Inspection on 11/08/06 for Applemead

This inspection was carried out on 11th 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 found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Applemead 15/09/09

Applemead 05/07/07

Applemead 04/10/05

Applemead 19/04/05

Applemead 23/09/04

Applemead 27/04/04

Similar services:

2 Perhaver Park

The Vicarage

7 Hyde Road

St George`s

5 Seafield Road

Credence House

Radfords

Trevaylor Manor

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

CARE HOME ADULTS 18-65 Applemead Station Road Whimple Exeter Devon EX5 2QH Lead Inspector Vivien Stephens Key Unannounced Inspection 11 and 15th August 2006 11:00 th Applemead DS0000021878.V294538.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 Applemead DS0000021878.V294538.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. Applemead DS0000021878.V294538.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Applemead Address Station Road Whimple Exeter Devon EX5 2QH 01404 823332 01404 823382 Phil.Welsford@sense.org.uk 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) Sense Miss Angela Denise Martin Care Home 6 Category(ies) of Learning disability (6), Physical disability (6), registration, with number Sensory impairment (6) of places Applemead DS0000021878.V294538.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 4th October 2005 Brief Description of the Service: Applemead provides support and personal care to people with a learning disability and sensory impairments. The property is a six bed roomed detached house located in the village of Whimple. The home is a few minutes walk away from the village and is less than 2 minutes away from the railway station. It is approximately 9 miles from the city of Exeter. Bedrooms are situated on the first floor of the house along with two bathrooms and integral toilets. The downstairs comprises of an office, kitchen, lounge / dining area, conservatory, a quiet soft padded snoozelem room, a shower room with toilet and laundry room. There is a sensory garden to the rear of the property. Some adaptations have been made to meet the needs of each deaf / blind person. The home is operated by the organisation SENSE, who specialise in sensory impairments. At the time of this inspection the fees ranged from £77,441 to £134,034 per annum. The home provides a copy of all inspection reports to the next of kin of each service user. A copy of each report is available in the home for anyone who wishes to read it (this is explained in the home’s Statement of Purpose). Applemead DS0000021878.V294538.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Three months before this inspection took place the manager completed a preinspection questionnaire and forwarded it to the Commission. Survey forms were sent to staff and service users. Responses were received from 5 support workers and the manager. No survey forms were returned from residents and/or their relatives or representatives. Many of the residents find it difficult to communicate with others and therefore the manager, Angela Martin, felt they would be unable to complete the survey forms. However, after discussion it was agreed that the home will look at ways of helping the residents to express their views about the home, using advocates or relatives to help them where appropriate. The survey forms will therefore be received after the inspection report has been completed and results will be forwarded to the home be separate letter. Any issues arising from the survey forms will also be addressed separately. At the time of this inspection there were six people living at Applemead. This unannounced inspection took place over 1½ days. On the first day the inspection began at 11am and finished at approximately 7.30pm. On arrival at the home most of the service users were out on various activities. Angela Martin, Manager, and Philip Wellsford, Area Manager were present. Records were checked and discussions took place on the management of the home. During the mid afternoon the service users and staff returned. The staff were interviewed. A tour of the home took place. Menus were discussed. Observations were made and time was spent with residents. On the second day the inspection took place in the afternoon. The administration of medicines were checked. Residents were busy doing various activities in the home. Final feedback was given to the manager. What the service does well: The home has good admission and assessment procedures in place. Prospective new residents are carefully assessed and given good information about the home before any decision to move in is made. Sense employs a specialist who carries out a detailed assessment to ensure the home is able to meet their needs. From this assessment a care plan is drawn up covering all aspects of each residents’ needs. The plans focus firmly on the preferences and wishes of the resident and explain to staff how they want to be helped to lead their daily life as independently as possible. Risk assessments are in place and show how residents are supported to take responsible risks. The care plans show how residents want to be helped with personal care needs. Records show that health care needs have been well met. Applemead DS0000021878.V294538.R01.S.doc Version 5.2 Page 6 A good range of activities, outings, and education are provided. The home provides transport to a wide range of sporting and leisure activities in the community, plus college courses and social groups. Each resident is supported by staff to follow their individual programme of planned activities. Within