Inspection on 22/04/08 for Buxton House

This inspection was carried out on 22nd April 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 12 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Buxton House 12/12/07

Buxton House 31/05/07

Buxton House 05/07/06

Buxton House 24/11/05

Buxton House 15/08/05

Buxton House 23/03/05

Buxton House 11/11/04

Extracts from inspection reports are licensed from CQC, this page was updated on 27/09/2008.

CARE HOME ADULTS 18-65 Buxton House 50 Barrow Road Streatham London SW16 5PG Lead Inspector Mary Magee Key Unannounced Inspection 22nd & 30th April 2008 09:30 Buxton House DS0000041799.V362905.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 Buxton House DS0000041799.V362905.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. Buxton House DS0000041799.V362905.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Buxton House Address 50 Barrow Road Streatham London SW16 5PG 020 8769 9667 0208 769 9667 janet-yeboah@uku.co.uk Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Buxton Healthcare Ltd vacant Care Home 6 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (6) of places Buxton House DS0000041799.V362905.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care Home Only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Mental Disorder, excluding learning disability or dementia - Code MD (of the following age range: 18 Years - 65 Years) The maximum number of service users who can be accommodated is: 6 12th December 2007 2. Date of last inspection Brief Description of the Service: Buxton House is a small registered care home. It operates from an end of terrace house on a residential road in Streatham, Southwest London. It was first registered in July 2004. It provides care and support for six people that experience mental health related conditions. There are six single bedrooms laid out over three floors, a lounge, dining room/kitchen and a conservatory. It is a short distance away from public transport facilities and the local shopping area. The home charges range from £650 to £1050 per week. Buxton House DS0000041799.V362905.R01.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 1 star. This means the people who use this service experience adequate quality outcomes. This unannounced key inspection lasted over two days. Present during the inspection was the newly appointed manager, the registered provider and two support workers. Staff were helpful and supported the inspection process. The inspector following an invitation attended a residents’ meeting, all six residents were present and engaged in the meeting. Case tracking was used to evaluate the service. Four residents were spoken to individually over the two days. Written questionnaires were received from four residents and two staff members. Comments too were received from two mental health professionals. Written care plans and CPA reports for two residents were viewed. Comment cards were sent to the mental health team, none were received at the time of writing this report. A completed AQQA was supplied by the home. Information from all the above sources was used to inform this inspection report. What the service does well: What has improved since the last inspection? The appointment of an experienced person to manage the service has resulted in an improving service. Care planning is much more person centred. Attention to detail is good on written records. Individual key workers write more detailed information on how Buxton House DS0000041799.V362905.R01.S.doc Version 5.2 Page 6 individuals are progressing and cross reference this with daily records and evaluations. Medication policies and procedures were reviewed, the medication procedures have improved too and are now safe. Residents that self medicate are supported to do so safely. The service should ensure that this improvement in medication procedures is sustained and continue to undertake regular spot checks and audits. Residents are offered a more healthy choice of living with the promotion of a more healthy diet. Staff morale has improved; this significantly impacts on the welfare of residents. Residents are satisfied find that the service is making good provision and meeting their needs. 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. Buxton House DS0000041799.V362905.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 Buxton House DS0000041799.V362905.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): 1 2 Quality in this outcome area is good, This judgement has been made using available evidence including a visit to this service. The home is delivering on services; residents find that individual needs and aspirations are considered and that the home is providing appropriate services to meet these. EVIDENCE: The home has a service user’s guide and a Statement of Purpose in place, this Is specific to the home and the resident group they care for. It requires updating to reflect the staff qualifications and the experiences of the staff team. A recommendation stated in previous inspection report is restated. No new residents have moved to the home since the last inspection. It was found in the last inspection visit that pre admission assessments were completed for all residents before moving to the home. We spoke to four residents over the first day to evaluate the service provision and share their experiences. On day two a residents meeting was in progress, which we were invited to attend. This was a good opportunity to find out how people’s views were put forward and how residents are included in decision-making. The views of five residents were received via written questionnaires; the information received confirms that the home is meeting aims and objectives. Buxton House DS0000041799.V362905.R01.S.doc Version 5.2 Page 9 Such comments received include the following, “This is the right environment I choose it with my care coordinator”, “The home provides stability for residents” Evidence too gathered from case tracking using information held on personnel files confirm that the service is delivering in accordance with assessed needs. Buxton House DS0000041799.V362905.