CARE HOME ADULTS 18-65
Bigwig House Rhubarb Hill Holywell Bay Newquay Cornwall TR8 5PT Lead Inspector
Lowenna Harty Unannounced Inspection 27th June 2006 09:30 Bigwig House DS0000009102.V301769.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 Bigwig House DS0000009102.V301769.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. Bigwig House DS0000009102.V301769.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Bigwig House Address Rhubarb Hill Holywell Bay Newquay Cornwall TR8 5PT 01637 831220 01326 371099 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) Spectrum Miss Ruth Jayne Colley Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Bigwig House DS0000009102.V301769.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 15th December 2005 Brief Description of the Service: Bigwig House provides care and accommodation for three people with autistic spectrum disorder. It is run by Spectrum, an organisation that provides specialist care to adults with an autistic spectrum condition. The home is situated in Holywell Bay, which is near Newquay. The accommodation is on two levels and consists of three single bedrooms, an office, kitchen, dining room and lounge. There is a sizable garden and adequate car parking for staff and visitors. The home has its own transport. The current residents do not need any specialist equipment or adaptations, and the home is not adapted for a person with a physical disability. Spectrum employs a registered manager and team of staff to run the home. Spectrum aims to provide service users with appropriate support in a small domestic environment in a community setting. Fees range from £650 - £3750 per week. Additional charges are made to service users for hairdressing, Newspapers and magazines, alcoholic drinks, confectionary, private chiropody, dry cleaning, entertainment provided outside of the premises and stationary. This information was provided to the Commission on 16 May 2006. Bigwig House DS0000009102.V301769.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an annual key inspection, which took place on 27 June 2006 and was unannounced. It lasted for approximately six hours. Information about the home received by the Commission since the previous inspection was taken into account when planning the inspection. The purpose of the inspection was to ensure that service users’ needs are appropriately met in the home, with particular regard for ensuring good outcomes for them. This involved interviews with them and observation of the daily life and care provided. There was an inspection of the home’s premises and of written documents concerning the care and protection of the service users and the ongoing management of the home. Staff were interviewed and observed in relation to their care practices and there was a discussion with the home’s manager. The principle method used was case tracking. This involves examining the care notes and documents for a select number of service users and following this through with interviews with them and/or their relatives and staff working with them. This provides a useful, in-depth insight as to how residents’ needs are being met in the home. At this inspection, all three of the service users were case tracked, although two declined to be interviewed. There was evidence of some improvement in care standards at this inspection and work is continuing to improve it further to provide service users with a safe and comfortable home in which they can develop their skills and independence. What the service does well:
Service users are assessed prior to their admission to the home so that they can be confident that it will meet their needs. They are given written information about the home, in formats that they can understand, so that they are aware of what they can expect from the home and what is expected from them as residents. Bigwig House DS0000009102.V301769.R01.S.doc Version 5.2 Page 6 Service users have detailed written care plans, which set out how the home will meet their personal, health and social care needs, including needs relating to their individual backgrounds and culture, age, sex, religion, individual abilities and sexual orientation. They, their relatives and representatives are invited to regular reviews so that their care plans can be agreed with them and updated. They are encouraged to make important decisions about their lives, such as what activities to take part in during the week and how to spend their free time so that they develop their confidence and independence. Any risks are carefully managed, to minimise restrictions on service users and enable them to take part in activities that develop their skills and enhance the quality of their likes. Service users enjoy a good quality of life in the home. Staff support them to take part in a wide range of activities in the home and the local community, which vary according to their individual needs and preferences. One attends a local college on a regular basis, whilst the others prefer a less structured lifestyle. Activities are age and culturally appropriate for them. The home has a television and DVD in the main lounge and service users have their own in their rooms. There is a computer in the lounge, with Internet access, which one service user makes use of regularly, for example. They attend a variety of social activities including visits to pubs and cafes with staff, in the community. They are actively supported and encouraged to maintain contact with their families so that they maintain and develop valued relationships outside of the home. They take part in planning, shopping and preparing meals independently or with staff support, depending on their needs, so that they enjoy their meals, eat healthily and develop their independent living skills. Service users are encouraged to independently attend to their personal care so that they look smart and appropriately dressed, with staff assistance as necessary. They are helped to access a range of NHS healthcare providers, such as doctors, opticians and community nurses so that they maintain good general health and receive any specialist services they need. Their medicines are safely stored in the home, staff have clear written guidance and sufficient numbers of them have received training so that service