Inspection on 05/08/05 for 85 Heath Road

This inspection was carried out on 5th August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 no outstanding requirements from the previous inspection report, but made 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

85 Heath Road 08/08/08

85 Heath Road 09/08/07

85 Heath Road 09/08/06

85 Heath Road 13/12/05

85 Heath Road 13/01/05

85 Heath Road 14/09/04

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

CARE HOME MIXED CATEGORY MAJORITY ADULTS 18-65 85 Heath Road Barming Maidstone Kent ME16 9LD Lead Inspector Lynnette Gajjar Unannounced 5 August 2005 17:15 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 Older People and 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. 85 Heath Road H56-H06 S23800 85 Heath Road V223171 050805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service 85 Heath Road Address Barming Maidstone Kent ME16 9LD 01622 729946 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) Category(ies) of registration, with number of places MCCH Society Limited Vacant CRH Care Home 3 85 Heath Road H56-H06 S23800 85 Heath Road V223171 050805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: 85 Heath Road is one of a group of small care homes managed by MCCH Society Ltd. The home provides care through encouraging independent living and support for 3 ladies with a Learning Disability, one of whom is over 65 years of age. The home does not provide 24 - hour care or night-time sleep-in care staff. The home’s care staff work on a roster basis to cover identified key care time to the individual care plans. The home currently has 84 direct care hours over 7 days. The Service Users in this home are required to be semi independent and have daily programmes within the local community and day services in the area. 85 Heath Road is situated in Barming, with good local amenities near by. It is on a main bus route to Maidstone town centre. The house has two bedrooms, communal bathroom/toilet and small office/staff room on the first floor. The third bedroom with en-suite facility is situated on the ground floor, alongside the lounge, kitchen/dining area. The home has car parking to the side of the property (but further car parking available on the main road) with a ramped pathway entrance to the front door. There is a small garden to the rear of the property 85 Heath Road H56-H06 S23800 85 Heath Road V223171 050805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, the first in the year running from April 1st 2005 to March 31st 2006. The visit lasted from 17:15 until 20.15. The home currently has 3 residents who have lived together a number of years. The visit was spent talking directly with service users; there were no staff rosters from 3pm. Service users were exceptionally welcoming to the visit and shared a lot of their feelings with the inspector of what it was like living here. The focus of this inspection was lead by the service users, who voiced a number of concerns. The inspector sought service users agreement to contact the organisation oncall staff to arrange for care staff or senior manager to attend the inspection to discuss these further. Due to the nature of the service, it is difficult to reliably incorporate accurate reflections of the service users in the report. Some judgements about quality of life and choices were taken from direct conversation with service users and observation followed by discussion with care staff and evidencing records held at the home. A tour of the premises was undertaken, with time spent assessing various records held in the home. Immediate requirements were issued by the inspector, in relation to areas raise by service users and direct observations made today. The manager and service co-ordinator met with the inspector on their return from leave on 8th August 2005 and agreed to address areas of concern immediately. What the service does well: What has improved since the last inspection? 85 Heath Road H56-H06 S23800 85 Heath Road V223171 050805 Stage 4.doc Version 1.40 Page 6 Service users are pleased with the redecoration and new furnishings purchased for the home. Service users have a stable core two care staff (74hrs) that cover the majority of the 84 hours allocated care time. With the remaining 10 covered through supported living staff. 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. 85 Heath Road H56-H06 S23800 85 Heath Road V223171 050805 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Individual Needs and Choices Lifestyle Personal and Healthcare Support Concerns, Complaints and Protection Environment Staffing Conduct of Management of the Home Scoring of Standards Statutory Requirements Identified During the Inspection Adults 18 – 65 (Standards 1–5) (Standards 6-10) (Standards 11–17) (Standards 18-21) (Standards 22–23) (Standards 24–30) (Standards 31–36) (Standards 37-43) Older People (Standards 1–5) (Standards 7, 14, 33 & 37) (Standards 10, 12, 13 & 15) (Standards 8-11) (Standards 16-18 & 35) (Standards 19-26) (Standards 27-30 & 36) (Standards 31-34, 37 & 38) 85 Heath Road H56-H06 S23800 85 Heath Road V223171 050805 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 (Adults 18 – 65) and Standards 1 – 5 (Older People) are: 1. 