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6 7 9 Quality in this outcome area is good, This judgement has been made using available evidence including a visit to this service. The care and support arrangements are good. Residents find that the home provides stability and consistency. They have confidence in the service and the support available. This service supports and enables them to take risks in leading a more independent lifestyle. EVIDENCE: Four residents were spoken to individually. A weekly residents meeting was in progress, we were invited and attended this gathering. We met with all six residents in the group setting. In addition four residents choose to give more information on how the service is delivering via written user questionnaires. Overall the outcomes for residents are overwhelmingly positive. Care arrangements are discussed with individuals and written plans are developed to reflect these support needs. Buxton House DS0000041799.V362905.R01.S.doc Version 5.2 Page 11 Case tracking was used to evaluate the service delivery. Written care plans in place are good and show signs of much improvement. Assessments and case records show that residents are enabled to take their own decisions in major parts of their lives; they are allowed to take reasonable risks with the appropriate support given. Residents feel safe and secure because of the stability provided. Even through they have experienced some changes to staffing personnel they find that the service has not been disruptive. They feel greatly part of their community and are consulted in most issues of the home, evident during residents meetings. Residents find that staff are familiar with their needs, they participate directly in developing their individual care plans. Residents hold their own meetings without the presence of staff to decide activities, menu, and take decision on choice and concerns. Residents attend and participate in social and community activities. They also hold regular weekly meetings on Wednesdays with the staff team to discuss issues relating to their needs. Residents are treated as individuals who are unique with regards to their level of needs and hence are given the due respect to be consulted in most areas of care delivery. Buxton House DS0000041799.V362905.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. 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. The home promotes an inclusive feel for all residents with opportunities given for personal development. Individuals that find life challenging and that often experience setbacks find the right level of support and encouragement from staff. Residents are fully involved in meal planning and preparation. EVIDENCE: There are signs that residents have improved the level of community activities participation in the past twelve months. Although there are individuals that choose not to enage (small number). Some enjoy attending college and training projects, part time employment. Residents are able to take their own decisions in major parts of their lives; they are enabled to take reasonable risks with the appropriate support. They feel part of their community and are consulted in most issues of the home. Residents hold their own meetings without the presence of staff to decide activities, menu, and take decision on choice and concerns. Buxton House DS0000041799.V362905.R01.S.doc Version 5.2 Page 13 Residents attend and participate in social and community activities. Individual residents enjoy a flexible and relaxed approach in their choice of activities, they receive appropriate support and encouragement to engage and participate in wide range of activities within and outside the community. Residents maintain their family and other relationships deemed important for them with all the necessary support from the staff team. Residents hold their own meetings without the presence of staff to decide activities, menu, and take decisions on choice and concerns. They also hold regular weekly meeting on Wednesdays with the staff team to discuss issues regarding the home. Residents find that their views are respected and that staff promote a warm and relaxed environment. Over the two day period it was observed that residents receive one to one support from staff on a regular basis. Staff have a good knowledge of individuals’ needs and demonstrate how they successfully motivate them when individuals are feeling less motivated. Residents are empowered, they manage their own finances and collect all their own benefits. According to the registered provider each resident has a bank account for which they hold the book. Residents are supported to manage personal finances more efficiently. Two residents were observed