Inspection on 11/01/07 for Blunt Street (9)

This inspection was carried out on 11th January 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Blunt Street (9) 23/12/08

Blunt Street (9) 19/12/07

Blunt Street (9) 13/02/06

Blunt Street (9) 06/09/05

Blunt Street (9) 14/02/05

Blunt Street (9) 12/08/04

Similar services:

Hillside

Applegarth

122 Scorer Street

St Marys Nursing Home

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

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

CARE HOME ADULTS 18-65 Blunt Street (9) Stanley Common Ilkeston Derbyshire DE7 6FZ Lead Inspector Tony Barker Key Unannounced Inspection 11th January 2007 09:20 Blunt Street (9) DS0000019939.V325346.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 Blunt Street (9) DS0000019939.V325346.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. Blunt Street (9) DS0000019939.V325346.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Blunt Street (9) Address Stanley Common Ilkeston Derbyshire DE7 6FZ (0115) 9323508 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) None United Response Christine Coates Care Home 4 Category(ies) of Learning disability (4), Physical disability (4) registration, with number of places Blunt Street (9) DS0000019939.V325346.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Four (4) persons (of either sex) in the category adults with learning disabilities / adults with physical disabilities. 13th February 2006 Date of last inspection Brief Description of the Service: 9 Blunt Street is a detached house in a small village development. Service users are provided with adequate accommodation and single rooms. There is a reasonably-sized rear garden. The Home offers personal and social care to people with a severe learning disability with associated conditions that include autism, sensory and physical disability and challenging behaviour. Activities are planned to meet individual needs. The fees currently range from £1500 to £1900 per week. Blunt Street (9) DS0000019939.V325346.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The time spent on this inspection was 8.0 hours and was a key unannounced inspection. The service users had high levels of dependency and therefore were not able to contribute directly to the inspection process, though they were observed working with and being cared for by staff. The Manager and one support worker were spoken to and records were inspected. There was also a tour of the premises. One service user was case tracked so as to determine the quality of service from their perspective. This inspection focussed on all the key standards and on the progress made towards achieving the requirements and recommendations made at the last inspection. The preinspection questionnaire was reviewed prior to this inspection. What the service does well: What has improved since the last inspection? What they could do better: The Manager must ensure that all care planning records are kept up-to-date, in order to keep service users and staff safe. Service users’ health assessment records must be kept up to date to ensure individuals’ health is adequately monitored. Recording practices, regarding care planning and the use of Blunt Street (9) DS0000019939.V325346.R01.S.doc Version 5.2 Page 6 medicines, need improvement. The proportion of staff who are qualified should increase. 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. Blunt Street (9) DS0000019939.V325346.R01.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 Blunt Street (9) DS0000019939.V325346.R01.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): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users had their needs assessed before admission to the Home so that staff could provide individually tailored care. EVIDENCE: The service user, most recently admitted to the Home, was case tracked. This admission took place in 2002 and records of the pre-admission assessment had been archived at the United Response headquarters, the Manager stated. However, it was recorded, in an inspection report from September 2003 that a pre-admission assessment was carried out in respect of this service user. Blunt Street (9) DS0000019939.V325346.R01.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 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users were benefiting from the care planning system but there could be further improvements to recording practices. They were making decisions about their lives, with assistance, and were being supported to take risks to improve their independence. EVIDENCE: Service users’ care plan documents were examined and some, but not all, were found to be up to date and clearly focussing on service users’ individual needs. A ‘Listen To Me Workbook’ was fully completed in respect of one service user and was in varying stages of completion regarding the other three service users. This Workbook was the Home’s first step towards ‘Person Centred Planning’ (PCP) - through identifying each service user’s individual likes, dislikes, aspirations and goals. The Manager spoke of this Workbook becoming a “working document” with staff being expected to adopt a “person centred approach” to their work. She accepted that records showed that some staff were taking a ‘reactive’ rather than ‘proactive’ approach to their work. For instance, the daily record sheets relating to one service user showed staff paying attention only to ‘incidents’ and medical appointments for the week Blunt Street (9) DS0000019939.V325346.R01.S.doc