Inspection on 22/08/07 for Apple Tree House Residential Care Home Ltd

This inspection was carried out on 22nd August 2007.

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 11 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Apple Tree House Residential... 02/06/08

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

Pennine Camphill

Muston Road (70)

Grayling

The Cornerstone

John Street Nursing Home

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

CARE HOME ADULTS 18-65 Apple Tree House Residential Care Home Ltd 31 Norwood Beverley East Yorkshire HU17 9HN Lead Inspector Sarah Sadler Key Unannounced Inspection 22nd August 2007 09:00 Apple Tree House Residential Care Home Ltd DS0000069449.V348816.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 Apple Tree House Residential Care Home Ltd DS0000069449.V348816.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. Apple Tree House Residential Care Home Ltd DS0000069449.V348816.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Apple Tree House Residential Care Home Ltd Address 31 Norwood Beverley East Yorkshire HU17 9HN 01482 873615 01482 866666 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) Apple Tree House Residential Care Home Limited Vacant Care Home 7 Category(ies) of Learning disability (7) registration, with number of places Apple Tree House Residential Care Home Ltd DS0000069449.V348816.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care Home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following category: Learning Disability - Code LD The maximum number of service users who can be accommodated is: 7 None as the service is a new registration. 2. Date of last inspection Brief Description of the Service: Apple Tree House is a Victorian terraced property in a residential area, close to the centre of the market town of Beverley. It is situated adjacent to a main road offering easy access to public transport, and within walking distance of the local shops and markets. On the ground floor there is a conservatory/dining area, lounge, kitchen and bedroom with further bedrooms and bathrooms on the first floor and externally to the home in the rear courtyard area. There is not a stair lift and as such the main part of the home is only suitable for people who have no mobility needs. One bedroom is part of the main building of the home, but is only accessible by a rear staircase. The bedrooms in the courtyard area all have their own bathroom, kitchenette and lounge area. The courtyard offers a small garden area to people. The home opened in March 2007, and people first moved in from July of this year. Personal care needs are met by the staff supporting people in the home and there is access to the local GP services. The manager confirmed that the weekly fees for living in the home range from £491.00 to £1191.00. In addition people pay for toiletries and hair care. Apple Tree House Residential Care Home Ltd DS0000069449.V348816.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced visit was undertaken on 22nd August 2007. It forms part of this inspection, which includes a review of all information received relating to the home since the last visit or registration. As such this report reflects information from the site visit, views from people via surveys, the Annual Quality Assurance Assessment (AQAA) document provided by the registered person and referral to any other relevant letters or occurrences in the home. The site visit commenced at 09.00 and was completed at 15.00. The manager was available from 10 am and for the remainder of the visit. There were no visitors to the home available to talk to. We did talk to two of the people living in the home and one staff member. A tour of the premises including people’s rooms was undertaken and people’s files; staff records, health and safety documents and other records were examined. Other information we considered included the AQAA. This is a self-assessment document which is completed by the registered person to evidence how well the home is meeting the national Minimum Standards, and what if anything needs to improve. From this information formal surveys were sent to the people living in the home, staff and other professionals. One health professional survey was returned. The commented that what they felt the service does well, ‘ The home has a very supportive feel. The clients are treated very much as individuals’ also that it is ‘ One of the more promising homes’. During the inspection process and again in preparation for the site visit we assessed other information received by the CSCI regarding the home, which included any letters from the registered person or others and any complaints, of which there has been none. What the service does well: People told us that they are very happy living in the home. They get on well with the staff and are happy with the support they are offered. People were clear that their rights to make choices and decisions in their lives are upheld. They decide what they are going to do each day, what to eat and what to wear. People told us that they have good support to maintain relationships with their friends and families. Their daily diary notes also included details of this. Support to maintain relationships helps people to continue to be a part of their family or social network. Apple Tree House Residential Care Home Ltd DS0000069449.V348816.R01.S.doc Version 5.2 Page 6 People live in a very comfortable and well-maintained home. They have private bedrooms, with their own bathrooms. They have been able to personalise their rooms to their own taste. What has improved since the last inspection? What they could do better: The staff have not completed individual assessments on all the people wanting to live in the home. This should be completed prior to the person moving in. it provides the staff team with up to date information on the persons strengths and needs and how these are to be met. This will assist the staff with the meeting of these. The staff in