Inspection on 23/09/05 for 8 Chestnut Road

This inspection was carried out on 23rd September 2005.

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 but made no statutory requirements on the home.

Other inspections for this house

8 Chestnut Road 31/10/06

8 Chestnut Road 19/01/06

8 Chestnut Road 22/03/05

8 Chestnut Road 14/01/05

8 Chestnut Road 30/03/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 8 Chestnut Road Downend South Glos BS16 5UN Lead Inspector Grace Agu Unannounced Inspection 23rd September 2005 09:30 8 Chestnut Road DS0000020300.V261175.R01.S.doc Version 5.0 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address 8 Chestnut Road DS0000020300.V261175.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. 8 Chestnut Road DS0000020300.V261175.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service 8 Chestnut Road Address Downend South Glos BS16 5UN 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) 0117 9572687 0117 9709301 Aspects and Milestones Trust Miss Claire Maine Care Home 5 Category(ies) of Learning disability (5) registration, with number of places 8 Chestnut Road DS0000020300.V261175.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. May accommodate up to 5 persons aged 16 - 30 years with Learning Disabilities 22nd March 2005 Date of last inspection Brief Description of the Service: 8 Chestnut Road is a care home operated by Aspects and Milestones Trust. The home previously provided nursing care for a mixed Service User group of up to five adults with learning disabilities. The home closed in it’s previous capacity on 31 March 2005 and reopened in July 2005 following refurbishment and redecoration and variation in the category of Service Users and type of service provided. The home is currently registered to provide personal care only for five people aged between 16 and 32 with learning disabilities. The home is set in a residential location in the middle of Downend, and is within close walking distance of local shops and amenities. The home is a converted bungalow, which has been extended and provides accommodation all on one floor. Bedroom accommodation is provided in five single rooms. Whilst there is no en-suite provision, all rooms have a wash hand basin. There is an open plan lounge and a dining room, which is fully utilised. Bathrooms and toilets have been fitted with adaptations to meet the care needs of service users within the home. There is appropriate provision of equipment to assist staff and clients. The home is set within its own grounds, and there is level access to the gardens. The home supports residents to use public transport access day care and social activities. Car parking is available. 8 Chestnut Road DS0000020300.V261175.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, which took place over seven and half hours and was conducted as a follow up in relation to re-opening of the home after refurbishment and re-decoration and also agreed variation from Care home with nursing to Care home for Personal Care only for people with learning difficulties. The category of residents was also changed to accommodate persons between 16-35. The home closed in March 2005 and the entire existing residents were found suitable accommodations in other Aspects and Milestones homes before it was reopened in July 2005. The inspection was also carried out in order to review the requirements made at the last inspection, which are still relevant after the changes at the home. Three of seven the requirements made at the last inspection were fully met. One of the requirements was no more relevant. It was agreed that requirements made in relation to medication training and fire drills would be reviewed at the next inspection. More information on this can be found in the body of the report. The recommendation does not apply any more because all the residents are mobile and may not require wheelchair for mobility. Generally the inspection was satisfactory; the residents met were found to be relaxed and were accessing all parts of the home without restrictions. Staff were noted interacting with residents in a sensitive and respectful manner. A tour of the building was undertaken and a number of records were viewed. Two residents and two staff members were spoken with on the day. What the service does well: The home is aware of the complex needs of the new category of residents and ensures that comprehensive pre-assessment is undertaken before residents move in. The home ensures that residents, families and or representatives and other health professionals are involved in the decision-making processes to ensure that individual needs are met holistically. 8 Chestnut Road DS0000020300.V261175.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? What they could do better: To ensure that the residents needs are met, it would be better if detailed care plans are in place to enable staff to provide appropriate and individualised care to the residents. Residents would be adequately protected if all hand written medication records are signed, risk assessment undertaken before self medication and clear labelling instructions obtained from the pharmacy to ensure that medication is not mismanaged. In addition, ensuring that there is a visitor’s record book would enable the home to monitor the type of persons visiting the home and to offer protection to the residents. Furthermore, reviewing the accident forms following a fall would enable staff to recognise and treat injuries promptly and satisfactorily if and when they occur. Residents would also be better protected if generic risk assessment of the home is undertaken to include, the kitchen, bedrooms, lounge and dining area. To ensure that the home meet the statutory requirement in relation to protection of resident, staff records must be provided at the home to be reviewed at inspection and ensuring that staff attend fire drill would raise staff awareness of the procedure to be followed in an actual emergency. Individuals living in the home would enjoy a better and more homely environment if the carpet in the foyer is cleaned and kept clean at all times. Prospective residents would be better informed about the home and be able to make a decision if a Service User’s Guide is provided for them. This document would also provide the general public with information about the home and it’s services. 