2. 3. Prospective service users have the information they need to make an informed choice about where to live. (OP NMS 1) Prospective users’ individual aspirations and needs are assessed. No service user moves into the home without having been assured that these will be met. (OP NMS 3) Prospective service users’ know that the home that they choose will meet their needs and aspirations. Service Users and their representatives know that the home they enter will meet their needs. (OP NMS 4) Prospective service users’ have an opportunity to visit and “test drive” the home. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitablity of the home. (OP NMS 5) Each service user has an individual written contract or statement of terms and conditions with the home. Each service user has a written contract/statement of terms and conditions with the home. (OP NMS 2) 4. 5. The Commission considers Standard 2 (Adults 18-65) and Standards 3 and 6 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2 Service users do not feel their individual aspirations or needs are being met. EVIDENCE: The homes statement of purpose clearly states the home provides contracted 84hours care per week funded by the local authority. Service level agreements from the local authority are in place. Service users discussed concerns over lack of staff support and allocated time. For the first time during an inspection, two ladies strongly stated they wanted more staff time, specifically covering the waking day until they retire to bed. They felt that they were not getting the support they needed both in the home but also in accessing the local community. 85 Heath Road H56-H06 S23800 85 Heath Road V223171 050805 Stage 4.doc Version 1.40 Page 9 Through discussion with staff, it was also identified that service users were requiring more support and guidance, that often exceeded the hours allocated. 85 Heath Road H56-H06 S23800 85 Heath Road V223171 050805 Stage 4.doc Version 1.40 Page 10 Individual Needs and Choices The intended outcomes for Standards 6-10 (Adults 18-65) and Standards 7, 14, 33 & 37 (Older People) are: 6. Service users know their assessed and changing needs and personal goals are reflected in their Individual Plan. The Service Users health, personal and social care needs are set out in an individual plan of care. (OP NMS 7) Service users make decisions about their lives with assistance as needed. Service Users are helped to exercise choice and control over their lives. (OP NMS 14) Service users are consulted on, and participate in, all aspects of life at the home. The home is run in the best interests of service users. (OP NMS 33) Service users are supported to take risks as part of an independent lifestyle. The service users health, personal and social care needs are set out in an individual plan of care. (OP NMS 7) Service users know that the information about them is handled appropriately and that their confidences are kept. Service Users rights and best interests are safeguarded by the home’s record keeping, policies and procedures. (OP NMS 37) 7. 8. 9. 10. The Commission considers Standards 6, 7 and 9 (Adults 18-65) and Standards 7, 14, and 33 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9,10 Service users do not feel their personal choices and individual care needs are being met. EVIDENCE: Care staff support service users through the 84 care hours allocated in personal care, household chores, cooking meals, shopping and accessing local community and health care appointments. Daily planners detail regular activities and support needs. Appointments with health professionals are well supported by staff with records kept of outcome. Through discussion with service users their understanding of the care hours allocation is very limited. Their expectations are higher than that what was currently being provided. 85 Heath Road H56-H06 S23800 85 Heath Road V223171 050805 Stage 4.doc Version 1.40 Page 11 Service users are maturing (one is elderly with limited mobility). They are not as able to undertake daily task /cleaning activities as promoted at the last inspection. In many activities, full support is required to complete the task. Service users understanding of day, time, written and reading skills are very limited. All service users were unable to recollect staff names working with them currently (but could those of long time ago) referring to staff as ‘him’ ‘her’ ‘ the lady, the man’. None were able to read dates on food stored in the fridge. No other formats or methods to assist are in place. Records seen, do not accurately recorded evidence of the changes described by both service users and staff in care needs. 85 Heath Road H56-H06 S23800 85 Heath Road V223171 050805 Stage 4.doc Version 1.40 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 (Adults 18-65) and Standards 10, 12, 13 & 15 (Older People) are: 11. Service users have opportunities for personal development. Service Users find the lifestyle experiencd in the home matches their expectations and preferences and satisfies their social, cultural, religious and recreational interests and needs. (OP NMS 12) Service users are able to take part in age, peer and culturally appropriate activities. