Inspection on 27/11/07 for Camellots House

This inspection was carried out on 27th November 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 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Camellots House 26/11/08

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Sutton Lodge Nursing Home

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

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

CARE HOME ADULTS 18-65 Camellots House 53 Arundel Road Littlehampton West Sussex BN17 7BY Lead Inspector Mr D Bannier Unannounced Inspection 27th November 2007 09:30 Camellots House DS0000069942.V349643.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 Camellots House DS0000069942.V349643.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. Camellots House DS0000069942.V349643.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Camellots House Address 53 Arundel Road Littlehampton West Sussex BN17 7BY 01903 719017 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) Crawford Homes Limited Mr Darren J Ling Care Home 8 Category(ies) of Learning disability (0), Mental disorder, registration, with number excluding learning disability or dementia (0) of places Camellots House DS0000069942.V349643.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD) 2. Mental disorder, excluding learning disability or dementia (MD). The maximum number of service users to be accommodated is 8. Date of last inspection N/A Brief Description of the Service: Camellots House is a care home, which is registered to provide personal care for up to eight service users in the category learning disability (LD) who are between the ages of 18 to 65 years of age. This care home is also registered provide care for a maximum of one person with a learning disability who is over 65 years. It is also registered to provided care for a maximum of one person who also has a physical disability. It is a detached property, which has been extended and adapted for its current use, and is located near to the centre of Littlehampton. Accommodation is provided in single bedrooms, which include ensuite WC and bath or shower facilities. Communal accommodation is made up of a lounge and a conservatory that is used as a dining room. They are located on the ground floor. An enclosed secure garden, which is available to all residents, is located to the rear of the premises. Fee levels currently range from £750.00 to £1,850.00 per week. The registered provider of this service is Crawford Care Homes Ltd. The Responsible Individual acting on behalf of the organisation is Mr Gajaruban Ragunathan and is responsible for supervising the management of the care home. The provider has appointed a manager. This person has yet to submit an application to be appropriately registered. Camellots House DS0000069942.V349643.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection has followed the Inspecting for Better Lives methodology and is called a key inspection as it assesses those standards determined by the Commission as key standards. This inspection will also determine the frequency of inspections hereafter. The registered provider returned an Annual Quality Assessment Form (AQAA) prior to the inspection. Residents who were considered capable of completing it, their relatives and health care professionals were sent surveys by the Commission entitled “Have Your Say.” These are designed to enable residents, relatives and other stakeholders to give their opinions about how the care home is being run. One survey completed by a care manager was returned to us. The information received from these documents will be referred to in this report. A visit to the care home was made on Tuesday 27th November 2007. This was an unannounced inspection. This means the care home has no prior knowledge of our intention to visit. We were unable to have meaningful conversations with residents, however we spent time with some of them during the morning in order to form an opinion of how it is to live at the care home. We spoke to three staff on duty in order to gain a sense of how it was to work at the care home. We also viewed some of the accommodation and observed care practices. Some records were also examined. The visit lasted approximately seven and a half hours. Mr Rajunathan and the manager of this care home were present and kindly assisted us with our enquiries. What the service does well: Camellots House has ensured all new residents needs are assessed before admission. This means that residents and their families will know that this care home can meet the resident’s needs. Care plans have been drawn up using the information from assessments. This means all staff have up to date information about residents’ care needs. Camellots House DS0000069942.V349643.R01.S.doc Version 5.2 Page 6 Residents are provided with a range of activities. Residents’ physical and emotional health care needs have been provided for. They have also been provided with a wholesome, varied and nutritious diet. The staff team is provided with a range of training to ensure they have the necessary knowledge and skills to work effectively with the residents accommodated. What has improved since the last inspection? 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 Camellots House DS0000069942.V349643.R01.S.doc Version 5.2 Page 7 contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Camellots House DS0000069942.V349643.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Camellots House DS0000069942.V349643.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. 