Inspection on 21/02/07 for Chiltern View (A)

This inspection was carried out on 21st February 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 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Chiltern View (A) 12/12/07

Chiltern View (A) 18/04/05

Chiltern View (A) 27/11/04

Chiltern View (A) 14/05/04

Chiltern View (A) 22/08/02

Chiltern View (A) 19/03/78

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Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

Pinta

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

CARE HOME ADULTS 18-65 Chiltern View (A) Oving Road Whitchurch Aylesbury Bucks HP22 4ER Lead Inspector Barbara Mulligan Unannounced Inspection 21st February 2007 10:00 Chiltern View (A) DS0000022962.V332032.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 Chiltern View (A) DS0000022962.V332032.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. Chiltern View (A) DS0000022962.V332032.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Chiltern View (A) Address Oving Road Whitchurch Aylesbury Bucks HP22 4ER 01296 641146 01296 641146 N/A londonroad@tiscali.co.uk Milbury Care Services Limited 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) Elizabeth Cypher Care Home 10 Category(ies) of Learning disability (10) registration, with number of places Chiltern View (A) DS0000022962.V332032.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: Chiltern View is registered to provide accommodation for up to ten adults with learning disabilities. The home is owned and staffed by Milbury Care Services and is located in a rural location outside of the village of Whitchurch. The home is not on a bus route and is 15 to 20 minutes walk from a few local shops and pubs. The towns of Winslow and Aylesbury are a short drive away. All bedrooms at the home are single and accommodation is on the ground floor with level access throughout. Service users have a range of learning and physical disabilities. Chiltern View has a cat, Thomas. The fees range from £932.64 to £1229.54 Chiltern View (A) DS0000022962.V332032.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection was undertaken on Tuesday 21st February 2007 at 10am. The visit consisted of discussions with the deputy manager, care staff and service users. A tour of the premises and an examination of the homes records, policies and procedures was undertaken. The inspection officer was Barbara Mulligan. The deputy manager who assisted with the inspection is Gordon Elloway. Twenty-five of the National Minimum Standards were assessed during this visit. Twenty-two of these are fully met, and three almost met. As a result of the inspection the home has received five requirements. No comment cards were received from service users, relatives and/or representatives. The evidence seen and documentation observed indicates that this service meets the diverse needs [e.g. religious, racial, cultural, disability] of individuals within the limits of its Statement of Purpose. The inspector would like to thank the deputy manager, the staff team and service users for their cooperation and assistance during this inspection. What the service does well: The home is a nice and comfortable place to live. There is a good and assessment process in place to make sure the home can meet the needs of the people who live there. Chiltern View (A) DS0000022962.V332032.R01.S.doc Version 5.2 Page 6 The care plans tell the staff how to care for the people living in the home. The people who live in the home are good friends. The home makes sure that the people who live in the home are safe when they go out and take part in activities. The home provides good healthy meals for all the people who live there. Staff have good training to help support the people living in the home. The people who live in the home and their friends and family, are supported to make their views known. Chiltern View (A) DS0000022962.V332032.R01.S.doc Version 5.2 Page 7 What has improved since the last inspection? The home makes sure that the records for medicines are properly completed. The home keeps all the important information and photos of all staff. What they could do better: This inspection at the home has shown 5 things need to be done to make it okay. Staff working in the home must have accredited training in medicines so that the people who live in the home are kept safe. Staff working in the home must have training approved by the local PCT before they are able to give rectal Diazepam stesolids to people living Chiltern View (A) DS0000022962.V332032.R01.S.doc Version 5.2 Page 8 in the home. Dining space in the home must meet the needs of all the people living in the home. Worktops in the kitchen need to be replaced. The smell of damp in the bath/shower is fixed. 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. Chiltern View (A) DS0000022962.V332032.R01.S.doc Version 5.2 Page 9 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 Chiltern View (A) DS0000022962.V332032.R01.S.doc Version 5.2 Page 10 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service Users needs are thoroughly assessed prior to admission, ensuring that staff are prepared for admission and have a clear understanding of the service users requirements. EVIDENCE: The last admission to the home was in 2005. The inspector examined the initial assessment documentation for this individual. This was comprehensive and detailed. The admission tool is fully completed and some areas this covers includes communication, hearing, personal hygiene, dressing, eating, domestic skills, money handling and budgeting. The home manager and a senior support worker completed this. The Deputy manager stated that introductory visits and overnight stays would take place prior to any final placement decisions. The views of existing service users would be taken into account. Chiltern View (A) DS0000022962.V332032.