users are protected from medication errors. Service users and their relatives are able to make their views known and are taken seriously, especially if they wish to complain about any aspect of their care. There are systems in place to ensure that they are safe and well cared for in the home and staff rarely work alone with them, but as a team. They are provided with training and guidance on how to effectively support and protect service users from harm and abuse. The home provides service users with an ordinary, domestic environment in which they can develop their independence and skills. It is situated in a small village community, within easy reach of a popular beach that they often visit with staff. Bigwig House DS0000009102.V301769.R01.S.doc Version 5.2 Page 7 Staff are recruited on the basis that they are suitable to work with vulnerable adults in a care setting. At the time of the inspection, during the daytime there were enough of them on duty to be able to work individually with the service users in and out of the home. The home is generally well managed for the benefit of the service users living there. The manager has recently registered with the Commission and is in the process of putting improvements into place to ensure that service users’ needs are met safely, and with reference to their views and preferences. What has improved since the last inspection? What they could do better:
Service users should be given clearer information about the cost of their placements in the home, including information on how the contributions they make are calculated so that they are fully aware of their financial rights and obligations. Bigwig House DS0000009102.V301769.R01.S.doc Version 5.2 Page 8 Service users would benefit from being provided with more detailed and specific goals in their care plans so that they and their representatives are better informed of their progress and achievements in the home over time. Essential maintenance tasks need to be carried out promptly so that service users are not left without essential facilities for extended periods and there need to be improved systems to protect service users from risks of crossinfection in the home, including safe transport of soiled laundry through the home and training in infection control for more of the staff. The proportion of staff who have achieved formal qualifications in care provision is quite low and should be increased so that service users and their representatives can have confidence in the skills and competence of people working in the home. Night time staffing arrangements need to be reviewed, urgently, to ensure that service users are not left at risk through only one person sleeping in, particularly with regard to the home’s relatively isolated location. Any staff member who works alone with service users must have sufficient training to be able to meet their needs in an emergency, including training in the provision of basic first aid, so that they are properly protected. Staff training records need to be improved with regard to records of new staff induction so that service users and their representatives can be assured that staff have received the training they need to be able to work safely and effectively with them. 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. Bigwig House DS0000009102.V301769.R01.S.doc Version 5.2 Page 9 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 Bigwig House DS0000009102.V301769.R01.S.doc Version 5.2 Page 10 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2&5 Quality in this outcome area is adequate. Service users’ needs are assessed prior to their admission to the home to ensure that it will be suitable for them and they are provided with written statements of the terms and conditions of their placement in the home so that they are informed of their rights and obligations, but this does not include clear, or in every case, accurate information about the cost of their placements or how their individual contributions towards it are calculated. EVIDENCE: The manager stated and records showed that there have been no changes to the service user group since the previous inspection. Copies of detailed assessment information relating to each of the service users were available on their personal files. Service users have written statements of the terms and conditions of their placement, in suitable formats to make the information accessible to them, which they have signed and which were reviewed during the inspection. The information given to them does not include the total cost of their placement or a detailed breakdown of how their personal contributions towards the total cost is calculated to provide them with clear information about their welfare rights. There is information on how they can contact a local advocacy service on their notice board. All of the service users have good verbal communication skills Bigwig House DS0000009102.V301769.R01.S.doc Version 5.2 Page 11 and are literate to varying degrees, according to the registered manager so they are able to access information easily. Bigwig House DS0000009102.V301769.R01.S.doc Version 5.2 Page 12 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. Service users are aware of their care plans, which address their health, social and personal care needs in full, including needs relating to their age, sex, sexual orientation, disability, cultural and ethnic backgrounds and religion. They would benefit from more detailed and specific goals to work towards so that they can monitor their own progress and achievements. They are encouraged to develop their skills in making decisions for themselves to develop their confidence and independence and to take managed risks in this respect. EVIDENCE: The service user who agreed to be interviewed confirmed that he is aware of and understands his care plan. He said that he is invited to attend and contribute to reviews. Relatives of service users who were interviewed by telephone confirmed this and said that the home is good at involving them in the care planning process. Copies of service users’ care plans and reviews were available for inspection. These set out service users health, social and personal care needs in full, although the goals set for them were not very detailed or specific.