collecting person al allowances from staff. When further explored it was found that residents experience difficulties with managing personal budgets, as a result they ask staff to hold small sums of money in safekeeping. This is held in a safe in the office. Signatures are in place to acknowledge all finances received by residents. Residents take it in turn to prepare the evening meal, rota is displayed of this. A copy of the menus used for the past month were viewed, these show that a wide variety of food is served. During the residents’ meeting a major topic was the discussion on menu planning. Evidence supplied confirm that meals served are according to personal taste, and meet both cultural and dietary needs. The support given to a resident on a weight reducing diet was explored during the case tracking. Weights are monitored regularly. Referrals are made to the dietician and appropriate diets are followed to assist and promote healthy eating. Examples were seen too of staff encouraging a resident to continue with the weight loss programme. Information is displayed on a noticeboard of the foods that contribute to good health. There is some confusion and an inconsistency regarding weight records, some staff are using metric while others are using imperial measurements. Staff should ensure that a consistent approach is used for recording body weights. Buxton House DS0000041799.V362905.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18 19 20 Quality in this outcome area is good, This judgement has been made using available evidence including a visit to this service. Residents receive reliable and consistent support which they find valuable and essential. Improvements in medication procedures have resulted in good progress and ensure that all prescribed medication are now managed more efficiently. EVIDENCE: All residents are self caring. However there are occasions when prompting And encouragement are required according to individual need and varying circumstances. Staff are good in promoting self worth and self esteem and recognize the importance of encouraging residents to take an interest in their appearance. The physical and psychological needs of individuals are monitored. recorded and reported to relevant health professionals as the need arises. Residents are registered with local GP practice. Records are maintained of all consultations. There are also records held of CPA meetings, appointments with psychologists, psychiatrist and community psychiatric nurses. Key workers’ reports for each month are much more detailed, they give a good indication of progress. Buxton House DS0000041799.V362905.R01.S.doc Version 5.2 Page 15 Staff generally are knowledgeable and respond promptly to changes noticed. Following recommendation from a mental health professional a chart is used by a resident to record any mood or behavior changes he experiences. Care staff support him to monitor his psychological state and manage to recognize any early warning signs that may trigger or affect his behavior. Records of CPA meetings are present on files. The home has made improvements to medication procedures. Medication is received in blister packs from a large pharmacist supplier. The pharmacist also provided to training on medication procedures for staff. The procedures for receiving administering and storing medication prescribed for two residents was checked. Residents are compliant with prescribed medication. MAR sheets are recording that staff sign and use correct codes to signify medication procedures. Medication is checked when received into the home; medication in stock is also audited at this time. The audit should be done at random rather than at the time of each delivery of new medication, a recommendation is made that additional random audits are done of medication in stock. Buxton House DS0000041799.V362905.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. 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 home provides a safe environment where residents are safeguarded by improved vetting procedures. Residents’ views are welcomed and used to help shape the service. EVIDENCE: Residents feel empowered, they have autonomy and feel comfortable at raising issues. Residents’ meetings are held independently without staff presence, residents feel comfortable meeting as a group and putting forward their views and suggestions. A suggestion box is in place so that residents can raise issues anonymously. Minor complaints are recorded in the complaints book. It was found that these are responded to and addressed appropriately. All residents spoken to are confident in the complaints procedure. In 2007 staff received training in safeguarding people from abuse or neglect. The safeguarding adults coordinator provided this. Staff spoken to appeared knowledgeable on safeguarding adult’s protocols. As a result of improved recruitment procedures residents are safeguarded by the vetting procedures Buxton House DS0000041799.V362905.