the home have not developed care plans for people. Although there are care plans completed by the Local Authority, the staff should complete up to date versions of these. These would provide the latest information needed to support people in the meeting of their needs whilst living in the home. A more comprehensive system of risk assessments could be in place. These would identify any areas of risk and the plans to manage and reduce the risk. This in turn would assist in keeping the people in the home safe. Medication storage and records could be improved upon. Medication must only be stored in a fixed and locked container/cupboard, this should not be able to be carried away from the home. Some of this work was completed on the day of the visit. However the registered person must make sure that these systems always meet the requirements and do not pose a risk to peoples health or safety needs. The procedure for Safeguarding Adults requires adapting to meet the latest guidelines and ensure that staff are aware of the best way to support people should an allegation of harm occur. Staff should be recruited correctly into the home to help make sure that people living there are safe. All staff must have two written references (on them) that reflect that they are suitable to work with the people in the home and do not pose a threat to their safety. The staff must be adequately trained to ensure that they have the correct skills to meet people’s needs. This training should include: Fire, Equality and Diversity and Safeguarding Adults. Apple Tree House Residential Care Home Ltd DS0000069449.V348816.R01.S.doc Version 5.2 Page 7 People’s health and safety needs must be met in the home. Maintenance checks/records must not be allowed to become out of date and past the time for checking, maintenance must be kept up to date to ensure that the environment does not pose a risk to the people in the home. This includes Gas and electrical safety. 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. The summary of this inspection report can be made available in other formats on request. Apple Tree House Residential Care Home Ltd DS0000069449.V348816.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 Apple Tree House Residential Care Home Ltd DS0000069449.V348816.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. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 4 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There are assessments undertaken of people to ensure that their needs can be met in the home. People are provided with information before moving in. this helps them to make decisions about where they would like to live. EVIDENCE: People’s files included copies of their Community Care Assessment and Care Plan completed by the Local Authority. These documents provide the home with information relating to the individual’s care needs and how it has been assessed that they can be met. Initially there was no evidence that the staff in the home assess people before they move in. However, the manager did produce a checklist for one person that he had completed before they moved in. Other detailed information had also been received from the previous care provider, detailing the strengths, needs and wishes of the individual. The information received had not been used to develop a plan of care within the home and the manager told us that this was something, which was being developed. Without an up to date assessment and plan of care, it is sometimes difficult for the staff to be fully aware of the current needs of the people who live in the home and how these needs can be met. Apple Tree House Residential Care Home Ltd DS0000069449.V348816.R01.S.doc Version 5.2 Page 10 People spoke about the manager of the home coming to meet them before they moved into the home and how they also visited the home, staying both for tea and overnight before moving in. People could not recall information about the home being given to them before they moved in. However the manager confirmed that people are given this information and one ‘pack’ was seen in a bedroom. One person thought that this information had been given to their representative. It would be good practice for this information to be reviewed with people when they move in and live in the home. This is so that they continue to understand both their rights and the rules for living in the home. Apple Tree House Residential Care Home Ltd DS0000069449.V348816.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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Care plans have not been developed to support with the meeting of people’s needs. Only basic risk assessments are undertaken to support people and help to protect them from harm. EVIDENCE: People have two files, one contains older or past information and one contains recent information, which the staff use on a daily basis. There are copies of the care plans developed by the Local Authority, but there are not any care plans developed with the individual person in the home. One person told us that they had no knowledge of a care plan, although the other person felt that they had. Ensuring that there is an up to date care plan, developed with the individual helps staff to have the correct information to support people in meeting needs. Apple Tree House Residential Care Home Ltd DS0000069449.V348816.R01.S.doc Version 5.2 Page 12 People told us that they are able to make decisions about their everyday lives, including what times to get up and go to bed. People were asked what they would like to do and were offered choices with drinks. There are some initial risk assessments in place and the manager told us that this is something that is also being developed as people settle into the home. The initial assessments will help to ensure that any risk are identified and help to keep people safe. However comprehensive risk assessments need to be in place to help ensure as far as possible that all risks are identified and management plans put in place to prevent these risks occurring. Apple Tree House Residential Care Home Ltd DS0000069449.V348816.