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. Prospective residents’ individual needs have been assessed. EVIDENCE: Three residents were identified for case tracking purposes. Documents and records seen confirmed that the registered provider had appropriately assessed the needs of identified residents. They also included assessments carried out by care managers of sponsoring authorities. Surveys returned by a care manager confirmed that assessment arrangements made by this care home has ensured that accurate information has been gathered. The care manager commented, “Camellots House is a new homethey did undertake their own assessments of my client’s needs prior their moving in. Combined with this a detailed community care assessment was provided from which Mr Ragunathan and the home manager are to develop and provide their own care plan for my client.” Discussions with staff on duty and observations of care practices confirmed they were aware of the needs of each resident. Camellots House DS0000069942.V349643.R01.S.doc Version 5.2 Page 10 Information returned by the registered provider confirmed that, “New service users are only admitted after a full assessment of whether the home can meet their needs.” Camellots House DS0000069942.V349643.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents’ assessed needs are reflected in their individual care plan. They do not include information about residents’ personal goals. Care plans do not include sufficient information or guidance for staff to ensure they support residents in making decisions about their lives, with assistance as needed. There was no evidence to confirm that staff support residents so they are enabled to take risks as part of an independent lifestyle. EVIDENCE: Care plans have been drawn up for each resident. The information provided has been transferred directly from initial assessments. There was no information about the action staff should take to ensure identified needs have Camellots House DS0000069942.V349643.R01.S.doc Version 5.2 Page 12 been met. This means it is not clear the care provided is in line with the wishes of the resident, their relatives or other representatives. It was not clear if staff provide care on a consistent and continuous basis. Since its’ opening, this care home has been subject to two investigations under safeguarding adults procedures. The registered provider had correctly notified us of the incidents that had affected the wellbeing of residents. The provider also notified the local authority. Discussions with the social worker who completed the investigation of one incident indicated that the care home did not fully appreciate the issues involved. Risk assessments and care management plans had been considered very basic. We noted that the manager has made some improvements to care plans. During this inspection the registered provider and the manager were advised to ensure individual care plans included clear guidance or instruction to staff with regard to the action they should take to meet the identified needs of each resident. As this directly affects the wellbeing of residents this has been made a requirement and appears in the appropriate section at the back of this report. The registered provider told us that residents are encouraged to make choices on a daily basis with regard to what they wish to eat, how they wish to spend their leisure time, when they wish to go to bed, what they wish to wear etc. However, this is not reflected in individual care plans in sufficient detail to confirm this is in line with individual residents’ wishes. The survey returned by the care manager confirmed that this care home usually provides support to individuals to live the life they choose, wherever possible. Information supplied by the registered provider confirmed that, “…we use the information from the residents’ assessment and care plans to implement the best environment and choice for residents.” Camellots House DS0000069942.V349643.R01.S.doc Version 5.2 Page 13 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 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are able to take part in appropriate activities. Residents have been encouraged to become part of the community. Residents have been supported in maintaining family relationships. Residents’ rights have been respected whilst ensuring their safety is maintained. Residents have been provided with a healthy, varied and appropriate diet. EVIDENCE: The registered provider has supplied a television, DVD and video recorder in the lounge. This television is also fitted with satellite television channels. We Camellots House DS0000069942.V349643.R01.S.doc Version 5.2 Page 14 also noted that there was a pool table in the conservatory. The registered provider told us he had recently purchased it, as he is aware a resident does like to play pool. An adult size trampoline was available in the garden. The garden has been fitted with artificial grass so that residents can make use of the facilities all year round. The registered provider is in the process of having a garden shed build and equipped so that residents will be able to enjoy a range of activities such as art and crafts here. During this visit we saw that three residents went out for a ride in the car. One resident was in the lounge making Christmas decorations with a member of staff. One resident was unwell and was in bed whilst another resident was in their room or around the house. The manager informed us that they are currently in the process of devising individual activity programmes. It is intended that contact is made with local colleges and day centres so that residents can take part in activities outside of the care home. We advised the manager to ensure they take into account the previous lifestyles and interests of residents as far as possible. Information supplied by the registered provider confirmed that, “The home offers a number of in house and out of house activities with: sensory room, beauty therapy, trips in disability van, Sky TV, hydrotherapy. Residents, families and social workers feedback has been positive.” We received a survey from one relative; unfortunately this was returned without being filled in. This person advised us that, as their relative had been living in the care home for only a short time, they did not feel they had sufficient knowledge to comment about the service. However, we saw the visitors’ record book. This indicated that relatives and friends do visit this care home frequently. The main cooked meal is provided at midday. At the time of our visit, the main meal consisted of meat pie, mashed potatoes, vegetables and gravy. Some residents require their food to be cut up to prevent choking. Otherwise residents not require any special diets. Some residents do need held with eating. There were sufficient staff available to provide the support each resident required. Equipment, such as plate guards and adapted cutlery, has been provided so that residents can be independent when eating. We were present whilst residents were eating their meal. One resident told us that they liked the food provided very much. Other residents who were unable to communicate were clearly enjoying their meal. The registered provider gave us copies of menus to examine. This information demonstrated residents have been provided with a varied, wholesome and nutritious diet appropriate to their needs. Camellots House DS0000069942.V349643.R01.S.doc Version 5.2 Page 15 Camellots House DS0000069942.V349643.