Inspection on 19/10/07 for 110a-c West Street

This inspection was carried out on 19th October 2007.

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 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

110a-c West Street 17/10/05

110a-c West Street 07/10/05

110a-c West Street 24/06/05

110a-c West Street 01/11/04

110a-c West Street 11/05/04

110a-c West Street 12/06/03

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Dalewood Respite Care

Orchard,The

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Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

Pinta

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

CARE HOME ADULTS 18-65 110a-c West Street Havant Hampshire PO9 1LN Lead Inspector Laurie Stride Key Unannounced Inspection 19th October 2007 11:15a 110a-c West Street DS0000040862.V347366.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 110a-c West Street DS0000040862.V347366.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. 110a-c West Street DS0000040862.V347366.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 110a-c West Street Address Havant Hampshire PO9 1LN 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) 023 9249 8333 Hampshire County Council Sarah Elizabeth Cruickshank Care Home 17 Category(ies) of Learning disability (17) registration, with number of places 110a-c West Street DS0000040862.V347366.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 17th October 2006 Brief Description of the Service: 110 (a-c) West Street is a purpose built group of three housing units located in a residential area close to the centre of Havant. Hampshire County Council owns the premises; and the range of services are: long-stay residential care and short-term respite and emergency care and they are managed by one manager. There is a central administration unit. 110 (a-b) are both long-stay residential units for up to five service users with learning disabilities. 110c provides a respite and emergency service for up to seven service users. This includes a bed-sit that is used for accommodating and supporting individual service users who are preparing to move on to more independent living arrangements. The aim of the service is to support service users in working towards a more independent lifestyle. The current fee is £798.00 per week, which includes a client contribution of between £34.86 and £52.36. This information was obtained at the time of the inspection visit. Members of the public may wish to obtain more up-to-date information from the care home. People who use the service are responsible for purchasing their own toiletries and items of a personal or luxury nature. 110a-c West Street DS0000040862.V347366.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced key inspection visit, which lasted approximately four hours, during which we spoke with two of the people who use the service, the home’s manager and a member of staff. Further evidence for this report was obtained through the service’s annual quality assurance assessment (AQAA), looking at samples of the home’s records and reading the previous inspection report. Six service user and fifteen staff survey questionnaires were sent out. One staff questionnaire was returned. Additional feedback from stakeholders was obtained from the results of the home’s quality assurance questionnaire. What the service does well: What has improved since the last inspection? What they could do better: The home needs to ensure that all relevant documentation is also obtained for short-term placements. The home has identified areas for improvement, including plans to improve the kitchen area in the respite unit and to further improve planning and staff support during induction. There are also plans to have better links with housing organisations, in order to provide more opportunities for people to move on to more independent living options. The home is planning to recruit more casual staff to provide additional cover for activities. The home should increase the number of staff who are qualified to or working towards NVQ level 2 or above. 110a-c West Street DS0000040862.V347366.R01.S.doc Version 5.2 Page 6 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. 110a-c West Street DS0000040862.V347366.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 110a-c West Street DS0000040862.V347366.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 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. There are good systems to assess the needs of individuals before they move into the home, but the service needs to ensure that all relevant documentation is also obtained for short-term placements. EVIDENCE: The home’s annual quality assurance assessment states that staff in the home are skilled at working with people in a crisis, often those admitted via the unplanned referral route. The home works with people in a proactive way in conjunction with other agencies. The emergency admission procedure states that assessment reviews are carried out with the care manager within 72 hours and again after a month. Previous reports have shown that people who use the service benefit from a detailed assessment of their individual needs before they move into the home. We looked at the assessment information in relation to two people admitted to the service since the previous inspection. One person had initially moved in for a planned three-week period, had been in the home for six weeks and was now being supported to move into more independent accommodation. A care plan including health records and personal details were on file. Although a written care management 110a-c West Street DS0000040862.V347366.R01.S.doc Version 5.2 Page 9 assessment had not been obtained for this individual, there was evidence that the care manager was still actively involved in arranging a provisional moving date. The home’s manager, who was confirmed in post at the end of September, said he was aware that the home needed to improve on ensuring that planned short stays are kept on track and all relevant documentation is obtained. The annual quality assurance assessment also identified the need to put in place a more robust admission procedure, to include objectives of stay and move on plans. Another person had come to the home as an emergency admission, as a previous placement had not worked out. This person was being assisted to look for a supported living placement. We saw that a care management assessment and contract was on file, together with a care plan and risk assessment. An assessment review date was scheduled for 26/10/07. 