Inspection on 14/01/08 for Barleycombe Residential Home

This inspection was carried out on 14th January 2008.

CSCI found this care home to be providing an Good service.

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

Barleycombe Residential Home 29/08/07

Barleycombe Residential Home 11/10/05

Barleycombe Residential Home 27/06/05

Barleycombe Residential Home 23/05/05

Barleycombe Residential Home 04/11/04

Barleycombe Residential Home 19/05/04

Barleycombe Residential Home 13/02/04

Barleycombe Residential Home 14/08/03

Barleycombe Residential Home 28/11/02

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

CARE HOME ADULTS 18-65 Barleycombe Residential Home Sudbury Road Long Melford Sudbury Suffolk CO10 9HE Lead Inspector Claire Hutton Unannounced Inspection 14th January 2008 2:50 Barleycombe Residential Home DS0000024331.V357819.R02.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 Barleycombe Residential Home DS0000024331.V357819.R02.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. Barleycombe Residential Home DS0000024331.V357819.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Barleycombe Residential Home Address Sudbury Road Long Melford Sudbury Suffolk CO10 9HE 01787 880203 01787 310809 barleycombe@activecarepartnerships.co.uk www.schealthcare.co.uk West Regent Ltd 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) vacant post Care Home 14 Category(ies) of Learning disability (14) registration, with number of places Barleycombe Residential Home DS0000024331.V357819.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 29th August 2007 Brief Description of the Service: Barleycombe is a care home for adults with a learning disability and currently only has male residents. The home consists of a two-storey building situated in extensive grounds, which had been cultivated to produce vegetables and maintain livestock. The home is set back from the main road running between Sudbury and Long Melford. Both towns are accessible via public transport, with Long Melford within reasonable walking distance. Fees for this home range from £407.00 to £1057.00 per week. The average fee was £757.00. More information about fees can be obtained from The Statement of Purpose and Service Users Guide available from the home. Barleycombe Residential Home DS0000024331.V357819.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use the service experience good quality outcomes. This was an unannounced key inspection that focused upon the core standards relating to Adults (18 – 65). A focus of this inspection was to follow up on the matters arising from last inspection at the home in August 2007. It took place on 2 week days lasting seven hours. The inspection process included visiting all areas of the home, discussions with staff and residents, observations of staff and resident interaction, and the examination of a number of documents including residents care plans and associated documents, medication records, the staff rota, records relating to health and safety and records relating to staff recruitment. The report has been written using accumulated evidence gathered before and during the inspection. An Annual Quality Assurance Assessment was completed by the previous registered manager and is referenced in parts of this report. This assessment is a self-assessment against the care standards to be achieved. On the evening of the first visit to the home 3 residents were spoken with and time spent with a group of residents in the lounge area. Also on the same evening 5 staff were interviewed in private. The newly appointed manager and Area manager were present on both days of the inspection and contributed positively to the process. What the service does well: What has improved since the last inspection? Barleycombe Residential Home DS0000024331.V357819.R02.S.doc Version 5.2 Page 6 Since the last visit to the home in August 2007 a new manager has been appointed and the requirements from the last report have been addressed. We have received an improvement plan from the home that addressed our previous concerns. This sets out the action the home was taking. This inspection found a new activities person has been appointed. They were in the process of developing a new program of in house activities at Barleycombe. The residents said they were being consulted on this. There are small group holidays being planned and more opportunities to go out individually and not just as part of a group. Concerns and complaints are being listened to. The home has promoted this by ensuring everyone is aware of how to express concerns through residents meetings, team meetings and information about the complaints procedure was in several places around the home. Protection and safeguarding of residents is taken seriously. Information was now collated and clearly showed what action had been taken. Safeguarding training for all staff was booked over 2 days in February 2008. The premises were now more appropriate for the stated purpose with repairs to a toilet now complete. A bath and washing machine were installed and being used by residents. The staffing situation on nights had been resolved and was no longer placing residents at risk. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Barleycombe Residential Home DS0000024331.V357819.R02.S.doc Version 5.2 Page 7 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 Barleycombe Residential Home DS0000024331.V357819.R02.S.doc Version 5.2 Page 8 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The needs of people were re-assessed, which ensured the service could meet their needs. People were provided with a contract and therefore agreements were established. EVIDENCE: The home had a Statement of Purpose and a Service Users Guide. As you enter Barleycombe there was a display case on the wall that held information about the home and the people who worked there. There were photographs of the staff with their names and the structure of the organisation ‘Active Care’. The Statement of Purpose and the Service Users Guide was located here. The existing resident group have been at the home for sometime and there have been no new admissions of late. In records examined for 2 residents there was reassessment of needs from which revised care plans had been developed. At the last inspection in August 2007 we found contacts in place that had been signed. Barleycombe Residential Home DS0000024331.V357819.R02.S.doc Version 5.2 Page 9 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 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff had access to up to date information so that they could