Inspection on 02/10/06 for Allan House

This inspection was carried out on 2nd October 2006.

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 no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Allan House 09/11/09

Allan House 21/07/09

Allan House 13/06/08

Allan House 12/11/05

Allan House 13/06/05

Allan House 01/11/04

Allan House 18/05/04

Allan House 29/07/03

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

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

CARE HOME ADULTS 18-65 Allan House 53 Uttoxeter Road Blythe Bridge Stoke On Trent Staffordshire ST11 9JG Lead Inspector Jane Capron Key Unannounced Inspection 2 and 5 October 2006 09:30 Allan House DS0000004906.V311864.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Allan House DS0000004906.V311864.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Allan House DS0000004906.V311864.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Allan House Address 53 Uttoxeter Road Blythe Bridge Stoke On Trent Staffordshire ST11 9JG 01782 397018 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) allan@jeffriesgroup.com Mrs Grace Jeffries Mr Ronald Jeffries Alison Nicklin Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Allan House DS0000004906.V311864.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th November 2005 Brief Description of the Service: Allan House is an eight-bedded care home for service users that have a learning disability. The home is one of two homes owned by Mrs Jeffries and her son. The home is located on the main road in Blythe Bridge and blends in with the surrounding properties. The home is a two-storey large family type house although all bedrooms and lounges are on the ground floor. The home provides six single bedrooms and one double bedroom. The environment internally is of a high standard and outside at the front is a car park and at the rear a large garden. The service users access local health resources and seven of the service users attend college, day centres or day services. The service users generally have low to moderate needs although the home is able to respond to some challenging behaviour. Service users assist around the home. Service users take care of their own personal care needs with the support of staff. Staff support service users to undertake food and clothes shopping. The aim of the home is to promote and develop the independence skills of the service users and if appropriate to support them to move to more independent living environment. The fees are currently between £532 and £750 per week. Allan House DS0000004906.V311864.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over two visits lasting approximately six hours. The inspection included discussions with some of the residents to gain their views of living at the home including whether they had lots to do and whether they were able to make choices over how they lived and whether they had the chance to be involved in aspects of running the home. Observation took place of residents and staff together. A discussion was held with the Care Manager and with the staff on duty. A sample of residents support plans were examined as well the arrangements for the administration of medication and for safeguarding residents’ finances. All the communal areas and bedroom accommodation was looked at as well as the arrangements in place for the Health and Safety of residents living at the home. The recruitment and selection process and staff training was looked at. Prior to the inspection a pre-inspection survey of residents, relatives and professionals took place. Since the last inspection there have been no complaints. What the service does well: The residents liked living at the home and some of their comments included: ‘Very nice place’, ‘The staff are nice’, ‘It’s good living here’ and ‘ I want to stay forever’. The home provided residents with a good standard of accommodation. The home was well decorated and furnished throughout in a homely and domestic manner. Residents said they liked their bedrooms. They were of a satisfactory size and were lockable. They all had ensuite facilities. They were well personalised with a wide range of residents’ possessions. The staff were well liked by residents and relatives. Residents felt staff to be helpful and supportive and said that they got on well with them. Comments from relatives included: ‘The staff are fantastic’ and ‘the staff are helpful and polite’. The staff were observed to treat residents with respect and to promote their rights including privacy, independence and choice. Allan House DS0000004906.V311864.R01.S.doc Version 5.2 Page 6 The residents said that they had lots to do. All except one went to college or day services and two had part time work. The activities included a range of social and leisure activities including basketball, going to the gym, and going out for meals and day trips as well as a range of board games and craft activities in the home. Residents had the chance to go on holiday and they funded this themselves. The home was meeting the health care needs of the residents. Residents went for regularly health screening and received specialist health care services when needed. The home had addressed the needs of a resident with sensory needs ensuring she had an assessment. She was awaiting a hearing aid to be provided. The home supported staff to be trained to meet the needs of the residents. Training provided included medication, adult protection, infection control, continence as well as training in working with people with a learning disability and NVQ level 2 and 3. The home was being well run. The manager was qualified and had the necessary knowledge and skills to be an effective manager. She was well liked by residents and well respected by staff. What has improved since the last inspection? What they could do better: Whilst the home was providing residents with a good service there were some areas that needed to be addressed. The home needed to put its service users guide in a user-friendly format and to give all residents and prospective residents a copy. The home needed to check that prospective staff were fit to do their work before employing them. The home needed to develop its evacuation plan so that good plans were in place should the home need to be evacuated. Allan House DS0000004906.V311864.R01.S.doc Version 5.2 Page 7 It was also recommended that the home look at ways that residents can be more involved in aspects of running the home, that information be provided in a more user friendly way and that they move to introduce person centred planning. 