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 good. This judgement has been made using available evidence including a visit to this service. Clear and consistent care planning systems are in place that provides staff with information they need to satisfactorily meet service users needs. Service users make decisions about their lives, with assistance and communication support, that allows them to influence their lifestyle and how the home is run. Service users are supported to take responsible risks within the context of the home’s risk assessments and risk management strategies that ensure service users can have independent lifestyles. EVIDENCE: The home provides individual plans of care for each service user living at the home and these appear to be used as a working tool. Care plans seen are detailed and include communication guidelines, medical information, a pen picture, information regarding daily living, specialist intervention, information about cultural needs, behaviour management plans, Chiltern View (A) DS0000022962.V332032.R01.S.doc Version 5.2 Page 12 information regarding personal care and likes and dislikes. Care plans acknowledge the holistic needs of the service users. Each care plan seen is in line with the service users current needs. There is good evidence of health screening taking place and how the home supports service users to access health advisors. The home ensures that each service user plan is reviewed regularly and involves the individual and where agreed their family or representative. Care Plans are updated regularly. The deputy manager stated that the home do not hold service user meetings. He informed the inspector that individual discussions are held with service users and this is how they are able to make informed discussions about their lives and how choices are made. However there was no evidence of these meetings recorded in care plans and this is strongly recommended. The key worker is responsible for supporting the service user in achieving the objectives set. At the time of the inspection there was one individual using the services of an advocate from Aylesbury Advocates. Risk assessments are in place for using transport, fire, missing persons, finances, personal care, medical and health support needs, physical support and daily living tasks. All risk assessments were found to be up to date, signed and dated by the author. Chiltern View (A) DS0000022962.V332032.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, 14, 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. Service Users can take part in age, peer and culturally appropriate activities, which support and enrich service users social and educational opportunities. Families and friends are welcomed to the home with no restrictions unless previously requested by the service user or significant others. Service users rights are respected and the daily routines of the home promote individual choice and providing service users with the ability to be as independent as their needs allow. Meals are prepared and cooked by staff with the support of service users in line with their capabilities. The service users at Chiltern View enjoy a varied, appealing and nutritious menu. EVIDENCE: Service Users are supported to take part in a variety of activities both in their home and in the local community. One individual attends the local college Chiltern View (A) DS0000022962.V332032.R01.S.doc Version 5.2 Page 14 where he is offered support to undertake life skills such as cooking and using public transport. There is good use of community resources with adequate staff support to access these resources. Seice users are well supported by the home and the organisation in pursuing appropriate activities. The inspector noted that the home has a computer that was donated by a member of staff. Two service users enjoy using this but its use is severely limited due to no Internet access. It is recommended that this be provided to the home to allow service users to pursue their chosen interests and hobbies further. One service user attends a day centre during the day and for a night class in the evening. Some individuals are supported to use public transport. This is difficult for all service users to access due to severe physical disabilities. Service users take part in varied leisure activities and use local community facilities regularly. Examples seen were the local leisure centre, cinema, shops, library, health centre and local pubs and restaurants. Two service users choose to be politically active and vote. The deputy manager said that relationships with nearby neighbours are good and there have been no difficulties encountered. Service users are supported to maintain contact with their families dependent on their own circumstances and personal wishes. There are no restrictions on visiting times and individuals can entertain family and friends as they wish. Staff knocking on bedroom, toilet and bathroom doors maintains the privacy of individuals. If service users are unable to open their mail, staff will open it with the individual and read the contents to them. Preferred term of address are used for service users and this is recorded in the care plans. Care staff seen interacting with service users do so with respect and in a manner that is appropriate to the individual. Service users are supported to choose their own menus. Meals are mainly prepared and cooked by the staff team. All service users are offered a choice of meal and staff support individuals to make healthy choices. The main meal is in the evening and meals are offered three times a day. Service users have access to snacks and drinks throughout the day. The dining room is part of the lounge area and was observed to be too small for the purpose of dining. The inspector observed a lunchtime meal. This needs to be undertaken in at least two sittings because of a severe lack of space. Several service users remain in their wheelchairs whilst having a meal and this was observed to make the already over crowded dining area hazardous and unsafe for both service users and staff. Several service users require full assistance to eat their lunch. The overcrowding does not allow for this to be carried out discreetly, although staff were observed to undertake this in a sensitive manner. Chiltern View (A) DS0000022962.V332032.R01.S.doc Version 5.2 Page 15 One staff member was observed to catch her foot on the wheel of a wheelchair during lunch. Another staff member was noted to be eating her lunch with service users. She had to leave the table on five occasions to attend to a service user in the lounge area. The organisation have been asked to look at ways to resolve this in previous reports, however there does not appear to be any improvement in this area and a requirement has been issued under standard 24. The nutritional needs of service users are assessed and there is evidence of regular monitoring in care plans. Service users are weighed regularly and recorded in care plans. Chiltern View (A) DS0000022962.V332032.