Inspection on 12/12/05 for 106 Queens Road

This inspection was carried out on 12th December 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

106 Queens Road 16/03/09

106 Queens Road 26/03/08

106 Queens Road 28/11/06

106 Queens Road 08/05/06

106 Queens Road 25/10/05

106 Queens Road 01/03/05

106 Queens Road 05/10/04

106 Queens Road 11/12/03

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Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 106 Queens Road Littlestone New Romney Kent TN28 8ND Lead Inspector Lois Tozer Announced Inspection 12th December 2005 09:35 106 Queens Road DS0000023147.V266913.R01.S.doc Version 5.0 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 106 Queens Road DS0000023147.V266913.R01.S.doc Version 5.0 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. 106 Queens Road DS0000023147.V266913.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service 106 Queens Road Address Littlestone New Romney Kent TN28 8ND 01797 366620 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) support@communitas.org.uk Communitas Limited Vacant Care Home 4 Category(ies) of Learning disability (4) registration, with number of places 106 Queens Road DS0000023147.V266913.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25th October 2005 Brief Description of the Service: 106 Queens Road is a detached property which offers care and support to a maximum of 4 service users who have learning disabilities. It is situated in the Littlestone area, with access to local shops and other amenities about 15 minutes walk away. The town of New Romney is accessible by foot (30 mins walk), by public bus service or by using the homes dedicated vehicle. The home is owned and operated by Communitas. Day to day management has recently changed, and is currently conducted by Mr Ian Pitman. The home is set in its own ground, with parking for several vehicles to the front and side of the home. An adverage size, semi secluded garden with patio space to the rear and a garage area for recreation and storage are available. The home offers 3 communal rooms, a lounge, conservatory (where smoking is permitted) and one dining room that ajoins the kitchen. One communal bathroom and two W.C. facilities are available. All bedroms are registered for single occupancy, one has full ensuite facilities. The main ethos of the home is the promotion of greater independence in skills, social development and responsible decision making. Activites are organised to develop practical skills both within the home and in the community. People are activly supported to maintain employment in the community. 106 Queens Road DS0000023147.V266913.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This statutory announced inspection took place on 12th December 2005 between 09.35 and 14.30, and was assisted by the area director, as the position of manager has become vacant. All three people living at the home gave some input throughout the visit, despite all having various jobs and domestic activities to attend to; the input from the service users is invaluable and will be reflected within this summary. The home and service users have experienced considerable disruption over the last 6 months; a new company has purchased Communitas Limited, and therefore a change of responsible person is imminent; an adult protection alert was raised in July 2005, was investigated and concluded in November 2005; the manager, recently appointed in August 2005, resigned in November 2005, after supporting the team through the adult protection investigation; the service users & team have seen changes within the staff structure, as well as having fluctuating leadership. The area director is currently overseeing the management of the home, and delegating duties to the senior support workers. It is a credit to the area director and the new organisation that a corporate decision has been taken, that until a manager has been secured to post and the home has stabilised, the number of service users supported in the home will be limited to 3. The following methods were used to conduct this inspection; discussion with the 3 residents, discussion with 1 staff member and the area director, observation of the staff supporting residents; documents included – service user weekly planners that guide the shift planning system, medication administration records and storage; individual support plans, risk assessments, goal plans, menu records, complaints procedure, quality assurance documentation and a tour of the premises. The people living at the home said that they enjoyed life there. Positive comments service users said (some comments have been paraphrased) were; ‘This is much better than the house I lived in before, this is near people and from here its easy to get out and about’. ‘I want to live in my own flat with some staff support, and I want to have paid work, as the benefits I get are very small’. ‘I am going to see about getting a qualification in horse management, and maybe then I will get a paid job’. ‘I had a good weekend, we all went to see a strongman competition (and got signed photos and T shirts)’. ‘I trust [the area director] and know that she will sort out problems, we have got her phone number’. Other comments, thankfully already identified by the area director as needing attention were; ‘Staff