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. Allan House DS0000004906.V311864.R01.S.doc Version 5.2 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 Allan House DS0000004906.V311864.R01.S.doc Version 5.2 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): 1,2,4,5 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Whilst the home had documentation identifying what the home offered, residents were not always benefiting from this as it this was not in a suitable format and was not provided to residents. The home’s admission process ensured that prospective residents needs were identified and that prospective residents had the opportunity to visit the home prior to making a decision to move there. EVIDENCE: The home had a Statement of Purpose and service user guide although these were not available in an easy read format. All residents had not been provided with a copy of the service user guide. Sampling of residents’ files showed that the home’s admission procedure ensured that prospective residents were assessed to identify their needs and to make sure the home could meet their needs. The assessments were completed by the local authority and by the home. The assessment included prospective residents’ health and personal care, their family contacts, educational and social needs. All the responses by residents to the pre inspection surveys stated that they were consulted about moving to the home. Discussions with a recently admitted resident showed that he had visited the home several times before making a decision to move to the home. The home’s admission procedure provided residents with this opportunity and for Allan House DS0000004906.V311864.R01.S.doc Version 5.2 Page 10 preadmission plans to included several visits, including having meals and over night stays. This provided prospective residents opportunity to meet the residents and staff. Examination of records and discussions confirmed that placements were made on a trial basis and only made permanent when a review of the resident and significant others had taken place. Residents were provided with contracts by the local authority and by the home that showed the terms and conditions. Allan House DS0000004906.V311864.R01.S.doc Version 5.2 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents had individual support plans that identified their needs and how these were to be met but residents would benefit from these being in a more person centred format. Residents were encouraged and supported to make choices over their lives and to participate in aspects of running the home although there was some scope for this to be further developed. EVIDENCE: A sample of support plans were examined. Residents had individual support plans that covered areas such as health and personal care, education, leisure and social activities, domestic activities and financial support. The plans showed the nature and level of support needed for residents’ needs to be met. Where needed the home had developed behavioural plans that were developed following monitoring and analysing residents’ behaviour. Support plans showed evidence of review. The plans were not in a person centred form. Several residents said that the staff discussed their care with them and they were involved in reviews. Allan House DS0000004906.V311864.R01.S.doc Version 5.2 Page 12 Individual risk assessments were in place. These covered such areas as accessing the community, the use of the kitchen, managing hot water and hot surfaces. Risk assessments were being reviewed. Residents were supported to make decisions. Residents said that they had resident meetings to discuss such issues as meals, activities, holidays and any concerns they had. Residents said that they chose how to spend their time either in their bedrooms or in the communal areas. Those that could access the community independently said they went out shopping to buy toiletries and small items. Discussions with staff showed that they were aware of how to support residents to make choices and were aware of the communication methods of residents with limited non-verbal communication skills. There was scope for further development of methods such as symbols and pictures to assist residents to express choices. Residents said that they took part in a number of activities relating to the running of the home. As well as resident meetings they assisted in a range of domestic tasks including going food shopping, helping with meal preparation, doing their laundry and helping to keep the home clean and tidy. Allan House DS0000004906.V311864.R01.S.doc Version 5.2 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): 12,13,14,15,17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents have a full and varied lifestyle taking part in a range of educational and leisure activities in and out of the home. Residents are supported to maintain and develop relationships with family and friends. The home provided residents with a varied menu taking account of residents’ preferences. EVIDENCE: Residents said they liked living at the home and had lots to do. Records and discussions confirmed residents had a full and varied lifestyle and that they regularly access community resources. Comments from residents included ‘ I play basketball and go to the club every week’, ‘I go to college and I go to work’ and ‘I play on my playstation and have been to see Stoke play football’. Records showed that two of the residents worked and five others either went to college or to Day Services. Currently the home is looking for activities for one resident who is not able to attend college. This resident remains at the Allan House DS0000004906.V311864.R01.S.doc Version 5.2 Page 14 home and is supported by staff. He goes out shopping, walking and to the gym a couple of times a week. Social and leisure activities included going to the Dolphin club, playing basket ball, going to the gym, going for walks, shopping, out to the pub, out for meals, bowling and going to the cinema. Within the home residents watched TV and enjoyed the soaps. They watched videos, played board games, did jigsaws and painted and drew and did craft activities. The home organised holidays following discussions with residents over where they wanted to go. All except the recently admitted resident had been on holiday. One resident spoken to said she had been twice. The residents themselves funded holidays. Residents also went on a number of day trips, which were paid for by the home. These had included West Midland Safari park and the monkey forest at Trentham. Residents said that they