Inspection on 27/11/07 for 374-376 Winchester Road

This inspection was carried out on 27th November 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 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 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

374-376 Winchester Road 18/05/09

374-376 Winchester Road 16/07/08

374-376 Winchester Road 18/05/07

374-376 Winchester Road 24/10/06

374-376 Winchester Road 15/02/06

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

CARE HOME ADULTS 18-65 374-376 Winchester Road Southampton Hampshire SO16 6TW Lead Inspector Annie Kentfield Unannounced Inspection 27th November 2007 10:00 374-376 Winchester Road DS0000062649.V349726.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 374-376 Winchester Road DS0000062649.V349726.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. 374-376 Winchester Road DS0000062649.V349726.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 374-376 Winchester Road Address Southampton Hampshire SO16 6TW 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 8078 9786 Integra Care Management Ltd Beverley Hambidge Care Home 8 Category(ies) of Learning disability (0) registration, with number of places 374-376 Winchester Road DS0000062649.V349726.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home only - (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 Disabilities (LD) The maximum number of service users to be accommodated is 8. Date of last inspection 18th May 2007 Brief Description of the Service: 374/376 Winchester Road is a small home providing care and support for up to eight residents with a learning disability and who may have challenging behaviour and complex care needs. The service provider is Integra Care Management Limited (a Midlands based company). The home provides a homely environment where the residents have a room of their own that has been designed and decorated to meet their individual needs and personal preferences. There is a range of communal rooms and a large enclosed garden. The building is accessible on the ground floor but does not have a passenger lift or stair lift. 374/376 Winchester Road is situated close to local shops and Southampton Common. Monthly Fees are from £1,500 to £3,000 with additional and varying charges for chiropody, toiletries, clothing etc. 374-376 Winchester Road DS0000062649.V349726.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report is a summary of information that we have asked for, or received, about this service, since the last inspection visit of 18th May 2007. We received the Annual Quality Assurance Assessment (AQAA) in May 2007. The AQAA is a self-assessment form that is completed by the home and should focus on how well outcomes are being met for people using the service. It should also give us some numerical information about the service. We sent surveys to relatives, staff, and health and social care professionals who visit the home. We looked at the previous inspection report and the improvement plan supplied by the home following the inspection of May 2007. We also looked at what the home has told us about things that have happened in the home (these are called ‘notifications’ and are a legal requirement). We made an unannounced visit to the home on 27th November 2007 with two regulation inspectors (Annie Kentfield and Chris Johnson) who were in the home from 10am to 5.30pm. What the service does well: What has improved since the last inspection? Following the last inspection of May 2007 the home was required to provide us with an improvement plan that demonstrated how they were going to meet regulatory requirements and improve practice in the home. The requirements have been partly met. Staff recruitment procedures have improved and this requirement has been met. The home has developed a system for quality assurance and this requirement has been met. The home has put into place a staff-training programme and this requirement has been met. The home is still awaiting delivery of new and dedicated storage for medicines and this requirement has been partly met. 374-376 Winchester Road DS0000062649.V349726.R01.S.doc Version 5.2 Page 6 Some of the previous recommendations for good practice have been carried out and the home has developed a ‘service user guide’ in a more accessible format for the residents and the complaints procedure is available in a pictorial symbol format. 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. 374-376 Winchester Road DS0000062649.V349726.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 374-376 Winchester Road DS0000062649.V349726.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 and 4 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. New residents do not move into the home until their care and support needs have been assessed and they have had an opportunity to visit the home. The manager has started to develop information about the home in different formats that meet the varying communication needs of residents in the home. EVIDENCE: The home currently has 7 residents and one room is vacant. No new residents have moved into the home since the last inspection, however, the manager explained that the process before residents move into the home is lengthy. This is to make sure that prospective residents are able to visit the home, meet existing residents and staff, and for the manager to undertake a comprehensive assessment of care and support needs and ensure that the home is able to meet those needs. Since the last inspection, and also to meet the regulatory requirement, the manager has started to develop a staff-training programme that aims to provide staff in the home with the skills and knowledge they will need to meet all of the residents’ care needs. The manager has also developed a folder of information about the home (Service User Guide) that uses lots of photographs to show residents what the 374-376 Winchester Road DS0000062649.V349726.R01.S.doc Version 5.2 Page 9 home is like, such as the bedrooms and communal areas, the garden, pictures of meals and activities, and will have photographs of the manager and staff. This should be developed to provide other ways of giving residents information about the home, particularly residents who may have a visual impairment, or who use other methods of communication, in line with recommended good practice. 