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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Support and personal care provided takes into account the wishes and personal preferences of each resident. The physical and emotional health care needs of residents have been met. Staff do not administer prescribed medications in a way that protects and supports residents. EVIDENCE: As we have mentioned previously, whilst care plans have been developed for each resident, they need to be amended to include clear guidance or instruction to staff so they know what they should do to ensure residents’ care needs are met. We also saw evidence that care plans have been reassessed twelve weeks after residents have been admitted. These records documented the needs of the resident and also how they will be met. The manager has Camellots House DS0000069942.V349643.R01.S.doc Version 5.2 Page 17 been advised to ensure this information is transferred into individual care plans. Where possible, care plans should also include the wishes of the resident with regard to how the care is provided. Records seen included a clear record of medical appointments made to health care services such as GP’s, opticians and dentists. This also includes a record of the outcome of the consultation and, where necessary, the treatment to be provided. The survey returned by the care manager confirmed that this care home usually monitors and attends to the health care needs of individual residents. We were informed that, at present, no residents are considered capable of looking after their own medication. We saw that appropriate systems were in place for the recording, storing, handling, administration and disposal of medication. Medication record sheets were seen. We were informed only staff who have received appropriate training administer all medication. However, it was concerning to note that there were significant gaps in the medication records, where they have not been completed over several days. This means there is no evidence to confirm that all medication has been administered to residents in accordance with the instructions of the prescribing doctor. The manager was advised to ensure such records are kept up to date and accurately maintained. As this directly affects the health and wellbeing of residents we have made this a requirement; this is listed in the section at the end of the report. Some discussion took place with regard to the current practices for administering medication. We were informed that staff are taking medication from containers marked by the dispensing chemist with directions for administering medication and putting them in unmarked containers. Staff then take medication to residents and give it to them from unmarked containers. This practice is known as pre administering medication and is considered to be poor practice as there is a risk that residents may not receive the correct medication prescribed to them. The manager acknowledged there is a risk and agreed to review practices so that a safer means of administering medication may be found. We also recommended that the manager obtain a copy of the amended guidance for administering medication in care homes, which has recently been published by the Royal Pharmaceutical Society of Great Britain. (RPSGB). This will assist the manager in reviewing and amending the home’s procedures. Again, as this directly affects the health and wellbeing of residents we have made this a requirement; this is listed in the section at the end of the report. Camellots House DS0000069942.V349643.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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has set up a system for ensuring residents’ views are listened to. Residents are protected from abuse, neglect and self-harm. EVIDENCE: A complaint procedure has been drawn up so that residents and their families know how to make a complaint if they wish to do so. Copies of the procedure were on display in the care home. We saw that the procedure has also been drawn up in a picture format so that residents are also able to understand how to make a complaint. The survey returned by the care manager confirmed that this care home has usually responded appropriately if concerns have been raised with them. Information supplied by the registered provider confirmed that, “ The complaints procedure is in picture format to make things easier for the residents to understand. Also they have key workers who can capture any concerns if there are any.” We were informed that the registered provider has received one complaint since this care home has opened. The registered provider informed us that this has been resolved to the satisfaction of the person making the complaint Camellots House DS0000069942.V349643.R01.S.doc Version 5.2 Page 19 within agreed timescales. The registered provider has kept a record of the complaint received and a copy of the letter that was sent in response to it. However there was no evidence of the action that what taken to carry out the investigation into the complaint. It is recommended that, in future, the registered provider keeps notes of any interviews he carries out or any other action required to investigate any concerns raised. This will serve as evidence should it be necessary for us to consider how the registered provider deals with complaints or concerns. Staff on duty confirmed they know how to identify different types of abuse and also know what to do if they witness a resident being abused. Training records confirmed that staff are provided with training about adult protection. The registered provider has also provided information that confirms appropriate policies and procedures are in place that are designed to protect vulnerable adults from harm. The registered provider also confirmed that, “…the staff all have POVA (Protection of Vulnerable Adults) training to safeguard from abuse. Camellots House DS0000069942.V349643.