Inspection on 23/08/07 for Cascade Care Ltd (Cascade 4)

This inspection was carried out on 23rd August 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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

Cascade Care Ltd (Cascade 4) 23/08/06

Similar services:

Townley Road, 2-3

Foxley Lane (121a)

Tudor Lodge

Stacey Street Nursing Home

Delrose House Ltd

Clovelly House Residential Home Ltd

Abbey Road [53]

Cherry Tree House

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

CARE HOME ADULTS 18-65 Cascade Care Ltd (Cascade 4) 40 Newick Rd Lower Clapton Hackney E5 0RR Lead Inspector Robert Sobotka Key Unannounced Inspection 23rd August 2007 10:00 Cascade Care Ltd (Cascade 4) DS0000067297.V344791.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 Cascade Care Ltd (Cascade 4) DS0000067297.V344791.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. Cascade Care Ltd (Cascade 4) DS0000067297.V344791.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cascade Care Ltd (Cascade 4) Address 40 Newick Rd Lower Clapton Hackney E5 0RR 020 8525 0866 020 8985 2589 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) Cascade Care Ltd Mr Casper Viriri Care Home 5 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (5) of places Cascade Care Ltd (Cascade 4) DS0000067297.V344791.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: Male Whose primary care needs on admission to the home are within the following categories: 2. Mental Disorder, excluding learning disability or dementia - Code MD The maximum number of service users who may be accommodated is 5. 23rd August 2006 Date of last inspection Brief Description of the Service: Cascade 4 is a residential care home, which offers care, support and accommodation for maximum of five male service users within a community setting, who have mental health needs. The home is situated in Lower Clapton in Hackney E5. The property is a large Victorian terraced house, which comprises five large bedrooms; a large communal lounge with cable TV and a music centre; separate laundry area with a dryer; bathroom and WC; separate WC, large dining room; fully equipped modern kitchen and a well-maintained garden at the rear of the building. The premises are not wheelchair accessible. The company has recently been bought as a going concern and subsequently re-registered with the Commission for Social Care Inspection on 20/07/06 with the new name of Cascade Care Ltd. Cascade Care Ltd (Cascade 4) DS0000067297.V344791.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over one day (morning and early afternoon) and was unannounced. As part of the visit, the inspector spoke to some of the service users and two care staff working in the home. He also conducted a tour of the premises and viewed various records. The registered manager was not present during this inspection, as he was on annual leave at the time of this inspection. The inspector was undertaken in the presence of the deputy manager and a member of staff. Prior to this inspection the home was asked to complete the Annual Quality Assurance Assessment. Some of the information provided in the assessment has been incorporated into this inspection report. The aim of this unannounced inspection was to check the home’s compliance with the National Minimum Standards for Care Homes for Adults (18-65) and The Care Homes Regulations 2001. The inspector would like to thank to both service users and staff who contributed to this inspection. What the service does well: What has improved since the last inspection? Cascade Care Ltd (Cascade 4) DS0000067297.V344791.R01.S.doc Version 5.2 Page 6 The registered manager has ensured that all six requirements from the last inspection have been met: The home’s statement of purpose has been amended and the statement that the home provides services to “men who have past or present history of drug dependence or alcohol abuse” has been removed. The responsible person has ensured that all policies and procedures listed in Appendix 2 of the National Minimum Standards are up-to-date and kept under review. Staff have received mandatory training, as previously required. The registered manager has ensured that the Commission is informed of any notifiable occurrence in line with Regulation 37 of the Care Homes Regulations. Problems with the supply of hot water have now been rectified. The registered manager has ensured that the fire equipment has been serviced. What they could do better: There following 3 statutory requirements were made following this inspection visit: - The responsible person must ensure that a record of all visitors to the care home is maintained, in line with Schedule 4 of the Care Homes Regulations. - The registered manager must ensure that record of the food provided for service users is maintained in sufficient detail to enable any person inspecting the record to determine whether the diet is satisfactory, in relation to nutrition and otherwise, and of any special diets prepared for individual service users. - The registered manager must ensure records relating to each complaint made to the home are sufficient in detail to demonstrate that it was fully investigated. In addition the following 2 good practice recommendations were made: - It is recommended that where any additional restrictions have been imposed for any of the service users, they are included in the service user’s contract, statement of terms and conditions and signed by both parties. Cascade Care Ltd (Cascade 4) DS0000067297.V344791.R01.S.doc Version 5.2 Page 7 - It is recommended that the team meeting minutes include action points, which could be reviewed during following meeting to monitor progress of decisions made. 