need to set the boundaries, coz sometimes I feel bullied by other residents. When X or X is on, this never happens, but when X and X are on, they let us get on with it – that’s not right is it? Staff need to help us more with setting rules and sticking 106 Queens Road DS0000023147.V266913.R01.S.doc Version 5.0 Page 6 to them – X is ‘firm but very fair’ and that suits us all – we know where we are with X’. A comment card received back echoed this sentiment that bullying was a problem, and this card also highlighted that the individual felt that there was not enough opportunity to talk about what needed changing in the home. What the service does well: What has improved since the last inspection? Individual plans have been revised, with service user involvement, and now reflect the positive aspects of the person; give a good insight into individual aspirations and wishes for the future; set out any teaching plans in a way that can be replicated by any staff member offering support and contain a way of monitoring progress. A service user said that they had been involved in the creation of the plan and understood what was in it. 106 Queens Road DS0000023147.V266913.R01.S.doc Version 5.0 Page 7 Known risks, personal and environmental, have been assessed, and are documented in an easy to read manner that states what actions must be taken to reduce risk occurrence. Residents said that they knew how to use the complaints procedure and who to contact if they had a problem that was not being resolved. All felt comfortable approaching the area director, and all had her telephone number – and had used it. Although two residents identified bullying within the peer group as a big concern, the improvement is that they are identifying it and are stating they want something done. Service users want to move on and aspire, and are clear that they need to live within sensible boundaries that work with their ADHD and other conditions that are provoked by anxiety. All service users want to move forward without using medication, and understand selfmanagement is crucial. Medication procedures have been tightened and a different method of packaging medication from the pharmacy has been arranged, which ensures medication leaving the home is now much safer. Medication training has not yet been obtained, but is being sought and is on track to meet the 1/2/06 deadline. Adult protection training was due to be given to all staff at the end of this inspection week. Quality assurance work is taking place; see below. Whilst it has improved, it continues to be a ‘work in progress’. What they could do better: Although the key worker system is needed, and is essential, staff must ward against excluding the needs of the group. Service users have identified bullying within the peer group, and have felt that staff boundary setting and support is instrumental to everyone’s wellbeing. Work in this area is on the area directors’ agenda for change, and service user group meetings have been reintroduced. This is absolutely the most crucial area that must be addressed from this inspection. The induction process used is TOPSS format, but does not cover any elements of the LDAF (Learning Disabilities Award Framework) accredited learning tools. Service users are highlighting staff need to set boundaries, so it would be appropriate that the service users lead this training, and using the LDAF framework, could become facilitators (if they wished). Additionally, using a service user specific learning tool will close the gaps in adult protection, communication, and condition specific support (especially around the autistic spectrum). 106 Queens Road DS0000023147.V266913.R01.S.doc Version 5.0 Page 8 A recommendation that the service users are supported to learn more about the effects of foodstuffs on behaviour was discussed. Menu’s are reasonable, but do not reflect the pro-active approach of managing behaviour without medication – whereas there is significant research to indicate that dietary issues have had a negative impact on people who have ADHD / Autism and other anxiety related conditions. Some recommendations were made to improve medication management further, these being service users taking a greater role in the management (especially as working toward independence); condensing records for ‘homely remedies’, so that stock is logged in and is easily audited on the medication administration records (MAR), making usage easier to track and to clearly state the maximum dose of paracetamol or homely remedies containing this ingredient. A signature list is in place, but records are completed with initials, so a set of initials is needed to be collected for comparison. Recruitment procedures are reasonably robust, and CRB / POVA checks are sought, and telephone references obtained, but written references were absent from the newest starter (although working under supervision until these checks had been cleared). The practice in the home is safe, but in the absence of a manager, an administrator or another person must have the responsibility of chasing up written references. The quality assurance information has been revised and improved, and for service users who can understand complex sentences, is fine. However, the area director notes that further simplification and reduction of questions (drawing out those most meaningful) will harvest better results. Work is underway to test out the process on the current service users and obtain their feedback as to what they would like to be asked, and how they want it presented. 