Inspection on 12/08/05 for 8 Winton Street

This inspection was carried out on 12th August 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 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

8 Winton Street 04/06/07

8 Winton Street 25/01/06

8 Winton Street 25/01/05

8 Winton Street 17/06/04

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Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

Pinta

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

CARE HOME ADULTS 18-65 Winton Street 8 Winton Street Ryde Isle of Wight PO33 2BX Lead Inspector Janet Ktomi Unannounced 12 August 2005 th 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 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 Stationary 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. Winton Street H55 H04_S12557_Winton Street_V218341_120805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Winton Street Address 8 Winton Street. Ryde, Isle of Wight, PO33 2BX Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01983 566437 01983 566437 Islecare 97 Limited Gail Lesley Brook Care home 4 Category(ies) of Learning disability registration, with number of places Winton Street H55 H04_S12557_Winton Street_V218341_120805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: none Date of last inspection 25/1/2005 Brief Description of the Service: 8 Winton Street is a residential home providing care and accommodation for up to 4 younger adults with Learning Disabilities. The home is a two storey, semi detached house in a residential area of Ryde, a short walking distance from local shops, the beach and leisure facilities. Also relatively convenient are Ryde town centre, the railway station and Ryde bus station. There are several steps with a handrail to the front door and ramped access to the rear garden. Parking is limited to the streets around the home. There is no lift so service users on the first floor must be fully ambulant.The home is managed by Mrs Gail Brooks and the registered provider is Islecare 97 Ltd., part of Somerset Care. Winton Street H55 H04_S12557_Winton Street_V218341_120805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was the first unannounced inspection of this inspection year, core and additional standards were assessed. Core standards not assessed during this inspection will be assessed during the second unannounced inspection. The inspection was undertaken on a weekday afternoon and lasted two and a half hours during which a tour of the building was undertaken. Discussions were held with staff on duty and everyone living at the home was met during the inspection and gave the inspector their views about the service. Pre-inspection questionnaire, relatives and service user comment cards were returned to the Commission shortly before the inspection and information from these has also been used in the report. Service users stated that they enjoyed living at the home and liked the staff. Care and other records and documentation identified in the report were viewed. What the service does well: What has improved since the last inspection? The home now maintains a record of ‘as-required’ Paracetamol administered to service users as part of the medication administration records. The home Winton Street H55 H04_S12557_Winton Street_V218341_120805 Stage 4.doc Version 1.40 Page 6 continues to provide a very individualised service to the four people who live there. 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. Winton Street H55 H04_S12557_Winton Street_V218341_120805 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Winton Street H55 H04_S12557_Winton Street_V218341_120805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2, 3, 4, and 5. The home supports new service users appropriately throughout the admission process, however there is a need to ensure that all the documentation in respect of admissions is fully completed. EVIDENCE: One service user has been admitted to the home since the previous inspection. The care plan and file for this person were viewed during the unannounced inspection. The care manager had provided a detailed assessment for the service user that had been completed four months prior to the service user being admitted to the home. A report had also been provided by the respite service previously attended by the service user. The file contained a copy of the home’s pre-admission assessment but only the initial two pages had been completed and this had not been signed or dated. It was not clear within the care plan that the care plans or risk assessments had been reviewed or updated since the service user was admitted despite a sheet on the back of the care plans stating that these were for monthly reviews of the care plans. Care plans contained records maintained by care staff of the care and support provided to individual service users including records of contact with health professionals. Discussions with care staff indicated that they had a good knowledge of the new service user and were aware of how to provide support and care for him. The service user stated to the inspector that he was happy living at the home and appeared well cared for. A comment card received from Winton Street H55 H04_S12557_Winton Street_V218341_120805 Stage 4.doc Version 1.40 Page 9 this service user prior to the inspection confirmed that the service user felt well cared for and was happy living at Winton street. The newest service user, existing service users and care staff confirmed that there had been a number of opportunities for the service user to visit the home prior to his moving in. The service user is funded by social services and a copy of the contract between Islecare ‘97 and social services for the