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. Cascade Care Ltd (Cascade 4) DS0000067297.V344791.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 Cascade Care Ltd (Cascade 4) DS0000067297.V344791.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): 1, 2, 3, 5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users are provided with sufficient information about the home to make an informed choice as to whether to move in. Appropriate admission systems were in place. The home was meeting the needs of those accommodated there. Prospective service users have an opportunity to “test drive” the home, prior to moving in. Service users had contracts in place, however it is recommended that additional conditions are introduced where it is considered necessary. EVIDENCE: The home’s statement of purpose has been amended and the statement that the home provides services to “men who have past or present history of drug dependence or alcohol abuse” has been removed. The service user’s guide was also in place and it gave potential residents useful information about the home. There has been one admission to the home since the last inspection. This particular service user moved from a sister home run by Cascade Care Ltd. The inspector spoke with the service user, who confirmed that he was happy with the move into this project. Cascade Care Ltd (Cascade 4) DS0000067297.V344791.R01.S.doc Version 5.2 Page 10 A comprehensive assessment was also available for inspection. There was evidence that appropriate and relevant information had been obtained from the placing authority. Following discussion with those who lived in the home, staff working in the home, reviewing documentation such as care plans, and direct and indirect observation, the inspector was satisfied that the home was meeting the needs of those living in the home. In the Annual Quality Assurance Assessment, the registered manager stated that the organisation carries out a comprehensive assessment of each service user in liaison with the purchasers (placing authority). Following an initial assessment, each service user undergoes day visits, which progress to overnight visits. This is for further assessments to find out whether the needs may be met and also for a service user to chose whether they like the place or not. Service users are also asked to fill in questionnaires so that the home can assess the quality of service provided. Since the last inspection, the home has started a programme where service users who are on their way to semi-independent living are encouraged to selfcater (with supervision). This involves them getting a budget for the week, do their shopping and do their own cooking. Service users will also administer their own medication in liaison with recommendation from any professionals. So far this has worked with one service user, who has moved on to independent living. Each service user had a contract, which included statement of terms and conditions in place. It was noted during this inspection that some of as a result on an unacceptable behaviour restrictions of some visitors to the home, visiting restrictions have been implemented in relation to some of one of the service users’ visitors. It is recommended that where any additional restrictions have been imposed for any of the service users, they are included in the service user’s contract, statement of terms and conditions and signed by both parties. Cascade Care Ltd (Cascade 4) DS0000067297.V344791.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, 9, 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home had a good care planning system in place and those who lived in the home were taking part in the care planning process. Appropriate risk management systems were in place. Confidentiality was being maintained. EVIDENCE: As part of this visit, the inspector viewed care plans of four service users. Documents viewed were well maintained and were reviewed on regular basis. Minutes from the Care Planning Approach meetings were also in place. There was evidence that service users are encouraged to participate in their care planning process and their views were taken into account. They are also encouraged to write down their comments about their progress in meeting agreed goals. Since the last inspection, the home has increased the frequency of care plan reviews. Care plans are now reviewed monthly. The registered manager stated in the AQAA document that the organisation operates a homely but structured environment, which works very well, as most of the clients come from institutions. The staff team work closely with service Cascade Care Ltd (Cascade 