the home there is a good supply of equipment for a range of arts, crafts and leisure interests. There is a well equipped sensory room. Menus are balanced and varied and meet the nutritional needs of the residents. Medicines have been stored and administered safely. Regular visits to the home have been made by a pharmacist to provide advice and guidance. Complaints have been investigated and handled appropriately. Staff have received training on safeguarding vulnerable adults. Good policies and procedures are in place to ensure residents are fully protected from potential abuse. Staffing levels are good and meet the needs of the residents. All records were found to be well maintained. Staff have received training on all relevant health and safety topics. Routine checks and servicing have been carried out on all equipment. Risk assessments have been carried out. Policies and procedures are in place to ensure staff and residents are safeguarded. There are good systems in place to ensure all areas are regularly maintained and kept clean and hygienic What has improved since the last inspection? What they could do better: One person has been admitted in the last year. The home was able to explain the assessment process and give assurances that careful procedures were followed. However, records of the assessment have not been retained – this is recommended. It is recommended that a record of complaints is kept, showing all stages of complaints including the outcomes. Applemead DS0000021878.V294538.R01.S.doc Version 5.2 Page 7 The overall appearance of the inside of the home is comfortable and homely. However, the exterior of the house looks shabby and is in need of repainting. Efforts should be made to bring the house up to a similar standard to the surrounding houses in order to prevent the house looking institutional, and to ensure good relationships with neighbours. The decoration of the stairway and upstairs corridor is beginning to look worn and the area would benefit from brightening up. While staffing levels are good, difficulties in recruiting and retaining staff have meant that the home has had to use a high level of agency staff. This has affected staff morale. On the day of this inspection staff were cheerful and positive and were working well together. However, they talked about problems and disagreements they have on some shifts. Sense have taken action to attract new staff and the home is in the process of recruiting seven new staff. However, it is important that underlying problems are addressed in order to improve staff morale if the home is to retain staff in the future. 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. Applemead DS0000021878.V294538.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 Applemead DS0000021878.V294538.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 “Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service.” The home has good admission and assessment procedures in place, ensuring that residents are able to make an informed choice about where they want to live. Records of initial assessments are poor in one instance. EVIDENCE: A copy of the updated Statement of Purpose was supplied for this inspection. The document is comprehensive and sets out the philosophy, aims and objectives of the home and how they will be met. A copy of this document along with a range of other relevant information about Applemead is given to anyone who enquires about moving into the home. In the last year one new resident has been admitted to the home. Unfortunately there was no written evidence available to show what information had been gathered during the assessment and admission stage for this person. However, Angela Martin and Philip Wellsford explained the process that Sense homes usually follow when admitting new residents. Sense employ a behavioural specialist who visits the person to undertake a thorough assessment. In this way they ensure the persons’ needs can be met. The person is then invited to visit Applemead for the day. Sense have policies and procedures setting out the process for the admission and assessment of new residents. Applemead DS0000021878.V294538.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 “Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service.” The home has good information systems that clearly show how residents’ needs and wishes are met. Residents are supported to take responsible risks. EVIDENCE: Each of the residents has a detailed file in place containing their care plan, risk assessments and a range of information about their health and social care needs. Three of the files were read during the inspection. The information was found to be detailed, while giving clear explanations to care staff about the way the resident should be assisted. The plans contain detailed and thorough information about every aspect of the care needs and how to reduce or eliminate risks, where appropriate. For those residents who have some level of communication skills the plans are written in their words, and are therefore clearly ‘person centred’. For those residents who have limited communication skills the plans are written in the words of the staff, but still give a very clear picture of the individual personality, preferences and needs of the individual. Applemead DS0000021878.V294538.R01.S.doc Version 5.2 Page 11 The plans have been regularly reviewed and are a working tool for all care staff. The staff explained how residents are encouraged and enabled to make decisions about their daily lives. They are helped to choose the foods they eat, the activities they do, and their daily routines. This is also set out in the care plans. Risk assessments have been completed for all aspects of the daily risks encountered. These documents are thorough, and give staff a very clear understanding of how each resident can be supported to take responsible risks as part of their chosen lifestyle. Applemead DS0000021878.V294538.