110a-c West Street DS0000040862.V347366.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): 6, 7 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has good care planning and risk assessment systems, which supports people who use the service to make decisions about their lives and take managed risks. EVIDENCE: The annual quality assurance assessment states that the home actively promotes individual choice and independence in care planning, which includes all relevant risk assessments. This has also been confirmed during our previous inspections of the service. We saw care plans for two people who use the service and these were comprehensive documents that gave staff clear information on what support was required and how and when this should be given. Staff had received training in person centred planning and there were support profiles, which gave information on individuals’ routines in the mornings, afternoon and evenings. We spoke with two people who live in the home, both confirmed that they knew about and have input into their care plans. 110a-c West Street DS0000040862.V347366.R01.S.doc Version 5.2 Page 11 Care plans also contained a section called ‘How I make choices’ that provide guidance for staff on the individuals’ preferred way of communicating. Comments from a member of staff were that the service is good at ‘giving service users choice and the support to make those choices’. We observed the home’s manager assisting one person to make a decision, by providing them with relevant information about the situation and letting the person decide what to do. People we spoke to said they do the things they want to and that staff members assist them if they need it. Individuals’ goals and aspirations are reflected in their care plans, for example increasing independence through finding alternative accommodation. Staff members maintain daily reports on each individual, so that any changes are recorded and can be monitored. Risk assessments were clearly written and gave information to staff on what support was required to minimise any potential risks. 110a-c West Street DS0000040862.V347366.R01.S.doc Version 5.2 Page 12 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 & 17 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The home continues to provide good support for people to take part in suitable activities, have opportunities for personal development, maintain relationships with family and friends and to have a balanced diet of food they enjoy. Staff members work in a manner that respects the rights and responsibilities of people who use the service. EVIDENCE: The majority of people who use the service can access the local community independently and staff members offer support to those individuals who need it. People are encouraged to be part of the local community and are supported to be aware of what events are happening locally. People who live in the home are well known in their local community and regularly go shopping, visit local pubs and cafes and attend community events in the local area. Comments from a member of staff were that ‘the home encourages socialisation, occupation and new opportunities as well as tolerance towards others.’ 110a-c West Street DS0000040862.V347366.R01.S.doc Version 5.2 Page 13 On the day of the inspection the majority of people currently living at the home were out taking part in different activities. Some had gone away on holiday, supported by staff. The home’s annual quality assurance assessment states that as a result of residents asking for more trips out at weekends, the staffing rota was changed so that on most weekends a trip, chosen by individuals who use the service, is offered. Two current residents are being supported to pursue personal relationships and in one case advice was sought from the Community Learning Disability Team. One person who uses the service told us that they can have visitors and that these have to sign the visitors’ book. An entry in the daily log in one of the units was a reminder for staff to support an individual to buy a relative a birthday gift. Of the two people we spoke with, one individual goes to college three days a week and goes to work with a relative on another day. Another person said they enjoyed being helpful around the house, and liked activities like art and listening to music. The homes’ manager said that there were currently no day activities in place for this individual, who had been admitted six weeks ago and was now planning to move on. In the last twelve months the home has supported three other individuals to move to other suitable accommodation. The manager was aware of the difficulties that could occur in finding suitable activities for people if short-term placements become longer term. There are plans to have better partnership working with housing organisations with the homes’ manager attending the local housing panel. Daily routines in the home promote independence as much as possible. People we spoke to told us they have a key to their rooms and also a front door key, and confirmed they are involved in all aspects of the day to day running of the home. They said that staff members do not come into their rooms unless they are invited. People who use the service are able to access all areas of the home and are able to choose if they wish to be alone in their rooms or be in the company of others. At the time of our visit, one person who lives in the home had chosen to stay longer in bed. A weekly menu of varied meals was seen in one of the units, this was in a pictorial format to assist people with making choices. Records are kept of what foods individuals like and dislike and of what they eat on a daily basis, so that nutrition can be monitored. There is written guidance for staff to support people to buy ‘low-fat healthy food’ and not ‘value range products’. People we spoke to who live in the home said they enjoy doing the shopping and cooking. We observed both individuals in the kitchen preparing their lunches independently. 110a-c West Street DS0000040862.V347366.R01.S.doc Version 5.2 Page 14 110a-c West Street DS0000040862.V347366.