support people appropriately. EVIDENCE: Three care plans and associated documents were examined. There was evidence that these care plans had been developed from assessments completed by the home. For one individual assessment had been made of their physical needs and dependency as their needs had changed since they had moved to the home. For this individual staff were offering more care support. This care support was well documented and all staff spoken with were aware of this persons needs. All the care plans seen were written about the same time – April 2007. There was evidence of review since that date and these dates varied. There was evidence that one plan was currently being reviewed and information being complied. All staff spoken with felt the care plans were satisfactory in the information they supplied and enabled them to provide appropriate support. Two staff thought the care plans were more Barleycombe Residential Home DS0000024331.V357819.R02.S.doc Version 5.2 Page 10 designed for older people and not for people with a leaning disability. The plans had sections on communication, personal care, social interaction and family links, but also had sections that were for people with a disability such as independence, life skills, inclusion and rights and advocacy. Each section of the care plan then had documented the support required for that individual. Risk assessments were in place for individuals. These ranged from falls risk assessment and mobility risk assessment for one person who needed care support to risk assessments on using transport, sexuality and relationships and going swimming to promote independence. Staff were spoken with about decision making. Staff said ‘we try not to do things for the residents – we let them make the decisions. We do not stop the people here making bad decisions, but we do offer advice’. Another staff member said ‘we help them help themselves. We support and encourage the people here’. One resident had a recent review that they were involved in and the decision around developing independence with self-medication was discussed. Staff said that this decision had been respected and they were now in the process of developing a risk assessment to support this. There were advocates involved at Barleycombe and there was evidence that they are involved in the review process to help support the resident. Residents meetings were held at the home and minutes kept. The new cook was spoken with and they were clear that the residents would be consulted upon any changes to the menus and decisions respected. Barleycombe Residential Home DS0000024331.V357819.R02.S.doc Version 5.2 Page 11 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, 14, 15, 16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Appropriate opportunities for leisure and personal development were offered and met the needs of the resident group. People enjoyed a varied diet. EVIDENCE: On the evening visit to the home there was a visitor to the home. This was explained as the person who regularly comes on a Monday evening to offer residents a shiatsu massage. Any resident can have a massage alternate Mondays. On the next visit to the home we were aware that one person had gone swimming with staff support, another person had gone shopping with staff support and another person had caught the bus into town for a haircut. This person was able to go out alone and did not need support, but needed to be given the correct money to enable them to pay bus fare and for the haircut. Staff ensured this was done. Barleycombe Residential Home DS0000024331.V357819.R02.S.doc Version 5.2 Page 12 Some residents attend external day centres such as the resource centre or the courtyard. Some residents attend college courses. One resident spoke of three courses that they were currently doing and was very pleased with the opportunities and that staff at the home had enabled them to be enrolled on the courses. The group of residents were spoken with about the new appointment of an activities person and they were all positive about this. A resident said ‘The new activities person is good, I’m pleased for them’. In the care plan and records of one resident, who required more personal support and care, it showed that he did not partake in the activities offered and did not go to any external day care. This was discussed with the manager and they assured us that offers of activities were still made and on occasion taken up, but also they were looking into alternatives such as a day facility called Genesis that could offer more sensory stimulation. Residents spoken with were able to say that they were pleased with the opportunities available in the evenings and weekends. Residents knew what was on offer and when it was scheduled. There was something most evenings on offer – going to the pub, attending the local gateway club (this is a social evening for people with a learning disability) going out for a meal, going to the local legion club, hiring DVD’s and at a weekend there was the take away night and swimming on a Sunday morning. Weekends also tended to be when people went home to see family or relatives visited Barleycombe. One resident said that they had gone home for 2 weeks over the Christmas period and really enjoyed seeing all their family. Another resident said that they regularly went home and this was seen recorded in the daily statements. We were told that one resident had visited a relative in another care home. They had enjoyed the musical entertainment at that home so much, they had brought back the details and it had been arranged for the residents at Barleycombe. The manager said that they had joined the home to a local video club and that more activities, such as meals out, were organised for residents on their own supported by one staff member. Also this year residents were planning holidays and these were in small groups. Staff were spoken with about how they promoted independence. All 5 staff were clear they offered support and did not do things for people. One staff member said ‘We encourage skills in such things as making a cup of tea or doing their own laundry’. Another staff member said ‘We support them with shopping and developing money skills’. A new cook was met on the second day of the visit. The menu was discussed and it was clear there was a choice given to residents. The menu offered an alternative at each meal. One resident who needed additional calories had a good wide choice to encourage eating more. The cook was aware of healthy eating and was in the process of developing the menu further to offer lower cholesterol foods, but also was aware of consulting residents in the changes. The number of empty plates that were returned to the kitchen encouraged the cook. On the evening visit staff were seen asking residents their choice of Barleycombe Residential Home DS0000024331.V357819.R02.S.doc Version 5.2 Page 13 meal – sausages or chicken chasseur, both came with vegetables and potatoes. Comments on the food were also recorded. Barleycombe Residential Home DS0000024331.V357819.R02.