4) DS0000067297.V344791.R01.S.doc Version 5.2 Page 12 users to achieve relationships based on trust and understanding. It is achieved by empowering service users by using tools, such as care plans and risk assessments. By working closely with service users, the home encourages them to take calculated risks through keyworking and individualised care plans, in which service users take part in deciding and agreeing. The inspector was satisfied that the service users are consulted as to how the home should be run. Their views are obtained during individual keyworking sessions and residents meetings. Those who spoke with the inspector also confirmed that their views were being taken into account by the home management team. Appropriate risk assessments were seen on each file. Assessments were being reviewed on a regular basis. Confidentiality was being maintained. Staff working in the home shared information about the service users with the inspector on a need-to-know basis. All confidential information was kept in the office, which was kept locked when not in use. Cascade Care Ltd (Cascade 4) DS0000067297.V344791.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, 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are encouraged and supported to be part of the local community and to develop and maintain friendships and family links. The service user’s rights and choices were respected and they had opportunities for personal development. Service users enjoyed food in the home, however records of food offered to the service users required improvement. EVIDENCE: The inspector spoke to two service users during this inspection, who said that they were happy with the quality of care provided and activities offered to them by the home. Service users accessed a wide range of activities both inside and outside of the home. One of the service users attended local college. In the AQAA, the registered manager stated that apart from activities of daily living that are provided in house, service users also access other services outside, such as day centres or cultural groups in the community. The Cascade Care Ltd (Cascade 4) DS0000067297.V344791.R01.S.doc Version 5.2 Page 14 organisation has also started an inter-project sporting activity, which is held with the home’s sister projects. Service users are encouraged to no suppress their sexual orientation in order to have a quality of like. Those who lived in the home and were able to go out independently were free to do so. Additional staff support was offered to service users who required escorting whilst out in the community. Service users were able to plan their leisure activities during regular house meetings. One of the service users went on their annual holiday to Butlins in Minehead earlier on in the year. Other people who used the service chose not to partake in the holiday. Visitors were allowed in the home on most occasions (see Standard 5). During the review of the home’s visitor’s policy, the inspector noted that it was inconsistent with the service user’s guide. Whilst the service user’s guide stated that visitors can be brought into service user’s room, the home’s visitors policy stated that staff should not encourage visitors to enter service user’s rooms This required clarification to ensure consistent approach within the home. Visitor’s book was in place, however the inspector noted that not all visitors were using the book. For example there was no evidence of visits from the Registered Provider undertaking her monthly-unannounced visits. The responsible person must ensure that a record of all visitors to the care home is maintained, in line with Schedule 4 of the Care Homes Regulations. Service users were also encouraged and supported to maintain appropriate relationships with their families and friends. There was evidence that some of the service users had very close relationships with their families. There were appropriate food supplies in the home. Those who spoke with the inspector stated that they enjoyed food offered in the home. Record of food offered to the service users required improvement, as at the time of this inspection, some of the entries made included general headings such as “individual cooking”, “snacks” and “take away”. The registered manager must ensure that record of the food provided for service users is maintained in sufficient detail to enable any person inspecting the record to determine whether the diet is satisfactory, in relation to nutrition and otherwise, and of any special diets prepared for individual service users. Cascade Care Ltd (Cascade 4) DS0000067297.V344791.R01.S.doc Version 5.2 Page 15 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. The home was appropriately meeting service user’s physical and emotional needs. Appropriate medication systems were maintained. EVIDENCE: At the time of this inspection, all service users who lived in the home at the time of this inspection attended their own personal care and staff only offered verbal prompts as and when required. There was evidence of an input from Psychiatrists, Community Psychiatric Nurses and Social Workers. The majority of the psychiatric reviews were