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 25 27 28 30 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. The home provides a clean comfortable and homely environment that residents feel contributes to their overall well being. The service needs to be more pro active in addressing issues that may be hazardous to residents. EVIDENCE: The home provides a small homely environment that residents enjoy. The premises are kept to a good standard of repair. It is attractively decorated and clean. A lounge, a conservatory and dining room supplement the resident’s individual space. All the communal areas are comfortable and pleasantly decorated. There are adequate numbers of appropriately located bathroom and toilet facilities. A window restrictor/safety catch on one bathroom window is broken and needs to be repaired or replaced. Requirement stated. Hot water temperatures are monitored regularly according to the records seen; however on numerous occasions these hot water temperatures are exceeding Buxton House DS0000041799.V362905.R01.S.doc Version 5.2 Page 18 safe limits and have the potential to scald residents. The manager took action to resolve this. A plumber was consulted to set a lower temperature on the hot water supply. Health and safety must be promoted and urgent action must be taken to address any hazard posed to residents. A requirement is stated. Residents also have a pleasant garden to the rear, also a terraced roof on the first floor. For residents that smoke there is a garden room at the end of the garden. Two bedrooms were viewed during a tour of the premises. These appeared homely with numerous personal possessions on display. One resident had bed linen that appeared well worn and dirty. He was concerned about the lack of sufficient bed linen available to change his bedclothes. Some residents have taken their own linen supplies. On checking with management and staff on linen supplies available the findings confirmed that the home has not made appropriate provision and that there is a shortage of bed linen in the cupboard. Before the second day of the inspection was completed bed linen was purchased. A requirement is stated in relation to linen supplies. The kitchen is sited off the dining room. In it are two fridges and a freezer, one fridge is used by residents solely to store additional perishable items that they purchases. The temperatures of fridge’s and freezers are monitored Buxton House DS0000041799.V362905.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 33 34 35 36 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Recruitment procedures are more robust and ensure residents are protected. The staff team continues to experience staff changes with a recruitment campaign in place to appoint more full time permanent staff. There are signs of improvements in training provision, but the service has not made appropriate provision to respond fully to individual training needs. Record keeping is not good; work schedules/rosters are not always kept up to date with the names of staff working shifts. EVIDENCE: The staff team continues to experience change. As a result of such changes there are lesser numbers of staff with NVQ qualifications than at previous inspection. Three staff are enrolled on the programme, evidence was seen of difficulties experienced with training agency providing the programme. Staff training is still an issue and the requirement stated in the previous inspection report is not fully met. The newly appointed manager is in the process of addressing training. He has planning mandatory training for staff, dates were seen of some of the mandatory training planned. The staff team consists of staff members with various skills, experiences and qualifications. Buxton House DS0000041799.V362905.R01.S.doc Version 5.2 Page 20 But the training provided so far is not considering the training needs of each staff member. The requirement is restated. Evidence is not available to demonstrate that induction is fully completed by two staff members. For both newly recruited staff members records present confirmed that recruitment procedures are robust and that they safeguard residents. There are vacancies within the staff team. Recruitment is underway according to the registered provider. Currently bank and part time staff covers vacancies. The staffing rotas are not maintained accurately and are not up to date. Within the last monthly period three of the four week shift periods did not have the names of additional staff members that were covering shifts. A requirement is stated. Buxton House DS0000041799.V362905.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 40 42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is now benefiting from the presence of an experienced person managing the service. Services are improving and residents’ needs are met. The quality assurance systems are not fully operational to drive improvements further. Health and safety polices and procedures show shortfalls. The current procedures are not totally effective and do not promote an environment that protects residents EVIDENCE: The home is showing signs of improvement. Residents and staff feel comfortable with the new management approach. The newly appointed manager has worked hard to develop and improve services; more person centred care plans are in place. He holds regular meetings with residents and staff. Medication procedures too are much improved and now safe. Buxton House DS0000041799.V362905.R01.S.doc Version 5.2 Page 22 He is confident in his ability to make a difference in the service, and has many years experience in a senior role working with this client group. Already he has identified that that the staff team require more training, he is making arrangements to access relevant trainers. The registration of the manager has yet to be completed. A requirement is stated. There are signs