Inspection on 07/08/06 for Amber House

This inspection was carried out on 7th August 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 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

Amber House 27/02/09

Amber House 29/02/08

Similar services:

21 High Street

Vale House

Chestnut Walk

The Old Vicarage

Cherwood House Care Centre

Ashley House

Ascot Nursing Home

Fountain View

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

CARE HOME ADULTS 18-65 Amber House 25/27 Norreys Road Didcot Oxon OX11 0AT Lead Inspector Nancy Gates Unannounced Inspection 11th July 2006 02:00 Amber House DS0000067152.V304040.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 Amber House DS0000067152.V304040.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. Amber House DS0000067152.V304040.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Amber House Address 25/27 Norreys Road Didcot Oxon OX11 0AT 01235 512509 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) alliedcareltd@aol.com Ashamber Homes Limited Tichatonga Nyenya Care Home 6 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (6) of places Amber House DS0000067152.V304040.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 2nd February 2006 Brief Description of the Service: Amber House comprises of two, three bedroom semi-detached properties, able to provide support to six people, which is on the outskirts of the Oxfordshire town of Didcot. The accommodation provided is extremely well decorated and furnished to a high standard in both the shared and personal space offered. The garden is landscaped to a good standard. Amber House provides 24-hour support to individuals who have been discharged from hospital and who require care, support and accommodation for mental health issues. Referrals to the service are received from many sources. The accommodation can support up to three individuals. The goal of the service is to enable service users to regain and enhance skills to return to independent living in the community. Adjoining conservatories link the properties. Internal access can be made through the adjoining door. The current scale of fees for this service is £850 to £1700 per week. Amber House DS0000067152.V304040.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. From the 1st April 2006 the Commission for Social Care Inspection (CSCI) has developed the way it undertakes the inspection of care services. The inspection of the service was an unannounced ‘key inspection’. The inspector arrived at the service at 11.30 a.m. on the 7th August 2006. The total number of hours spent at the home was 6 hours. The time spent at the home allowed for a thorough look at how well the service is doing. The inspection took into account detailed information provided by the service manager inclusive of information that CSCI has received about the service since the last inspection. The inspector asked for the views of the people who use the service. The inspector also asked the views of others who support the needs of the people who use the service via a questionnaire that the CSCI sent out. Two members of staff were on duty. The members of staff and the residents were very welcoming. The inspector looked around the home including the bedrooms of the residents at their invitation. A number of records were viewed including a resident’s care plans, staff recruitment records, staffing rotas and maintenance records. The inspector looked at how well the service was meeting the standards set by the government. The report includes judgements about the standard of the service. What the service does well: The assessment and admission information held about prospective and new residents is of a good standard. Information provided within assessments is from multi professional sources and described the inclusion/contribution of the resident. A good standard of support and opportunity is provided to residents within the boundaries of care plans. Residents’ care plans/records/risk assessments are written clearly and are of a good standard. Resident’s personal and healthcare needs are appropriately supported. Needs and wishes are respected. Access to additional support from health care professionals is consistent and meets residents health needs. From the evidence seen, the inspector considers that this service would be able to provide a service to meet the needs of individuals of various religious, racial or cultural needs. Amber House DS0000067152.V304040.R01.S.doc Version 5.2 Page 6 A complaints procedure or residents, policy guidance for the management of resident’s finances and policy guidance to ensure the protection of residents is available to all staff. Residents are appropriately protected. Staff have a clear awareness of protection of vulnerable adults procedures. The home provides clean, warm and comfortable accommodation for the residents but it is in need of redecoration in areas. The staff on duty were experienced and knowledgeable. Responses to residents were respectful and clear, whilst allowing for a homely atmosphere. The staff at the home manage to create a very laid-back feeling, allowing residents to be at ease. This is clearly underpinned by a good knowledge base and the use of experience and skills. Residents expressed generally positive views of the support offered. Recruitment documentation ensures the protection of residents. The registered manager provides leadership; guidance and direction to staff to ensure residents receive consistent quality care. Monthly visits to the home assess the quality of support offered to residents. Residents’ welfare is appropriately monitored. The views of residents are valued. What has improved since the last inspection? What they could do better: Medication for residents who require support is received within boxes from a pharmacist and is then dispensed by the manager, who is a qualified nurse into dosette boxes. Re-dispensing medication into an alternative administration system leaves room for error and therefore could place residents at risk of receiving an incorrect dosage. The area manager stated consideration is being given to using a monitored dosage system from a local pharmacist. This is welcomed as a positive change to ensure the protection of residents. Amber House DS0000067152.V304040.R01.S.doc Version 5.2 Page 7 The main areas of the home are clean and comfortable, providing living spaces that are light and well heated whilst providing ventilation. A number of areas within the home are looking jaded and in need of re-decoration. The bathrooms in both properties also need to be updated. The bathroom in No.25 was grubby, is in need of re-decoration and the bath panel was broken and in need of repair or replacement. The bathroom in No.27 is also in need of re-decoration and has a broken shower unit. A resident highlighted the bathroom as an area for improvement in the home. The inspector checked the hot water temperature by hand at an outlet in both bathrooms and noted that the water remains extremely hot to the touch. This continues to place residents at serious risk of scalding, although it is acknowledged that no incidents have been recorded. Staff members stated that water temperature regulators were due to be fitted to all outlets. The area manager confirmed to the inspector that the regulators would be fitted the day after the inspection and that water temperature would continue to be recorded on a regular basis. 