Inspection on 05/02/07 for 40 Cooperative Street

This inspection was carried out on 5th February 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

40 Cooperative Street 21/10/08

40 Cooperative Street 20/08/07

40 Cooperative Street 12/12/05

40 Cooperative Street 28/07/05

40 Cooperative Street 28/02/05

40 Cooperative Street 03/08/04

40 Cooperative Street 21/02/04

40 Cooperative Street 09/10/03

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

CARE HOME ADULTS 18-65 40 Cooperative Street Stafford Staffordshire ST16 3DA Lead Inspector Mr Berwyn Babb Key Announced Inspection 5 February 2007 10:45 40 Cooperative Street DS0000032165.V327182.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 40 Cooperative Street DS0000032165.V327182.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. 40 Cooperative Street DS0000032165.V327182.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 40 Cooperative Street Address Stafford Staffordshire ST16 3DA 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) 01785 252645 F/P 01785 245903 kwebb@staffordshire.gov.uk Staffordshire County Council, Social Care and Health Directorate Mrs Karen Jane Webb Care Home 13 Category(ies) of Dementia (4), Learning disability (13), Learning registration, with number disability over 65 years of age (1), Mental of places disorder, excluding learning disability or dementia (3), Physical disability (5) 40 Cooperative Street DS0000032165.V327182.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th December 2005 Brief Description of the Service: 40 Co-operative street is located in a residential area of Stafford. Close to the town centre, it is well situated for access and public transport. The unit is registered for 13 adults who have learning disabilities and complex needs. The service provides a high standard of support to individuals who exhibit behaviours that are challenging. The residential provision is divided into three elements. A ground floor provision for 3 residents, A first floor provision for up to 8, And a two-bedded house in the grounds of the main house. The home provides a good standard of accommodation, décor is well maintained throughout. There are two communal lounges on the first floor and one on the ground floor. These offer space for residents and opportunities for staff to facilitate work with small groups or 1 to 1. Services provided include laundry, catering and domestic services and the home has its own day care facility on the ground floor. Number 40 A is a three bedded detached house containing a dining lounge, kitchen, storage covered, hallway, and toilet on the ground floor, and three bedrooms, one of which is used for a member of staff to sleep in , a bathroom, and a landing. 40 Cooperative Street DS0000032165.V327182.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place during the morning and afternoon of Monday 5 February 2007. The registered care manager, Mrs Karen Webb was on duty all day, and day service officers, kitchen staff, an administrative officer, and assistant managers assisted her. All residents were in the home at some time during the inspection, and at other times were going about their normal daily activities, some with their key workers, and some in the Stafford Day Service provision. Information for this report was provided from discussion with the manager; from information provided in the Pre-inspection questionnaire; from comments cards returned by seven sets of relatives and one professional; from a telephone conversation with a parent; from observation of the environment and of the dynamics between staff and residents, from a scrutiny of records and documents held at the home, and from a formal interview with a member of staff. On this occasion the two-bedded property on the grounds was included in the environmental part of the inspection, but the kitchen and ancillary preparation and storage areas of the main building did not form part of this visit. Dependency levels of the residents were described as being high, all of them having communication difficulties and needing a robust level of support to ensure their personal care needs. All but three of the residents were described as presenting challenging behaviour, but the care manager and her staff were feeling very encouraged that recent training, reviewed strategies of intervention, and reviews of medication, had enabled them to introduce more pro-active intervention, reducing the need for reaction occasioned by incidents of challenging behaviour. The current level of fee is £1658 per week. What the service does well: This service has achieved a Charter Mark Award, and the staff team have received recognition in the Staff Award Scheme of the local authority. These awards reflect the ability to provide a high quality, highly specialised service to a group of younger adults, male and female, with a substantial level of Learning Disability, associated with various communication barriers, and unpredictable challenging behaviour. 40 Cooperative Street DS0000032165.V327182.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. 40 Cooperative Street DS0000032165.V327182.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 40 Cooperative Street DS0000032165.V327182.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. The quality outcome in this area for this group of residents was good. This judgment was arrived at using all available evidence including that gathered during the visit to the service. This reflects the evidence showing that residents have only been admitted after a proper and appropriate assessment had confirmed the ability of the home to meet their needs and known choices. EVIDENCE: Two care plans were reviewed in detail, and they demonstrated that, not only was a full and proper assessment of needs and known choices had being undertaken prior to the admission of a resident, with multi disciplinary input using Care Management arrangements, but that continuous review was taking place to keep up with the changing needs experienced by the individuals. Discussion with the care manager and members of staff highlighted how even the most subtle change of routine or environment can result in some major changes in the life and behaviour of the group of residents accommodated at 40 Cooperative St. This demonstrated forcefully the high importance of continuous care plan reviewing, not only in the period immediately after admission, but throughout the whole placement of a resident. 