carried out promptly. The majority of the service users choose to attend their GP surgeries and hospital appointments independently. In some cases staff accompanied service users to appointments. Appropriate medication systems were in place. The home was using a monitored dosage system (MDS from Boots), which was dispensed in blister packs. All medication was appropriately stored and records of medication Cascade Care Ltd (Cascade 4) DS0000067297.V344791.R01.S.doc Version 5.2 Page 16 received into the home, administered and disposed of were maintained. It is the company’s policy that 2 staff sign a record of any medication administered to each service user, in order to eliminate any possible mistakes. The inspector checked a random selection of medication stocks kept in the home, which were found correct. Cascade Care Ltd (Cascade 4) DS0000067297.V344791.R01.S.doc Version 5.2 Page 17 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. Some improvements were required to the home’s complaints systems. Those living in the home were protected from abuse, neglect and self-harm. EVIDENCE: The home had a complaints policy in place, which included details of the Commission for Social Care Inspection. The inspector viewed the home complaints book. There have been 6 complaints brought to the attention of the registered manager since the last inspection. Although all of the complaints appeared to have been resolved, the inspector was of the opinion that more information should have been included to demonstrate how each complaint was dealt with and what was the outcome of each complaint. The registered manager must ensure records relating to each complaint made to the home are sufficient in detail to demonstrate that it was fully investigated. Adult protection procedure and the Whistleblowing policy were in place. All incidents were clearly recorded and all records/ documentation were reviewed by the manager on a regular basis. The inspector was satisfied that all significant events were being reported to the Commission in line with Regulation 37 of the Care Homes Regulations. Staff who spoke to the inspector demonstrated their awareness of adult protection issues. Staff have attended Protection of Vulnerable Adults training. Cascade Care Ltd (Cascade 4) DS0000067297.V344791.R01.S.doc Version 5.2 Page 18 The majority of people managed their own finances. Where it is felt that support or guidance in managing finances is needed by service users, this is readily available from members of staff. Cascade Care Ltd (Cascade 4) DS0000067297.V344791.R01.S.doc Version 5.2 Page 19 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. People who use the service benefit from a homely, comfortable and clean environment. EVIDENCE: The home is an ordinary domestic property situated in a residential street. Those service users who spoke with the inspector told him that they were happy with their bedrooms and communal areas. Since the last inspection problems with the hot water supply has been rectified. In addition an electric shower has been fitted in one of the rooms, so that service users have a constant supply of how water in the event of the boiler developing problems. There are plans to have all the radiators replaced, as a measure of updating them, due to fitting of the boilers. The inspector was also informed that there were plans to redecorate the front of the building. The inspector undertook a tour of the premises and he was satisfied that they were well maintained. Cascade Care Ltd (Cascade 4) DS0000067297.V344791.R01.S.doc Version 5.2 Page 20 The registered manager stated in AQAA that all communal areas are cleaned by staff on duty. Service users are encouraged to clean their rooms and this is incorporated in their care plans. All rooms are en-suite and are kept in good standard. There is a large garden at the rear of the home and service users are encouraged to take part in gardening and are given therapeutic earnings. The home does not accommodate people with physical disabilities. The premises were well maintained, clean and hygienic at the time of this unannounced visit. Cascade Care Ltd (Cascade 4) DS0000067297.V344791.R01.S.doc Version 5.2 Page 21 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 good. This judgement has been made using available evidence including a visit to this service. Service users are supported by appropriately trained and committed staff team. EVIDENCE: The inspector viewed duty rosters, which showed that there were sufficient numbers of staff on duty. There are two members on each shift, including nights. Night staff remain awake throughout the night. Staff spoken to stated that they felt that staffing levels were sufficient to meet the assessed needs of the service users accommodated in the home. Staff meetings are organised on a regular basis, minutes from which were available for inspection. It is recommended that the team meeting minutes include action points, which could be reviewed during following meeting to monitor progress of decisions made. The majority of staff either have obtained the NVQ qualification or were in the process of obtaining one. Staff have received mandatory