleagues. Steps have been taken to improve the handling of medication following a number of errors. The serious illness and unexpected death of two long-standing residents have been managed with compassion and sensitivity. EVIDENCE: Individual records show that staff have a detailed knowledge of residents’ personal care needs and of how they wish to be supported. Staff are observant regarding any changes in a person’s condition, in particular those residents who communicate non-verbally. Annual health check forms are well completed. The Manager commented on the good support received from health care colleagues, in particular the Community Matron, who has been introducing preventative health care. Concerns about the deteriorating health of some residents have been followed up promptly, by referral to the GP and hospital Consultant. An increased number of falls experienced by one resident has been investigated and steps Piper House DS0000035201.V373140.R01.S.doc Version 5.2 Page 14 taken to reduce the risk of reoccurrence. Records show that attention is paid to oral health care, with regular dental treatment, usually at St Charles Hospital and visits by the Hygienist. The medication policy and procedures have been reviewed following a number of medication errors. A new induction for agency and temporary staff has been introduced, which covers the same competency training given to permanent staff, including observation of administering medication on 3 occasions. The Team Leader in flat C has changed the flat’s medication to a monitored dosage system, supplied by a local Pharmacy, which she reports staff are finding easier to administer. All recent MAR sheets were seen and were up to date, with no gaps. The medication for a resident who had been away for the weekend was carefully handled. However the new medication policy and procedures need to cover ‘leave’ medication, including residents taking medication at day services, when staying with families and friends and on holiday. The storage of medication and MAR sheets for 2 residents who had complex medication regimes, were looked on in flat B. There were gaps for the administration of eye drops on one MAR sheet, though the Team Leader was sure they had been given. A member of staff had used Tippex to correct an error. The Manager and Team Leader confirmed that staff had been reminded about not using Tippex on MAR sheets. No external refresher training has been arranged for staff, though the Manager said that he plans to arrange training in the New Year. The new medication policy and procedure has been developed with the Service Manager and staff. While generally clear and comprehensive the following areas need to be included: ‘leave’ medication as discussed above; the recording of medication prescribed ‘as required’ (PRN), to include a note on the back of the MAR sheet giving the reason for administration; disguised or covert medication, which is referred to but needs to be covered in more detail, in line with current guidance; the storage and handling of controlled drugs, although none are currently in use. It is recommended that consideration is given to installing a controlled dugs cabinet that meets the required standard and to providing a separate medicine fridge. Since the last inspection in September 2007, two residents have died. One person died following a long illness during which he received excellent end of life care from staff and from the Palliative Care Team. Staff and residents were still recovering from the shock of the recent unexpected death of a resident in flat B who at lived at Piper House for many years. Staff and some residents had attended her funeral, which was carried out in line with her religious beliefs. Photos of the late resident were in evidence throughout the flat and staff said that her room had been left open so that residents could go into the room and spend time with their memories of her. Piper House DS0000035201.V373140.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents at Piper House receive good support to express their views from staff and from local advocacy services. Policies and procedures to safeguard residents are in place. EVIDENCE: There have been no formal complaints since the last inspection. Residents are encouraged to raise any concerns with staff, at residents meetings and at the Quality Action meetings, which are attended by staff from the local advocacy service. The Manager said that he is looking at ways of quantifying lower level complaints, for example inter-resident disputes, which are currently noted elsewhere. A number of residents attend assertiveness groups and events, such as those organised by Equal People. Information about making a complaint is displayed in the flats, in an accessible format, with photos of the relevant managers. The Service Manager visits regularly and meets with residents to hear their views about the service. Two safeguarding strategy meetings have taken place since the last inspection. Training records show that all staff receive training in safeguarding adults, with copies of the local multi agency policy and procedures available in the home. Incidents are carefully recorded and body charts used to note any marks or bruising. Piper House DS0000035201.V373140.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 27, 28 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Piper House is well located, close to shops, public transport and local services. The current building has a number of short-comings that cannot be remedied without major alterations. Plans are well advanced for the refurbishment of the building, which will provide a higher standard of accommodation for residents. EVIDENCE: A feasibility study to provide updated facilities for all residents has been completed and proposals are being put to Elected Members early in the New Year. If accepted, the proposals would provide residents with a fully accessible building and self-contained accommodation with en suite bathrooms. One resident showed the Inspector his bedroom, which has a large number of personal possessions, well displayed. The outlook and light in the room has been improved by the cutting back of some overhanging branches. Replacement and renewal of equipment has continued to take place, including a new hob and work- tops in the kitchen in flat C and replacement of flooring in some bedrooms. The skylight in one of the bathrooms in flat B has been Piper House DS0000035201.V373140.R01.S.doc Version 5.2 Page 17 covered over, which while not particularly decorative, has made the bathroom warmer. Work was taking place to install a washing machine with sluicing facilities in flat C at the time of the inspection. No further requirements are made in this report regarding the building, in view of the progress made in the planned refurbishment/remodelling. The building was clean and tidy at this unannounced visit. Piper House DS0000035201.V373140.