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. 106 Queens Road DS0000023147.V266913.R01.S.doc Version 5.0 Page 9 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 106 Queens Road DS0000023147.V266913.R01.S.doc Version 5.0 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 The pre admissions assessment is designed to draw out individual aspirations and needs and will highlight if the home can support the prospective service user. EVIDENCE: The documentation available in respect of existing service user needs assessment was robust and had incorporated the findings of a qualified psychologist, who was employed by the organisation. Pro-forma assessment tools lead the assessor to ask the questions that will indicate if the home can meet the individuals needs. 106 Queens Road DS0000023147.V266913.R01.S.doc Version 5.0 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9, 10 The service user plan reflects the direction that the individual wishes their life to take and considers support needs, areas of risk and where everyday living skills could improve. Records are stored in a safe place, and service users know they may have access to their own records. EVIDENCE: Individual plans have improved considerably, and now reflect how far each individual has come, their (many) positive aspects and where they want to go in life. Although the last 6 months have been disrupted with various personnel changes, the three service users have benefited from a focused look at their lives. Service users are clearly being included in decision making, and made it quite clear that they feel that they are being listened to when it comes to making decisions. There are requests for more structure within the staff team, as service users have seen the benefit of strong leadership resulting in greater opportunity. Service user meetings have just been re-introduced, a resident having highlighted that these had fizzled out. Risk management has been revised, documentation is now easier and clearer to use and covers the host of environmental aspects that had not been previously assessed. A service user confirmed that access to personal files was easy, and staff would help where needed. 106 Queens Road DS0000023147.V266913.R01.S.doc Version 5.0 Page 12 106 Queens Road DS0000023147.V266913.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16, 17 People are given opportunities and support to develop as individuals, but service users say they need more structure and guidelines from staff to make the most of their lives. Activities are chosen by the individuals, but levels of engagement with staff could possible be improved. Work placements within the local community are well supported. Contact with friends and family is supported, as per individuals’ wishes. Rights and responsibilities are built into the day-to-day running of the home, but as above, staff are requested by residents to be firm yet fair at all times. An adequate budget for food is in place and residents have a major say in what goes on the menu, but little educational work takes place to highlight the association between certain foods and ADHD anxieties. EVIDENCE: Personal development has come along way, and service users can see the benefits of developing as responsible adults. Service users identified that they are living at the home because they need support, especially in the daily routines of the house, but their ultimate goal is to live in their own accommodation, have jobs and receive minimal support. To reach this goal, service users feel that staff must play an active part in preventing inter-peer bullying and take a firm but fair approach to daily structure. Service users 106 Queens Road DS0000023147.V266913.R01.S.doc Version 5.0 Page 14 have praised some staff, while others are seen as ‘letting us get on with it’. Educationally, this is not a responsible stance for staff to take, and clearly letting service users get on with it in such circumstances does not work. A long discussion took place, including the area director and service user. This is the most pertinent area needing development and is linked into the training needs of the home. All service users have freedom and opportunity to get out in the community, and all have voluntary employment, and some have a desire for education and qualification, which is supported. Service users who have some communication difficulties would benefit from an up to date speech and language assessment and a programme of support to increase confidence and a chance to practice assertive behaviours – also discussed. Leisure needs are well met, both individually and as a group. Friendships outside of the home have been established and maintained, and family contact is supported as per the service users wishes. Service users have a lot of say in the planning and purchasing of food, and a reasonable amount of practice at cooking. The menu was reasonable, however did contain many items associated with increasing anxiety in people who have ADHD / are on the autistic spectrum. A recommendation that nutritional information be sought and, in an accessible way, information about selfmanagement of behaviour though foodstuffs is provided to the service users. 