8 Chestnut Road DS0000020300.V261175.R01.S.doc Version 5.0 Page 7 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. 8 Chestnut Road DS0000020300.V261175.R01.S.doc Version 5.0 Page 8 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 8 Chestnut Road DS0000020300.V261175.R01.S.doc Version 5.0 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4,5 The home has a detailed and well-planned admission process to enable prospective residents to make an informed choice about moving into the home with the assurance that their needs would be met. EVIDENCE: The home has a statement of purpose, which has detailed information about services and facilities provided at the home. The manager stated that some of the residents came to view the home after the renovation and participated in choosing the furniture for the home before their admission. The manager also stated during discussion that the Social Services care plan provided her with detailed information about the residents and in addition, she visited the residents in their various locations and spent time with them and their families or their representatives to enable them to ask any questions that they may have before admission. Furthermore, the home organised a party for the residents and their families to enable them to interact with one another. All the residents visited the home on several occasions and some stayed overnight before moving in finally. Some residents moved in at different stages. The manager stated that the home currently has four residents and that the home is not in a haste to fill the vacancy and that this is to enable the staff to be more familiar with the current residents and their complex needs. Terms 8 Chestnut Road DS0000020300.V261175.R01.S.doc Version 5.0 Page 10 and Conditions in form of Licence Agreement were noted in each individual care file viewed. 8 Chestnut Road DS0000020300.V261175.R01.S.doc Version 5.0 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9,10 Residents are supported with risk assessment to participate in the running of the home with the assurance that information about them will be kept confidential. However, the home fails to provide them with comprehensive and individualised care plan to meet their assessed needs. EVIDENCE: All four care files of the current residents were reviewed and information noted included; guidelines for male staff working with a female resident, family contacts, personal safety, risk assessment and personal likes and dislikes. The manager stated that the home is currently assessing the needs of the residents by using the information provided on the social services care plan. The home is also gathering information in relation to individual residents to enable the home to draw up Person Centred Care plan for all the residents living at the home. One resident spoken with stated that “ they look after me, I make my bed” and that she is supported to make decisions. During a discussion the manager 8 Chestnut Road DS0000020300.V261175.R01.S.doc Version 5.0 Page 12 stated that one resident is currently being assessed in relation to going out independently. Staff currently working at the home have experience of working with people with Learning Difficulties and were selected from other Aspects and Milestones homes for their experience in dealing with complex needs. The manager stated that staff have attended confidentiality training but would be arranging an update amongst other arranged training courses. A confidentiality policy was noted at the home. It was noted whilst walking round the home that two residents were being supported on a one to one basis, the manager stated that one of the residents has an extra thirty hours support from the community services because of her high level of needs and that another resident has ten hours extra support from the community services due to his/her mental health needs. The manager also explained that the extra hours are also to enable one of the residents to settle at the home due to his/her background. Staff are aware of residents individual forms of communication, one resident has special communication equipment in his room and all staff have attended training on how to use this equipment. One staff member interviewed demonstrated understanding and awareness of this equipment. One resident with a medical condition also has a special equipment to alert staff of excessive movement at night. 8 Chestnut Road DS0000020300.V261175.R01.S.doc Version 5.0 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,14,15,16,17 Residents have opportunities for personal development and are supported to maintain links with the community, families and friends. Their individual rights are respected whilst providing healthy diets at chosen times. EVIDENCE: Discussion with the manager, staff and information from the review of the care files showed that the residents are supported to engage in leisure activities both outside and within the home. The manager stated that residents are involved in planning their individual activities as much as practically possible with staff weekly before it is displayed on the notice board. A senior staff member audits these activities weekly to ensure that they actually took place. Some activities noted on the board include 18 -getaway programme from 22 September - November 24 2005, Fitness club, Quiz night and Sportability club. One resident spoken with stated that she goes shopping with staff, that mum visits on Tuesdays, does gardening on Sunday, and goes to college on 8 Chestnut Road DS0000020300.V261175.R01.S.doc Version 5.0 Page 14 Wednesdays to study