374-376 Winchester Road DS0000062649.V349726.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 and 9 - Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The lack of evidence of up to date records of residents’ finances means that the home cannot demonstrate that residents’ finances are being protected. More work is needed to develop person centred individual care plans. EVIDENCE: Residents in the home do not have the capacity to manage their own financial affairs and we were told that the person who represents the owners of the home (responsible individual) acts as financial appointee and has power of attorney for 4 of the residents. This is not safe practice and National Minimum Standard 7.7 says, “an appointee or agent should be independent of the service. If no independent agent is available, the registered manager may be appointed agent, and we must be notified and records must be kept of all incoming and outgoing payments, and independently audited/monitored”. We were told that the financial records for residents’ monies are held by the responsible individual and are not available in the home for inspection. This is 374-376 Winchester Road DS0000062649.V349726.R01.S.doc Version 5.2 Page 11 not safe practice and the home must demonstrate how they are protecting residents from potential financial abuse by maintaining accurate and audited records that are always available for inspection. We wrote to the registered providers with an immediate requirement for the financial records to be made available. (Following the inspection we were told that the records are available in the home and a further visit will be made to inspect these.) At the last inspection it was evident that staff are thinking and acting in a person centred way (by person centred we mean looking at the whole personal support and care needs of each individual resident in liaison with the resident and/or their representatives) and this needs to be reflected in the individual plans of care. Whilst some work has started; to review and develop each care plan in a person centred way, the manager is aware that more work is needed. Some training for care staff in the area of person centred care planning is also needed. (This has been a recommendation over the last three inspections). The home has started to use a communication system called PECS using picture recognition with photographs. At the moment the use of this is limited but the manager and staff plan to develop the system where it is appropriate for one of the residents. Risk assessments are in place for each resident in the care records that look at the risks and how these can be best managed to minimise risk without limiting each residents’ preferred activity or choice. No information was provided by the responsible individual in the Annual Quality Assurance Assessment (AQAA) that would have demonstrated how the home meets individual needs and choices and provides support that is person centred. The AQAA said “difficult to explain” and did not provide any evidence of practice in the home that promotes choice and independence for the residents. We were told that the service does support the residents to have contact and support from their families or independent advocates but there was no evidence in the individual care plans as to how this is agreed, arranged and reviewed. We were told that some of the residents have an advocate from a local independent resource. 374-376 Winchester Road DS0000062649.V349726.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 – 17 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager and staff are committed to developing and providing lots of opportunities for the residents to take part in meaningful activities of their choice and to develop their interests and independent living skills. EVIDENCE: Residents have a kitchen area where some of the residents are able to make themselves snacks and drinks with support from the staff. Main meals are cooked and served by the staff and the menu is varied with choices available where staff know the likes and dislikes of each resident. Better use of photographs to illustrate the daily menu and meals could be made and the manager explained that she plans to do this. The manager explained that she holds the food budget and supervises the food shopping to ensure good quality and nutritious food is available for the residents. 374-376 Winchester Road DS0000062649.V349726.R01.S.doc Version 5.2 Page 13 Each resident has an activities programme and we saw that these included walking, shopping, going out, musical and creative art activities, hand and foot massage and other activities that individual residents like to do such as listening to music in their room. Some of the comments received from staff indicated that they would like to see more activities arranged for the residents and there is a commitment from the manager and staff to develop meaningful activities and opportunities for this. We saw evidence that the manager and staff work in a person centred and creative way to meet the individual needs and preferences of the residents, for example in the way that rooms are furnished and decorated that shows how individual needs are considered. 