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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents have been provided with a homely, comfortable and safe environment in which to live. Not all residents’ bedrooms suit their needs and lifestyles. The home has been kept to a good standard of cleanliness and hygiene. EVIDENCE: We visited most of the bedrooms of residents, the lounge and dining room. Those areas of the home seen were presented in a homely and comfortable manner. The decoration and furnishings provided ensured residents live in a comfortable and safe environment. Residents have been able to personalise their own rooms with small items of furniture, photographs and pictures. Camellots House DS0000069942.V349643.R01.S.doc Version 5.2 Page 21 During our visit we found evidence that bedrooms provided do not always suit residents’ needs and lifestyles. We are advising the registered provider to carry out a full assessment of each resident to determine if the room provided is sufficient for their needs. We also recommend that, where possible, the wishes of the resident and the views of the family and any care manager is also sought. If, as a result of the assessment, the room is not considered appropriate the registered provider will need to make alternative arrangements to accommodate the resident. We viewed the kitchen and the utility room. These areas of the premises were fresh, clean and hygienic. Cleaning schedules are in place to ensure all areas are cleaned on a regular basis. Care staff are expected to undertake laundry and domestic tasks to ensure the premises is kept clean and residents’ clothes are properly laundered. Information supplied by the registered provider prior to this visit confirmed he has taken appropriate steps to ensure the premises and equipment within the care home is safe for use. Gas and electrical appliances have been checked and maintained regularly. The registered provider commented, “The home manager has a home decoration to do list which they and the health and safety manager update. This is given to the provider to give to the home’s DIY person to implement to ensure the premises are suitable. The home has policies and procedures for the safe handling and disposing of waste and maintaining a clean home.” Camellots House DS0000069942.V349643.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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There are insufficient numbers of staff to adequately support residents. The home’s recruitment practices and procedures do not protect vulnerable residents. The registered provider has provided training to ensure staff have the necessary skills and knowledge to meet residents’ needs. EVIDENCE: We were given copies of staff rotas of the week of our visit and for three weeks before that. They indicated that from 8am to 8pm there are at least three care staff on duty. On some days this can increase to as many as five care staff. At night, from 8pm to 8am there is one member of staff who is awake and member of staff asleep in case of emergencies. Care staff are also expected to cook meals and to undertake cleaning duties. Camellots House DS0000069942.V349643.R01.S.doc Version 5.2 Page 23 We also looked through the care records of identified residents. We were informed about a recent incident between two residents. As a result the registered provider carried out a risk assessment. This concluded that each resident required support on a one to one basis to ensure his or her safety. However, it is not clear from staff rotas how this can be provided given the staffing levels available. The registered provider is advised to review staffing levels to ensure they are sufficient to meet the needs of all residents. As this has direct effect on the health and wellbeing of residents this has been made a requirement and appears at the end of this report. We examined the recruitment records of four staff who have been appointed since Camellot House has been registered. Not all appropriate checks and information were in place to ensure vulnerable residents have been protected. There was no evidence that proof of identity had been obtained, including a recent photograph. There was no evidence that the registered provider had sought information about the health of staff he has employed. On some occasions only one reference had been obtained; this did not include a reference from the most recent employer. In one instance, the registered provider had employed one member of staff before he had obtained a criminal records check (CRB). There was no evidence that the member of staff had been appropriately supervised whilst the CRB was returned. As this directly affects the safety and well being of residents this has been made a requirement and appears at the end of this report. We looked at staff training records. They demonstrated that newly appointed staff undertake structured induction training. This includes providing an understanding of the principles of good care practices and covers the promoting of residents’ rights, independence, choice and dignity. We noted that the induction package does not include a basic understanding of the needs of people with learning disabilities or autistic spectrum disorders. The manager informed us that staff are provided with such training after they have completed the induction. Training records also provided evidence that confirmed staff have been provided with mandatory training such as identifying and reporting