saw their relatives. Comments received from the pre inspection relative survey showed that relatives felt welcomed to the home and were kept informed and involved. The home supported residents to develop friendships and where necessary supported them to access specialist services to make informed decisions over intimate relationships. ‘The food is good’ was the comment made by all the residents spoken to. The home provided a varied menu having the main meal at lunchtime and a lighter meal at teatime. This was because most of the residents had a hot meal when they were out at college or the day services. Residents said that they had their breakfast whenever the got up and this was a choice of cereals and toast. The menus showed a wide range of food being served. Residents said that if they did not like a meal they could always have something else. Residents discuss meals in the resident meetings and some residents were involved in putting the menu together. There may be scope for the involvement of other residents through the use of symbols. All of the residents took some part in the meal preparation for example some assist with peeling vegetables, some lay and clear the table and some go with staff to do the food shopping. The home was monitoring residents weight on a monthly basis. Allan House DS0000004906.V311864.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home was meeting the personal care needs of the residents. Health care needs were being met with evidence of multi agency working taking place. The home was meeting the medication needs of the residents. EVIDENCE: The home’s records showed the personal care and health care needs of the residents. Records showed and residents confirmed that they went to the doctor when they felt ill and went to the dentist, optician and chiropodist. Residents were supported by the home to access services from the psychiatric service, district nurses, the Speech and Language therapist and the Behavioural Services. The home also had links with the Community Nursing service. One resident with a hearing loss had been assessed and was awaiting a hearing aid. The home had purchased a wheelchair to assist one resident to have greater access to the community. Observation showed that residents’ personal care needs were being met. Residents said that they had a bath or shower daily and that they chose the clothes they wore. They said that they went with staff to buy clothes. Allan House DS0000004906.V311864.R01.S.doc Version 5.2 Page 16 The arrangements for the administration of medication were inspected. The medication was kept securely in a locked cabinet in a cupboard. The home operated a monitored dosage system and at the time of the inspection two residents were having medication. None of the resident was self-medicating. Examination of the records confirmed that the records were being kept correctly and there were no gaps. Staff had received training in medication from the health trust. Allan House DS0000004906.V311864.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home had a complaints procedure and residents felt confident that staff would sort out their concerns however residents would benefit from this being in a user-friendly format. Residents were safeguarded by the home’s safeguarding procedures and with staff having been trained in issues relating to adult protection. EVIDENCE: The home had a complaints procedure in place and this was displayed in the entrance area. Discussions with residents showed they could state how they raised concerns. They said that they would talk to staff individually or in resident meetings. They were confident that staff would respond to any issues they raised. The pre inspection survey showed that residents felt that staff listened to them. The residents would however benefit from having the procedure in a user-friendly format. The home maintained records of complaints and had not received any complaints since the last inspection. The home had procedures in place to safeguard the residents. The home had a procedure in place identifying how to respond to any concerns of adult protection and procedures in place to safeguard residents’ finances. Discussion with the Care Manager showed her to be aware of her responsibilities to ensure residents were protected. The staff member on duty showed she was aware of adult protection issues and how to respond to any concerns. Most staff had undertaken training in adult protection and the home had plans for all staff to undertake this training. An examination of a sample of residents/ finances confirmed that suitable records were being kept. Allan House DS0000004906.V311864.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,26,27,28,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provided residents with a good standard of accommodation. The residents were provided with a home that was clean and had procedures in place to control the spread of infection. EVIDENCE: The home was suitable to meet the needs of the residents. It was well maintained and well furnished and decorated in a domestic and homely style. Externally it has a large car park at the front and an extremely large rear garden. There was a large pond at the very rear of the garden and this was fenced. Internally all the accommodation except the main kitchen is on the ground floor. The home has a lounge that is large enough for all residents to sit in. It has TV and video. The home has a second lounge that is used as a quiet room for residents to sit, for private discussions with residents, for meetings and as a staff sleep in room. The home has a downstairs kitchen diner. This kitchen is used for residents to help make their breakfast and for drinks and snacks. The main kitchen is upstairs and is accessible to residents with staff to assist with meal preparation. Allan House DS0000004906.V311864.R01.S.doc Version 5.2 Page 19 The home had adequate bathing facilities with one bathroom with bath and shower over and a toilet. There was an additional toilet that had disabled access. The home provided six single bedrooms and one shared room. These all had ensuite facilities. The residents sharing had done so for some time and got on well. Bedrooms were all lockable. Residents said they liked their rooms. They were well furnished and decorated and had all been personalised with a range of personal possessions including soft toys, ornaments, photos and certificates showing their achievements. Bedrooms provided residents with seating. The home had a small laundry that was adequate to meet the laundry needs of the home. The home had procedures in place to ensure that the home was clean and hygienic. Staff had training in infection control. Allan House DS0000004906.V311864.