Inspection on 29/07/05 for Chepstow House

This inspection was carried out on 29th July 2005.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Chepstow House 28/11/06

Chepstow House 19/01/06

Chepstow House 24/02/05

Chepstow House 15/06/04

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

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

CARE HOME ADULTS 18-65 Chepstow House Old Maids Walk Ross-on-Wye Herefordshire HR9 5HB Lead Inspector Christina Lavelle Announced Inspection 29 July 2005 12:30 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 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 Stationary 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. Chepstow House E52 E02 S41406 Chepstow House V240104 290705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Chepstow House Address Old Maids Walk Ross-on-Wye Herefordshire HR9 5HB 01989 566027 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Category(ies) of registration, with number of places Chepstow House (Ross) Ltd Ms Sally Keene Care Home only 14 LD Learning disability (30 years and over) -(14) Chepstow House E52 E02 S41406 Chepstow House V240104 290705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: In addition to the categories of registration detailed on the previous page of this report the following conditions of registration apply to this service:1. Service Users may also have physical disabilities in addition to their learning disabilities. 2. Service users may also have a mental health disorder that is associated with their learning disability. 3. Service Users must be at least 30 years of age. Date of last inspection 24 February 2005 Chepstow House E52 E02 S41406 Chepstow House V240104 290705 Stage 4.doc Version 1.40 Page 5 Brief Description of the Service: Chepstow House provides a home for fourteen people (men and women) who must be older than thirty and need care due to learning disabilities. Service users could also have a mental health disorder or a physical disability that is linked with their learning disability. They may also show challenging behaviour and have limited communication and social skills. The home was full at this time and service users were aged from forty five up to seventy eight. The home is a large detached house set in a quiet location that is within easy walking distance of the town of Ross-on-Wye. The property was an original old house on two floors that has been extended. All the bedrooms are single and there are five ground floor bedrooms and six first floor bedrooms in the main part of the home. There is also a separate four bedroomed flat on the ground floor. Two bedrooms have an ensuite toilet and shower. There are two sitting rooms for service users (the one in the flat includes a dining area) and a separate dining room in the main part of the home. The garden is at the front of the house, with a patio, and has a ramp fitted for easy access. There is a small-enclosed courtyard area, used by people who smoke. Chepstow House E52 E02 S41406 Chepstow House V240104 290705 Stage 4.doc Version 1.40 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This routine inspection took place in about four hours on a Friday afternoon in the summer. The main aims were to check if Chepstow House continued to provide a good quality service and was meeting its stated purpose. The home’s purpose being to offer a homely environment to service users. Also to encourage them, through education and stimulation, to achieve as much as they can in a way that is generally valued by society. Time was spent talking with the manager about the care service users receive, staffing and how the home is run and kept safe. Two staff were spoken with individually about their experience of working in the home and their training. Questionnaires were sent for staff before the inspection asking if they thought aspects of the service were good or not. Also to show their training and to make other comments about the home if they wanted to. Nine were filled in and their views will be referred to in this report. Some service users discussed their lives at the home. Time was spent in the company of other service users who are less able to say what they think due to their disabilities. Various records were checked about the service users’ care, staffing and safety in the home. The premises were looked at. Reports made by the provider following their monthly visits to the home to make sure it is running well and that staff and service users are happy gave useful information What the service does well: Chepstow House is in a good location for service users to walk to the shops and use other facilities in Ross-on-Wye. It is in a quiet road and the building is set back and so is private and secure. The home provides service users with a very comfortable home and the premises were well furnished and kept to a high standard of repair and decoration. Service users seemed very at home and staff were kind and caring towards them. There was a very friendly and relaxed atmosphere and service users said they were happy with their lives at Chepstow House and liked the staff. Good care planning for service users helps ensure staff are aware of all their needs and how to meet them better. The “person centred approach” makes sure service users wishes and goals are known and are part of their care plans. Any risks to service users’ and other people’s safety are identified and staff are told how to deal with them. Keyworkers make care given to individual service users more personal as they have one special member of staff they can relate to and to discuss what they need and want with. Chepstow House E52 E02 S41406 Chepstow House V240104 290705 Stage 4.doc Version 1.40 Page 7 Staff have enough time to support service users to enjoy a range of leisure and other activities to make their lives more interesting and develop skills. They also help them to mix with the community and to keep links with their families. Staff worked well as a team and were committed to making the service and care of good quality. They received training in all the areas needed for them to meet service needs, keep the home safe and do their jobs properly. The home was well run with an open and positive management approach. 