placement was noted in the file. Winton Street H55 H04_S12557_Winton Street_V218341_120805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7, 8 and 9. All service users have individual care plans and risk assessments. EVIDENCE: The care plan for one of the four service users was viewed during the inspection. Additional care plans will be viewed during the next unannounced inspection to be undertaken later in the year. The care plan viewed was individual to the service user who had been living at the home for the previous four months. Care staff stated that the service user is helping to write some parts of his care plan such as his life history section. The care plan viewed contained relevant sections with care needs identified and how these should be met. Care staff complete recordings as to care provided to the service user and those read would appear relevant and concise. During the inspection staff were observed to respect service users’ rights to make decisions within the limitations of their abilities. During the inspection staff were noted to ask service users questions and give appropriate time for them to respond in either verbal or non-verbal communication. Care staff were seen to seek service users’ permission before entering their bedrooms. Service users’ relatives are encouraged to maintain involvement, and could be utilised Winton Street H55 H04_S12557_Winton Street_V218341_120805 Stage 4.doc Version 1.40 Page 11 should complex decisions have to be made. Service users are supported by staff to manage their personal finances. The arrangements in respect of service users’ personal finances will be inspected during the next unannounced inspection. Throughout the inspection it was clear that service users have control over many aspects of their own lives and in the organisation and running of the home. There are regular service user meetings. During these meetings service users are encouraged to discuss a variety of issues such as menu planning and holidays. Service user meetings also allow the manager to keep service users up to date with anything that is to happen within the home. The home is small and therefore service users have much control over the day to day decisions made within the home. Staff were noted to ask service users what they wanted for pudding on the day of the inspection. Service users are encouraged to participate in a variety of domestic activities within their rooms and the home, helping with shopping, gardening, meal preparation and cleaning as they wish. Service users spoken with during the inspection confirmed that their views and opinions are sought and that they felt able to express their opinions to the care staff and manager. Winton Street H55 H04_S12557_Winton Street_V218341_120805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11, 12, 13, 14, 15, 16 and 17. Service users enjoy a varied lifestyle with lots of opportunities for community and leisure activities. The home supports and maintains links with family members and friends. Service users are involved in planning a varied nutritious diet. EVIDENCE: Each service user has an individual weekly programme of activities that includes a range of day services, college, work opportunities and leisure activities, intended to help develop and maintain life skills and provides opportunities for socialisation away from the home. Care plans contain a record of ad hoc social outings and activities organised by care staff. Discussions with care staff and service users confirmed that service users enjoyed these activities and had been involved in the development of their individual plans. During the unannounced inspection one service user returned from their day services and stated that she had enjoyed herself and another returned from an ad hoc outing with a staff member. Winton Street H55 H04_S12557_Winton Street_V218341_120805 Stage 4.doc Version 1.40 Page 13 Within their bedrooms service users have a variety of home entertainment equipment such as TVs, videos, music systems and relaxation equipment. During the inspection service users were noted to be able to spend their time as they wished, one watching cricket in his bedroom and the others socialising and assisting staff in the preparation of the evening meal. Service users are encouraged to assist with domestic activities with one proudly showing the inspector an area of the garden he was cultivating. The location of the home is close to the beach and town centre of Ryde with easy access to local bus and train services. Service users said they regularly attend local pubs and restaurants and staff support is provided if necessary. There is usually two staff on duty in the evenings and at weekends therefore support to attend community events is available. Care staff stated that they will suggest specific events such as carnivals or shows and service users may then decide if they wish to attend. All service users had recently been to the circus. Service users are also involved in assisting care staff with food shopping in the local shops and use local health facilities. Care records detail community activities service users have attended within the daily recordings and monthly summaries. Staff rotas confirmed that additional staff are provided at evenings and weekends to facilitate leisure activities. Service users informed the inspector that they will all be going on holiday this year, one going with a staff member to visit Cornwall where he used to live and the remaining three service users together to Bournmouth. Service users are supported to celebrate life events and one recently enjoyed several parties and an airplane ride as part of his sixtieth birthday celebrations. Service