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. (OP NMS 12) Service users are part of the local community. Service users maintain contact with family/ friends/ representatives and the local community as they wish. (OP NMS 13) Service users engage in appropriate leisure activities. Service users find the lifestyle experienced in the home matches their expectations and preferences and satisfies their social, cultural, religious and recreational interests and needs. (OP NMS 12) Service users have appropriate personal, family and sexual relationships and maintain contact with family/friends/representatives and the local community as they wish. (OP NMS 13) Service users’ rights are respected and responsibilities recognised in their daily lives. Service users feel they are treated with respect and their right to privacy is upheld. (OP NMS 10) Service users are offered a (wholesome appealing balanced) healthy diet and enjoy their meals and mealtimes. Service users receive a wholesome appeaing balanced diet in pleasing surroundings at times convenient to them. (OP NMS 15) 12. 13. 14. 15. 16. 17. The Commission considers standards 12, 13, 15, 16 and 17 (Adults 1865) and Standards 10, 12, 13 and 15 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11,12,13,14,15,16,17 Service users lifestyle is not currently meeting their individual expectations or need. 85 Heath Road H56-H06 S23800 85 Heath Road V223171 050805 Stage 4.doc Version 1.40 Page 13 EVIDENCE: Continued support from staff for 84 hours per week enables individuals to access local amenities and area including shopping, bowling, trips and meals out, and attending leisure sessions within club connect. Service users were stating this is not enough and when they do go out “ it’s rush rush rush”. Discussion evidenced going on a day trip with club connect and shopping to Blue water. These hours also include direct personal care and daily chores at the home. Service users stated that they only get supported to prepare and cook one meal a day the remaining they have to sort out themselves. No-one could remember if they had cooked tea but did know it was fish. On discussion with staff they had fish pie for lunch. Service users could not recollect eating anything else this evening. Staff had gone off duty at 3pm. Service users discussed getting hungry, having upset stomach and being very unhappy with food. Exploration of the fridge raised concerns over poor food hygiene practice for storage of foods and dating of foods in stock. Service users had no number skills to recognise use by dates or understanding of good safe food storage. Staff stated service users often helped themselves to food during the evening and had mostly had breakfast before they arrive. They also have identified service users popping to the local shop to buy biscuits, cakes and sweets, when staff go off duty. Recognition of dietary needs due to diabetes was selective and limited by service users. Staff stated they had changes shopping from once a week to three times a week to ensure fresh food stored, not too big a stock of food held to limit temptation but also to offer new places to visit and go out during the week. The age and mobility of current service users can restrict contact with relatives and friends. Service users discussed their families in detail. Staff help and support is required for writing letters and providing transport for planned visits within 84 hour contract staff time. 85 Heath Road H56-H06 S23800 85 Heath Road V223171 050805 Stage 4.doc Version 1.40 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 – 21 (Adults 18-65) and Standards 8 – 11 (Older People) are: 18. 19. 20. Service users receive personal support in the way they prefer and require. Service users feel they are treated with respect and their right to privacy is upheld. (OP NMS 10) Service users’ physical and emotional health needs are met. Service users’ health care needs are fully met. (OP NMS 8) 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. Service users, where appropriate, are responsible for their own medication and are protected by the home’s policies and procedures for dealing with medicines. (OP NMS 9) The ageing, illness and death of a service user are handled with respect and as the individual would wish. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. (OP NMS 11) 21. The Commission considers Standards 18, 19 and 20 (Adults 18-65) and Standards 8, 9 and 10 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19,20 Service users health care needs are promoted through regular contact with professionals. Service user health care could be further enhanced through better staff allocation over the 24-hour day. Service users are at risk of not taking the right medication at the right time. EVIDENCE: Staff were observed to be open and respectful to service users. Staff showed genuine concerned that service users had not felt able to discuss this with them. Service users were not as open and vocal with staff present. Staff have been present or in the home at previous inspections. It is difficult to assess as to why there was such change in their confidence to speak out but an area managers must explore to enable service users to feel safe in sharing their views on the service and support given openly. 