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 contacting your local CSCI office. Chepstow House E52 E02 S41406 Chepstow House V240104 290705 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Chepstow House E52 E02 S41406 Chepstow House V240104 290705 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2, 3, 4, & 5 Information about the home is available to help prospective service users and/or their representatives decide whether Chepstow House is where they might like to live and if the home would meet their needs. The service users’ guide could be made easier for people with learning disabilities to understand. Thorough assessment procedures ensure that only service users whose needs could be suitably met are accommodated at the home and would be admitted. EVIDENCE: Suitable information documents are provided for the home, including a statement of purpose, service users’ guide and terms and conditions for residence (contract). Although the manager confirmed the guide was always explained to prospective service users it would be easier for them to understand if it was in a format with symbols, pictures and/or photographs. There had not been any new service users admitted to the home for a while. However it was confirmed before that there were appropriate assessment and admission procedures for when possible new service users are referred. This would include them visiting the home a few times and also possibly having weekend stays. Service users needs were assessed by the home’s managers at their current residence prior to admission. A trial stay was then arranged and within six weeks a review held to decide if the placement was suitable. Service users and all relevant other people would be involved in this process. . Chepstow House E52 E02 S41406 Chepstow House V240104 290705 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7, 9, & 10 Thorough and “person centred” assessment and care planning makes sure that staff know all service users’ needs and wishes and how to meet them properly. Service users were also enabled to make choices and decisions in their lives. Relevant risk assessments had been carried out to safeguard service users, whilst allowing them to take some risks to promote their independence. Due attention is paid to maintaining confidentiality in the home. EVIDENCE: A sample of service users’ care records were looked at. They included their photograph and useful background information about each person. A life story section had been completed with their allocated keyworker. Staff made daily reports and recorded any significant events in each service user’s life. Care plans had been drawn up based on a comprehensive assessment of their needs and other relevant information. Plans covered all areas of service users’ personal, emotional and social needs and an action and behavioural care plan was drawn up based on their needs. Whenever possible service users were involved in drawing up their own plan Chepstow House E52 E02 S41406 Chepstow House V240104 290705 Stage 4.doc Version 1.40 Page 11 and their short and long term goals, likes and dislikes e.g. food and daily routines were included. Plans were appropriately reviewed at least monthly by keyworkers. Families who maintain contact with their relative were consulted and invited to annual care reviews. Keyworkers help to individualise care given by taking a greater role in working with their allocated service user. They also help to ensure their plans always reflect what the individual wants as far as is possible and that they are involved in reviews of their care and agree any changes to their plan. Risk assessments had been carried out covering any areas that could be a hazard or service users could not manage safely. This included their ability to hold their own bedroom door key, aggressive behaviour, moving and handling and use of bedside rails. Individual management and/or physical intervention plans were in place for people who may show challenging behaviour. A new system had recently been implemented by an external consultant, which made it very clear how staff must respond to any aggressive incident. The home’s management was monitoring these plans closely and the consultant was also reviewing them to decide whether any changes to the plans might be needed. Each staff member is expected to read and sign a confidentiality statement. The principles are also covered in the induction programme for new staff. Chepstow House E52 E02 S41406 Chepstow House V240104 290705 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11, 12, 13, 14, 15, 16 &!7 Service users were given choice and flexibility in their lives and daily routines to promote their independence and self-determination. Staff also enabled them to participate in a wide range of social, leisure and other activities to help them to lead interesting lives and improve their daily life and social skills. Staff supported service users to regain and/or keep contact with their families and kept their relatives informed and involved in their lives and care. Good attention