Version 5.2 Page 10 leading up to this inspection – there was no recording of any positive outcomes. There were also examples of staff only partially completing care planning records and a ‘Behaviour Management Plan’ in the case tracked service user’s file was dated March 2004. The benefit of providing staff with training on good recording practices was discussed with the Manager. It was noted that care plan review meetings were being held every six months, approximately, and minutes from these meetings were being held at the Home – an improvement from the position found at the previous inspection. It was also noted that staff were signing service user records. One of the supports workers was asked for examples of service users making decisions and choices. She said service users were all encouraged to make decisions about the food they eat. They were either able to verbally respond or staff took them to the larder to choose an alternative to the meal on the menu, for instance. She said that three service users were able to choose their own clothes in the morning, with some prompting. She appropriately added that “we don’t want to draw attention to them, when out, by inappropriate clothing and colours”. Each service user’s file contained a newly devised ‘Behaviour/Activity Risk Assessment’ document that was generic. These were designed to take the place of most of the existing specialist risk assessments, the Manager said. These new risk assessments included appropriate headings such as ‘How could harm occur?’ and ‘Action taken to minimise the risk’. A further heading of ‘What are the benefits from taking the risk?’ was included, showing that the Home was enabling service users to take responsible risks in order to promote their independence. The Manager said that, in the past, the staff group had been somewhat negatively risk focussed and had expected challenging behaviour from some service users. There was recorded evidence on the case tracked service user’s file of one member of staff recently accompanying the service user to an animal reserve, with no challenging behaviour during the visit. The Manager had taken this example of good, proactive practice to a staff meeting to show staff that the service user did not need two staff on trips out. She said she would be following this up in individual staff supervision sessions. The Manager said she intended to request a place on a risk assessment training course, for herself. The support worker, spoken to, also felt it beneficial to service users to take certain risks, which “develop” them. She gave an example of one service user who used to self-abuse while out in the community – staff persevered and this behaviour stopped. This service user now goes swimming with staff with no challenging behaviour. Blunt Street (9) DS0000019939.V325346.R01.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): 12,13,15,16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users were involved in fulfilling and age-appropriate activities within the Home and in the local community. They were able to maintain appropriate family relationships and peer friendships. Service users were provided with a healthy personalised diet. Daily routines reflected their individual choice and promoted independence. EVIDENCE: Each of the service users had a mix of day services and ‘personal days’ spent at, and around, the Home. Day services comprised either external United Response day service provision or a local authority day centre or was based on or around the Home. The support worker, spoken to, considered that service users were being offered activities that were valued by them and were fulfilling. She spoke of the case tracked service user thoroughly enjoying walking – evidenced by the fact that the person “walks and walks”. This service user “loves bus riding”, the support worker added, evidenced by the positive noises made by the person. Blunt Street (9) DS0000019939.V325346.R01.S.doc Version 5.2 Page 12 The support worker spoke about a number of activities undertaken by the service users in the local community. These included pub lunches, local walks and visits to parks, shops and supermarkets. She said of one service user “everyone seems to know (the person’s) name in Derby Morrisons and use that name”. Each service user had family involvement to varying degrees, the support worker stated, although this was limited to telephone contact and greetings cards, only, for one service user. She said that two service users in the Home were good friends with each other and received visits from ex-staff at Morley Manor, where they used to live. The support worker considered that a number of the Home’s routines promoted service users’ independence. She gave as an example service users putting away their laundered clothes, with staff support, and selecting their clothes and choice of toiletries. The Manager had previously mentioned that three of the service users had individual bank accounts although they were unable to understand bank statements. Staff opened this type of mail but more personal mail, such as greetings cards, were given to service users to open. A varied and nutritious three-week rolling menu was seen. There was no menu displayed for the day and there was a discussion with the Manager about the benefits of displaying a menu in picture form or photographs. The menu included meals eaten out and ‘theme nights’ at the Home. The evening meal was taken between 6 and 7pm and there was differing involvement by service users in its preparation. The support worker stated that all the service users were encouraged to take their plates to the sink after meals. Also, all were involved with food shopping. Two service users enjoyed a baking activity, she added. Food stocks were assessed – these were at a good level and included fresh fruit and vegetables. The kitchen was clean and tidy. Blunt Street (9) DS0000019939.V325346.