85 Heath Road H56-H06 S23800 85 Heath Road V223171 050805 Stage 4.doc Version 1.40 Page 15 Discussion showed regular appointments and familiarity with the GP and other health professionals. Records also supported this. Two service users currently self medicate, their understanding of their medication was limited. They stated, “Staff make sure I take it”. Service users through discussion evidenced more dependency on staff to make sure things are done or completed. 85 Heath Road H56-H06 S23800 85 Heath Road V223171 050805 Stage 4.doc Version 1.40 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22-23 (Adults 18-65) and Standards 16, 18 & 35 (Older People) are: 22. 23. Service users feel their views are listened to and acted on. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted on. (OP NMS 16) Service users’ are protected from abuse, neglect and self-harm. Service users legal rights are protected. (OP NMS 17) Also Service users are protected from abuse. (OP NMS 18) Also Service users financial interests are sageguarded. (OP NMS 35) The Commission considers Standards 22 and 23 (Adults 18-65) and Standards 16, 18 and 35 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22, Service users do not feel their views are listened to. Service users are vulnerable and at risk through their lack of understanding of personal safety and security of the home. EVIDENCE: Service users do not feel comfortable to discuss their concerns about the care they receive with staff directly in or involved with the home. Service users referred to previous manager/staff but could not relate talking to current staff team. “They don’t care, I’m glad you’re here”. Service users looked confused when asked if they felt safe. “ Don’t know what you mean”. This visit has highlighted concern over service users safety and security when staff are not at the home. Their understanding particularly of inviting people into their home and leaving doors open unattended was directly observed to be at serious risk of abuse and reinforces their vulnerability when staff are not present to guide and support them. 85 Heath Road H56-H06 S23800 85 Heath Road V223171 050805 Stage 4.doc Version 1.40 Page 17 Environment The intended outcomes for Standards 24 – 30 (Adults 18-65) and Standards 19-26 (Older People) are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users live in a safe, well-maintained environment (OP NMS 19) Also Service users live in safe, comfortable surroundings. (OP NMS 25) Service users’ bedrooms suit their needs and lifestyles. Service users own rooms suit their needs. (OP NMS 23) Service users’ bedrooms promote their independence. Service users live in safe, comfortable bedrooms with their own possessions around them. (OP NMS 24) Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Service users have sufficient and suitable lavatories and washing facilities. (OP NMS 21) Shared spaces complement and supplement service users’ individual rooms. Service users have access to safe and comfortable indoor and outdoor communal facilities. (OP NMS 20) Service users have the specialist equipment they require to maximise their independence. Service users have the specialist equipment they require to maximise their independence. (OP NMS 22) The home is clean and hygienic. The home is clean, pleasant and hygienic. (OP NMS 26) The Commission considers Standards 24 and 30 (Adults 18-65) and Standards 19 and 26 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,30 Service users live in a comfortable, nicely decorated home. Personal choice, lifestyle and safe access to the garden is restricted for elderly service users with limited mobility due to staff support needed. EVIDENCE: Internal decoration has taken place enhancing the communal areas of the home. New dining room furniture has been purchased. The ground floor bedroom has been adapted with an en-suite bathroom. Standard of cleanliness here and in the cooker are not promoting good infection control and 85 Heath Road H56-H06 S23800 85 Heath Road V223171 050805 Stage 4.doc Version 1.40 Page 18 cleaning standards. All rooms are single and are personalised by individuals. Two service users on the first floor have to share the bathroom, WC and washbasin. Access to the garden requires re-assessment to ensure safe use for service users. Service users have restricted mobility, additional lighting, highlighting, grab rails and pathways and seating would enable them freedom to access the garden, which at present has to be escorted. As the home is not staffed 24 hour this access is restricted to staff allocated time at the home. Access is through the back door in the ground floor bedroom or through the garage. The laundry is sited in the garage and requires dirty laundry to be carried through the kitchen as access. Risk assessments are in place. 