374-376 Winchester Road DS0000062649.V349726.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 - Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The healthcare needs of the residents are monitored and appropriate action and intervention taken. The home understands the need to comply with the regulations for the administration and safekeeping of residents’ medication and the manager has responded to previous requirements, however, further action is needed to fully comply with these requirements. EVIDENCE: At the last inspection we found that the systems for storing and recording medication were not safe and were not meeting regulatory requirements. The home sent us an improvement plan that told us what they had done to meet these requirements and to make sure that practice in the home is safe for the residents. We found that some areas of the home’s medication practice have improved and are meeting regulatory requirements: medication is checked in by staff and signed for on the appropriate records, some of the staff have done specific training in the safe administration of medicines, returned medication is recorded and signed for, the manager has reviewed the home’s policy and procedures for medication, the key to the medication cupboard is securely stored. However, the home told us that a new medication cupboard had been 374-376 Winchester Road DS0000062649.V349726.R01.S.doc Version 5.2 Page 15 ordered in August but we found that this was not ordered until the end of October and the home are still awaiting suitable storage. At the moment, medicines that do not fit into the current medication cupboard are stored in a locker. This is not safe practice as the locker could easily be opened and is not totally secure. We found that some medication is stored in a fridge that is accessible to residents and this is not safe practice as they may be stolen or other people might help themselves and overdose with serious consequences. The home must have a separate fridge that is only used for medicines that require cold storage and where there is a constant need to store medicines that are taken daily, such as insulin. The senior carer on duty has to regularly check that medicines have been given (or not) and make sure that this is recorded on the medication administration record (MAR) charts. However, we found some gaps on the MAR charts even though they had been checked, we also found that staff were not all following the same procedure for recording, for example, some staff are recording the reason when a medicine was not given, but other staff are leaving the record blank. We also found that there is not a clear written procedure for every intervention, such as the use of nebulisers, or the administration of eye drops. The home has a written general protocol for any medicines that are prescribed to be given ‘as required’ (PRN) but it would be safer practice for each medicine to have an individual written protocol to ensure that staff have clear guidance on when, how and why PRN medicine must be dispensed. When medication records are not clear or staff do not follow the home’s policy and procedures there is a risk that errors may be made. All of the home’s policies and procedures for the safe administration of medicines must be reviewed in line with the guidance for care homes issued by the Royal Pharmaceutical Society of Great Britain ‘The Handling of Medicines in Social Care’. The registered manager said that she would be doing this. 374-376 Winchester Road DS0000062649.V349726.R01.S.doc Version 5.2 Page 16 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 adequate. This judgement has been made using available evidence including a visit to this service. The manager is aware of the need to have policies and procedures in place to protect residents from abuse, neglect and self-harm, and to have a complaints procedure. However, the lack of up to date and audited records of residents’ financial affairs does not demonstrate that robust procedures to protect the residents from the risk of financial abuse are in place. EVIDENCE: We have made an immediate requirement for the residents’ financial records to be available in the home for inspection. We were told that the responsible individual is appointee and has power of attorney for 4 of the residents. Best practice would be for the residents’ appointee to be independent of the home, but where this is not possible or practicable, the reasons for the provider being appointee should be clearly recorded and up to date and audited records kept. (Following the inspection we were told that the records are available in the home and a further visit will be made to look at these.) The manager has made the home’s complaints procedure available around the home in pictorial format for the residents. This is a positive development but the manager needs to consider how residents are made aware of this, and how the home meets the information needs of residents with a visual impairment. The complaints procedure includes details of a complaints log and this needs to be maintained. The monthly inspections by the representative of the homeowners are a regulatory requirement but there is no record in these 374-376 Winchester Road