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 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides good support to meet the personal care and health needs of people who use the service. The system for storing and administering medication protects people. EVIDENCE: The annual quality assurance assessment said that there is one care manager who is available to deal with general issues in respect of all individuals referred to the home. All individuals’ health needs are regularly reviewed including medication reviews with a doctor or consultant. We saw that care plans gave information on individuals’ personal care needs and that people who use the service are involved in decisions about this. The staff team are flexible round the times when people want their personal support and there are no set routines, however there are general daily routines for people who live in the home to help with consistency. The majority of people who use the service only require verbal prompts to ensure that personal hygiene is maintained. Staff were observed providing support in a 110a-c West Street DS0000040862.V347366.R01.S.doc Version 5.2 Page 16 friendly and respectful way, which maintained the privacy and dignity of people who use the service. We saw evidence of the involvement of the community health teams, where appropriate, in the support of individuals living in the home. Records also showed that one person was attending monthly health clinics. Individuals are registered with a number of different doctors at Havant Health Centre and dental, hearing and sight checks are carried out regularly. People who live in the home are encouraged and supported to manage their own health care appointments as much as possible. Staff members monitor individuals’ health and support them to access appropriate healthcare professionals and to attend any appointments. Previous reports have shown that the home has clear policies and procedures in place for the receipt, storage and administration of medication. Each unit has a suitable cabinet to store medication appropriately and records were kept of all medication administered. There was clear information for staff for administering when required medication. We saw a sample of medication administration records and these were up-to-date and completed correctly. Two people we looked at records for were being supported to manage their own medication and there are clear policies and risk assessments in place to enable this to be monitored. People who look after their own medication have lockable storage facilities in their rooms. 110a-c West Street DS0000040862.V347366.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 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service are protected by a simple, clear and accessible complaints procedure and the homes policies and procedures protect people from any form of abuse. EVIDENCE: The home’s annual quality assurance assessment (AQAA) states that all people newly admitted to the home are provided with written information on how to make a complaint. The previous inspection report identified that the home has a clear complaints procedure and keeps clear records of any complaints made and also records of its responses. The homes’ manager confirmed that there have been no complaints received by the home since the last inspection. People we spoke to who live in the home were aware that there was a complaints procedure and said that they would speak to a member of staff if they were unhappy. The also indicated that they were confident that staff members would respond to any concerns appropriately. Both confirmed that staff treated them well and that they felt safe living in the home. Comments from a member of staff indicated that they know what to do if a service user or other person has concerns about the home. The home’s AQAA reported that there is a robust adult protection procedure, which is shared with adjacent local authority services. All staff are trained on the issues relating to adult protection. We saw records that confirmed staff members have received relevant training. The previous report showed that 110a-c West Street DS0000040862.V347366.R01.S.doc Version 5.2 Page 18 staff members were clear about their responsibilities and the procedure to follow. The home had kept us informed about an ongoing investigation, which had been referred to the relevant agency. The homes’ manager reported that this had now been completed following a meeting the previous day and he would be informing us in writing of the outcome. 110a-c West Street DS0000040862.V347366.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 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The premises are well maintained and provide a safe, homely environment for people who use the service. EVIDENCE: We visited two of the three housing units, where service users and/or staff members were present, and those parts of the premises that we saw during our visit were kept safe and secure. Furniture and fittings were of good quality and the home was in a good state of repair. There are plans to improve the kitchen area in the respite unit. People who use the service are encouraged to take part in cleaning tasks and staff members offer support to individuals to do this. People we spoke to were happy to be involved in cleaning tasks and said they liked their bedrooms. All areas were clean and there were no offensive odours. We saw that there are staff checklists regarding cleaning tasks throughout the unit. Training records showed that staff receive training on infection control. 110a-c West Street DS0000040862.V347366.R01.S.doc Version 5.2 Page 20 Each unit has a laundry with tumble drier and a washing machine that can wash clothing at appropriate temperatures. People who use the service confirmed they are supported to do their own laundry and each individual has a set laundry day, although they can wash clothing at other times if they wish. Staff members offer support to people to do their laundry as appropriate. 110a-c West Street DS0000040862.V347366.