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 & 20 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users were receiving personal support in the way they required and preferred. Their health needs may not have been fully met as records were unclear on this. The Home’s procedures for dealing with medicines were potentially putting service users at risk. EVIDENCE: The Manager said there was still need to improve service users’ ability to communicate with particular emphasis on communicating to staff reasons for frustration that may lead to challenging behaviour. She felt this should be easier to achieve now the Home was fully staffed. There was evidence of ‘communication boards’ in use – comprising pictures that staff refer to when communicating with service users. The support worker stated that all staff had been trained in Makaton (sign language). She said that “routines are as flexible as are needed for the individual”, adding that one particular service user needs fairly rigid routines or the person becomes anxious. The support worker gave examples of equipment such as a shower seat and an electrically operated bath seat being provided for one service user to maximise the person’s independence. She also gave examples of how service users’ privacy needs were being met, for example during baths being taken. One service user’s dignity was being taken account of by staff leaving the person in the Blunt Street (9) DS0000019939.V325346.R01.S.doc Version 5.2 Page 14 bath, for a time, to ‘have a soak’. Although this routine was recorded on the service user’s ‘Life Skills’ care plan there was no risk assessment in place to address how the potential risks should be managed. For the two female service users there was always a female member of waking night staff on duty, the Manager stated. She added that there had been an increase in the male staffing establishment, since the previous inspection, to take account of male service users’ needs. During this inspection staff behaviour was noted as being positive and patient and service user-focussed. As at the previous inspection no consistent records were being made of service users’ appointments with health professionals. The Medical Profile, in one service user’s file, although completed had still not been reviewed since February 2004. The Manager accepted this was the same for all four files. It was not possible to identify any health appointments for the case tracked service user other than one with an audiologist in October 2006. The Manager confirmed that the only evidence of health appointments was in diaries. All service users were registered with the same GP practice. The support worker spoke of a range of health professionals involved with service users, including chiropodist, dentist, physiotherapist and members of the local Community Learning Disability Team. Female service users attended the Well Woman Clinic. The Manager described a sound system for the passing of medication, on a monthly basis, to the respective day services attended by service users. The Home’s medicine records were examined and a number of discrepancies were found... • a quantity of 168 paracetamol tablets received were recorded on one service user’s medicine sheet but there were only 96 in the container, with none administered. The Manager suggested the figure of 168 included other service users’ paracetamol, • on another service user’s medicine sheet the quantity of Haloperidol tablets (to be taken as and when required) had not been entered. On the same sheet a quantity of Haloperidol capsules had been entered by the pharmacist but a separate record indicated that Haloperidol capsules had been returned to the pharmacist in October 2006. There was no signature on this record, • there were two unused bottles of Diazepam tablets (to be taken as and when required), prescribed for one service user’s agitation, dated 30 November and 23 December 2006, • one handwritten entry, for an antibiotic, had not been signed, dated or countersigned. These discrepancies indicated that staff were not following United Response written procedures on the safe use of medicines. Photographs of service users were filed with the medicine records. The Manager stated that a staff specimen signature list had been compiled but it could not be found. Blunt Street (9) DS0000019939.V325346.