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 “Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service.” Residents lead interesting and varied lives to suit their individual interests and preferences. Menus are balanced and varied and meet the nutritional needs of the residents. EVIDENCE: Information provided by the home shows that there is a wide range of recreational and educational activities provided both in the community and at home. Some residents have attended courses at Bicton College and Taunton College, and St David’s Community College and there are also work groups organised by the National Trust. The home has 2 vehicles that are used daily to take residents to organised activities and outings. Residents regularly use leisure facilities at the Doyle Centre, Exmouth, swimming pools in the East Devon area, and have regular horse riding lessons. Applemead DS0000021878.V294538.R01.S.doc Version 5.2 Page 13 Other activities enjoyed by the residents include visits to the beach, moors, local parks, libraries and museums. On the day of the inspection some residents and staff went to the Donkey Sanctuary. During the inspection residents were seen participating in various activities, including arts and crafts, cooking, and helping with daily routines such as laundry. The home has a well equipped sensory room. The garden has been laid out to provide various sitting areas with scented plants, a swing and garden furniture. Around the home there are textured signs to help residents find their way around. Staff were seen sitting with residents, involving them in conversations and in all aspects of the daily life at the home. Staff were sensitive to residents’ wishes to sit alone or in company, to stay in their bedrooms or to sit in communal areas or the garden. Bedroom doors have doorbells or flashing lights to ensure staff respect residents’ privacy. Residents enjoy going out for walks in the local community. While the home is generally well integrated into the village there have been some recent complaints and grumbles from neighbours. Philip Welsford gave assurances that Sense is acting to address these issues in order to promote and foster good relationships with neighbours and other members of the community. Menus have recently been reviewed to ensure they are balanced and varied. Staff know residents’ likes and dislikes, and those residents who are able to express their views have been involved in the planning of meals. Staff talked about how they are sensitive to individual likes and dislikes and how they will always provide a suitable alternative if the resident does not like the food offered. However, the high use of agency and bank staff was raised as a problem on a few occasions in the past when staff have provided quick to cook snack type meals such as pizza and chips. This has been recognised by the home and the new menus were drawn up to ensure residents always have nutritious meals that meet their individual dietary needs. Applemead DS0000021878.V294538.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 “Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service.” Residents receive good support from well-trained staff to meet their personal and health care needs. Medicines are stored and administered safely. EVIDENCE: The care plans clearly show how residents should be assisted by staff. Where possible the plans are written in the words of the residents and clearly show how personal care should be provided in order to ensure dignity, privacy and respect. Residents were seen being assisted by staff during the inspection in a caring and respectful manner. The home has their own version of a key worker system where specific staff are designated to work closely with individual residents. Technical aids and equipment have been provided as required. The home has good links with all relevant health care professionals. Regular health checks are carried out and any changes in health have been followed up with specialist health professionals. These have been well documented in the care plan files. Applemead DS0000021878.V294538.R01.S.doc Version 5.2 Page 15 Many of the medications administered are in liquid form; therefore the home does not use blister packs or monitored dosage systems. Medicines are stored securely in a locked metal cabinet. Controlled drugs are also held securely. The medicines cupboard was tidy and well organised. Good records have been maintained of the medicines received into the home, medicines administered, and medicines returned. A pharmacist visits the home regularly to provide advice and support. Staff have received training for specialist procedures as required. No medicines held at the home at the time of this inspection required refrigeration. Applemead DS0000021878.V294538.