dancing and gardening. The resident also cleans her/his room on Sundays and enjoys the company of other residents. Another resident stated that she goes to school daily and that she participates in the activities at school and the ones organised at the home. One staff member was seen doing music exercises with one of the residents in the afternoon. Other residents attended day centres based on their individual needs. A Record of visitors to the home was noted in the staff communication book, it was agreed that the home provide a separate visitors book to ensure that individuals visiting the home are properly recorded for residents protection and for the purpose of accountability in the event of fire emergency. Each resident had individual detailed dairies and residents are encouraged and supported to write in them. Where a resident was unable to write, staff make entries and read it back to the resident. There was an entry on 24/8/05 by a resident, it was noted that the date corresponded with his/her sister’s visit to the home. The manager stated that the home plans to use the information gathered from the dairies as another tool for the development of Person Centred Plans for the residents. Residents take in turns to plan the weekly menu with the support of staff members. The manager stated that only dinner is planned and that breakfast is dependent on individual preferences. Extra shelves were installed in the kitchen for individual residents to store their food based on their individual needs. At lunch time the resident at home was noted eating his/her meal with two staff members, the resident was provided with special cutlery to assist with the meal which looked very nutritious. Staff were noted interacting with the resident in a sensitive and dignified manner. The kitchen was noted to be clean, fridge and freezer temperatures were regularly recorded and food left in the fridge was labelled and in date. 8 Chestnut Road DS0000020300.V261175.R01.S.doc Version 5.0 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,29,21 Residents receive preferred support as required, their emotional and physical health needs are met, also respect is given to their wishes in the event of death, however the home fails to protect the residents from potential harm through it’s medication malpractices. EVIDENCE: On the morning of inspection, three residents with high complex needs were met at the home. One of the residents was noted being taken by a visitor to the day centre, the resident looked well presented and was seen being managed in a sensitive and dignified manner. One staff member met on duty was seen interacting with the other two residents with respect and demonstrating awareness of their individuality in all aspects of their care. One resident spoken with stated that staff help her when she wants them to, however, she is able to manage her personal care, another resident stated that staff support her when she needed also stated that “I can dress myself”. One staff member spoken with stated that she/he knows the resident very well and that the information she/he gathered about the resident is usually communicated to the rest of the team to ensure every person is aware 8 Chestnut Road DS0000020300.V261175.R01.S.doc Version 5.0 Page 16 of the needs of the resident. The staff member also stated that she/he is aware of the resident’s behaviour problems and lack of communication and ensures that there is a consistent approach in managing the resident. Staff are aware of the resident’s expectation and that the resident is aware of the staffs expectation. In order to promote a consistent approach to the residents care, information about individual needs of the resident was noted in the folder for all Bank Staff. Evidence from the care files showed that the residents are registered with the local GP and other professionals visit as required. The daily report had entries of how the residents spend their days and there was also a communication book for all staff in relation to issues concerning the home. Medication review showed that all medication was securely locked away, however it was noted that the home had a large stock of liquid medication, it was agreed that the home stop requesting those identified liquid medications until the present stock are administered. A requirement was made in relation to unsigned hand written medications and for the home to ensure that all medications are labelled with clear instructions from the pharmacy. All staff working at the home have received training on Epilepsy and administration of Rectal Diazepam in an emergency. A letter of consent from the GP was noted in the file. The manager stated that staff working at the home were selected from other Aspects and Milestones homes and have been with the company for many years. She is confident that they have all attended medication competency training, however evidence from the training matrix sent to the commission showed that staff working at the home have not attended medication competency training. The manager stated that she would ensure that all staff working at the home undertake another medication competency update. The home is required to provide evidence of this training to ensure that staff administering medication to the residents are competent to do so. A requirement was made in relation to a resident who was self-medicating without consent, an agreement and written risk assessment. 