that the service is making better provision by including residents in the developments of the home, e.g. suggestion box, questionnaires. The service has not however made available the outcome of quality assurance questionnaires/responses from residents. . No indication was given of how this information is collated and used to analyse outcomes or to inform development plans. More work needs to be done so that a development plan is devised for the home based on the success of the service in achieving the aims and objectives. The requirement stated in the previous inspection report is restated. According to records presented fire prevention measures are in place. Fire fighting equipment is serviced and maintained to good working condition. Essential equipment in the premises is maintained in good working order, PATRH testing takes place as appropriate. The home has health and safety policies and procedures in place. As a result of the evidence gained some of these procedures need to be reviewed. The regulation of hot water temperatures is not fully considered in the current health and safety procedures, there are no health and safety guidelines on the actions to take if the temperatures are found to be unsafe. It is not clear from examining the manuals that all the procedures that promote health and safety are fully documented or that procedures are effective. The broken window restrictor in the first floor bathroom was not recorded for attention or repair. Health and safety audits/checks are not described in polices or procedural guidelines. The last audit was completed in 2007. There is no other checking system in place to identify if there are any safety issues requiring attention. The owner of the home said that a complete policy review is underway following a recent agreement with a consultant. The evidence gained demonstrates that the health and safety management needs attention. A requirement is stated. A business and financial plan was the subject of a requirement in the last inspection report. This was not made available, the requirement is restated. Buxton House DS0000041799.V362905.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 3 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 3 26 2 27 2 28 3 29 X 30 2 STAFFING Standard No Score 31 X 32 2 33 2 34 3 35 2 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 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 2 X 2 2 X 2 2 Buxton House DS0000041799.V362905.R01.S.doc Version 5.2 Page 24 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 YA26 Regulation 16 (2) Requirement Timescale for action 30/05/08 2 YA27 23 (2) b Appropriate and suitable quantities of clean bed linen must be made available for residents use. The broken window restrictor on 30/05/08 the fist floor bathroom window needs to be repaired or replaced. Hot water temperatures in bathrooms and showers must be maintained to a safe limit. Staff training needs need to be assessed, and a training and development programme put in place to respond to these needs. A dedicated budget to be allocated for this project. (Not fully met in timescale of 30/09/07&29/02/08)) Records specified in Schedule 4 must be kept up to date and accurately reflect staff that work on each shift. An Induction and Foundation programme must be developed and implemented for staff. This programme to meet Skills for Care workforce targets. All newly employed staff must complete this programme. (Not fully met DS0000041799.V362905.R01.S.doc 3 4 YA27 YA42 13 (4) c, 23 (2) j 18 (1) (a) & (c) 30/05/08 30/05/08 YA32 YA33 5 YA33 17 (3) 30/05/08 6 YA35 18 (1) (c) (I) 30/05/08 Buxton House Version 5.2 Page 25 in previous timescales of 30/08/07 or 29/02/08)) 7 8 YA37 YA39 8, 9 24 (1) a & b The appointed manager must be registered with CSCI. Effective quality assurance system must be developed and implemented at the home, these to be based on reviewing and improving the standard of service provided. (Not fully met in timescale of 29/02/08) Policies and procedures must be reviewed and reflect current legislation and provide a safe environment. The procedures must promote and protect the health and safety of residents and staff. The registered person must supply CSCI with a copy of the business and financial plan for the home for evaluation. (Unmet in previous timescale of 14/02/08) 30/06/08 30/06/08 9 YA40 13 (4) a, back 30/06/08 10 YA43 25 (2) a b cd 30/06/08 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 YA21 Good Practice Recommendations The registered person should continue to work with residents around recording information about their wishes with regard to illness and death. The registered person should update the complaints book to include information about what actions are taken to respond to complaints received. The registered person should ensure that the service users guide is kept updated to reflect changes to staffing. DS0000041799.V362905.R01.S.doc Version 5.2 Page 26 2. YA22 3. YA1 Buxton House 4. 5 YA17 YA20 Staff should ensure that a consistent approach is used for monitoring and recording body weights. Additional random audits should be undertaken of medication in stock Buxton House DS0000041799.V362905.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG 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 Buxton House DS0000041799.V362905.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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