training, as previously required. The home was able to demonstrate that new staff receive induction. Cascade Care Ltd (Cascade 4) DS0000067297.V344791.R01.S.doc Version 5.2 Page 22 The inspector checked staff files of the most recently recruited member of staff. Although there was evidence that all information listed in Schedule 2 of the Care Homes Regulations has been obtained prior to the person starting work in the home, it was noted that both references were addressed “To whom it may concern”. It is recommended that the organisation obtains written references itself, rather than accepting references, which have been supplied to the prospective member of staff with a heading of “To whom it may concern”. Supervision and appraisal records were not checked during this inspection visit, however staff who spoke with the inspector stated that they have received supervision and appraisals. This will be fully tested at the next inspection visit. Cascade Care Ltd (Cascade 4) DS0000067297.V344791.R01.S.doc Version 5.2 Page 23 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): 39, 40, 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Improvements have been noted to the way the home is managed. Satisfactory quality assurance systems were in place. Appropriate health and safety checks were also in place. EVIDENCE: There has been a change in the registered manager since the last inspection. Following the resignation of the previous registered manager, the organisation has promoted the deputy manager of the home, who has been approved by the Commission as fit to manage a home for people with mental health issues. As the registered manager was on annual leave at the time of this inspection, standard 37 could not be fully assessed. It was noted however that both service users and members of staff on duty positively commented on the registered manager’s performance. Cascade Care Ltd (Cascade 4) DS0000067297.V344791.R01.S.doc Version 5.2 Page 24 This standard will be fully assessed at the next inspection visit. Appropriate quality assurance systems were in place. Monthly unannounced checks were being undertaken by the registered provider were taking place in line with Regulation 26 of the Care Homes Regulations, reports from which were being forwarded to the Commission on a regular basis. There was also evidence that the views of people who used the service were also obtained in order to improve the quality of service offered by the home. Since the last inspection the responsible person has ensured that all policies and procedures listed in Appendix 2 of the National Minimum Standards are up-to-date and kept under review, as previously required. Appropriate health and safety checks were in place. As previously mentioned the ongoing problems with supply of hot water have been rectified. The previous requirement that the home’s fire alarm must be tested has also been met. The certificate of the most recent fire alarm service was seen during this inspection visit. The home was insured for its stated purpose. Cascade Care Ltd (Cascade 4) DS0000067297.V344791.R01.S.doc Version 5.2 Page 25 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 3 4 X 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 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 2 33 3 34 2 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X X X 3 3 X 3 X Cascade Care Ltd (Cascade 4) DS0000067297.V344791.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA15 Regulation 17(2) Sch 4.17 Requirement The responsible person must ensure that a record of all visitors to the care home is maintained, in line with Schedule 4 of the Care Homes Regulations. The registered manager must ensure that record of the food provided for service users is maintained in sufficient detail to enable any person inspecting the record to determine whether the diet is satisfactory, in relation to nutrition and otherwise, and of any special diets prepared for individual service users. The registered manager must ensure records relating to each complaint made to the home are sufficient in detail to demonstrate that it was fully investigated. Timescale for action 01/10/07 2. YA17 17(2) Sch 4.13 01/10/07 3. YA22 22(3) 15/10/07 Cascade Care Ltd (Cascade 4) DS0000067297.V344791.R01.S.doc Version 5.2 Page 27 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA5 Good Practice Recommendations It is recommended that where any additional restrictions have been imposed for any of the service users, they are included in the service user’s contract, statement of terms and conditions and signed by both parties. It is recommended that the team meeting minutes include action points, which could be reviewed during following meeting to monitor progress of decisions made. 2. YA33 Cascade Care Ltd (Cascade 4) DS0000067297.V344791.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Ilford Area Office Ferguson House 113 Cranbrook Road Ilford IG1 4PU 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 Cascade Care Ltd (Cascade 4) DS0000067297.V344791.R01.S.doc Version 5.2 Page 29 - 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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