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are given good support to make choices and live their lives as they wish. They maintain relationships with people and receive a diet of their choice. EVIDENCE: One person told us that activities include trips out, bowling, out for lunch, shopping, going to Hornsea, and going to Bridlington. They would like to go for more walks in the countryside. Another person told us that both the people who live in the home and the staff decide jointly on the activities, which are going to take place, and that individually they like to play keyboards, write letters, make cards, watch TV and read magazines. People’s daily diary notes recorded what time they got up and went to bed, what they did during the Apple Tree House Residential Care Home Ltd DS0000069449.V348816.R01.S.doc Version 5.2 Page 14 day, and if they went out with family. Activities listed did include shopping, going for a walk and attending an Advocacy club. One person told us that they are supported to maintain contact with their family and that this includes visiting, telephone calls and going out with them. People’s daily diary notes also recorded when people had visited or gone out with their family. At the time of the visit one person went out with their relative for lunch. Good support in maintaining valuable relationships helps people with the move from previous homes and helps them stay part of their family. One person told us that staff ‘leave them alone’ and ‘let us do what we want’. That they were happy with the level of support they receive and that staff explain things and they like living in the home. Two of the people who live in the home told us that they receive their own post. One commented that they hold a key to their own door and in practice it was observed that staff only enter people’s rooms with a master key and with their permission. One person confirmed that staff ‘usually’ knock before entering their room. Staff confirmed that people are supported to make choices and this was observed on the day of the visit. Ensuring that people live their lives as they choose helps people in maintaining a sense of identity and self worth. The dining room is very nicely decorated and provides a relaxing environment for meals. Breakfast was observed to be a relaxed experience with people eating at different times, as they got up. People told us that they were happy with the food provided in the home and that they sometimes go out for lunch. There are menus in the home and people told us that they have each chosen a meal that they like. The manager told us that the menus are continuing to be developed with an aim for a 4 week cycle that reflects the likes and dislikes of the people in the home. Apple Tree House Residential Care Home Ltd DS0000069449.V348816.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. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People are happy with the personal support they receive. Systems are in place to support people with their health needs. However medication handling could be improved upon to ensure people’s medication needs are safely met. EVIDENCE: Both of the people living in the home spoken to were happy with the level of support that they receive from the staff. One commented ‘ I like them they are very nice, the support is really good.’ Staff were seen to have very good interactions with people, having good and positive discussions. People told us that they had been to the new GP practise to register with the GP. As people had only been in the home a matter of weeks, no one had required the assistance of a medical practitioner. People’s records did include letters from other professionals who support people had accessed. This also provides the staff in the home with information relating to each person’s health needs and how these can be met. One health professional survey was Apple Tree House Residential Care Home Ltd DS0000069449.V348816.R01.S.doc Version 5.2 Page 16 received. They commented that the staff usually seek advice to help people with their health needs and sometimes their needs are met by the service. They commented ‘They liaise with ourselves and the health centre’. Of the two people spoken with only one person receives support with medication and they confirmed that they are happy with the staff undertaking this. Records were kept of the administration and disposal of medicines to ensure that for this part there was a clear audit trail. Medicines were not stored in an appropriate locked cupboard due to the medicine containers not fitting. The manager rectified this at the time of the visit. No records are kept of medicines received into the home and the need for this as part of the process to prevent errors was discussed with the manager. Duplicate copies of the Medication Administration Records (MAR) were held within the home and the manager told us that there had been some problems with the medication systems from the pharmacist. The manager spoke with the pharmacist at the time of the visit, who amended the system to ensure that duplicate MAR sheets were not required. Reducing the risk of possible errors with medication. The registered person must ensure that correct records and storage of medicines are in place at all times, to reduce the risks of errors occurring and to ensure that people’s needs are safely met. Apple Tree House Residential Care Home Ltd DS0000069449.V348816.