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. Amber House DS0000067152.V304040.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 Amber House DS0000067152.V304040.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): 2 The quality of the outcomes in this area is good. This judgement has been made using available evidence including a visit to the service. The assessment and admission information held about prospective and new residents is of a good standard. EVIDENCE: Observations of the resident’s files detailed the admissions to the home. The files contained Care Programme Approach (CPA) assessments and care plans. Referrals were received from a clinician within an in-patient (hospital) setting who provided clinical and diagnostic information. A care management assessment was provided, inclusive of expectations of the support to be provided at the home. Referrals can be received from local authorities throughout the UK. An Amber House assessment is undertaken with the individual, family members (when available) and members of the clinical team. The inspector observed that information provided within assessments was from multi professional sources and described the inclusion/contribution of the resident. Restriction of movement is stipulated within discharge from hospital in relation to the Mental Health Act 1983. The current scale of fees for this service is £850 to £1700 per week. Amber House DS0000067152.V304040.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 The quality of the outcomes in this area is good. This judgement has been made using available evidence including a visit to the service. Clear and comprehensive assessment information and care/support plans underpin a good quality of support for assessed needs. Risk management and assessment is completed appropriately and supports the needs of residents. EVIDENCE: The inspector observed four residents’ files. The files contained Care Programme Approach (CPA) assessments; care plans completed by care managers/key nurses (in patient setting), as well as an ongoing plan stating needs/outcomes, interventions and responsibilities. The documentation supports the admission to Amber House. Individual’s plans completed by the manager and clearly in consultation with residents include information regarding physical health, mental health, legal requirements, education/courses, employment opportunities and daily notes Amber House DS0000067152.V304040.R01.S.doc Version 5.2 Page 11 (recording significant events). Daily notes are not completed on a daily basis and are not always signed by staff members. It is recommended that staff sign to accept responsibility for the contents of the account of a person’s day. The area manager stated that the Ashamber/Allied care format for care/support plans would be introduced and used in the near future. A quality systems manager attended the home for part of the inspection to introduce the new system to the staff members on duty. Residents confirmed that they attend CPA and care plan reviews and the reviews are conducted with service users, keyworkers and relevant professionals as required. Review documentation was observed to be available in accordance with the CPA process. The CPA process and hospital discharge provides risk management guidance to the home. The manager undertakes responsibility for additional risk assessments and guidance for staff with reference made to the home’s risk management policy. The risk assessments for one resident were not up to date. Residents confirmed that an appropriate level of support is provided to make informed decisions in lifestyle choices relating to responsible risk. Resident’s plans contain risk assessment and guidance, providing clear and comprehensive information, with appropriate cross-referencing. Risk management policy documentation is available within the home, the policies and procedures of the new provider, Ashamber Homes Limited are slowly being introduced into the home to ensure consistency within the organisation. Policy information is also available regarding unexplained absences and substance misuse. From the evidence seen, the inspector considers that this service would be able to provide a service to meet the needs of individuals of various religious, racial or cultural needs. Amber House DS0000067152.V304040.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17 The quality of the outcomes in this area is good. This judgement has been made using available evidence including a visit to the service. Residents are supported to make lifestyle choices in relation to their mental health needs. A healthy, balanced and varied diet is offered to all residents. EVIDENCE: The CPA review process identifies occupational activities within a structured programme at the home. Access to local community facilities has to be considered in relation to specified restrictions for individuals alongside completed risk assessments. Residents confirmed that they access shops and local community facilities. Residents have access to local transport. Amber House DS0000067152.V304040.R01.S.doc Version 5.2 Page 13 Residents are encouraged to maintain links with family and friends, linked to the CPA process Individuals confirmed that they choose to see whom they want within their rooms but are reminded of the points stated within the contract and house brochure regarding visitors. CPA documentation, alongside risk assessments relating to the requirements of the Mental Health Act 1983 provides details of ‘restrictions and vulnerability’ for inclusion within service users care plans. The plans are regularly monitored and reviewed in consultation with service users. The inspector observed positive interaction