was paid to providing food service users’ like; ensuring they had a healthy diet that was also suitable for people with special dietary needs. EVIDENCE: Service users social needs and interests had been assessed and included in their plan. Each person had a weekly activities sheet drawn up by staff that included leisure and other activities within the home and the wider community. Staff interviewed felt they had enough time to support service users with their activities, including some on a one to one basis. Chepstow House E52 E02 S41406 Chepstow House V240104 290705 Stage 4.doc Version 1.40 Page 13 The location of the home is convenient for access to the town’s shops and facilities and the home provides a vehicle for transport further afield. Holidays and outings were arranged to suit service users’ needs and wishes. One service user had recently been to Spain. None of the current service users would be able to hold down a job, (and some were too old to). However one of the younger people was enrolled on a course at college and three others were going to enrol on a cookery course to develop their daily living skills. Staff were seeking a work placement for one service user and some people attended local day services on various weekdays. Today nine service users were at home and five were attending the local day service for older people with learning disabilities. During the inspection several service users went out, either for lunch or to the shops etc. with staff. Others were in the lounge, colouring, sewing, watching television and talking to staff. It was clear that staff had time to spend socialising and promoting activities with service users and considered this to be an important part of their role. Staff supported service users to maintain appropriate links with their families. The inspector spoke with one keyworker who was making a real effort on behalf of one service user to re-establish contact with their relative. A four-week menu plan for meals was in place, which was changed regularly. The menu seen indicated a good range of wholesome food was provided. Fresh fruit and vegetables were included and such as cereal and wholemeal bread. Staff were aware and took account of service users’ food likes and dislikes, and ensured that any special dietary requirements were met. It was good that one person had fresh fruit in his bedroom so that he could help himself, and he had his own fridge for cold drinks etc. Most service users were not able to assist staff with cooking, although they helped to lay up tables and clear up and went out with staff to do shopping locally. Each person had an individual food record kept whenever they needed a special diet or had chosen an alternative dish to the menu. A Dietician had appropriately been involved to advise when one person had eating difficulties. Chepstow House E52 E02 S41406 Chepstow House V240104 290705 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19 & 20 Appropriate arrangements were in place to ensure the personal, emotional and health care needs of service users were met. This included obtaining the input of relevant health care and other professionals. EVIDENCE: Service users’ plans included any help and guidance they needed from staff for their personal care. Service users were seen to well presented and dressed appropriately. Their keyworkers supported them to purchase their clothes. Care records showed staff closely monitored service users’ health, mood and behaviour. They had taken action to promote service users’ good health and wellbeing. Checklists and records were kept for specific medical conditions and difficulties e.g. epilepsy and weight. Body charts were completed for injuries. Input from relevant health care professionals had been sought and obtained. This included monthly clinical visits from a Consultant Psychiatrist whose services are employed for the home. Arrangements were made for routine health care checks e.g. GP and Dentist and keyworkers supported service users to attend the appointments in the community. One service user was very ill and confined to bed. He looked very comfortable and well cared for and it was good that it had been arranged for a member of Chepstow House E52 E02 S41406 Chepstow House V240104 290705 Stage 4.doc Version 1.40 Page 15 staff to sit with him all the time. Community nurses were visiting regularly to support him and to advise staff and had provided a pressure relief mattress. Staff were continually checking to make sure pressure areas did not develop and help him eat and drink. Records were kept of fluid intake and personal care given and his care plan had been revised to reflect the changing needs. Is was clear that all this service user’s needs were being met and he was being looked after in a very caring and respectful way by staff. His family were being kept fully informed about his condition and enabled to visit and sit with him. Chepstow House E52 E02 S41406 Chepstow House V240104 290705 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 & 23 Appropriate attention was paid by the home to ensure that service users’ rights are promoted and they are protected from abuse or neglect. The open atmosphere and staff approach indicated that service users would feel able to express their views and concerns and they would be taken seriously and action taken to resolve any issues. EVIDENCE: There is a written complaints procedure, which is also available in a suitable format that people with learning disabilities are more likely to understand. A record is kept when complaints are raised, with details of the concern, the investigation and outcome. There had not been any