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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People have some systems to support them to raise concerns and for if an allegation of harm occurs. EVIDENCE: There is a complaints procedure within the home that provides people with the necessary information should they wish to make a complaint. People told us that if they had a complaint they felt able to raise it and were confident that it would be dealt with appropriately. The contact details of the local office of the CSCI were incorrect and this was discussed with the manager. There is a safeguarding adults policy which provides staff with information should an allegation of harm be raised. This policy is not clear in the actions to be taken and instructs staff that all allegations should be reported direct to the police. This is not the correct procedure. The policy also detailed that staff may themselves investigate ‘minor’ allegations. Again this is not the correct procedure. Without the correct procedures in place people may not be supported correctly when an allegation is raised. The staff member on duty had not received formal safeguarding adults training, although in discussion they gave appropriate answers to how they would handle a potential incident of harm. Apple Tree House Residential Care Home Ltd DS0000069449.V348816.R01.S.doc Version 5.2 Page 18 Correct recruitment procedures have not been followed to ensure that people are safe. This is referred to in detail later in the report. Apple Tree House Residential Care Home Ltd DS0000069449.V348816.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People live in a clean and comfortable home. EVIDENCE: People live in a very comfortable and well-maintained home. It has been updated, whilst keeping many of the original features and is well decorated. There are different areas that people can sit in to relax including their own rooms. People have been supported to personalise their own rooms and these are also pleasant and comfortable. One person showed us around their room, and was pleased with it. There are records kept of a monthly fire drill and weekly fire check. There are no records of fire training, although the manager confirmed that all staff had Apple Tree House Residential Care Home Ltd DS0000069449.V348816.R01.S.doc Version 5.2 Page 20 completed the in house training. It would be recommended good practice that all staff receive formal fire training in relation to this home. Apple Tree House Residential Care Home Ltd DS0000069449.V348816.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. People are supported by adequate numbers of staff. But staff are not recruited correctly or fully inducted and trained. EVIDENCE: There is a duty rota in place, which shows that there are normally 2 staff on duty during the day, with one waking staff on duty at night. The registered person lives adjacent to the home and so is the ‘sleep in’ or on call person each night in case of an emergency. Staff records are not comprehensive. Two of the three files examined included an application form and the manager provided up to date Criminal Record Bureau (CRB) checks for the selected staff. The manager had confirmed in the AQAA that all staff had completed satisfactory pre-employment checks. Two of the three staff had only one reference in place and the third person had no references in place. The manager told us that this was because this person was Apple Tree House Residential Care Home Ltd DS0000069449.V348816.R01.S.doc Version 5.2 Page 22 related to them. Staff should all have 2 separate references obtained on them, one ideally from their last employer. This helps to ensure that they are suitable and fit to work with the people who live in the home. The manager also confirmed that all the staff employed had previously worked for his last employer. Although this may support the manager and people in the home as he is aware of the strengths of the individual staff, it would be recommended good practice, that staff are employed from a variety of settings to provide a broader mixture of experiences and skills. The manager wrote in the AQAA that the staff induction met the Skills for Care requirements. However there was no evidence in the staff files that they had completed any induction. The AQAA also stated that staff promote equality and diversity as they have been trained to help them promote this. Again there was no evidence of this training. This was discussed with the manager who confirmed that these had not been undertaken. The manager told us that all staff had competed Diabetes training and have commenced a 16-week medication-training course. In house Fire training has been completed and all of the staff recently completing fire training with the previous employer. Moving and Handling and Safeguarding Adults training was planned for 24th August 2007 and that a tutor who works for Selby College supports the staff. Only two staff hold a National Vocational Qualification (NVQ) level 2 or equivalent in care and the recommendation that 50 of the staff team hold this has not yet been met. There were only limited records of this training and certificates of achievement. Adequate staff training helps to ensure that the staff have the necessary qualifications to work with people to meet their needs. To ensure this there should be a staff-training plan. Staff should be up to date with training and undertake ongoing training to ensure that these skills are updated. Apple Tree House Residential Care Home Ltd DS0000069449.V348816.R01.S.doc Version 5.2 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People live in a home that is adequately managed, but which does not fully provide them with systems to raise ideas or protect them from harm. EVIDENCE: The manager has recently applied to the CSCI to become the registered manager for the home and this application is being processed. The manager told us that he has previous experience of managing a similar care service. Prior to this he also has experience in other care areas. He confirmed that he has completed the Registered Managers Award and plans to complete a National Vocational Qualification (NVQ) level 4 or equivalent in care. Apple Tree House Residential Care Home Ltd DS0000069449.V348816.R01.S.doc Version 5.2 Page 24 Some of the information provided within the AQAA, which was completed by the manager was not correct. This has been discussed earlier in the report. The quality assurance system is continuing