85 Heath Road H56-H06 S23800 85 Heath Road V223171 050805 Stage 4.doc Version 1.40 Page 19 Staffing The intended outcomes for Standards 31 – 36 (Adults 18-65) and Standards 27 – 30 & 36 (Older People) are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported and protected by the home’s recruitment policy and practices. (OP NMS 29) Service users are supported by competent and qualified staff. Service users are in safe hands at all times. (OP NMS 28) Service users are supported by an effective staff team. Service users needs are met by the numbers and skill mix of staff. (OP NMS 27) Service users are supported and protected by the home’s recruitment policy and practices. Service users are supported and protected by the home’s recruitment policy and practices. (OP NMS 29) Service users’ individual and joint needs are met by appropriately trained staff. Staff are trained and competent to do their jobs. (OP NMS 30) Service users benefit from well supported and supervised staff. Staff are appropriately supervised. (OP NMS 36) The Commission considers Standards 34 and 35 (Adults 18-65) and Standards 27,29 and 30 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33,35 Staffing numbers seen today were not directly meeting the care needs of current service users. EVIDENCE: The home is not staffed 24 hour a day. 84 direct care hours have been assessed and contracted by the local authority with 24-hour on-call support. Service users explained that staff are often late, did not stay their allotted time and were not at the home enough to help them. Service users for the first time were expressing they wanted staff working at the home from when they get up until they go to bed. All three were adamant that they did not want a sleep in staff. 85 Heath Road H56-H06 S23800 85 Heath Road V223171 050805 Stage 4.doc Version 1.40 Page 20 Service users stated they liked all the staff currently working with them, with particular favourites they have known for long time. Many names they did refer to, have not worked in the home for a long time. Rosters evidenced on weekdays two staff on duty with one covering ½ day at the weekends. The signing in book did not correlate to this, with staff not signing in or completing their time of arrival and leaving the home. There are two permanent carers who cover 74 hours with the remaining covered by Supported living. Staff stated that they often worked over their rostered hours and were logging time of in lieu records. The additional 10 hours on the roster does not detail actual staff rostered to cover these shifts. A full review of the care hours must take place to ensure adequate residential car staff hours are provided to the home to meet the health and welfare of service users and their aspirations. 85 Heath Road H56-H06 S23800 85 Heath Road V223171 050805 Stage 4.doc Version 1.40 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 (Adults 18-65) and Standards 31-34, 37 & 38 (Older People) are: 37. Service users benefit from a well run home. Service users live in a home which is run and managed by a person who is fit to be in charge of good character and able to discharge his or her responsibilities fully. (OP NMS 31) Service users benefit from the ethos, leadership and management approach of the home. Service users benefit from the ethos, leadership and management approach of the home. (OP NMS 32) Service users are confident their views underpin all self-monitoring, review and development by the home. The home is run in the best interests of service users. (OP NMS 33) 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 homes record keeping, policies and procedures. (OP NMS 37) Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. Service users rights and best interests are safeguarded by the homes record keeping policies and procedures. (OP NMS 37) The health, safety and welfare of service users are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (OP NMS 38) Service users benefit from competent and accountable management of the service. Service users are safeguarded by the accounting and financial procedures of the home. (OP NMS 34) 38. 39. 40. 41. 42. 43. The Commission considers Standards 39 and 42 (Adults 18-65) and Standards 33,35 and 38 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 38,39,42 Service users do not understand the current management structure, to enable them to feel confident to discuss the service they receive. EVIDENCE: 85 Heath Road H56-H06 S23800 85 Heath Road V223171 050805 Stage 4.doc Version 1.40 Page 22 The overall management of the home has transferred from supported living to residential services of MCCH Society Ltd. Service users do not understand the changes and are continuing to refer to previous staff. Service users know staff currently working with them but not by name. Service users were aware of new lady (the manager) but they had not discussed any concerns with her. Staff were concerned service users had not felt able to discuss the concerns raised today through their house meetings or one to one time. The staff and manager were not at all aware of the issues shared with the inspector. Regulation 26 visits have not occurred to assist with this; the last report received by the commission was for May 2005. The manager and service co-ordinator met with the inspector immediately they returned from annual leave and are working with staff, service users and care management to address the areas concerned. Particularly creating open and comfortable process for the service users to discuss their concerns. Service contracts for maintenance of fire equipment, bath chairs and electrical equipment are within appropriate timescales. 