DS0000062649.V349726.R01.S.doc Version 5.2 Page 17 inspection reports that the complaints procedure and complaints log are checked. We spoke to some of the care staff that confirmed that they were aware of the procedures to follow if they had any concerns about the safety of residents or suspicion of abuse. Staff spoken to confirmed that they had done some training in awareness of safeguarding adults and ‘team teach’ (this covers control and restraint good practice). The manager has met the previous requirement to ensure that residents are protected with thorough and robust staff recruitment procedures and we found that recruitment records were satisfactory. In discussion with the manager it was recommended that where a verbal reference is given it is good practice to record this, until the written reference is received. The manager agreed to do this. 374-376 Winchester Road DS0000062649.V349726.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Generally the home environment is safe and comfortable for the residents. Improvements have been made to the home and more are planned. EVIDENCE: Since the last inspection the garden has been landscaped and new fencing put up. This provides residents with a safe and private outdoor area with room for residents to do the activities they like such as cycling and using the trampoline. There is one corner of the garden that needs to be completed and the manager is awaiting disposal of some of the old furniture that is currently stored in the garden. We were told that there is an ongoing programme for refurbishment of the home; new flooring is planned for the hallways and stairs and one of the sitting rooms. Some parts of the home are in need of decoration and the manager is still awaiting refurbishment of the kitchen. In one of the surveys that we received, comments were made about the “poor décor” in the home, however, 374-376 Winchester Road DS0000062649.V349726.R01.S.doc Version 5.2 Page 19 the comments also recognised that the home does need a high level of repair and maintenance due to the high level of use, and the needs of the residents. The manager is aware of this and is able to call on regular skilled maintenance workers to carry out small repairs and replacement. Because the home needs a high level of maintenance and repair we were told that all major works are identified and agreed by the manager and registered owner and a programme of work agreed that causes minimal disruption to the residents. This enables the manager to plan the work on a priority basis and also make contingency plans for when repair work will possibly be temporarily disruptive for the residents. The needs of the residents are such that disruption to routines can be detrimental to their health and wellbeing. The home now employs a cleaner and we found the home to be clean and tidy and smelt fresh and clean. Training for all staff in good practice in infection control has still to be arranged, however, staff said they are aware of good hygienic practice and we saw that there are hand-washing facilities available and staff are provided with gloves and aprons to use where appropriate. 374-376 Winchester Road DS0000062649.V349726.R01.S.doc Version 5.2 Page 20 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 adequate. This judgement has been made using available evidence including a visit to this service. The manager has taken action to meet regulatory requirements from the previous inspection and must now ensure that the improvements to staff training and development are sustained and the needs of the residents are supported by a skilled and effective staff team at all times. EVIDENCE: At the last inspection we found that one of the barriers to improvement was the lack of a training budget and access to training resources. This has improved and the manager has met the previous requirement to develop a staff training and development programme to ensure safe working practice and to meet the specific support needs of the residents. We spoke to some of the staff and looked at training records and looked at what the home told us they had done in their improvement plan. The manager has introduced a training calendar that records what training has been done and what is planned. Some of the staff are enrolled to achieve a National Vocational Qualification (NVQ) in care and it is planned for this to be ongoing and more staff will enrol when others have completed their NVQ. 374-376 Winchester Road DS0000062649.V349726.R01.S.doc Version 5.2 Page 21 Improvements have been made to the way that new staff are ‘inducted’ and supervised and there is a comprehensive induction programme that meets nationally agreed training standards. The manager should ensure that a record is kept of the initial introduction to the home to demonstrate that staff are aware of basic and safe working practice such as fire safety and health and safety etc. We spoke to some of the new staff who gave positive feedback and felt that the levels of support and supervision provided by the manager and other staff are “very good”. Comments from staff indicated that they would like to see more permanent staff and less use of agency staff, however, it was pointed out that the home try to use the same agency staff to ensure some continuity of care for the residents. The manager is aware that these improvements must be sustained and continued investment in training resources is needed to ensure the residents changing needs are met by a skilled and effective staff team at all times. Recruitment procedures have improved and this requirement has been met. Records show that new staff have satisfactory checks in place before starting work, this makes sure that the residents are protected by the home’s policies and procedures. 