to be developed in the home. People have only been living in the home for a few weeks. However, some people living there have completed individual surveys and further work has to be completed to include surveys for all stakeholders. When in place the quality assurance system should provide a system for people in the home and other stakeholders to raise their views and assist in the ongoing development of the home. When first registered the home complied with the health and safety requirements; producing the necessary safety checks/ certificates. For example a Landlords Gas Safety certificate, and portable appliance testing (PAT). However many of these are now out of date. Although the manager confirmed that plans were in place to update these certificates this is not considered best practice, and certificates should be updated at the correct time of renewal. This helps to reduce the risks to people in the home of an accident occurring that could have been prevented through regular maintenance. Apple Tree House Residential Care Home Ltd DS0000069449.V348816.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 2 3 X 4 2 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 1 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 x 32 1 33 x 34 1 35 2 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 1 3 x 1 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 1 x 2 x 2 x x 1 x Apple Tree House Residential Care Home Ltd DS0000069449.V348816.R01.S.doc Version 5.2 Page 26 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA6 Regulation 15 Requirement The registered person must develop in consultation with the individual, a plan of care. This will identify the person’s strengths and needs, and how these may be met. The registered person must ensure that comprehensive risk assessments are undertaken for each individual. These must identify potential risk and the plans to prevent the risk occurring. The registered person must ensure that medicines are at all times stored safely. This will help to ensure adequate supplies and that no errors occur. The registered person must ensure at all times that records of medicines entering the home are up to date and accurate. This will assist to ensure that the risk of errors is reduced. The registered person must ensure that the systems in place to prevent people being placed at harm. And to handle such a situation should it occur are correct and up to date. Meeting DS0000069449.V348816.R01.S.doc Timescale for action 30/09/07 2 YA9 13 30/09/07 3 YA20 13(2) 30/09/07 4 YA20 13(2) 30/09/07 5 YA23 13 30/09/07 Apple Tree House Residential Care Home Ltd Version 5.2 Page 27 6 YA23 13 7 YA32 18 8 YA32 18 9 YA35 18 10 YA34 19 11 YA42 13 with the latest Safeguarding Adults procedure. The registered person must ensure that staff are adequately trained in Safeguarding Adults procedures. This will help staff to support people correctly should this situation arise. The registered person must ensure that staff receive adequate training to complete their roles and support the people in the home. The registered person must ensure that staff are correctly inducted into the home. The induction must meet the requirements of Skills for Care. This will help ensure that staff have the necessary basic skills for supporting the people in the home. The registered person must complete a staff training and development plan. This will enable for effective planning and maintenance of staff training and skills. Ensuring that they continue to meet people’s needs. The registered person must ensure that the correct recruitment procedures are followed. This includes that two written references are taken for each staff member. This will help to ensure that the correct people are employed within the home and that the safety of the people in the home is not compromised. The registered person must ensure the health and safety of the people in the home. All maintenance checks must be kept up to date and correct. This must include Gas and electrical checks. 30/10/07 30/10/07 30/10/07 30/10/07 30/09/07 30/09/07 Apple Tree House Residential Care Home Ltd DS0000069449.V348816.R01.S.doc Version 5.2 Page 28 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 Refer to Standard YA2 Good Practice Recommendations The registered person should ensure that the staff in the home undertake a full assessment of the person proposed to live there. This should be undertaken prior to them moving in. It should provide a clear picture to staff what the person’s current strengths and needs are and how these are to be met. The registered person should ensure that the people in the home are informed of their rights and kept up to date on the rules for living in the home. The registered person should ensure that the complaints procedure includes the correct details of the local office of the CSCI. The registered person should ensure that staff have received formal fire safety training. The registered person should ensure that 50 of the staff team are qualified to National Vocational Qualification (NVQ) level 2 or equivalent in care. The registered person should ensure that staff have undertaken Equality and Diversity training. This will assist them in their role with the people in the home and in the meeting of their needs. The registered person should ensure that the quality assurance system allows all stakeholders to raise views. It should be undertaken regularly, with a report produced. This will assist the home in its ongoing development. 2 3 4 5 6 YA4 YA22 YA32 YA32 YA35 7 YA39 Apple Tree House Residential Care Home Ltd DS0000069449.V348816.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Hessle Area Office First Floor, Unit 3 Hesslewood Country Office Park Ferriby Road Hessle HU13 0QF National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Apple Tree House Residential Care Home Ltd DS0000069449.V348816.R01.S.doc Version 5.2 Page 30 - 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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