8 Chestnut Road DS0000020300.V261175.R01.S.doc Version 5.0 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 The Residents are supported and encouraged to complain with the confidence that their views would be listened to and acted upon. Staff are aware of how to protect residents and systems are in place to protect residents from harm and abuse. EVIDENCE: The complaints book showed evidence of no complaints. It was noted when reviewing the care files that all the residents have a complaints procedure which was in picture format due to their special needs. Information about the Commission for Social Care Inspection was included in the document to enable residents and their representatives to contact the Commission if they were not satisfied with the services provided at the home. The complaints procedure was also noted displayed at the home. The home has a policy and procedure on the Protection of Vulnerable Adults from abuse. The manager and staff showed awareness of the procedure. One staff member interviewed stated that she has received training on abuse and would report any bad practices to the manager. One resident had guidance, for male staff, in the care file to ensure that the resident is adequately protected. The manager was unable to provide evidence of staff recruitment documentation on the day of inspection, she stated that the staff records were at the Aspects and Milestone head office, however the training matrix was sent to the Commission before the completion of this report. The training matrix showed that all staff working at the home have attended training on Protection of Vulnerable Adults from abuse. 8 Chestnut Road DS0000020300.V261175.R01.S.doc Version 5.0 Page 18 Criminal Bureau checks disclosures have been obtained for all staff working at the home. Other recruitment documentation will be reviewed at the next inspection. 8 Chestnut Road DS0000020300.V261175.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26,27,28,29,30 The residents are provided with a good comfortable environment with suitable specialist equipment where they feel safe to live, however the home fails to provide cleanliness in some parts of the home. EVIDENCE: There have been changes in relation to the category of residents registered at the home. The home previously provided accommodation with nursing care for adults with learning difficulties; this was recently changed to provide personal care only for person’s form 16 to 32years of age with learning difficulties. The structures of the home have not been altered however the home has been refurbished and redecorated to meet the needs of the present category of residents. The numbers of bedrooms have not been altered, the four bedrooms presently occupied were noted to be personalised, colour co-ordinated and spacious. The fifth bedroom was noted to be tidy. The communal area was noted to be well furnished homely and comfortable. It was noted that the concern raised at the last inspection in relation to the condition of the road surface resulting in pot holes remain unresolved. The homes current residents have less mobility problems and may not need wheelchairs for mobility. 8 Chestnut Road DS0000020300.V261175.R01.S.doc Version 5.0 Page 20 All the corridors were fitted with handrails to assist residents’ mobility, the toilets, bathroom and shower room have grab rails. The shower room was also fitted with non-slip flooring to provide extra protection for residents. However, the high low Arjo hoist bath was noted with rust on the bottom end of the bath, this is hazardous to the residents and staff. The carpet in the hallway leading to the dining room had food stains and needed a deep clean to remove the stains. A requirement was made in relation to the above issues of concern. The laundry was noted to have good flooring to ensure residents safety, there were two washing machines and one dryer and this was sufficient to meet the residents’ needs. A poster with guidelines on Control of Substances Hazardous to Health was also noted in the laundry to provide residents and staff with information dealing with chemical emergencies. Generally the residents were noted to be relaxed and enjoying each other’s company. One resident was seen accessing all areas without restrictions. Another resident spoken with stated that she likes the home and gets on well with other residents. 8 Chestnut Road DS0000020300.V261175.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35,36 Residents enjoy good warm relationships with competent staff and are protected by the home through staff provision. EVIDENCE: The available staff training records at the home and training matrix sent to the Commission showed that all staff have attended training on Epilepsy awareness and Dynamite training for specialist electronic communication for a resident with sever communication problems. Other training attended included Active listening, Basic first aid, Manual Handling, and Health and Safety and Fire awareness. One staff member interviewed stated that she has attended manual handling training, abuse training and also an Empowerment Practice course. All staff are aware of their roles and responsibilities in relation to the care of residents. The manager during discussion stated that four staff members have undertaken National Vocational Qualifications (NVQ) in care at level 3, two staff members are currently undertaking NVQ at level 3, one staff member has almost completed and another staff member is in the process of registering for NVQ at level 3. One staff member interviewed stated that there is a good communication within the team. Minutes of the last team day meeting evidenced discussion 8 Chestnut Road DS0000020300.V261175.R01.S.doc Version 5.0 Page 22 around individual residents’ needs, information from staff who have worked with present residents, epilepsy update, record keeping and communication, local community links and Person Centred planning. Staff have received regular supervision to enable them to perform their duties effectively and to discuss any areas of difficulties. Review of staff duty rotas evidenced that the home is adequately staffed, however on the day of inspection one staff member was met on duty in the morning with three residents with highly complex needs. The staff member stated that a Bank Support Worker was expected to be on duty in the morning but had not arrived and no reasons were given for his/her absence. The staff member stated that she was able to cope because she knew the residents routine well and that one resident had gone to school and another resident was also going out to the day centre shortly. She would ask for help and contact the manager if she was unable to meet the needs of the residents. The manager was contacted and she arrived at the home within 45 minutes of contact. The staff member showed evidence of knowledge of the residents through her interaction and dealings with the residents before the arrival of the manager who assisted the staff member with providing personal care for the residents throughout the morning. The inspector was particularly pleased with the depth of knowledge, care and sensitivity showed by the Support Worker met in the morning of the inspection before the arrival of the manager. The manager stated that she would find out the cause of the Bank staff’s absence. 