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The staff team is experienced and qualified, with generally low levels of turnover. Staff have access to a comprehensive training programme and receive good support from senior staff. EVIDENCE: Piper House has had a good record of retaining staff, which provides consistency for residents. The Manager notes that 6 staff have worked at the home for more than 10 years. Unusually, at the time of the inspection flat B had 4 vacancies, which was putting pressure on permanent staff. The vacant posts had been advertised and two staff offered positions but for various reasons, neither took up the post. Staffing in flat B was also affected by the unavailability of two regular agency staff who had been covering vacant shifts. The Manager said that the posts would be re-advertised in the New Year. Flat C had one 18 hour vacancy. Recruitment is undertaken with the Borough’s HR team, who carry out all checks, including CRB checks. Residents in flat C take part in the recruitment process by meeting with candidates. Piper House DS0000035201.V373140.R01.S.doc Version 5.2 Page 19 Records show that staff have attended a wide range of relevant training over the past year, including NVQ level 3, using multi media, nutrition and the Mental Capacity Act. All permanent staff have an annual performance review. Good communication and support is provided through regular staff meetings, handovers and supervision. Piper House DS0000035201.V373140.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 41 and 42 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Piper house is a well managed service, with an experienced and qualified senior staff team. The views of residents and other stakeholders are systematically sought to contribute to the development of the service. Recording is of a good standard. EVIDENCE: The Manager and both Team Leaders are qualified Social Workers and have achieved at least NVQ4, the Registered Manager’s Award. The Manager, who has many years experience in managing social care services, regularly updates his knowledge and skills by attending in-house and external training and contributes to service planning through involvement in Council initiatives and planning groups. Piper House DS0000035201.V373140.R01.S.doc Version 5.2 Page 21 All of the three senior staff take part in sleeping-in duties and have detailed knowledge of residents’ needs. Residents’ views are formally sought through the regular quality action group meetings, which are attended by a member of the local advocacy service. In addition a survey of residents and of other stakeholders is taking place, including interviews with residents undertaken by Psychologists from the Learning Disability Team. This survey is not yet complete. Favourable comment from Care Managers was seen. Recording is of a good standard. Daily notes seen in flat B were particularly well recorded, with details of care and support provided. The daily notes provide a good record of each resident’s day and of staff support and activity. Ways of supporting residents to contribute to their records, in particular to daily notes should be considered. Good recording is also maintained in flat C, though staff would benefit from easier access to IT, which is only available in the ground floor offices. Residents in flat C might also benefit from IT access. Records show that staff receive training in health and safety during their induction and as refresher training. The Manager has identified that not all staff have received training in food handling, which he is arranging for the New Year. The Manager confirms that one of the Borough’s health and safety officers’ makes regular visits to Piper House to check that standards are being met and to look at health and safety records. A business and development plan is available for the service. Staff confirm that the Service Manager visits regularly at different times of the day and meets with residents and staff. Piper House DS0000035201.V373140.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 x 2 3 3 x 4 x 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 3 26 x 27 2 28 3 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 3 2 x LIFESTYLES Standard No Score 11 x 12 4 13 3 14 4 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 4 4 x 3 x 3 3 x Piper House DS0000035201.V373140.R01.S.doc Version 5.2 Page 23 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 2 Standard YA9 YA20 Regulation 13 13 Requirement Timescale for action 31/01/09 Risk assessments must be available for each resident who is occasionally left alone in the flat. The medication policy and 31/01/09 procedure should be expanded to include more details on covert medication, leave medication, recording of medication prescribed PRN and the storage and handling of controlled drugs. A date for refresher training for all staff should be arranged. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 Refer to Standard YA20 YA41 YA41 Good Practice Recommendations The provision of a controlled drugs cupboard and medication fridge should be considered. Ways of involving residents in their record keeping, in particular in their daily notes should be considered. Access to IT in flat C for the use of residents and staff could be looked at. Piper House DS0000035201.V373140.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG 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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