between residents and staff. Recent events have highlighted the need for staff to be assured that their welfare is considered whilst supporting the mental health needs of residents. Contribution/participation in menu planning and cooking is considered an element of rehabilitative planning and an opportunity to build upon skills for independent living. Residents are provided with £20 to budget and shop for food on a weekly basis. Staff oversee this. Needs are met as far as possible, dietary and nutritional requirements can be stipulated within care plans. Service users are able to access snacks and drinks at any time. Meals are offered three times a day, inclusive of a cooked meal. Amber House DS0000067152.V304040.R01.S.doc Version 5.2 Page 14 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 The quality of the outcomes in this area is good. This judgement has been made using available evidence including a visit to the service. Resident’s personal and healthcare needs are appropriately supported. Needs and wishes are respected. Access to additional support from health care professionals is consistent and meets residents health needs. Medication is stored securely and administration is accurate, ensuring residents safety. EVIDENCE: CPA discharge care plans and the home’s assessments/care plans note the support needs of individuals. The current residents at Amber House do not require staff support for personal hygiene. Times for going to bed and getting up continue to be flexible within the remit of residents’ contracts and the motivational requirements supporting individual’s mental health needs. Amber House DS0000067152.V304040.R01.S.doc Version 5.2 Page 15 The community mental health team provides psychiatric nursing care, with regular reviews undertaken and recorded within residents’ plans. All residents are registered with a local GP. Regular reviews are undertaken with the CMHT including medication reviews with a psychiatrist. Residents will independently access their GP, CPN and psychiatrist. They are made aware of the need to share information that may impact on the remit of their support. Medication was observed to be stored appropriately in a locked cabinet and at the correct temperature. Residents are encouraged to self medicate, supported by staff and clear policy documents. Medication Administration Records (MAR) are completed for all medication administered to residents. No omissions within the documentation were seen. Copies of the completed MARs are retained at the home for future reference if required. Medication for residents who require support is received within boxes from a pharmacist and is then dispensed by the manager, who is a qualified nurse into dosette boxes. Re-dispensing medication into an alternative administration system leaves room for error and therefore could place residents at risk of receiving an incorrect dosage. The area manager stated consideration is being given to using a monitored dosage system from a local pharmacist. This is welcomed as a positive change to ensure the protection of residents. Amber House DS0000067152.V304040.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 The quality of the outcomes in this area is good. This judgement has been made using available evidence including a visit to the service. A complaints procedure or residents, policy guidance for the management of resident’s finances and policy guidance to ensure the protection of residents is available to all staff. Residents are appropriately protected. Staff have a clear awareness of protection of vulnerable adults procedures. EVIDENCE: No complaints have been received at the home since the last inspection. No information concerning complaints, concerns or allegations have been received by the Commission since the last inspection. Residents confirmed that a copy of the complaints procedure has been provided. External points of contact for complaints are documented within the home’s brochure, inclusive of the details of the CSCI. The home has a copy of the Oxfordshire Multi-Agency Protection of Vulnerable Adults (POVA). Residents remain able to manage their finances, although restrictions can be related to mental health support needs and are recorded within documentation. Future residents could be supported with financial management; details would be recorded within support documentation. Amber House DS0000067152.V304040.R01.S.doc Version 5.2 Page 17 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 & 30 The quality of the outcomes in this area is adequate. This judgement has been made using available evidence including a visit to the service. The home provides clean, warm and comfortable accommodation for the residents but it is in need of redecoration in areas. Water temperatures at outlets accessible to residents are too high although it is recognised that action has been taken to resolve the issue. EVIDENCE: Amber House comprises of two, three bedroom semi-detached properties and is generally decorated and furnished to a good standard. The main areas of the home are clean and comfortable, providing living spaces that are light and well heated whilst providing ventilation. A number of areas within the home are looking jaded and in need of re-decoration. The area manager stated that Amber House would be updated in the near future. A large conservatory at the rear of both properties leads into a large garden that has been designed to a good standard. The premises are secure. Amber House DS0000067152.V304040.R01.S.doc Version 5.2 Page 18 The conservatory at the rear of the properties has an adjoining door. The conservatory at the rear of No.25 is used as an identified smoking area. There is an air filtering system in the conservatory that reduces the amount of smoke and odour. Residents are provided with rooms containing furniture and linens. Rooms can be decorated to meet resident’s tastes. A resident, whose room has been recently decorated, confirmed that they chose the colour; the room clearly reflected the preference of the individual. The rooms reflect the personal tastes of the individuals, containing personal belongings that give them identity. All rooms are lockable. Residents hold a key to their rooms. The rooms reflect the personal tastes of the individuals, containing personal belongings that give them identity. All rooms are lockable. Residents hold a key to their rooms. The bathrooms in both properties need to be updated. The bathroom in No.25 was grubby, is in need of re-decoration and the bath panel was broken and in need of repair or replacement. The