complaints made to the home or the Commission since the last inspection. It was clear from observation and talking to service users they had trust and confidence in the manager and staff and could talk openly and freely to them. Adult Protection policies and procedures, including whistleblowing, are provided. Staff had received instruction to make sure they understand their responsibility and when and how to refer any evidence or suspicion of abuse or neglect of service users. There were specific risk assessment and behaviour management plans in place for individual service users whose behaviour may be challenging and so could need physical intervention from staff to ensure their and other peoples safety. Chepstow House E52 E02 S41406 Chepstow House V240104 290705 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 25, 26, 27, 28 & 29 Chepstow House has been suitably adapted for its purpose. The home offers service users a secure, safe and very comfortable environment that is in a convenient location. Effective arrangements were in place to ensure the premises and equipment were well maintained and for the accommodation continue to be improved. EVIDENCE: Chepstow House is in a convenient location for Ross town’s shops and services and the building fits in unobtrusively with the local community. The home was found to be clean and tidy and there was a good standard of furnishings, repair and decoration. Work was ongoing to improve the premises and there was a planned redecoration, recarpetting and general upgrading programme. The self contained flat provides a bedsit for one person to promote their independence and a more secure, supported environment for other service users. Service users’ bedrooms are well furnished and fitted. Those rooms seen were comfortable and had been personalised to their occupants’ interests Chepstow House E52 E02 S41406 Chepstow House V240104 290705 Stage 4.doc Version 1.40 Page 18 and taste. One person had a huge television and a small fridge and confirmed he had chosen the colour of his bedroom and was very pleased with it. All the bedroom doors have locks and those able and choosing to could hold their own key. A risk assessment showed when this would not be possible. There are suitable and sufficient toilets and bathrooms, including two baths and shower facilities plus two en-suite bedrooms. The home has two sitting rooms and although one has to used as a thoroughfare it is spacious and comfortable and well used by service users. Both sitting areas have televisions and music centres and tables to sit at for activities (one also used for meals). The garden is a reasonable size and accessible and has a patio area with seating and a barbecue. An alarm call bell system is provided throughout the building and there are various aids and equipment. Chepstow House E52 E02 S41406 Chepstow House V240104 290705 Stage 4.doc Version 1.40 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 34, 35 & 36 There was a stable core group of committed, appropriately trained, and well supported staff who ensured that service users’ needs were appropriately met. The home was staffed effectively for the benefit of service users. Robust recruitment procedures were operated to help make sure unsuitable people are not employed at the home for the protection of service users. EVIDENCE: All staff receive an appropriate job description and contract. Staff members were delegated particular tasks, dependant on their position, including that of keyworker. Staff interviewed understood their roles and responsibilities and the aims of the home. It was clear the staff team were well motivated and committed to meeting service users needs and providing good quality care. Rotas showed that suitable staffing levels were maintained to meet service users’ needs. The manager confirmed the aim was to always have six care staff on duty throughout the working day, with at the very minimum four in exceptional circumstances. There were also hours allocated over and above hours needed for direct care especially for the management task. Chepstow House E52 E02 S41406 Chepstow House V240104 290705 Stage 4.doc Version 1.40 Page 20 There was a relatively stable staff team and appointments had just been made for two current staff vacancies. Although agency staff had been deployed to cover the home they were using the same few people so they could get to know the home and service users better. It was good that the home always checks agency staffs CRBs and carry out a basic induction with them before they start working there. It was also ensured they always work along side permanent staff until it was felt they were able to work unsupervised. It was previously confirmed that thorough recruitment procedures were in place. The record of a new staff member was checked and found to be satisfactory. Two written references (one from their previous employer) and a CRB/POVA check taken up. The person had also signed a criminal conviction and health declarations. A new induction programme had been introduced based on LDAF, which is accredited and especially for people working in the learning disabilities field. Staff training also included topics related to service users’ special needs, such as autism, epilepsy and interventions for the management of challenging behaviour. A training session on people with learning disabilities who develop dementia had recently been arranged and another was planned regarding communication from a Speech Therapist. Almost half the staff had achieved an NVQ qualification and most others were doing the course. There should no difficulty therefore for half the staff team to become qualified