abuse, fire safety, health and safety, first aid, and food hygiene. Staff have also received training in understanding autism. Staff spoken to confirmed the training and induction training they had received. The survey returned by the care manager confirmed that staff have the right skills and experience to support individual social and health care needs. Information supplied by the registered provider confirmed that, “The home employs good quality staff based on equal opportunities. Also the home has a strict set of qualifications the staff need to complete in their probation period. Staff are supervised closely to ensure this.” Camellots House DS0000069942.V349643.R01.S.doc Version 5.2 Page 24 Camellots House DS0000069942.V349643.R01.S.doc Version 5.2 Page 25 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, 29 and 42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The care home is not always well run and in the best interests of residents. The registered provider has yet to develop a means of ensuring the views of residents and their families are sought as part of any self – monitoring, review and development of the care home. The health, safety and welfare of residents and staff have been promoted. EVIDENCE: Camellots House DS0000069942.V349643.R01.S.doc Version 5.2 Page 26 There has been a change of manager since this care home was first registered. The current manager was appointed in July 2007. However, we have yet to receive an application to register as required by current legislation. The manager informed us that this will be sent to us in the near future. The registered provider informed us he visits Camellot House each month to ensure this care home is being run in the best interests of residents. Reports of such visits were available to examine during our visit. We noted that reports include details of discussions with staff on duty and, where possible, discussions with residents or observations of care and support provided. The registered provider has yet to set up a quality assurance system. We advised him that this should be in place in time for the first anniversary of the home’s registration. Information supplied by the registered provider confirmed that, “Quality monitoring is harder with autistic residents but feedback is currently being done with families and service managers (CTPLD)”. During our visit, we identified a number of areas where work is needed to make improvements to the way the home is being run. This will ensure the home is being run in the best interests of residents. Improvements need to be made to care plans so that they include clear guidance to staff with regard to the action they should take to meet individual residents’ needs. Improvements must be made to medication records to ensure they are accurate and up to date. Improvements must be made to the way in which medication is administered to ensure residents are protected. Staffing levels must be reviewed to ensure they are sufficient to meet the needs of residents. Recruitment procedure must be improved to ensure vulnerable adults’ safety. Following discussion with the manager, we found there was no evidence that a procedure regarding infection control had been drawn up. This means that residents and staff could be at risk of cross infection, particularly when dealing with bodily fluids. We recommended that the manager seek advice from the local environmental health officer before drawing up a local procedure for staff to follow. The manager agreed to take the necessary action to implement this. Information supplied by the registered provider prior to this visit confirmed he has taken appropriate steps to ensure the premises and equipment within the care home is safe for use. Gas and electrical appliances have been checked and maintained regularly. There is an internal system for staff to use to record and report any issues related to the maintenance of the premises to ensure any defects or repairs are dealt with. The registered provider has developed a system for ensuring we have been notified of those incidents and accidents that are required to be reported. We recommended that the registered provider develop a system for reviewing the reasons why accidents have occurred to ensure the premises are safe. Training records seen confirmed that staff have been provided with training regarding Camellots House DS0000069942.V349643.R01.S.doc Version 5.2 Page 27 health and safety issues, manual handling, fire drills and evacuation procedures. This will ensure the safety and wellbeing of residents and staff Camellots House DS0000069942.V349643.R01.S.doc Version 5.2 Page 28 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 2 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 2 33 X 34 2 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 2 X 2 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 2 X 2 X 2 X X 3 X Camellots House DS0000069942.V349643.R01.S.doc Version 5.2 Page 29 N/A 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 15.1 Requirement The agreed action to be taken by staff with regard to how each resident’s needs are to be met must be clearly recorded When medication is administered to people who use the service it must be clearly recorded to ensure that people receive correct levels of medication. When medication is administered it must be done in accordance with RPSGB guidance to ensure people receive correct levels of medication. Staffing levels must be reviewed and, where necessary, increased to ensure residents’ needs are met. Recruitment procedures must be sufficiently robust to ensure the safety of vulnerable adults. Timescale for action 27/12/07 2 YA20 13.2 27/12/07 3 YA20 13.2 27/12/07 4 YA33 18.1 27/12/07 4 YA34 19.1 27/12/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. Camellots House DS0000069942.V349643.R01.S.doc Version 5.2 Page 30 No. Refer to Standard Good Practice Recommendations Camellots House DS0000069942.V349643.R01.S.doc Version 5.2 Page 31 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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. 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