Bigwig House DS0000009102.V301769.R01.S.doc Version 5.2 Page 13 The home’s manager, staff and service users themselves provided examples of how they are enabled and encouraged to make decisions for themselves and their abilities in this respect are considered as part of the care planning process. There are records of formal consultation exercises held with service users and their representatives on their personal files, although the main forum for this is during their care plan reviews, which are held at least six monthly. Service users were observed exercising choices during the course of the inspection, about what to wear, when to get up in the morning, when and where to take their meals and how to spend their time during the day, for example. There are detailed, written risk assessments in place for each service user, with clear risk management plans so that service users can undertake a range of activities to develop their skills and independence in ways that are safe. These also detail any restrictions that are necessary to protect the service users and/ or other people. Copies of these are sent to their representatives, according to the home’s records and a relative of a service user who was interviewed during the inspection confirmed this. Bigwig House DS0000009102.V301769.R01.S.doc Version 5.2 Page 14 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. Service users access a wide range of activities, in accordance with their individual needs and preferences, so that they develop their skills and independence. They regularly access resources in the local community and are supported to maintain valued relationships with their friends and relatives so that they are not isolated and they enjoy a good quality of life. Their rights and responsibilities are recognised and promoted as far as is practicable and they are well fed so that they stay physically healthy and enjoy their meals. EVIDENCE: The manager stated that service users have individual activity plans, which are developed according to their needs and preferences. The home’s records confirmed this and service users were observed engaging in different activities in and out of the home during the day. Staff who were interviewed said that they are employed in sufficient numbers to be able to work with each service user individually and were observed to engage appropriately with service users throughout the day. The service user who was interviewed said that he enjoys a good lifestyle in the home and is satisfied with the activities provided.
Bigwig House DS0000009102.V301769.R01.S.doc Version 5.2 Page 15 Service users were observed accessing community resources during the day. One attends a local college on a regular basis and the daily care records confirmed this. The service user who agreed to be interviewed said that he enjoys going out to local pubs with staff so that he has opportunities to mix with people in a non-care environment. The home provides transport suitable for taking service users out and sufficient numbers of staff who can drive. The registered manager said that service users are sensitively supported with regard to relationships issues and are encouraged to maintain contact with their families. Spectrum’s senior management team are available to provide staff with specialist input and advice, where necessary, in this respect. At the time of the inspection a relative of one service user telephoned the home to speak to them. The service user was able to receive the call in the privacy of his room. Service users’ guides set out clearly expectations of service users as residents of the home and their rights, with regard to the conditions of their placements. They are provided with clear advice on how to access independent advocates and/or the commission via their notice board. The service user who was interviewed said that he is satisfied with the food provided to him at the home and he was observed choosing where and when to eat at lunchtime. The manager said that service users are able to access the kitchen, independently or with staff support, depending on their risk assessments, at any time. This was observed during the inspection so that service users were given drinks and snacks at appropriate times. The home’s records take account of service users’ nutritional needs and preferences, which are regularly reviewed and they are able to make choices about the main meals provided to them. Bigwig House DS0000009102.V301769.R01.S.doc Version 5.2 Page 16 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. Service users are helped to maintain and develop their independence with regard to their personal care. They are assisted to access the healthcare services they need so that they can stay well and enjoy their lives. Arrangements for managing medicines are mainly safe but some improvements are needed to ensure that service users are protected from medication errors. EVIDENCE: Service users were observed to make use of the bathrooms and facilities for maintaining their personal care independently, whilst staff were available at all times to prompt and assist them in low key ways, where necessary. The home’s records provide staff with detailed instructions on how to support service users appropriately and safely with regard to their personal care. The home’s records show that service users regularly attend health checks at a range of NHS healthcare facilities, including doctors and dentists and specialist services, where necessary. Relatives and representatives interviewed stated that they are satisfied that service users’ health care needs are managed appropriately. Bigwig House DS0000009102.V301769.R01.S.doc Version 5.2 Page 17 There are secure storage facilities for service users’ medicines, although there is