40 Cooperative Street DS0000032165.V327182.R01.S.doc Version 5.2 Page 9 40 Cooperative Street DS0000032165.V327182.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. The quality outcome in this area for this group of residents was good. This judgment was made using all the available evidence including that gathered during a visit to the service. It reflects care plans being a living document describing how the needs of residents were met, how there was respect for their choice, and that protocols and procedures were in place to ensure they received the most independent lifestyle possible. EVIDENCE: In all two plans and three daily records were scrutinised in detail, and were seen to show a comprehensive picture of the needs and known choices of residents concerned. Residents were involved in care planning to the extent that they were able, and there were appropriate examples of input from both family, and relevant outside professionals who were part of the wider team ensuring the best possible care for that particular individual. 40 Cooperative Street DS0000032165.V327182.R01.S.doc Version 5.2 Page 11 Much discussion took place about the positive benefits being experienced as a result of some very robust reviews of the medication that residents had been taking, in conjunction with more mature approaches to anxiety and behaviour management than had been sanctioned previously. In one of the plans there was good evidence of the input of a family member to inform the service of the diversity of the cultural background of the resident, and it was pleasing to see that staff had then accessed the Internet to undertake research of their own to enable them the better to understand the cultural needs of that resident. There were risk assessments in place relating to the very particular and serious health care needs of the residents, and also in relation to their ability to take whatever decisions they could for themselves. 40 Cooperative Street DS0000032165.V327182.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, and 17. The quality outcome for this group of residents in this area was good. This judgment was made using all available evidence including that gathered during a visit to the service. It reflects residents activities being appropriate for that age and culture, them accessing local community, and maintaining contact with family, being shown respect, and having an enjoyable, nutritious, and appropriate diet. EVIDENCE: The first thing established by the inspector with the registered care manager, was that day-care is no longer provided within the building of 40 Cooperative St, as has happened previously when he inspected the service, and that in her own words: This is now a 24-hour home for these residents . The area previously used as a day-care centre has been converted to a large dining/activities room, and it was stated that the size of this space had been extremely beneficial in enabling residents to have their meals without being crowded together. 40 Cooperative Street DS0000032165.V327182.R01.S.doc Version 5.2 Page 13 This feature was said to be particularly helpful when someone was experiencing periods of behaviour which made it either advisable for the whole community, or soothing to them, to have an extended area of personal space around them. Even though those who continued to access mainstream or specialist day services only had to go as far as one of the adjacent buildings within the cluster on the same site, (where both traditional and individually tailored specialist day services were provided) the actual event of them leaving the building that was their home, had been seen to be beneficial and correspond to a de-escalation of challenging behaviour. Some residents were attending courses arranged through Stafford College, and these included basic first aid, and cookery, and had the additional benefits of bringing residents into regular contact with a wider group of individuals. Those residents who were going further afield and attending Rodbaston College near Penkridge were exploring further “life skills”. In relation to maintaining personal and family relationships it was established that a range of contacts was being maintained, represented by such things as: One person going to stay with her mum every fortnight. One person being visited by both parents every week. One mother visits as and when she can, but also writes regular letters. One Father (who lives abroad) writes at the least every week. And one resident who uses a mobile phone to speak to his father twice weekly, and who has been educated by members of staff to be able to use the text facility, whereby both saving money, and been able to see and save the rapid responses to his contact. No restrictions were placed on visiting, though the care manager did say that they encourage families to avoid coming at mealtimes if they were able to visit at any other time, and also they encourage the families of those people who became distressed by any interruption to their expected daily program, to phone staff in good time, so that the resident will not be surprised/disturbed by the visit. The welcome given to visiting family members was extolled by one mother in a telephone conversation to the inspector during which she also confirmed that residents went out into the community for leisure and recreation, and examination of some daily record sheets identified visits to shops, pubs, fitness centres, and two leisure centres. Following detailed discussions with