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users were benefiting from the Home’s complaints policy and procedures and were being protected from abuse. EVIDENCE: United Response had a robust procedure for dealing with complaints. A copy of the Home’s complaints procedure was displayed – this made appropriate use of symbols so that service users could better understand it. The Manager reported that no complaints had been received during the 12 months previous to this inspection. Positive action had been taken regarding two previous complaints, from neighbours unhappy with the noise coming from the Home. The Manager stated she was having monthly meetings with a local resident spokesman - provided good feedback on noise levels and opportunity to remind staff about closing windows. Also, in response to these complaints, rooms had been fitted with sound-deadening material and windows fitted with triple glazing. The Manager spoke of holding a record of informal complaints from service users. This was being held at a nearby care home also managed by the Manager of this Home. The Manager also said that consideration was being given to finding independent advocates for three of the service users to ensure that their needs were being fully met. The staff training record confirmed that all staff had received ‘Safeguarding Adults’ (adult abuse) training and SCIP (non-physical intervention) training. The Manager said the aim was for the SCIP facilitator to attend a staff meeting once a year. The support worker spoken to showed good awareness of the Home’s ‘whistle blowing’ policy. There had been no ‘Safeguarding Adults’ investigations during the 12 months previous to this inspection. There had Blunt Street (9) DS0000019939.V325346.R01.S.doc Version 5.2 Page 16 been one incident of staff restraining a service user. The Manager had notified the Commission about this incident and there were no concerns about the way the incident was managed. However, the member of staff concerned had not recorded the use of physical restraint but had since been made aware this was contrary to United Response procedures. The template used to record any restraint was examined – it did not guide staff to include details of the physical hold used, part(s) of the body held or duration of hold. Blunt Street (9) DS0000019939.V325346.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users were living in a comfortable and safe environment that was clean and hygienic. EVIDENCE: A number of improvements had been made to the premises since the previous inspection. These made the Home more comfortable and suitable for service users’ needs. The original lounge had been partitioned into two separate rooms, providing more flexible use of lounge space. The Manager said a new five-piece suite had been ordered, with specific design and build specifications to match service users’ needs. Also more wall pictures were planned, she added. The dining room had been redecorated and the kitchen had new cupboards, worktops and had been redecorated. The Manager spoke of a walk-in shower being planned for the ground floor bathroom – this is in addition to the existing first floor bath. In this bathroom wall tile transfers helped to make the room look homely. Two bedrooms were seen and these were nicely personalised and fitted out with equipment to meet individual needs. The Manager spoke of plans to swop two service users’ bedrooms to provide a larger room for one and a room with an improved view for the other. This proposed move addressed the assessed needs of these two service users. Blunt Street (9) DS0000019939.V325346.R01.S.doc Version 5.2 Page 18 There were several photo-collages in the Home. One was in the bedroom of a service user who had helped create it. There were some areas requiring attention... • the ceiling strip light cover in the laundry room was full of insects, • wall plaster repairs on the landing needed redecoration, • some wall areas needed repainting. Standards of cleanliness and hygiene at the Home were satisfactory. The washing machine had a sluicing programme and the support worker spoken to described good practice regarding the transportation of infected materials around the Home. There were no unpleasant odours within the Home during this inspection. Blunt Street (9) DS0000019939.V325346.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34 & 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users were being supported by a generally well-trained staff group, though more care workers needed to have a care qualification to ensure greater competence. Service users were protected by the Home’s recruitment procedures. EVIDENCE: Three (30 ) of the care staff had achieved a National Vocational Qualification (NVQ) in Care to level 2 or above, including two staff who had achieved an NVQ at level 3. This did not meet the National Minimum Standard to maintain a staff group with at least 50 qualified staff. The Manager said that five additional staff were currently undertaking an NVQ course at level 2. The Manager stated that the staff was at full establishment – an improvement from the previous inspection. Other aspects of standard 33 were not assessed on this occasion. The file of a member of care staff appointed in June 2006 was examined. It was found to contain all but one of the elements, required by current Regulations, regarding recruitment practices. There was no explanation of one Blunt Street (9) DS0000019939.V325346.R01.S.doc Version 5.2 Page 20 gap of three months in the person’s employment history. It was noted that United Response usually follow good staff recruitment practices. There was evidence of this same member of staff being provided with induction training to Learning Disability Award Framework (LDAF) standards, as recommended by Standard 35. Training records showed that all staff had been provided with all mandatory training, except that four staff had not undertaken Moving and Handling training. The Manager stated that this had been planned for Autumn 2006 but was cancelled due to sickness of the trainer. She spoke of providing a half-day workshop for all staff following the structure of ‘The way we work’ sessions for new staff, that address good practice issues. The support worker confirmed she had been provided with a number of training courses over the previous 12 months, including some that addressed the individual needs of service users. She added that one of the best things about working at the Home was the training provided by United Response. Blunt Street (9) DS0000019939.V325346.