not a designated person in charge of the keys, which there should be so that there is a clear line of responsibility in this respect. Staff have clear written guidance for the safe management of medicines in the home. There are clear written records in respect of medicines provided to service users. Most of the staff have undergone training in the safe handling of medicines through distance learning via a local college, which a staff member who was interviewed confirmed. Bigwig House DS0000009102.V301769.R01.S.doc Version 5.2 Page 18 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. There are formal and informal systems in place so that service users’ views can be taken into account in the day-to-day running of the home. Service users’ welfare and best interests are well protected so that they feel safe and well cared for in the home. EVIDENCE: The service user who was interviewed said that they are satisfied with the care and services provided to them at the home and they are able to contribute their views and opinions formally in care planning reviews. Relatives who were interviewed indicated that any complaints they have or issues they raise are taken seriously and investigated by Spectrum’s senior managers, if necessary so that they can be resolved. They all confirmed that they are able to contribute their views formally during service users’ reviews and one said that questionnaires about the quality of the service were sent to them in the previous year. There were records of these, including questionnaires circulated among the service users held in the home and full and detailed records of how complaints had been resolved. The service user who was interviewed said that he feels safe in the home and relatives who were interviewed confirmed this. The home’s written procedures to guide staff on what action to take if they suspect a service user has been abused have been updated so that they have clear information on what to do to protect them. The registered manager has applied to attend multi-agency training on the protection of vulnerable adults from abuse and in the interim he and staff working in the home have been provided with training by Spectrum. The home’s records showed that staff are recruited on the basis that they are suitable to work with vulnerable people in a care setting. Service users are not isolated and are encouraged to take part in community activities and maintain contact with relatives and representatives from outside of the home.
Bigwig House DS0000009102.V301769.R01.S.doc Version 5.2 Page 19 Bigwig House DS0000009102.V301769.R01.S.doc Version 5.2 Page 20 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome area is adequate. The home is mainly comfortable and safe for service users but important maintenance work needs to be completed more promptly to ensure their comfort and privacy. Equipment and systems to protect staff and service users from cross-infection need improvement. EVIDENCE: The home provides service users with an ordinary, domestic environment in a village community within very easy reach of a local beach, which they enjoy. They have sufficient private and communal space to meet their needs. Most of the premises appeared clean, tidy and well decorated at the time of the inspection. Service users are able to personalise their rooms and keep them as they like. They can lock their bedroom doors for privacy, subject to their individual risk assessments. Security arrangements are appropriate to service users’ needs and risks. Essential maintenance tasks need to be attended to more quickly however. At the time of the inspection a service users’ bedroom door was broken and replaced with a curtain. An immediate requirement was issued for it to be mended, and prompt action was taken to rectify the situation, but the service user had been without a proper door to his room for almost a month. The home has suitable washing machine facilities to meet service users’ needs, but arrangements for the transport of soiled laundry through the home were
Bigwig House DS0000009102.V301769.R01.S.doc Version 5.2 Page 21 unsatisfactory so that staff and service users could be at risk of cross-infection. Staff training records and the home’s manager confirmed that insufficient numbers of the current staff team have formal training in infection control, which they should be provided with, so that they are aware of the risks and how to manage them. Bigwig House DS0000009102.V301769.R01.S.doc Version 5.2 Page 22 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34 & 35 Quality in this outcome area is poor. There is only one member of staff who is qualified to NVQ level 2, which is considerably below the 50 recommended in the National Minimum Standards so that service users can have confidence in the people working with them. Whilst staffing levels during the day have improved so that service users are able to safely access individual activities and resources, night-time staffing levels need to be reviewed to ensure that service users are adequately protected. Recruitment and selection of staff is fair, safe and effective so that service users can have faith that the people working with them are suitable to work with vulnerable adults in a care setting. Staff have good access to ongoing training although improvements are needed to ensure that they all have the knowledge and skills they need to be able to work safely in the home. EVIDENCE: The registered manager stated that only one member of a staff team of eight carers is qualified to NVQ level 2 and records reviewed confirmed this. The registered manager said that he has changed the deployment of staff and increased levels during the daytime so that they are able to provide service users with more input individually. There were sufficient staff on duty at the time of the inspection and they were observed interacting respectfully and appropriately with the service users. Duty rosters indicate that there are sufficient staff to meet service users’ needs during the day, but night staffing levels are reduced to a single member of staff sleeping in. This needs to be