the care manager and principal officer for the home, it will be recommended that steps should be pursued much more robustly, to identify safe means by which one resident can be provided with a 40 Cooperative Street DS0000032165.V327182.R01.S.doc Version 5.2 Page 14 Web Cam. This is to enhance the experience of speaking to a parent who lives on another continent, and who would otherwise hardly ever be seen. The kitchen and associated storage and preparation areas were not a visited during this inspection, but a selection of menus were provided which demonstrated a variation in the provision of meals, including the use of seasonal foods and local delicacies, and the recognition of a special dietary considerations (and care plans recorded the input and advice of appropriate health professionals such as dietician and speech and language services) and cook was in possession of a list of everybodys birthday, when she would prepare a special meal of their own choosing. In addition to the main kitchen, there was a small training kitchen where residents could undertake (with the support of a member of staff) activities for themselves in addition to their formal cookery classes. Whilst there was a pro forma timetable of meal times, this had and extensive degree of flexibility built in to accommodate for both the activities and choices of residents, and any problems that were being encountered in relation to behavioural difficulties. Breakfast could be taken at any time between 7:45 a.m. and 9 a.m., and as well as lunch and tea, there was also a snack supper sometime between 8:45 and 10 p.m. Where previously planned main dishes did not meet with resident’s approval, an alternative was always available and could be provided from the extensive food stores maintained (confirmed on a previous visit) by the home. 40 Cooperative Street DS0000032165.V327182.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, and 20. The quality outcome for this group of residents in this area was good. This judgement has been made using available evidence including a visit to this service. It reflects that resident’s dignity was valued in the way they were cared for; they received appropriate health intervention and advice, and that protocols and procedures in place to ensure they received the right medication at the right time in the right quantities using the right route. EVIDENCE: This home provides a service to a group of users all of whom exhibit some degree of challenging behaviour, and some of whom (10) where this was considered to be extreme. Otherwise they have various degrees of dependency requiring assistance from staff to help meet their daily needs and exercise their personal choices. Because of their conditions, there were well established links with healthcare professionals in both general and specialist fields. Discussion with staff and observation of care records confirmed that this included both regular monitoring of their cases by consultant led teams, and 40 Cooperative Street DS0000032165.V327182.R01.S.doc Version 5.2 Page 16 well maintained and detailed programmes of access to both primary and tertiary health care. In addition to visit to and by their GP and district or specialist nurse, the state of their hearing, vision, dentistry, and foot care were regularly assessed, and where necessary addressed. At this time no residents were holding or administering their own medication, though the care manager has initiated a liaison with the GP over one resident who has been assessed as being quite capable of undertaking this task for himself. Currently, all medication is administered by members of the management team, and during the day several of these confirmed in discussion that they had received regular and appropriate training to enable them to undertake this task. Procedures for administering and recording were observed and felt to be appropriate, as in the main was the provision for storage, though the home has yet to comply with a recent change in best practice being advised, which is to ensure that storage facilities are secured to a solid wall by means of Rag bolts . This action is recommended. In a formal interview with a member of staff, the undertaking of an intimate personal task was to discussed, and from the description of her actions received, it was obvious that staff in this home regarded it as second nature to ensure and enable residents to retain their dignity, and the highest degree of independence that they are able to. In addition to recordings regular events such as outpatient appointments, the care plans also detailed the provision of depot injections, annual flu jabs, monitoring body mass, blood pressure, fluid and food intake (where appropriate), and the very full health checks afforded to each resident on an annual basis by the local GP (in other areas known as Well Woman or Well Man checks), and a whole range of pro active health interventions especially in the areas of behaviour management, that have improved and enhanced the life experience of residents. 40 Cooperative Street DS0000032165.V327182.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. The quality outcome in this area for this group of residents was good. This judgment was based on all available evidence including that gathered during a visit to the service. It reflects robust training being given to members of staff with regard to the protection of vulnerable adults, and to them having an awareness of the need to advocate in the case of residents were unable to make complaints for themselves. EVIDENCE: In a formal in-depth interview with a member of the care of staff, both complaints procedure and the subject of the abuse of vulnerable adults was discussed at length. Her responses confirmed the written policies and procedures of the home in as much as assistance would be given to help residents to make complaints, where they lacked that ability themselves. Additionally, she was able to recount the regular input of training surrounding issues of abuse, and to recognise the wide range of people (anybody) who could perpetrate an abuse upon the vulnerable adults in her charge. She also knew what procedures she should follow should she suspect that this was happening, and displayed knowledge of a whole host of situations that would be considered abusive. In addition to this training, she confirmed that all staff undertake training in the management of actual and potential aggression, which is also relevant to help residents avoid being abused by fellow residents who are responding to their internal conditions, rather than who have any preconceived intent to injure their housemates. 