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 & 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service are supported by a supervised and trained staff team and are protected by the home’s recruitment procedures. EVIDENCE: People we spoke to told us that staff support them well and are very kind. During the visit we observed staff interacting with people who use the service in a friendly and respectful manner. The homes’ manager reported that out of fourteen support staff, four are qualified to or working towards NVQ level 2 or above. This figure was previously six but two staff members are no longer working in the home. The manager said that two staff members are being put forward to do NVQ level 4 awards in January 2008. The home has a rolling programme and number of places for staff undertaking NVQ level 3 awards. The home’s annual quality assurance assessment stated that all staff recruitment checks were carried out and this was confirmed through inspecting a sample of files on new staff. The two staff members’ files contained evidence of Protection of Vulnerable Adults (POVA) and Criminal Records Bureau (CRB) checks, two written references, completed application forms with employment 110a-c West Street DS0000040862.V347366.R01.S.doc Version 5.2 Page 22 histories. Records also included information about staff probation and induction periods. The homes’ manager told us that two of the people who use the service had participated in the recruitment of new staff. Service users had opportunities to ask the candidates questions and score points that were added to the management interview panel scores. The annual quality assurance assessment identified that recent staffing shortages have at times created difficulty in providing some activities, such as trips out for people who use the service. The home has tried to reduce the impact of this through staff being flexible with their shifts and, at times, the home has used agency and casual staff to support activities. The home is planning to recruit more casual staff to provide additional cover. There is a central, standardised training programme and we saw a sample of staff records that demonstrated that staff receive training relevant to their role. Examples of training included Strategies for Crises Intervention and Prevention, Adult Protection, Moving and Handling, Fire Safety, Food Hygiene, and Infection Control. The homes’ manager told us that the service can obtain training for any identified training need. Comments from a member of staff indicated that induction covered mostly everything they needed to know to do the job when they started. They also confirmed that they receive training which is relevant to their role, helps them understand and meet the individual needs of people who use the service and keep up to date with new ways of working. The annual quality assurance assessment identified plans to further improve planning and staff support in relation to the induction process and training. The homes’ manager has formal supervision meetings with the senior support workers who supervise staff working in the units. 110a-c West Street DS0000040862.V347366.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 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management arrangements continue to provide people who use the service with a well run home and they can be confident that their views are taken into account when developing the service. The homes policies and procedures promote and protect the health safety and welfare of people who use the service and staff. EVIDENCE: We had been informed about the current registered manager being seconded to another service and the home being run by the deputy manager. Following interviews in September, the deputy manager is now the home manager and the current registered manager will not be returning from her seconded position. The newly appointed homes’ manager has experience of running the service and is preparing an application to register with the Commission for Social Care Inspection. He is currently undertaking an NVQ level 4 in 110a-c West Street DS0000040862.V347366.R01.S.doc Version 5.2 Page 24 management and has plans to complete the registered manager award. Comments from a member of staff indicated the homes’ manager is supportive and performs his role well. The homes’ manager said there are staff meetings to discuss any significant changes and house meetings for the long-stay and respite units. People who use the service also told us that they sometimes have meetings. These give people the opportunity to say what they think about the way the home is managed. Questionnaires are sent out to people who use the service, their relatives and staff at six monthly intervals, to gain their views of the quality of the service that is being provided. The manager collates this feedback into a short report, which had not been finalised for the most recent survey. However, we saw questionnaires completed by six of the people who use the service, who had been supported by staff to answer the questions, and nine relatives. The results of the survey were generally very positive. Senior managers visit the home each month to review the service quality. Reports of these visits also identify any actions that are required to improve the service. We saw evidence that demonstrates safe working practices are promoted and maintained within the service. The home has a designated fire safety coordinator, there is a fire risk assessment and regular checks are made of the fire warning system and the equipment. In-house fire training is held every six months and these are recorded. People who use the service were aware of actions to take in the event of a fire. The fire officers inspection in December 2006 found the fire systems and precautions to be satisfactory. There are property health and safety audits for the building, the most recent being conducted in June 2007. Records of maintenance, repairs and service contracts were seen on file. Portable electrical appliances are tested annually. 110a-c West Street DS0000040862.V347366.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 X 2 3 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 3 13 3 14 X 15 3 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 110a-c West Street DS0000040862.V347366.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 110a-c West Street DS0000040862.V347366.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI 110a-c West Street DS0000040862.V347366.R01.S.doc Version 5.2 Page 28 - 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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