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. Service Users needs are outlined in their individual plans ensuring the manner in which they are supported and cared for by staff is appropriate and promotes their preferences. The physical and emotional healthcare needs appear to be well met and ensures the ongoing and changing health care needs of service users are. The management of medications within the home is conscientiously undertaken by staff, effectively protecting service users. However staff training for the administration of medicines must be accredited and approved by the local PCT. EVIDENCE: Information regarding personal care is recorded in the individual care plans. Service users are supported to choose when they like to go to bed, have a bath, have their meals and take part in other activities. Care plans set out in detail the service users preferred routines, likes and dislikes and partnerships with families and friends. Staff ensure that personal care is flexible, consistent and responsive to the changing needs of service users. This is well documented in care plans. Chiltern View (A) DS0000022962.V332032.R01.S.doc Version 5.2 Page 17 There is good evidence of health care screening in care plans. Visits to the home from healthcare professionals take place in the service users bedrooms. Service users are able to choose their own GP and have access to all NHS healthcare facilities in the local community. The inspector was informed that the dietician has advised the home about diets and nutritional screening appears to be good and this is well recorded in care plans. The home have also gained advice from an eating and swallowing advisory group. Staff provide support to individuals needing to attend outpatient and other appointments. There is evidence that eye screening is being undertaken on a six monthly basis and an optical service visits the home to carry this out. Dental services are accessed via the hospital and check ups are carried out six monthly. Chiropody Services are accessed on a needs only basis. An aroma-therapist visits service users fortnightly to massage feet and help with relaxation. Additional support is accessed through the Community Learning Disabilities team where service users can access physiotherapists, occupational therapists, speech therapists, and community dietician and continence advisor. Eight service users have Epilepsy and several attend the National Society for Epilepsy to ensure their epilepsy is closely monitored. None of the service users in the home are able to self-administer their own medication. Following the previous report a requirement was issued that staff must maintain accurate records of drugs administered to service users. Medication records seen were fully completed with no omissions noted. It is pleasing to see that this requirement has been complied with. The home uses a monitored dosage system. There were no out of date medications held in the service users home with a returns procedure in place. There are no controlled drugs in use at the time of the visit. One hand written entry for eye drops was observed on the MAR sheet. This was not signed by any staff member and it is strongly recommended that all hand written entries are signed by two staff. There are several service users who require rectal stesolids when they have epileptic seizures. A Registered Nurse employed by the organisation has provided training for this procedure. However, the organisation must ensure that this training is approved by the local PCT, and evidence of this is sent to the Commission for Social Care Inspection. This will be a requirement of the report. Training records demonstrate that the registered manager has undertaken accredited training in the safe handling of medicines. She then provides Chiltern View (A) DS0000022962.V332032.R01.S.doc Version 5.2 Page 18 training for the staff at Chiltern View. However, medication training must be accredited for all staff and this will be a requirement of the report. Chiltern View (A) DS0000022962.V332032.R01.S.doc Version 5.2 Page 19 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 Organisation has a robust complaints procedure which is accessible to service users and significant others, enabling them to make a formal complaint appropriately. Policies and procedures to protect service users from abuse are in place and staff receive up to date POVA training, ensuring service users are not at risk of abuse and harm and their rights to be safe are protected. EVIDENCE: The organisation has a complaints procedure and the home have made this available in picture for service users. A copy of this is available in every individual’s bedroom. The complaints procedure needs to include the address for the new hub office in Oxford. The deputy manager stated that the organisation are in the process of updating their complaints procedure and it is recommended that this is completed as soon as possible. Copies of the complaints procedure are included in the Statement of Purpose and the Service Users Guide and this gives guidance about referring a complaint to the Commission for Social Care Inspection. The inspector examined the complaints log and there are no recorded complaints since 2004. The deputy confirmed that this is correct. The Commission for Social Care Inspection have not received any complaints in the previous twelve months. The home uses the Bucks Multi Agency POVA policy and an organisational policy in conjunction with this. This includes guidelines for staff about the Chiltern View (A) DS0000022962.V332032.R01.S.doc Version 5.2 Page 20 responsibilities of the staff, types and signs of abuse and what to do if you suspect abuse. All care staff receive training about Adult Abuse and this forms part of their induction. There have not