40 Cooperative Street DS0000032165.V327182.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, 26, 27, 28, 29, and 30. The quality outcome for this group of residents was good. This judgment was made using all the available evidence, including that gathered on a visit to the service. It reflected residents lived in a homely, comfortable, and safe environment, and their personal and communal space meeting their needs and lifestyle, and helping to promote their independence, and giving them sufficient privacy to live their lives with dignity, in an environment that was well maintained, clean, and hygienic. EVIDENCE: A tour of the internal environment of the premises was undertaken. It was interesting to discover that after liaising with a fire officer over what was an acceptable solution, the walls of the main lounge that had previously suffered much damage from the propensity of one resident to head-butt them during periods of acute behavioural disturbance, had now been clad in fire retardant ply and emulsion. This softer material had the additional benefit of reducing damage to the resident. 40 Cooperative Street DS0000032165.V327182.R01.S.doc Version 5.2 Page 19 Good-quality carpeting and furnishing was observed throughout the tour, with maintenance programs keeping well abreast of the need for touch up painting, and rolling schedules of redecoration. Not all bedrooms were visited on this occasion, but those that were contained top-quality pine furnishing, varied decor schemes, and individual items that reflected the personality of the resident individual. Many had favourite photographs including extensive records of their life and their family members, as well as sensory equipment to help them relax. Some rooms were more sparsely equipped, and had received modification to enable the resident safe time on their own. (Where someone had regular behaviour of trashing their room, care had been taken to ensure that there was nothing that if broken might cause them to hurt themselves. This had included relocating the light switch in the corridor outside, so that the resident was still able to control it, without being endangered by possible live wires becoming exposed during an outburst of extreme behaviour, which were usually contained to his room.) Other modifications and adaptations that were discussed during this visit included changing the style of a buckle used on a wheelchair lap strap so that the occupant did not put herself at risk of falling out and hurting herself. The detached property containing accommodation for two residents and a sleep in room for a member of staff, was examined during this inspection. Suggestions were made to the care manager about more appropriate ways of storing hobby and craft equipment in the communal room, and this will be followed up at subsequent inspections. Two small areas that required spot redecoration were pointed out, but otherwise the accommodation met all the relevant national minimum standards. The service was warm, clean, light and airy throughout, and at no point where any hints of malodour detected. The garden, which received high praise in the last report, was looking rather neglected. The registered care manager was very disappointed that the development, supported by the Princes Trust Charity, had not excited residents in the expected manner, and had been a target for theft and vandalism by non-residents. Not only had the chairs to the garden furniture been stolen, but plants had actually been dug out of the garden and taken away unobserved. 40 Cooperative Street DS0000032165.V327182.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. The quality outcome for this group of residents in this area was good. This judgment was made using all available evidence including that gathered during a visit to the service. It reflects an adequate staff to resident ratio, and there being sufficient and appropriate training and employment of experienced and qualified staff. EVIDENCE: In a conversation with the inspector the mother of one resident stated that: The various people running this home have been absolutely marvellous . (Unfortunately she was in less enthusiastic mood when it came to telling of the changes in policy and reductions in commitment to service that she had experienced over the years from the local authority, who are the providers of this home. Her concern was reflected in two of the comments cards returned prior to this inspection by other parents, regarding how they felt themselves to have been let down over assurances given in the past that their son or daughter would be cared for the rest of their life by the authority. None of them were convinced that plans to purchase care through other providers met the authoritys obligation of care set out in various legislation dating back to the 1948 National Assistance Act.) 40 Cooperative Street DS0000032165.V327182.R01.S.doc Version 5.2 Page 21 A schedule of staff employed was provided, including their CRB number and the date on which confirmation had been given that no information was held against them, and during a formal interview with a member of staff, and from inspection of staff records, it was confirmed that all staff had been required to provide two references a clear police check, details of any disciplinary action over to immigrants