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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People were supported in a manner suited to their personal preference. Medication practices were sufficiently effective to protect people. EVIDENCE: Three care plans inspected contained specific information about personal support. Two residents had specific care needs around continence issues – their care needs were set out in their plan and the detailed daily recording showed these needs were met routinely to ensure the dignity of residents. Staff spoken with were aware of these care needs and were asked about how they ensured the privacy and dignity of the residents. One staff member said ‘I allow the person to wash themselves and direct what is happening. I always tell them what is happening, never force them to do anything and respect their choice’. Another staff member said ‘I always knock on bedroom or bathroom doors and wait. If they need privacy, I do not disturb. I never surmise anything I always ask’. In care plans there was evidence of good use of health professionals. There was access to standard health services such as GP, chiropody, dentist and Barleycombe Residential Home DS0000024331.V357819.R02.S.doc Version 5.2 Page 15 opticians. There was also good access and use made of more specialist healthcare services such as the wheel chair service, the continence advice service, community learning disability nurses and clinical psychologists. On the day of the visit a resident was taken to see the GP and a staff member accompanied them and used the homes transport. The management of medication at the home was examined. Currently there are no residents who self medicate, but this is being looked at following a recent review as mentioned earlier in the report. The security of medication is good. There is a locked medication fridge for medication as well as a steel medication cupboard. The system used is a Boots monitored dosage system. There was a policy and procedure available for staff to follow. One staff member was observed giving medication and was seen to follow the procedure. There was evidence of staff training, but one staff member spoken with said they administered medication, but had not been trained to use this system. The medication administration records were examined and one was found to have gaps. The mistake was noticed and action taken to correct the matter. This was discussed with the manager who agreed to look into obtaining a different supply of medication for home visits. This will ensure that the homes records and systems can be managed in an accountable way. There were sample signatures and initials that clearly identified who had administered medication. There was a clear audit trail that showed medication prescribed had been administered and by whom. When staff administered medication they wore a red tabard that said ‘Do not disturb medication administration in process’. Barleycombe Residential Home DS0000024331.V357819.R02.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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are protected and their views listened to. EVIDENCE: The last inspection report on the home contained 2 requirements. One related to complaints and said that the home must listen to concerns and take matters seriously. Records must be kept with action taken recorded. We received an improvement plan. The plan set out that the home intended to ensure all the residents were aware of how to raise concerns if they needed to, by displaying a pictorial and text laminated signs about the home on how to raise concerns and to whom. These were seen during the visit in bedrooms. Issues were also to be raised at residents meetings. Residents meetings are regularly held and minutes kept. Staff were spoken with about how they would ensure residents know how to complain if they needed to. All 5 staff were clear about listening to concerns and following matters up. One staff member said ‘I’d listen and try to resolve but if I could not I’d pass it on to a manager’. Another staff member said ‘I think I would notice if they were unhappy and I’d encourage them to speak up or I’d speak up for them’. Residents spoken with said they had not concerns currently. The complaints log was examined. The log had information on 2 complaints. One had been investigated and had conclusions and recommendations made. The second was a safeguarding referral that was currently being investigated by the police. We were subsequently informed of another safeguarding referral following the inspection. Barleycombe Residential Home DS0000024331.V357819.R02.S.doc Version 5.2 Page 17 The management and staff at Barleycombe were aware of the local policy and procedure to be followed when safeguarding issues arises. We were aware that appropriate referrals were made and strategies agreed and supported by the home. The home was also aware of its duty to refer to the national POVA listing. (Protection of Vulnerable Adults) Staff spoken with were aware of their duty to respond to any allegation they were told or witnessed. One staff member said ‘Yes I know what to do and I would report it to the manager. I would ensure it was kept confidential’. Another staff member said ‘I would report the information, but if it was not dealt with I’d contact Social Services directly’. From the 5 staff spoken with 4 said they had received training in safeguarding and one said they had training planned but the trainer did not turn up. The manager confirmed this and had new dates set to ensure all staff had received safeguarding training. Barleycombe Residential Home DS0000024331.V357819.R02.