this year as the Standard specifies. Staff commented on an increased opportunity for training and their level of training reflects positively on the skills and knowledge, and so competence of the staff team. Staff received regular and appropriate supervision from the manager and seniors and they were very positive about this. Their individual training and development needs were ascertained and plans made to address any needs Chepstow House E52 E02 S41406 Chepstow House V240104 290705 Stage 4.doc Version 1.40 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 38, 39, & 42 The home and service users benefit from an open and positive management approach and by having a suitably experienced and qualified manager. Suitable systems were in place for the home to be run effectively and for staff and service users to be kept safe and their healthy and welfare promoted. An appropriate system is operated to ensure the service continues to improve and develop to benefit service users in a way that they wish and need. EVIDENCE: The manager (Sally Keene) has achieved an NVQ level 4 qualification in care and management. She had previous experience working with people with learning disabilities and is knowledgeable about their special needs. There was a clear sense of direction and leadership in the home and all the evidence obtained showed the home is well run. Staff interviewed said they Chepstow House E52 E02 S41406 Chepstow House V240104 290705 Stage 4.doc Version 1.40 Page 22 were kept well informed through handovers and staff meetings. Also that they felt able to express their views and use their initiative when doing their job. There were clear lines of accountability within the home and with the provider. The manager confirmed that she and the home receive good support and supervision. The provider’s required monthly visits were made unannounced and the auditing process of the service was comprehensive and based on the National Minimum Standards. Reports were made following these visits, with a copy sent to the Commission. The views of service users and significant other people were to be obtained through annual questionnaires. There was also a comment book and feedback was obtained at care reviews. All this information should be used to inform how the service develops. All staff had to complete the mandatory health and safety topics i.e. fire safety, food hygiene, first aid and moving and handling. Some staff needed their first aid training updated, which was arranged. In the meantime it must be ensured there is always a qualified first aider on duty at the home. Staff handling medicines had attended a relevant training session and the manager a risk assessment and management course. Other staff had completed a ten week certificated City and Guilds health and safety course. Other steps taken to promote and maintain the health, safety and welfare of service users and staff included: • The fire log showed all the required tests and checks on the fire safety system and equipment were recorded as carried out at the specified intervals. A fire safety engineer visited regularly for servicing and the home had a written fire risk assessment. Drills for staff were arranged at least six monthly, with records of staff attending, which should help make sure that all staff attend a drill at least annually. • COSHH risk assessments were in place, with guidelines. • A weekly general health and safety checklist was completed and any faults found had been recorded, with the action taken to address them. • Accident and incident records were maintained appropriately. • Notifications of events had been sent to the Commission as required. • Water temperatures were checked regularly and recorded. As some were indicated as being rather high work was to be done on the thermostatic system. The manager confirmed service users could not access the areas where the water could be too hot unsupervised anyway. • Regular checks were made and kept on the home’s vehicle. • Regular checks were made to ensure window restrictors worked properly. • Tests had been made on portable electrical appliances. There were no issues identified that could adversely affect anyone’s health and safety during this inspection. Along with the above information it was evident that due attention was paid to safety in the home. Chepstow House E52 E02 S41406 Chepstow House V240104 290705 Stage 4.doc Version 1.40 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 3 3 3 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 x Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score 3 3 4 3 4 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 Chepstow House Score 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 3 3 x x 3 x Version 1.40 Page 24 E52 E02 S41406 Chepstow House V240104 290705 Stage 4.doc 21 3 Chepstow House E52 E02 S41406 Chepstow House V240104 290705 Stage 4.doc Version 1.40 Page 25 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard Regulation Requirement Timescale for action 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 1 Good Practice Recommendations The service users guide should also be made availble in a format more suitable for people with learning disabilities. Chepstow House E52 E02 S41406 Chepstow House V240104 290705 Stage 4.doc Version 1.40 Page 26 Commission for Social Care Inspection 178 Widemarsh Street Hereford HR4 9HN National Enquiry Line: 0845 015 0120 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 Chepstow House E52 E02 S41406 Chepstow House V240104 290705 Stage 4.doc Version 1.40 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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