and, and had undertaken both an initial induction and inservice refresher training courses, and were receiving regular supervision. The nature of this matter was discussed with staff, and it was established that supervision was a two-way process where they could bring to the attention of their supervisor any areas of concern, or training they felt they might benefit from. The care manager was able to show the inspector a very full matrix of training recently undertaken, and soon to be received, and as well as including all the mandatory subjects, there was planned and had already been undertaken much training pertinent to the particular conditions of these residents. In addition to management of actual and potential progression for all existing staff during May and June, and by five induction days for all new staff, these cover such things and out infection control, refresher courses are on blood glucose monitoring (and for the management team alone, instruction on how to give insulin) and pro active support, and added training from the consultant at New Burton House on anxiety management. This latter was regarded as the main course of the reduction in challenging behaviour being seen in the home, and the ability of the medical professionals to review and reduce much of the medication previously taken by residents. The diabetes training, and the robust links with Mrs Gill Green the specialist nurse, was said to have remarkably improved the quality of life for one resident, with the beneficial knock-on affect for the rest of the home. 40 Cooperative Street DS0000032165.V327182.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, and 42. The quality outcome for this group of residents in this area was good. This judgment is based on all available evidence including that collected during a visit to the service. It reflects residents being seen to benefit from a well-run home, to have good quality monitoring, so that their health, safety, and welfare, have been promoted and protected. EVIDENCE: In a discussion with the administrator it was established that residents benefited from competent accountable management of the home in the way their finances were being handled. Parents were appointees for the benefit of two residents, with the responsible individual, Mr Alan Lottinger, being the appointee for the others. 40 Cooperative Street DS0000032165.V327182.R01.S.doc Version 5.2 Page 23 Residents derived income from a mixture of benefits including Disability Living Allowance, Severe Disablement Allowance, and Income Support. Each was entitled to a personal allowance of £19 60 and were given money each day to pay for meals out, and day-care activities. Any surplus that they did not spend on personal choice items are accumulated in an individual (interest paid) savings account at the Halifax bank, and accommodation fees were recovered centrally by the local authority with all transactions being done by automatic banking. Evidence was seen during the tour of inspection of savings having been used wisely to improve the quality of life of residents as with such things as music centres, top of the range furniture, and sensory equipment, some of which was tactile, some visual, and some auditory. The registered care manager has all qualifications and experience necessary to fit her post, and in discussion with staff was given a very positive testimonial for the open, inclusive, and transparent way in which she ran the home. The inspector was told that she shared everything with all the members of staff as soon as it became known to her, and was always ready to support an individual, and to discuss any concerns they may have at any time. She herself was able to detail recent training that she had undertaken to maintain and update her knowledge, skills and competence, for managing the home. It was not possible to obtain from this group of residents any information about how their opinions and choices underpinned quality monitoring and development for home, but reference to care plans and discussion with staff and a family member, suggested that considerable steps were taken to try and determine what the residents wanted most, and to explore ways of meeting these choices. An action plan has been generated taking into account the views expressed in a quality audits based on responses from residents and their families. Nothing was seen during this inspection to arouse concern about the health, safety, and welfare of the residents, and the report of training given and planned included mandatory refreshers in these areas. Regular monthly visits were made by a principal officer of the local authority to the home, and these include sections on health and safety, and a report on them has been made available to CSCI. 40 Cooperative Street DS0000032165.V327182.R01.S.doc Version 5.2 Page 24 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 3 27 3 28 3 29 3 30 4 STAFFING Standard No Score 31 X 32 4 33 X 34 4 35 4 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 4 3 X 4 X 3 X X 3 3 40 Cooperative Street DS0000032165.V327182.R01.S.doc Version 5.2 Page 25 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. 1. Refer to Standard YA15 Good Practice Recommendations It is recommended that steps should be pursued much more robustly, to identify safe means by which one resident can be provided with a Web Cam. This is to enhance the experience of speaking to a parent who lives on another continent, and who would otherwise hardly ever be seen. It is recommended that the medicine cabinet should be affixed to a solid wall using Rag bolts . 2. YA20 40 Cooperative Street DS0000032165.V327182.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Stafford Office Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES 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 40 Cooperative Street DS0000032165.V327182.R01.S.doc Version 5.2 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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