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. 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. Service users were benefiting from a well run home and their needs were generally underpinning the Home’s services. Their health, safety and welfare were being protected. EVIDENCE: The Manager had achieved a NVQ in Care and Management at level 4 and had been in this post for three years. She had worked with people with learning disabilities for 19 years. She spoke of being involved in United Response’s Leadership Management Development Programme – comprising monthly conference calls. She was also undertaking periodic training to maintain her knowledge and competence to manage the Home. For instance, she said she was attending training in Makaton sign language the day following this inspection. The Home’s quality assurance measures included… • regular review of care plans, Blunt Street (9) DS0000019939.V325346.R01.S.doc Version 5.2 Page 22 annual observational visits from a member of the United Response Practice Development Team – whose assessment is discussed with the Manager and her line managers, • a Quality Assurance Manual, • ‘The way we work’ training, when the values of the Home and United Response are explored, • surveys of opinion from service user’s relatives – these had been sent out but not yet returned. The Manager spoke of questionnaires planned to be sent to external professionals, too. There had been no monthly independent audit visits to the Home on behalf of the Registered Provider, as required by Regulation 26, since July 2006. The Manager stated that arrangements were now in place to ensure that monthly audit visits occurred consistently in the future. Cleaning materials were being securely stored in a locked cupboard. The preinspection questionnaire, completed by the Manager, indicated that equipment was being serviced and checked at appropriate intervals. Fire alarm tests were carried out weekly and fire drills once a month – with night time ones twice a year. No Health and Safety hazards were found at this inspection. • Blunt Street (9) DS0000019939.V325346.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 2 X 3 X 3 X X 3 X Blunt Street (9) DS0000019939.V325346.R01.S.doc Version 5.2 Page 24 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA6 Regulation Requirement Timescale for action 01/02/07 2. YA19 3. YA20 13(4)(b)(c) The Manager must ensure that 15(2)(b)(c) care planning records relating to individuals’ behaviour management are kept up-todate, in order to keep service users and staff safe. 14(2)(a)(b) Service users’ ‘Medical Profiles’, or other health assessment records, must be maintained up to date to ensure individuals’ health is adequately monitored. 13(2) When medication is received, administered to service users and returned to the pharmacist it must be clearly recorded at each stage, to ensure that people receive the correct levels of medication prescribed for them, and only for them, personally. 01/02/07 01/02/07 Blunt Street (9) DS0000019939.V325346.R01.S.doc Version 5.2 Page 25 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. 5. 6. 7. 8. 9. Refer to Standard YA6 YA6 YA17 YA18 YA19 YA20 YA20 YA22 YA23 Good Practice Recommendations The Manager should continue encouraging staff to take a more proactive approach to their work. Staff should be provided with training on good recording practices. A menu in picture form or photographs should be displayed, where appropriate, for service users. A risk assessment should be recorded to address how the potential risks, of one service user being left alone in the bath, should be managed. The Manager should ensure that records of service users’ health appointments are consistently maintained on personal files. (This was a previous requirement) Excessive amounts of prescribed medicines should not be stored in the Home. The Manager should ensure that hand-written medicine records are signed, dated and countersigned. This was a previous requirement) The record of informal complaints from service users should be held within the Home, as should all records relating to service users and the Home. The template used to record incidents of restraint should guide staff to include details of the physical hold used, part(s) of the body held and duration of hold. Recording on a ‘body map’ is also recommended. Maintenance items needing attention, as detailed in standard 24, should be addressed. 50 of staff should achieve a National Vocational Qualification (NVQ) to level 2 or above. (This was a previous requirement) There should be a written explanation of any gaps in applicants’ employment history, on job application forms. All staff should undertake Moving and Handling training. Monthly independent audit visits to the Home, on behalf of the Registered Provider, should be made consistently. 10. 11. 12. 13. 14. YA24 YA32 YA34 YA35 YA39 Blunt Street (9) DS0000019939.V325346.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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 Blunt Street (9) DS0000019939.V325346.R01.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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