374-376 Winchester Road DS0000062649.V349726.R01.S.doc Version 5.2 Page 22 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 adequate. This judgement has been made using available evidence including a visit to this service. The registered manager is competent and experienced and residents and their representatives can be confident that the home is being managed in the best interests of the residents. However, the lack of up to date and audited records of residents’ income does not demonstrate open and transparent management of residents’ monies or that their best interests are being safeguarded by the home’s record keeping policies. EVIDENCE: We looked at some of the home’s records for health and safety checks and maintenance of equipment and it was evident that the manager is aware of her responsibilities to ensure the home is meeting all of the requirements of relevant health and safety legislation. 374-376 Winchester Road DS0000062649.V349726.R01.S.doc Version 5.2 Page 23 The registered manager is responsible for the day-to-day running of the home and since being appointed has been working to set up effective management systems, for example, the manager has introduced a daily log sheet to record who is on duty, who is responsible for medication, any important issues relating to residents’ care and the daily allocation of work. The manager has completed the Registered Manager Award (NVQ level 4) and plans to complete the NVQ level 4 in care next year. Comments from staff and observation of practice in the home demonstrate that the manager is an effective communicator and the residents benefit from her open and positive management approach. The home now has a deputy manager and there are clearer lines of accountability within the staff team. The manager has set up a procedure for a quality assurance system and has sent a questionnaire to all stakeholders in the service (by stakeholders we mean relatives, staff, visitors, health and social care professionals who visit the home) and plans to do this on a twice-yearly basis. All comments have been responded to personally wherever possible and the manager could summarise the replies and what action she has taken, as part of the home’s development/improvement plan. The registered manager maintains daily records and receipts of the day-to-day expenses of the residents and we looked at these. However, we have already detailed in previous sections that there are no records in the home of residents’ income and financial affairs (that are managed by the responsible individual, Mrs Wade). We have written to the owners of the home making an immediate requirement that these records are made available for inspection in the home. We looked at the reports of the monthly inspection visits that are made by the homeowner’s/registered provider’s representative (responsible individual). These inspections are a regulatory requirement because registered care home providers are responsible for monitoring the quality of service provided in their care homes. We also looked at what the responsible individual has told us in their improvement plan after the last inspection. Although the improvement plan says that medication procedures are checked each month and recorded on the care provider’s report, we did not find evidence of this. There was also no evidence on the monthly provider’s report of regular checks to ensure that the service is compliant with the Care Homes Regulations 2001 and is meeting the National Minimum Care Standards, until the November report, that was more detailed and focussed on the required improvements. The Commission website provides guidance for care providers on visits to their care homes (Regulation 26). The reports of these visits should help the provider to monitor and improve the quality of their service in ways that matter to the residents using it. This is particularly important when we have concerns about the quality of service being provided. 374-376 Winchester Road DS0000062649.V349726.R01.S.doc Version 5.2 Page 24 374-376 Winchester Road DS0000062649.V349726.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 X 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 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 2 33 X 34 3 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 2 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 3 X 2 3 X 374-376 Winchester Road DS0000062649.V349726.R01.S.doc Version 5.2 Page 26 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. Standard YA20 Regulation 13 (2) Requirement Medication must be safely and appropriately stored and administered. This requirement has been partly met from the previous inspection and the home is awaiting delivery of new medication storage. 2. YA41 17 (2) and Schedule 4 Up to date and audited records 10/12/07 of residents’ financial affairs must be kept in the home and be available for inspection. This was an immediate requirement and the registered providers have confirmed that the records are now in the home and available for inspection. Timescale for action 30/12/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. 374-376 Winchester Road DS0000062649.V349726.R01.S.doc Version 5.2 Page 27 No. Refer to Standard Good Practice Recommendations 374-376 Winchester Road DS0000062649.V349726.R01.S.doc Version 5.2 Page 28 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. 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