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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 28 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Barleycombe provides a clean and comfortable place to live. EVIDENCE: A tour of the premises was undertaken and several bedrooms were seen with the permission of the individual residents. Bedrooms were individual with personal possessions such as TV’s DVD’s, pictures, games and musical instruments. The lounge area was comfortable and well used by the residents. The dining room looked bright and fresh with the new tables. The picture menu for residents was a new development, but was not up to date on the day. The quiet lounge was furnished to an acceptable standard. The telephone looked unsightly as it had a large metal plate and lock over it to stop usage without permission. There have been developments environmentally since the last inspection. The matters raised in the last report had been addressed. The staff toilet was now fully functioning. The bath and washing machine in the flat were installed. Barleycombe Residential Home DS0000024331.V357819.R02.S.doc Version 5.2 Page 19 The back step had been made safe. All areas of the home including the laundry and kitchen were found to be clean. A discussion was held with the manager and area manager about maintenance in the home and at what level were repairs outside the scope of the current handyman. All the door locks in the home were very worn with the handles sagging. Whilst there a resident reported that his bedroom door lock had broken. Barleycombe is heavily used and the décor and fittings are in need of constant maintenance. The management agreed to consider the issues raised. Barleycombe Residential Home DS0000024331.V357819.R02.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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 and 36. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There were sufficient staff that were well recruited, adequately trained and supervised, therefore residents are appropriately supported. EVIDENCE: A board with a Perspex front had been positioned in the front entrance. This contains photographs of staff with their names. This was useful to residents and visitors to the home. Also in the lounge area was a photo roster for the residents to see who was on duty that day and who would be supporting them. The group of residents spoken with said that liked this new development. There had been several developments within the staff group and more recruitment had taken place. A new activites person, a new deputy manager and a new cook had been appointed. There were also 4 new support staff that had been appointed since out last visit to the home. There was still one vacancy for a night member of staff but the issue of staffing the night shifts had been resolved. Barleycombe Residential Home DS0000024331.V357819.R02.S.doc Version 5.2 Page 21 The recruitment records for 2 new staff were examined. These were found to have all the necessary checks in place before the person started work at the home. There was evidnce that these 2 new staff had received induction training in line with skills for care. There was also evidence that these 2 staff had received formal supervision. The 5 Staff spoken with also said they received regular formal supervision. At the last inspection in relation to training we found that staff received training updates in basic food hygiene, fire training, health and safety with training in the use of chemicals, manual handling, first aid and care planning. Staff spoken with confirmed this. There were dates planned for autism training and new dates for adult safeguarding training. The manager said that level 2 training was planned to follow up for the 6 staff who had achieved level 1 in total communication. A further development at the home in relation to training was that the home had got trainers based at the home for infection control, manual handling, person centred planning and heath and safety. Barleycombe Residential Home DS0000024331.V357819.R02.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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Barleycombe was well managed and residents were able to express their views. EVIDENCE: Since the last visit to this home we have been notified that the registered manager no longer works at the home. A new manager had been appointed and they are appropriately qualified and have experience in working with people with a learning disability. We await their application for registration. The group of resident spoken with were very positive about the new manager and one person said ‘She is nice – nice to have a boss again’. All 5 staff spoken with were positive about the new appointment. One staff member said ‘I get good support from the manager and staff moral is high’. A new deputy manager had been appointed but had not yet started work at the home. Barleycombe Residential Home DS0000024331.V357819.R02.S.doc Version 5.2 Page 23 In relation to quality assurance within the home there was an auditing system in place that was completed by the home and fed up through the organisation. There were auditing and action plans for such matters as medication, health and safety, the environment and complaints. These documents were seen to be in place. We have received regular reports from senior managers with in the organisation who visit the home (regulation 26 visits). There were regular residents meetings and staff meetings held with records kept. The inspector was aware that residents and staff are surveyed from time to time. The self-assessment completed by the home evidenced that all services to the home had been serviced within the last year. Records relating to fire were examined at the previous inspection in August 2007 and found to be in order. Window restrictors were in place and records relating to the safety of hot water were examined. In the kitchen records relating to food safety and cleaning schedules were kept and were available for examination. Barleycombe Residential Home DS0000024331.V357819.R02.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 3 3 X 4 X 5 3 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 3 25 3 26 X 27 X 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 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 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 2 3 3 3 X X 3 X Barleycombe Residential Home DS0000024331.V357819.R02.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. 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. Refer to Standard YA20 Good Practice Recommendations For the safety of residents all staff that administer medication should be trained to use the system in operation. Barleycombe Residential Home DS0000024331.V357819.R02.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Colchester Fairfax House Causton Road Colchester Essex CO1 1RJ 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 Barleycombe Residential Home DS0000024331.V357819.R02.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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