85 Heath Road H56-H06 S23800 85 Heath Road V223171 050805 Stage 4.doc Version 1.40 Page 23 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. Where there is no score against a standard it has not been looked at during this inspection. 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 x x x Standard No 22 23 Score 2 x Score ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score x 2 2 2 2 2 2 2 2 2 2 1 Standard No 24 25 26 27 28 29 30 STAFFING 2 x x x x x 2 Score 11 12 13 14 15 16 17 Standard No 31 32 33 34 35 36 x x 2 x 1 x x 1 2 x x 2 x Version 1.40 Page 24 CONDUCT & MANAGEMENT PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 85 Heath Road Score 2 2 2 x 37 38 39 40 41 42 43 H56-H06 S23800 85 Heath Road V223171 050805 Stage 4.doc 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 YA30 OP26 Regulation 13(3) Timescale for action The registered person shall make Immediate suitable arrangements to prevent infection, toxic conditions and the spread of infection at the care home.In that good standards of food hygiene are promoted and followed by staff and service users. The cooker is cleaned to good standard on a regular basis. There are provided at Up dated appropriate places in the action plan to be premises sufficient numbers of lavatories and of washbasins submitted to include completion dates. Immediate The registered person shall, having regard to the size of the care home, the statement of purpose and number and needs of the service users ensure that at all times suitably qualified, competent and experienced staff are working at the home in such numbers as are appropriate for the health and welfare of service users.Through a thorough review of current 84 care hours contracted and provided and the need to be increased. As well as Version 1.40 Page 25 Requirement 2. YA30 OP26 23(2)(j) 3. YA33,YA35 18(1)(a) 85 Heath Road H56-H06 S23800 85 Heath Road V223171 050805 Stage 4.doc 4. YA39 OP33 12(1)(a)( b) close monitoring of actual staff hours worked to those detailed on the homes roster. The registered person shall ensure that the care home is conducted so as to promote and make proper provision for the health and welfare of service users and to make proper provision for the care and supervision of service users.In that appropriate levels of competent staff are on duty to meet the contracted care needs of service users and proper formal provision to monitor and audit quality of care by the registered persons are implemented. Immediate 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 YA05 OP2 Good Practice Recommendations 3. 4. It is recommended a written contract between MCCH and the Service User for the care support to be provided to complement the very good housing tenancy agreement. YA6 OP7 It’s recommended that the home explore an account, with separate sub-accounts within it. The sub-accounts are interest bearing; therefore ensuring interest is calculated on the amount in each account. Monies can be managed in relation to each sub-account by the manager /organization finance department through a modem link to the bank. For the joint account for service users agreed Christmas fund and cat expenses. Carried forward from previous inspection not assessed on this occasion. YA28 YA 19 It is recommended that additional private area be provided for visitors and consultations.The office/staff room is currently available. However this is not accessible for the ground floor Service User due to their mobility difficulties. Service Users are encouraged to use their own rooms on such occasions. YA30 OP26 It is recommended that laundry facilities are located so H56-H06 S23800 85 Heath Road V223171 050805 Stage 4.doc Version 1.40 Page 26 85 Heath Road 5. YA30 OP26 6. YA39 YA33 that soiled clothing and linen are not carried through areas were food is stored, prepared, cooked or eaten.No action carried out at present. Still located in main kitchen area It is recommended that consideration should be given to having a dishwasher to help maintain Service Users independence but promoting good safe hygiene practise in the kitchen. It is strongly recommended that alternative methods of service users consultation be explored as current methods are not used or service users feel comfortable to use. 85 Heath Road H56-H06 S23800 85 Heath Road V223171 050805 Stage 4.doc Version 1.40 Page 27 Commission for Social Care Inspection The Oast, Hermitage Court Hermitage Lane Maidstone ME16 9NT 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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