106 Queens Road DS0000023147.V266913.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20 Staff providing the structure and guidelines the service users request would better meet emotional health needs; physical health needs are well met. Medication management has improved, but some recommendations for further improvement were made. EVIDENCE: As discussed above, emotional well-being was highlighted as an aspect that staff could improve by offering better support structures to limit and avoid inter-peer bullying. Documentation shows that service users are supported to attend all the generic health care specialists as they need to, and are supported to access specialists as required. Medication management has improved, and medication leaving the home now does so safely. A clear and accountable count back system is in place. Staff are still awaiting medication training, and this is being sought at the moment. The area director feels that this will be achieved by the deadline of 1/2/06. Some areas of improvement forming recommendations are; staff signatures also have examples of initials; medication storage should be considered to be moved to the individuals rooms (per risk assessment), and the individual be supported to manage their own medication. Logging in and use of ‘homely remedies’ could be improved, as currently a long-winded and complex system is in place. Individual analgesics such as paracetamol and ibuprofen would benefit from a statement of maximum dose in 24 hours and a warning to avoid 106 Queens Road DS0000023147.V266913.R01.S.doc Version 5.0 Page 16 other medicines containing this active ingredient (or any others that have contra-indications). 106 Queens Road DS0000023147.V266913.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Service users now feel they are listened to and are confident to contact a named person to support issue resolution. Staff have not received adult protection training, and a level of abuse – inter-peer bullying – is reported to be tolerated by some staff. EVIDENCE: Although service users have reported that they feel staff could do more to support them in the home, and avoid inter-peer bullying (stating examples of staff who manage the shift without this occurring), they do feel that this is being dealt with. Service users all know the complaints procedure, how to use it and the area director is in constant contact with the home during this unstable period. Service users have used the complaints procedure and have found it works, and feel confident that the current problems will be resolved. This standard cannot be met though, as staff must be capable of taking service user concerns seriously and supporting the use of the complaints procedure. All staff were due to receive adult protection training on 16/12/05. The home has experienced three adult protection alerts in the last 12 months. The home is under new ownership, so considerable improvement in this area is expected. 106 Queens Road DS0000023147.V266913.R01.S.doc Version 5.0 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28, 30 A full refurbishment, currently underway, will improve an already very nice house. Bedrooms are highly personalised and to individuals liking. Bathrooms and toilets are in sufficient supply. The home is clean and hygienic throughout. EVIDENCE: The house is a large, detached property with a garage for storage, garden and is situated on a quiet residential road. Decoration has taken place in the hall and lounge, and after New Year, the kitchen and bathrooms will be refurbished. The current lock on the bathroom door cannot be over-ridden and should be replaced at refurbishment. Each service user has a highly personalised bedroom, liked by each. One has an en-suite, and this too will be refurbished soon. All service users confirmed that they were consulted about the changes. The home is clean and hygienic, however, the conservatory adjoining the dining room is used for smoking by staff, one service user, and the building contractors, which must be monitored so not to ‘kipper’ the house or impinge on non-smokers. Additionally it is also the storage area for the freezer. 106 Queens Road DS0000023147.V266913.R01.S.doc Version 5.0 Page 19 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35, 36 Two staff hold an NVQ qualification. An NVQ accreditation programme is in place, but the home does not use LDAF (Learning Disability Award Framework) learning tools to provide the level of underpinning knowledge required. Training provision has been inadequate, but plans for improvement are in place. The staff team have mixed abilities, but must focus on meeting service user assessed and perceived needs in a developmental manner. Recruitment processes need revision to ensure all written references are obtained. Staff have received regular supervision, but by an inconsistent management team, therefore service users have not had the manner of support they need. EVIDENCE: The organisation supports the NVQ programme, but does not use the LDAF accredited training resource to provide underpinning knowledge. Some essential education / training such as adult protection, communication and supporting people is covered in this resource, so