Bigwig House DS0000009102.V301769.R01.S.doc Version 5.2 Page 23 carefully risk assessed in light of the home’s location and the time it might take for on-call managers to reach it in an emergency. Recruitment records indicate that staff are recruited fairly, in accordance with equal opportunities, safely, in that appropriate checks are made to ensure that they are fit to work in a care home and effectively in that they are selected on the basis of their suitability to work with vulnerable adults in a care setting. Staff interviewed verified this and the service user who was interviewed said that staff care for him well. The manager and staff who were interviewed said that they have good access to ongoing training. The manager has drawn up a training plan for the whole staff team so that training can be prioritised. Each staff member also has an individual training plan. Records indicate that not all staff have the basic training they need to work safely with service users. In the case of one, who has recently started to work at the home, there was no record of their induction. There have been occasions when the single staff member sleeping in at night had undergone very little training and was not even qualified in the provision of basic first aid. Bigwig House DS0000009102.V301769.R01.S.doc Version 5.2 Page 24 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. The registered manager is competent and fit to run the home on a day-to-day basis so that service users can have confidence that they are in safe hands. There are systems in place to ensure that service users’ views are considered in the ongoing planning and development of the service. There are systems in place to protect the health and welfare of service users and staff so that they feel safe in the home. EVIDENCE: The manager has recently registered with the Commission as fit and competent to be in charge of a care service. Records indicate that he undergoes ongoing training to develop his qualifications and skills. The service user who was interviewed and relatives who were contacted said that they are mainly satisfied with the services the home provides. Service users are formally consulted on the quality of the service during their care plan reviews and informally, on a day-to-day basis. There are records of formal consultation exercises carried out with them and their families on their personal files.
Bigwig House DS0000009102.V301769.R01.S.doc Version 5.2 Page 25 There are records to show that the home’s manager has reviewed the home’s fire safety and environmental risk assessments. Staff confirmed that essential maintenance tasks relating to ensuring health and safety in the home are carried out promptly. Bigwig House DS0000009102.V301769.R01.S.doc Version 5.2 Page 26 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 3 3 X 4 X 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 2 33 1 34 3 35 1 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 X 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 3 X X 3 X Bigwig House DS0000009102.V301769.R01.S.doc Version 5.2 Page 27 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. Standard YA24 YA24 Regulation 12(4)(a) 16(2)(c) 23(2)(b) Requirement The broken door to a service users’ bedroom must be replaced. The registered provider must ensure that essential maintenance tasks are completed promptly. The registered manager must ensure that there are satisfactory systems in place to prevent the risk of crossinfection in the home, including suitable arrangements for the transport of soiled laundry through the home and appropriate staff training. There must be a review of the night-time staffing arrangements to ensure that service users are adequately protected by sufficient numbers of suitably qualified and trained staff at all times, with particular reference to training in the provision of first aid. The registered manager must ensure that induction records are maintained in respect of all staff working in the home. The home must not be left in the
DS0000009102.V301769.R01.S.doc Timescale for action 04/07/06 01/09/06 3. YA30 13(3) 01/09/06 4. YA33 12(1)(a) 13(4) 18(1)(a) 04/07/06 5. YA35 17(2) 01/09/06 6. YA35 12(1)(a) 04/07/06
Page 28 Bigwig House Version 5.2 13(4) 18(1)(a) sole charge of anyone who is not competent to meet the health and safety needs of service users, with particular reference to training in first aid. 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 YA5 Good Practice Recommendations Service users should be provided with clear information about the costs of their placements, including more detailed and accurate information on how their personal contributions are calculated Service users’ individual care plans should contain more specific and detailed goals to assist them to develop their skills and independence in practical activities of daily living. The key to the medicines cupboard should be stored securely or in the possession of a designated member of staff at each shift. The registered provider should ensure that at least 50 of the staff team are qualified to at least NVQ level 2. 2. YA6 3. YA20 4. YA32 Bigwig House DS0000009102.V301769.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection St Austell Office John Keay House Tregonissey Road St Austell Cornwall PL25 4AD National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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