been any allegations of abuse reported to the Commission. The homes policies regarding service users money and financial affairs ensure service users access to their money, valuables and safe storage is safe guarded. Staff are instructed during induction about physical and verbal aggression by a service user. Chiltern View (A) DS0000022962.V332032.R01.S.doc Version 5.2 Page 21 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, 27, 28, 29 and 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The standard of the environment within the home is adequate and provides service users with an attractive and homely place to live. However designated dining space does not meet the collective needs of service users. The overall quality of the furnishings and fittings is good ensuring the safety and comfort of service users. Standards of cleanliness at the home appear to be good meaning that service users live in an environment that is clean and hygienic, protecting their health, safety and welfare. EVIDENCE: Chiltern View is a residential home providing care and support to ten adults with a learning disability. The home is owned and staffed by Milbury Care Services and is located in a rural location outside of the village of Whitchurch. The home is not on a bus route and is 15 to 20 minutes walk from a few local shops and pubs. The towns of Winslow and Aylesbury are a short drive away. Chiltern View (A) DS0000022962.V332032.R01.S.doc Version 5.2 Page 22 All bedrooms at the home are single and accommodation is on the ground floor with level access throughout. Service users have a range of learning and physical disabilities. Chiltern View has a cat, Thomas. There is one communal lounge. This is nicely decorated, bright and homely. The lounge is also used as a dining area. This is not large or adequate enough for its intended purpose. Lunch was observed to be chaotic and rushed. Several service users are required to remain in their moulded wheelchairs whilst eating. These are large and cumbersome. This adds to the already over crowded dining area making it hazardous and unsafe for both service users and staff. Several service users require full assistance to eat their lunch. The overcrowding does not allow for this to be carried out discreetly. One staff member was observed to catch her foot on the wheel of a wheelchair during lunch. Another staff member was noted to be eating her lunch with service users. She had to leave the table on five occasions to attend to a service user in the lounge area. The organisation have been asked to look at ways to resolve this in previous reports, however there does not appear to be any improvement in this area. The designated area for dining does not meet the collective needs of the service users in a homely, safe and comfortable way. It is a requirement of this report that the organisation ensures that dining space is adequate to meet the individual and collective needs of service users and ensures that mealtimes are relaxed, unrushed and flexible. The kitchen is well equipped and spacious. This was observed to be clean and well looked after. Worktops are worn and need to be replaced. This will be a requirement of the report. The furnishings observed in communal areas are of good quality and suitable for the range of interests and activities preferred by service users. Lighting in communal areas is domestic in character and sufficient to facilitate reading and other activities. The home has a pleasant garden that is maintained by staff and service users. There are no CCTV cameras in use within the home at the time of the inspection. There are accessible toilets available for service users throughout the home. The shower room smells strongly of damp and the paint is peeling off the lower walls in this room. The organisation must investigate the cause for the strong smell of damp and ensure that remedial action is taken to resolve this. This will be a requirement of the report. Laundry facilities are sited so that soiled articles, clothing and infected linen are not carried through areas where food is stored, prepared, cooked or eaten and do not intrude on service users. The home has an infection control policy and the inspector observed this. Chiltern View (A) DS0000022962.V332032.R01.S.doc Version 5.2 Page 23 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 good. This judgement has been made using available evidence including a visit to this service. Service users benefit from a staff team who are appropriately trained to ensure that service users are cared for by skilled staff at all times. There are effective recruitment procedures in place to ensure service users are protected from harm. There is a staff training and development programme that ensures staff fulfil the aims of the home and meet the changing needs of service users. EVIDENCE: Staff are aware of the organisations policies and procedures and understand how their work, and that of other staff, promotes the main aims of the home. There is written evidence that is achieved through staff meetings, and formal staff supervision sessions. There were no staff members under the age of eighteen and there are no staff under the age of twenty one left in charge of the home at any time. At the time of the inspection the registered manager has achieved NVQ level 4, two staff have achieved NVQ level 2 and another support worker has a certificate in health and Social Care. Chiltern View (A) DS0000022962.V332032.R01.S.doc Version 5.2 Page 24 Following the previous inspection a requirement was issued for the full CRB certificate or confirmation of enhanced level clearance and the outcome to be available for inspection. On the day of inspection these were not held in the home, however confirmation of CRB checks were sent via fax from the head office. The inspector requested to look at the recruitment files for staff including the most newly appointed staff. These were unavailable for inspection because the deputy manager did not have access to these files. However, with the exception of CRB checks being held in the home the recruitment process was assessed as being robust at the previous inspection. The inspector spoke to a newly employed member of staff who was in her second week working at the home. She confirmed the recruitment process had taken place and felt that this had all been completed smoothly. There is an induction programme in place to ensure that new staff members are familiarised with the organisation and their roles and responsibilities and provides the staff member with a personal development portfolio. This includes fire safety, moving and handling techniques and core skills training. Training records reflect that staff have received mandatory training and this appears to be up to date for all staff. There is specialist training available for staff, an example of this is Autism training, Epilepsy training and non-violent crisis intervention. Staff confirmed that there are regular staff meetings. Chiltern View (A) DS0000022962.V332032.