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,33,34,35 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staffing levels were able to meet the needs of residents. The current staff had the necessary knowledge to provide residents with the support they needed. Whilst the home was undertaking most of the pre employment checks the home needed to ensure that all checks were always undertaken to ensure that residents were fully safeguarded. EVIDENCE: ‘The staff are fantastic’ and ‘staff are helpful and polite ….. and we’ve been welcomed by staff’ were some of the comments made by relatives in the preinspection questionnaire. Residents as spoke highly about the staff with comments such as ‘ I like all the staff’ and ‘the staff listen to us’. The staff were aware of residents’ needs and how these were to be met. Observation showed them treating residents with respect and promoting choice and privacy. Copies of the rosters were examined. The home provided adequate staffing with a minimum of two care staff on duty when all residents are in the home. Additional staff would be provided at particular times in order to offer residents support to access the community and to take part in activities. The home had two sleep-in staff members. The home had recently lost two staff members and two had been recruited but had not started. The registered provider was Allan House DS0000004906.V311864.R01.S.doc Version 5.2 Page 21 working at the home providing staff support to ensure that residents’ needs were met. The home placed a high emphasis on staff training. Staff were encouraged and supported to undertake NVQ training and three had obtained NVQ 2 and two of these were due to start NVQ 3. A number had undertaken training accredited through the Learning Disability Framework. Additional training included dealing with difficult behaviour; medication, continence, training related to Health and Safety issues. Staff felt supported to undertake their role. There were staff meetings and staff received individual supervision and yearly appraisal meetings. A sample of staff files were examined to identify whether the home’s recruitment and selection procedures were safeguarding the residents. Staff completed application forms but one was not fully completed. Staff were subject to a CRB and POVA check and two references were sought for staff. Staff identifies were confirmed. There was no health check on file. Staff were provided with a contract outlining terms and conditions. Allan House DS0000004906.V311864.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents were benefiting from a home was well managed by a suitably qualified and trained manager. The home monitors and reviews its performance and undertakes a range of self-reviews that include seeking the views of residents and relatives. In nearly all respects the home is providing residents with a safe environment but does need to develop its evacuation plan. EVIDENCE: The Care Manager had worked at the home for some years starting as a support worker through to being the manager. She had completed the required care and management qualifications and undertakes periodic training to keep up to date with current practices. She had the responsibility for ensuring that the home met the necessary standards and legislation. In her role she has demonstrated her commitment to safeguarding the residents. The home has systems in place to monitor and review the service. The home sought the views of residents through individual surveys and resident Allan House DS0000004906.V311864.R01.S.doc Version 5.2 Page 23 meetings. The views of relatives were gained through surveys. The Care Manager monitored these responses to look at areas were the home could be developed. The home had a Health and Safety policy and procedures in place to ensure a safe environment. Staff had undertaken Health and Safety training including moving and handling, emergency aid and fire. Staff and some residents had completed training in food hygiene. Staff were also taking a qualification in domestic practices including managing hazardous substances and infection control. The home had undertaken servicing of fire equipment, including the fire alarm. The home reported that it had a gas safety certificate and had an electrical installation check. The home was undertaking the necessary fire prevention checks including weekly checks of the fire alarm and monthly checks on the emergency lighting. The home was undertaking regular fire drills but this is recommended to occur at varying times during the day. The home was aware it needed to develop an evacuation plan. The Environmental Health department had visited the home in February 2006 and had found the kitchen standards satisfactory. Allan House DS0000004906.V311864.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 2 3 3 X 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 3 ENVIRONMENT Standard No Score 24 4 25 X 26 3 27 3 28 4 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 2 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 X 12 4 13 3 14 4 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 4 X 3 X X 2 X Allan House DS0000004906.V311864.R01.S.doc Version 5.2 Page 25 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. 2. 3. Standard YA1 YA34 YA42 Regulation 5(1) 19 Schedule 2 23(4)(c) Requirement The home to develop a suitable service user guide. That as part of the recruitment process staff’s fitness to do the work is checked. That the home develop the evacuation plan Timescale for action 01/01/07 01/11/06 01/11/06 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. 3. 4. 5. Refer to Standard YA1 YA6 YA7 YA8 YA42 Good Practice Recommendations To provide information in a user-friendly format. To develop person centred planning with plans in a more user-friendly format. To look at additional methods to support residents make choices i.e. symbols and pictures To look at further developing the opportunities for residents to participate in aspects of running the home. To provide fire drills at varying times during the day. Allan House DS0000004906.V311864.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Stafford Office Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES National Enquiry Line: 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 Allan House DS0000004906.V311864.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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