8 Chestnut Road DS0000020300.V261175.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,38,39,40,41,42,43 The home is managed by a competent leader who safe guards the rights and interest of residents and also protects them through application of policy and procedures; however, the home fails to protect them through lack of appropriate risk assessment. EVIDENCE: Claire Maine was recently registered as manager of 8 Chestnut Road after a successful “Fit Persons Interview” at the Commission for Social Care Inspections. Nicola obtained the Registered Managers Award in 2003. She is well experienced in the care of people with learning difficulties. Other courses attended by Nicola include Epilepsy awareness, Dynamite training and NVQ workshops. Staff spoken with on the day of inspection commented positively on the manager’s ability in relation to managing a care home for people with learning difficulties. Staff stated that the manager is caring, kind, approachable and will listen and act upon any concerns raised. The manager stated at a discussion 8 Chestnut Road DS0000020300.V261175.R01.S.doc Version 5.0 Page 24 that the team have had two meeting days and that the most recent one was on 5/07/05,the minutes of the meeting were noted on the file. The manager stated that her objective is to draw up care plans for the needs of the residents using the Person Centred Plan; this will be ready amongst other things to be viewed at the next inspection. The residents at the home were unable to make comments about the manager, however it was clear that the manager had good positive relationships with the residents as was seen in her interaction with them on the day of inspection. The home is currently monitoring its quality of service through the monthly provider visits, the manager stated that the residents questionnaire will be introduced after the residents meeting on the 23/09/05, the relatives questionnaire will be sent out in October then reviewed 6 monthly. It was agreed that questionnaires should be sent to health professionals that visit the home in order to seek their views in relation to the services provided at the home. Policies and procedures noted at the home to ensure that the residents are adequately protected include medication policy, record keeping and communication, accidents, Health and Safety, control of infection and Missing Person’s policy. The fire logbook was viewed and was found to be well maintained. Other Health and Safety checks seen included, Gas yearly inspections certificate, maintenance book, portable appliance testing certificate (for electrical appliances) and service certificate for bath hoist. It was noted at reviewing the records that only two staff had attended the fire drill on 3/09/05. The manager is required to ensure that all staff attend regular fire drills in order to have knowledge and awareness of how to deal with actual emergencies if and when they occur. Accidents were recorded in each individual resident’s file however, reviews need to be satisfactorily carried out to enable staff to detect and deal with injuries promptly if and when they occur. It was also noted that guidelines were in place in the accident book in relation to how to deal with a resident who had behavioural problems and was aggressive towards another resident. Residents’ money kept at the home was checked and the balance was correct, other records were seen to be securely locked away. The home is part of a group and is financially stable. 8 Chestnut Road DS0000020300.V261175.R01.S.doc Version 5.0 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 3 3 4 3 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 3 3 3 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 2 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 2 16 3 17 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 8 Chestnut Road Score 3 3 2 X Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 2 2 DS0000020300.V261175.R01.S.doc Version 5.0 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 2 Standard 6 20 Regulation 15(1) Requirement Timescale for action 23/10/05 07/10/05 3 4 5 6 7 8 9 30 15 42 43 43 1 42 Ensure that Care Plans are in place for all residents assessed needs. 13(2) All hand written medication on the Medication Administration Record Sheet (MARS) must be signed 16(2)(j) Ensure that carpet in the hallway is kept clean at all times SCH 4(17) Provide Visitors record book at the home. 13(4)(c) Undertake generic risk assessment of the home. SCH 4(14) Ensure that all staff attend fire drills. SCH4(6) Ensure that all staff records are available at the home. 5 Ensure that Service Users’ Guide is available at the home. 14 Ensure that accidents are satisfactorily reviewed. 07/10/05 23/10/05 23/12/05 23/12/05 23/12/05 23/12/05 23/10/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. 8 Chestnut Road DS0000020300.V261175.R01.S.doc Version 5.0 Page 27 No. Refer to Standard Good Practice Recommendations 8 Chestnut Road DS0000020300.V261175.R01.S.doc Version 5.0 Page 28 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos BS32 4RG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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