should be used, as all have been shortfalls identified at this and previous inspections. There have been considerable gaps in training, but a full audit has taken place and a programme of training is rolling out from December 2005, with adult protection training taking place on 16/12/05. As highlighted by service users, staff are not consistently supporting the household in a beneficial and developmental way; the laissez-fair style of support has not worked to establish better relations within and outside of the home, and as such, must be revised. Supervisions have taken place on a regular basis over the last 12 months, however, these have been with a variety of managers and senior 106 Queens Road DS0000023147.V266913.R01.S.doc Version 5.0 Page 20 support staff, so consistency of approach has not been possible to promote. A knowledgeable, competent, and efficient full time manager is needed; efforts to recruit are underway. Staff recruitment has been managed reasonably well, and much of the required documented checks are in place. CRB and POVA, and telephone references have been obtained, and new staff work under supervision, however as no-one has been specifically allocated the task, written references have not been chased up. 106 Queens Road DS0000023147.V266913.R01.S.doc Version 5.0 Page 21 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, The manager position is currently vacant, and as such, a consistent approach is difficult to maintain. Measures to improve quality assurance from the service user perspective are underway. EVIDENCE: The home has experienced many and varied changes over the last 12 months, including several changes of manager. This has been bad for service user continuity and for staff morale. The result has been three adult protection alerts and several avoidable incidences within the home, and a breakdown of relationships with the neighbours. The area director is currently taking a lead in running the home, and, with the recently departed manager, has refocused the team to support the service users in a more professional manner. No manager has, to date, been recruited to post, so the changes for the home are by no means over. The quality assurance process has begun with the area director spending time with each service user and building up a rapport to establish what the future shape of the service will be. Many aspirations have been acknowledged, and a total review of the service users development plan has given them some hope 106 Queens Road DS0000023147.V266913.R01.S.doc Version 5.0 Page 22 that they are moving forward in their lives. Questionnaires have been sent to family and supporting professionals, and the area director has acknowledged the surveys designed for service users need revision to be more meaningful to them – the revised format is yet to be trialled. 106 Queens Road DS0000023147.V266913.R01.S.doc Version 5.0 Page 23 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 3 X X X Standard No 22 23 Score 2 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 3 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 2 3 N/A 3 LIFESTYLES Standard No Score 11 2 12 3 13 3 14 3 15 3 16 2 17 Standard No 31 32 33 34 35 36 Score X 2 2 2 2 2 CONDUCT AND MANAGEMENT OF THE HOME 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 106 Queens Road Score X 2 2 X Standard No 37 38 39 40 41 42 43 Score 1 X 2 X X X X DS0000023147.V266913.R01.S.doc Version 5.0 Page 24 YES 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 YA16 YA20 Regulation 13 13 & 18 Requirement Staff must support service users in a way that prevents bullying (inter-peer or otherwise). Previous requirement, timescale 31/01/05 not met. Staff receive medication training appropriate to the work they are expected to carry out. Keep a list of staff initials to compare on the MAR sheets All existing staff to receive robust Adult Protection training by Obtain outstanding written references and, in the absence of a manager, ensure that someone is accountable for ensuring these are obtained. Timescale for action 01/01/06 01/02/06 3 4 5 YA20 YA23 YA34 13 18 19 01/02/06 01/01/06 01/01/06 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 Refer to Standard YA12YA13 Good Practice Recommendations Seek advice from the Department for Work and Pensions DS0000023147.V266913.R01.S.doc Version 5.0 Page 25 106 Queens Road 2 3 YA17 YA20 4 YA39 and the Disability Rights Commission regarding paid and therapeutic work. Provide service users with manageable information about nutrition and its effect on ADHD. Assess possibility of service user being supported to manage their own medication. Implement a simpler, more accountable logging in and usage sheet for homely remedies and ‘as required’ analgesics, and make clear the maximum dose in 24 hours and any contra-indications. Simplify the quality assurance questionnaire and trial on the service users for feedback. 106 Queens Road DS0000023147.V266913.R01.S.doc Version 5.0 Page 26 Commission for Social Care Inspection Kent and Medway Area Office 11th Floor International House Dover Place Ashford Kent TN23 1HU National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI 106 Queens Road DS0000023147.V266913.R01.S.doc Version 5.0 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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