users are able to invite friends to visit them at the home, one informing the inspector that he regularly invites his girlfriend for meals. Family members are also welcome at the home. The home’s routines tend to be organised around the service users and if they are not home when main meals are served these are plated and available when the service user returns home. Risk assessments are in place to promote service users’ independence and freedom of movement with skills training being offered by staff to further promote independence. All the bedrooms have a lockable door that some service users choose to use. The home has a nonsmoking policy, however one service user does smoke. There is no suitable place within the home to smoke so he must do so outside in the rear garden. The home does not employ separate catering staff so care staff take turns to cook each day. Staff help service users to choose menus, and service users are encouraged and supported to cook their own meals during home days. Service users are provided with a cooked breakfast at weekends, cereal and toast weekdays. They take packed lunches to work, college or day services and have a main cooked meal in the evenings. Records showed that meals are varied Winton Street H55 H04_S12557_Winton Street_V218341_120805 Stage 4.doc Version 1.40 Page 14 and nutritious. Service users commented that they liked the food at the home and that they could ask for something different if they did not want what was available. During the inspection service users were consulted on the choice of pudding. Winton Street H55 H04_S12557_Winton Street_V218341_120805 Stage 4.doc Version 1.40 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 standard(s) 18, 19 and 20. Service users’ physical and emotional health needs are met. Privacy and dignity are maintained during any personal care support provided. Medication is appropriately stored and administered, however the home must ensure that it appropriately records when medication is refused or not administered. EVIDENCE: Pre-inspection comment cards were received from all the service users that confirmed that their privacy and dignity are maintained. The care plan for one service user was seen during the inspection and this contained information as to how personal care needs should be supported. The home operates a key worker system that provides for individual support and monitoring of service users’ daily needs. All service users are independently mobile and require minimal physical support from care staff. There was evidence from conversations with staff and care records showed that individual service users have access to specialist support and advice as and when required. Service users spoken with confirmed that they are able to choose their own clothing, hairstyles and appearance. Service users also confirmed that staff respect their privacy and knock on bedroom doors before entering. All service users are registered with local GPs and support is provided from care staff to make and attend appointments. The pre-inspection questionnaire information confirmed that no service users have attended the accident and Winton Street H55 H04_S12557_Winton Street_V218341_120805 Stage 4.doc Version 1.40 Page 16 emergency department and all have regular dentist, optician and chiropody appointments. Care records recorded that specialists such as speech therapists, psychologists and community nurses are accessed as and when required. One service user showed the inspector her communication folder containing numerous symbols to aid communication. At the time of the unannounced inspection all medication was found to be stored appropriately. The medication administration records were viewed. It was noted that on several occasions when one service user had refused topical medication the correct code for refusal by service user was not recorded on the Medication Administration record sheet. The home is required to ensure that accurate records are held in respect of medications with the correct codes used to indicate reasons for non-administration. The home uses a pre-dispensed system for tablets with liquid medication dispensed at the time of administration. None of the service users living at the home are able to self medicate, therefore all medication is administered by care staff who have received additional training and been deemed competent. The pre-inspection questionnaire completed by the manager stated that care staff have undertaken the BTEC medication course. Care staff on duty at the time of the unannounced inspection stated that they have completed the BTEC medication course at the college. The home keeps information leaflets about medication in use in the home and individual service users have a list of current medication and information relating to the tablets such as potential side effects. Guidelines as to the administration of ‘as required’ medication (such as Paracetamol) were seen. It is noted that some of the guidelines for ‘as needed’ medications had been written in 2001 and it is required that these guidelines are re-assessed and then reviewed at six monthly intervals. The home now appropriately records individually when ‘as needed’ Paracetamol is administered to service users. No controlled medications are held within the home. Winton Street H55 H04_S12557_Winton Street_V218341_120805 Stage 4.doc Version 1.40 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 standard(s) 22 and 23. The home has a complaints policy in symbol format with service users’ opinions sought and respected by staff. Staff within the home are aware of adult protection issues and follow the locally agreed procedure in the event of adult protection concerns. EVIDENCE: Islecare ‘97 has a complaints policy which is made available to service users or their representatives in the service users’ guide. There is also information as to how to complain available around the home. The complaints policy should ensure that all complaints are appropriately investigated within twenty-eight days. The home maintains a complaints book, this was viewed and no complaints have been received during the past year. Staff spoken with were aware of what procedure they should follow should a service user or their representative make a complaint. Service users at the home are cognitively able to make a complaint and it is the manager’s opinion that should they wish to do so service users would be able to complain. Pre-inspection comment cards returned by service users indicated that they would inform the manager or care staff if they had any complaints. The home has a copy of the Isle of Wight Adult Protection Policy together with the Islecare ‘97 adult protection and whistle blowing policies. The preinspection questionnaire stated that care staff receive training in respect of adult protection. Staff spoken with during the inspection were all aware of the adult protection policy and procedures and clear about their responsibilities to report issues of concern without delay. All service user bedrooms contain a secure lockable facility where valuables or money may be stored. The employment procedures followed by Islecare ‘97 should ensure that unsuitable people are not employed at the home and include POVA and CRB checks. Winton Street H55 H04_S12557_Winton Street_V218341_120805 Stage 4.doc Version 1.40 Page 18 Winton Street H55 H04_S12557_Winton Street_V218341_120805 Stage 4.doc Version 1.40 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 standard(s) 24, 25, 26, 28, 29 and 30. The premises is suitable for the existing service users providing all single bedrooms and appropriate bathing, WC, and communal space. The home is well maintained and clean. EVIDENCE: A tour of the building, including two of the service users’ bedrooms, was undertaken during the inspection. The home is safe, generally well maintained and at the time of the unannounced inspection clean and warm. The home meets service users’ needs in a homely and domestic way. Bedrooms are all single and spacious with communal areas, lounge and kitchen/diner appropriate for the service users. There is ramped access to the rear garden, which is mainly laid to lawn with seating for service users. There are no wheelchair users amongst the current service users. The home is situated close to local amenities and transport links and is maintained with the help of a handyman employed by Islecare ‘97. As previously stated, one of the four service users living at the home smokes. The home has a no smoking policy therefore he must smoke outside in the back garden. Winton Street H55 H04_S12557_Winton Street_V218341_120805 Stage 4.doc Version 1.40 Page 20 All service users are provided with a single bedroom, one of which has en-suite facilities. Bedrooms seen were all pleasantly decorated and individually personalised. Personal home entertainment equipment such as televisions, music centres and sensory lights were seen in the bedrooms. One service user informed the inspector that his bedroom was due to be redecorated whilst he was on holiday and that he was to have new bedroom furniture. The communal space provided is domestic in nature and appropriate in size and furniture to meet service users’ needs. There is a kitchen/dining room and lounge. The home does not have separate areas for visitors to be received in private. The home has a reasonable sized level rear garden which service users are able to enjoy during the summer months. Care staff and service users confirmed that the gardens, which are safe, private and flat are used during the summer with garden furniture available for service users. Hand rails and a small ramp are provided at the rear door, although these are not required by the existing service users but would enable visitors with a physical disability to access the home. On the day of the unannounced inspection the home was noted to be clean, tidy and free from offensive odours throughout. Care staff undertake all domestic and laundry activities. The home has policies and procedures in place for the control of infection. Care staff confirmed that they receive initial and update training in respect of food handling, health and safety, infection control and hygiene issues. Supplies of liquid soap, disposable gloves, aprons and paper towels were seen during the inspection. Laundry facilities are able to wash to high temperatures if required. Winton Street H55 H04_S12557_Winton Street_V218341_120805 Stage 4.doc Version 1.40 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32 and 33 The home employs appropriate care staff in terms of both numbers and skills to meet the needs of service users. EVIDENCE: Care staff confirmed that they have all received job descriptions provided by the company, Islecare ’97, and were aware of their roles as key workers and care staff. Staff spoken with understood when and how to seek advice and support via the Islecare on-call system. Services users stated that they liked the care staff, that they were helpful and they could ask their help with any problems. All care staff have completed induction training and core, update training. Service user specific training is, or has been, arranged by the manager to meet identified needs. 