bathroom in No.27 is also in need of redecoration and has a broken shower unit. A resident highlighted the bathroom as an area for improvement in the home. Bathrooms are provided for use by residents and staff. The inspector checked the hot water temperature by hand at an outlet in both bathrooms and noted that the water remains extremely hot to the touch. This continues to place residents at serious risk of scalding. Staff members stated that water temperature regulators were due to be fitted to all outlets. The area manager confirmed to the inspector that the regulators would be fitted the day after the inspection and that water temperature would be recorded on a regular basis. All areas within Amber House are cleaned to a good standard. Laundry facilities continue to be sited within the kitchens, supported by the recommendation of an environmental health assessment that stated that washing could only be laundered when food is not being prepared, cooked or eaten. Amber House DS0000067152.V304040.R01.S.doc Version 5.2 Page 19 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, 34 & 35 The quality of the outcomes in this area is good. This judgement has been made using available evidence including a visit to the service. A core of well-established staff that provide consistency and commitment to support residents. Recruitment documentation ensures the protection of residents. Staff are offered appropriate training to meet the needs of residents. EVIDENCE: Two members of support staff were present during the inspection. The support staff employed at Amber House presented a good level of knowledge and competence in supporting people with mental health issues, one person’s knowledge being underpinned by a nursing qualification. The individual is not employed as a nurse but their skills are used to good effect. The additional member of support staff present at the home is employed has recently moved to work at Amber House and is an existing employee of Ashamber/Allied care. Residents expressed generally positive views of the support provided, although one resident stated that “it’s sometimes difficult to get out and do what you want because there’s only two car drivers and they’re not always on duty or available.” Amber House DS0000067152.V304040.R01.S.doc Version 5.2 Page 20 Positive comments included, “Everything’s cool at the moment, staff are alright, they’re alright to me…I like staff, they’re alright to talk to and help me when I ask.” Staff records are held at the home. A large file contains the details of current and previous staff and also holds details of staff that have not been employed at the home. Recruitment information held for staff ensures the protection of residents. Information regarding a member of staff on duty was not available. The area manager stated that the member of staff had been recruited within Allied care and that all information is held within a central office. Copies of the file were sent by fax during the inspection and confirmed that the person has been recruited appropriately. The file was bulky and confusing as there was no clear system of finding current staff. A clearer system of holding information needs to be sought. Records of staff training confirm attendance at fire safety, first aid, health and safety and food hygiene courses. Copies of certificates of attendance are also held. Consideration is also given to course attendance relevant to service users’ needs. An induction package and mandatory training (including medication administration) is provided for all new employees. Amber House DS0000067152.V304040.R01.S.doc Version 5.2 Page 21 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 The quality of the outcomes in this area is good. This judgement has been made using available evidence including a visit to the service. The registered manager provides leadership; guidance and direction to staff to ensure residents receive consistent quality care. Monthly visits to the home assess the quality of support offered to residents. Residents’ welfare is appropriately monitored. The views of residents are valued. EVIDENCE: A registered manager was appointed to the home in March 2006. The manager has significant nursing and management experience to support the needs of adults with mental health issues. The registered manager provides additional management support for another manager within the Ashamber group. Amber House DS0000067152.V304040.R01.S.doc Version 5.2 Page 22 The Area Service Manager for Ashamber Homes Limited visits the home regularly. The visits are currently occurring on a very regular basis to ensure that the transition between the previous owner and the new proprietor does not have a negative impact on residents. The policies and procedures of the new proprietor have been made available to staff. The hot water temperatures identified within the environmental section of this report relate to health and safety responsibilities of the proprietor. It is acknowledged that the manager is attempting to address the issue to ensure the health and well being of residents. Quality monitoring is undertaken by asking the views of residents and their representatives reviewing the policies and procedures for the home and reviewing the premises offered. Training opportunities for staff include subjects relating to the health and safety. The staff members confirmed that knowledge would be updated in the future. Maintenance and health and safety records are completed appropriately. Amber House DS0000067152.V304040.R01.S.doc Version 5.2 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. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 2 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Amber House DS0000067152.V304040.R01.S.doc Version 5.2 Page 24 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard YA20 YA24 Good Practice Recommendations The registered manager should consider adopting an alternative medication dispensing system to ensure the protection of residents. The registered manager should ensure that all areas of the home are well maintained and provide comfortable shared and private space for residents. Amber House DS0000067152.V304040.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Oxford Area Office Burgner House 4630 Kingsgate, Cascade Way Oxford Business Park South Cowley Oxford OX4 2SU 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 Amber House DS0000067152.V304040.R01.S.doc Version 5.2 Page 26 - 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. 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