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 “Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service.” Complaints are investigated and handled appropriately. Residents are fully protected from potential abuse. EVIDENCE: Information supplied by the home for this inspection showed that they have received two complaints in the last year. One of these was still in the process of being addressed at the time of this inspection. The complaints indicated that there has been an underlying unhappiness within the staff team, and this may in part be caused by the high level of agency staff used by the home and difficulties in recruiting permanent staff (see section on staffing) The home does not keep a separate record of complaints and therefore it was not immediately obvious how these were addressed. However, after discussion with Angela Martin and Philip Welsford, and by reading available information it was possible to see the content of the complaints and the responses. The complaints have been dealt with following the Sense policy. It is recommended that the home keep a separate record of all complaints to show clearly all stages of the investigation and how the issues have been resolved. Two further concerns/complaints have been raised by neighbours. These do not directly refer to the care of the residents, and therefore do not have to be recorded in line with the National Minimum Standards or Care Home regulations. Sense have, however, taken appropriate steps to address the matters Applemead DS0000021878.V294538.R01.S.doc Version 5.2 Page 17 Sense have detailed policies and procedures in place relating to all aspects of adult protection. Staff have received training in this subject. Applemead DS0000021878.V294538.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, 25, 28, 30 “Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service.” The accommodation has been reasonably maintained, although some areas are in need of redecoration and repair. There are good systems in place to ensure all areas are regularly maintained and kept clean and hygienic. EVIDENCE: Applemead is situated in the village of Whimple, approximately 9 miles from Exeter. It is just a few yards away from the railway station and within easy walking distance of local shops and pubs. However, staff recruitment has been difficult and the location of the home has been considered to be part of the reason for this, due to the distance any potential new staff may have to travel. The exterior of the home has not been painted for several years and looks shabby. The paint is peeling and dirty, the front door looks faded and uninviting, and there are weeds around the parking area that give the home an un-cared for appearance. Most of the neighbouring houses are attractive and have neat front gardens, and therefore Applemead immediately looks different, and has an institutional appearance. This must be addressed. Applemead DS0000021878.V294538.R01.S.doc Version 5.2 Page 19 The interior of the home has been generally well maintained and has a comfortable appearance. A new kitchen was installed last year and this is a bright and well equipped room. However, the upstairs corridors and staircase are beginning to look tired. Both the woodwork and walls are coloured and there is no natural light in this area, and the area generally looks a little dark and dingy, with some chipped areas of paintwork. The living room and conservatory are comfortable areas that are used flexibly for a variety of activities. There is a well-equipped sensory room. Residents’ bedrooms are generally bright, clean and comfortable. They have been individually decorated and furnished and reflect the tastes and interests of each resident. However, in one room the drawer fronts of a chest of drawers had broken. These should be repaired or replaced. Curtains were hanging down in one room and Angela Martin said they were considering using Velcro to hang curtains in rooms where they may be frequently pulled off the curtain tracks. The home was clean throughout. There are cleaning routines in place to ensure all cleaning tasks are carried out regularly. The laundry is well equipped and in good order. Applemead DS0000021878.V294538.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): 31, 32, 33, 34, 35, 36 “Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service.” Staffing levels ensure residents’ needs are met but improvements are needed to ensure they are met adequately. There are signs this is about to improve. EVIDENCE: During the first day of the inspection all of the staff on duty were interviewed individually. Survey forms were also received from 5 care workers and the manager several weeks before the inspection. Permanent staff have received contracts of employment and job descriptions. Through induction and ongoing training they have a good understanding of the aims and values of the organisation, and have an awareness of the policies and procedures. On the day of the inspection there was a lively and happy atmosphere within the home and evidence of good team working and co-operation. However, several staff talked about an underlying unhappiness within the staff team. Some of the staff felt that the high use of agency staff has caused some problems and gave examples of poor practice, lack of motivation and differences of opinion. The home is in the process of recruiting seven new staff, and they are hoping that this will overcome all of these problems. The lack of permanent staff has been an issue at this home for a number of years. Applemead DS0000021878.V294538.R01.S.doc Version 5.2 Page 21 New staff undertake thorough induction training covering nationally recognised standards. The home has good records of the training provided to all staff, and have drawn up a plan of future training needs. The home employs a Personal Development Worker whose role is to support staff and to promote good practice. She has some responsibility for staff