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, 39 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager appears to be supported well by the staff team in providing clear leadership and demonstrating an awareness of their roles and responsibilities to the benefit of the service users. Various methods of measuring quality assurance are in place based on seeking the views of service users to measure success in achieving the aims, objectives and statement of purpose of the home. There are systems within the home that are used to ensure that service users health, safety and welfare are protected and promoted. EVIDENCE: The present registered manager was unavailable during this inspection. However, the deputy manager was available to assist with this inspection. Training records for the registered manager were available and demonstrate that she is up to date with all mandatory training and has completed the Chiltern View (A) DS0000022962.V332032.R01.S.doc Version 5.2 Page 26 Registered Managers Award. Further specialist training includes sensory activities workshop, safe and enjoyable mealtimes and control of asbestos and legionella in the work place. The registered manager appears to be well supported by the staff team and staff supervision and team meetings occur regularly. The home has a complaints procedure in place and a whistle blowing policy, which enable staff and service users to voice concerns and affect the way in which the service is delivered. The organisation undertakes monthly Reg 26 reports and these were available for inspection. The deputy manager said that the organisation send out service satisfaction questionnaires regularly but is unsure what happens to these once they have been returned. The inspector requests a copy of the outcome of the recent Quality Assurance audit. There is monthly monitoring of accidents in the home and relatives are invited to service user reviews if it is requested. Records were seen for fire safety. Fire records are comprehensive and up to date. The homes fire risk assessment is dated December 2006. There is evidence of weekly testing of the fire alarms and regular checks of emergency lighting and fire equipment. Fire training appears to be up to date for staff. The last inspection of the home by the Fire Authority was 08/05/06. Mandatory training is up to date for all staff and this includes moving and handling, infection control and basic food hygiene training. Service reports are in place for PAT testing dated March 2006,gas boiler certificate is dated 21/07/06. The certificate for electrical installation could not be found and the inspector requests notification be sent to the Commission, with the date this was last completed. There is evidence of monthly health and safety checks and regular water temperature checks. COSHH sheets are up to date and accurate. The inspector looked at Infection Control guidelines that are available for all staff. Chiltern View (A) DS0000022962.V332032.R01.S.doc Version 5.2 Page 27 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 2 25 X 26 X 27 3 28 2 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 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 3 X 3 X X 3 X Chiltern View (A) DS0000022962.V332032.R01.S.doc Version 5.2 Page 28 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 YA20 Regulation 13(2) Requirement The registered provider is required to ensure that training in the administration of rectal stesolids is approved by the local PCT and confirmation is sent to the Commission for Social Care Inspection. The registered provider is required to ensure that training in the administration of medicines is accredited for all care staff. The registered provider is required to ensure that dining space meets the collective needs of service users in a safe, comfortable and safe way, and allows for meals to be taken in a congenial setting. The registered provider is requested to send an action plan of how this will be achieved to the Commission. The registered provider is required to ensure that the worktops in the kitchen are replaced. The registered provider is required to ensure that they investigate the possible cause for the damp in the shower room DS0000022962.V332032.R01.S.doc Timescale for action 30/04/07 2 YA20 13(2) 30/08/07 3 YA28 23(2) 30/05/07 4 YA24 23 30/06/07 5 YA24 23 30/06/07 Chiltern View (A) Version 5.2 Page 29 and then undertake any action necessary to resolve this. 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 YA7 Good Practice Recommendations It is strongly recommended that outcomes from individual meetings with service users are recorded in care plans and demonstrate how service users make informed decisions and how choices are made. It is recommended that Internet access is provided to the home. It is strongly recommended that all handwritten entries made on the medication records are signed by two staff It is recommended that the organisations complaints procedure is updated to include the address of the Oxford hub office. 2 3 4 YA14 YA20 YA22 Chiltern View (A) DS0000022962.V332032.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Oxford Office Burgner House 4630 Kingsgate Oxford Business Park South Cowley, Oxford OX4 2SU 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 Chiltern View (A) DS0000022962.V332032.R01.S.doc Version 5.2 Page 31 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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