40 of the care staff have NVQ level 2 or above in care with the remaining care staff now registered and commencing NVQ courses. The manager is an NVQ assessor and is committed to training. There are five permanent care staff employed within the home. Staff rotas and discussions with staff confirmed there is one staff member on duty in the daytime with two staff available from about 4.00 p.m. throughout the evening and all day at weekends. One staff member sleeps in during the night with additional staff on call away from the home. Staffing rotas are designed to ensure staff are available at times when service users are at home and where possible key workers are on duty for service users’ home days. Staff spoken Winton Street H55 H04_S12557_Winton Street_V218341_120805 Stage 4.doc Version 1.40 Page 22 with felt that the staffing levels and arrangements were appropriate to the service users’ needs and that activities relating to social and leisure were frequently organised during the evenings and weekends. The staff have worked at the home for several years and are familiar with the service users. Both male and female staff are employed. Service users informed the inspector that they liked the staff who they described as helpful and nice. Service users were able to name their key workers. Winton Street H55 H04_S12557_Winton Street_V218341_120805 Stage 4.doc Version 1.40 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 38, 40, 41 and 42. The home is well run however the manager must ensure that a record is maintained on the duty rotas of the hours she works within the home. Records are generally well maintained with the exception of some aspects of the medication administration records and manager’s hours worked in the home. The health, safety and welfare of service users are promoted and protected. EVIDENCE: The manager, Mrs Gail Brook, has now managed the home for about two years. Telephone discussions were held with the manager following the unannounced inspection. The manager stated that she works 20 hours per week in the home with the remainder of her full time hours being completed with training work for the Islecare ‘97 company. There was no record available in the home to confirm the number of hours that the manager spends in the home and it is required that a record is maintained on the duty rotas to confirm hours worked by the manager. Winton Street H55 H04_S12557_Winton Street_V218341_120805 Stage 4.doc Version 1.40 Page 24 Care staff spoken with during the inspection stated they were able to discuss issues and make suggestions to the manager. There are regular and ad hoc staff meetings. Service users stated that they felt able to discuss any concerns with the manager. The home employs the corporate Islecare `97 Ltd policies and procedures that cover a comprehensive range of topics and comply with current legislation. Policies are subject to regular reviews. All staff are provided with information about new policies and required to read these and sign to confirm they have done so. Policies and procedures are held within the office and available for all staff. During the unannounced inspection a variety of records held within the home was viewed. These involved records in respect of fire detection equipment, safety checks, pre-admission assessments, care plans and risk assessments, Medication Administration records, menus and duty rotas. As previously stated, the manager must ensure that the medication administration records are correctly completed and ‘as required’ medication guidelines are updated and kept under regular review. The manager must ensure that the hours she works in the home are recorded on the duty rota. Records are appropriately and securely stored with access to information limited to those who should have access to records. At the time of the unannounced inspection there were no obvious risks to health and safety of service users. Staff receive training in manual handling, first aid, health and safety, fire awareness and food hygiene. Safety notices were seen appropriately positioned around the home and infection control equipment was available for care staff. Covers are fitted to all radiators with water temperature controls fitted to the bath. Winton Street H55 H04_S12557_Winton Street_V218341_120805 Stage 4.doc Version 1.40 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 x 2 3 3 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 3 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 x 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score 3 3 3 x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Winton Street Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score 2 3 x 3 2 3 x H55 H04_S12557_Winton Street_V218341_120805 Stage 4.doc Version 1.40 Page 26 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 2 Regulation 14 (2) Requirement The manager must ensure that up to date pre-admission assessments are completed prior to the service users admission. The manager must ensure that the correct codes are used to record the reasons for non administration of medication. The manager must review the as needed medication guidelines and ensure that these are reviewed six monthly. The hours worked in the home by the manager must be recorded on the duty rota. Timescale for action Immediate 12-8-05 Immediate 12-8-05 1-9-05 2. 20 and 41 13 (2) 3. 20 and 41 13 (2) 4. 5. 37 and 41 Schedule 4 (7) Immediate 12-8-05 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. 2. Refer to Standard Good Practice Recommendations Winton Street H55 H04_S12557_Winton Street_V218341_120805 Stage 4.doc Version 1.40 Page 27 Commission for Social Care Inspection Mill Court Furrlongs Newport PO30 2AA National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Winton Street H55 H04_S12557_Winton Street_V218341_120805 Stage 4.doc Version 1.40 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!