supervision, and will also ensure staff receive any specialist training required to meet the needs of the residents. Permanent staff have undertaken National Vocational Qualifications, and have also received training on the Learning Disabilities Award Framework (these are both nationally recognised qualifications). All permanent staff have received training on relevant health and safety topics. The files of two staff employed since the last inspection were checked. These showed that careful recruitment procedures had been followed. References and all required checks had been taken up before staff have been appointed. There is a good balance of male/female staff to reflect the gender mix of the residents. Staff rotas provided for the inspection showed that there are sufficient staff on duty at all times to meet the needs of the residents. However, to ensure consistency and prevent low staff morale, more permanent staff would benefit residents. Staff meetings are held and permanent staff receive regular supervision. Comments from staff who responded to the inspection by survey forms included – “Get more regular staff so that the home isn’t dependent on so many agency staff”. “Stop using agency staff”. “We have an excellent manager who does an excellent job, who is always there if we need any advice on anything, always there if we need a helping hand.” The home “meets deaf/blind individuals needs well with individual communication guidelines and training to enable staff to learn required skills”. “I really feel concerned about the staffing situation at Applemead. Despite regular recruitment drives we still run on 7/8 members of staff down. With the shifts made up of a vast number of agency workers it can be difficult to ensure consistency and enable the individuals to access fully the wide range of services and facilities available to them. As a staff member this is frustrating. I feel the individuals are settled and very well cared for, but with a full staff team the scope of what we could offer would be so much more.” Applemead DS0000021878.V294538.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 home is well managed. All records have been well maintained. The home has taken all possible steps to ensure the health and safety of residents and staff. EVIDENCE: Angela Martin was registered as the Manager of Applemead in May 2006. She had previously been the Acting Manager of the home for several months. She was previously the registered manager of another home in East Devon. Angela holds NVQ level 3. She intends to start NVQ level 4 in September 2006, and to start the Registered Managers’ Award in September 2007. Among the new staff about to be appointed will be two Senior Support Workers who will support Angela in the day-to-day management of the home. During the inspection Philip Welsford talked about his role in ensuring there is a robust quality monitoring and continuous improvement procedure for the Applemead DS0000021878.V294538.R01.S.doc Version 5.2 Page 23 home. He carries out monthly visits to the home in which he checks all records, talks to staff and residents, and carried out his own inspection of the facilities and services. Sense have detailed and thorough quality assurance procedures in place. During the inspection the following records were checked – Fire log book Accident records Care plan files Budgets Money held by the home on behalf of residents Menus Staff recruitment and training files Menus Medications All records were found to be well maintained and showed that safe procedures have been followed. Permanent staff have received training in relevant health and safety subjects. Health and safety checks and risk assessments have been carried out on the environment. Applemead DS0000021878.V294538.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 3 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 2 23 3 ENVIRONMENT Standard No Score 24 2 25 3 26 X 27 X 28 3 29 X 30 3 STAFFING Standard No Score 31 3 32 3 33 2 34 3 35 3 36 3 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 3 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 Applemead DS0000021878.V294538.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? No 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 YA24 Regulation 23(2) (b and n) Requirement The registered person must ensure the premises are of sound construction and kept in a good state of repair. (This refers to the exterior paintwork and general appearance of the home) The registered person must ensure that the employment of any persons on a temporary basis at the care home will not prevent service users from receiving such continuity of care as is reasonable to meet their needs. Timescale for action 01/03/07 2 YA33 18(1)(b) 01/01/07 Applemead DS0000021878.V294538.R01.S.doc Version 5.2 Page 26 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 Refer to Standard YA2 YA22 YA24 YA24 Good Practice Recommendations The home should ensure that records of initial assessment information are retained. The home should keep a register of complaints and concerns. Furniture in residents’ bedrooms should be in good repair. Interior paintwork should be repainted where necessary, particularly in the staircase and upper corridors. Applemead DS0000021878.V294538.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Exeter Suites 1 & 7 Renslade House Bonhay Road Exeter EX4 3AY 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 Applemead DS0000021878.V294538.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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