CARE HOME ADULTS 18-65
Chippings 28 Russells Crescent, Horley, Surrey, RH6 7DN Lead Inspector
Penelope Calthrop Unannounced 07 July 2005 10:00 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. Chippings H58-H09 S13601 Chippings V234309 070705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Chippings Address 28 Russells Crescent Horley Surrey RH6 7DN 01293 775350 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) Gresham Care, Berry House, 58 High Street, Bletchingley, Surrey, RH1 4PA To be confirmed CRH Care Home 6 Category(ies) of LD Learning disability, 6 registration, with number of places Chippings H58-H09 S13601 Chippings V234309 070705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: 1 The age/age range of the persons to be accommodated will be: 18-45 YEARS Date of last inspection 23 Novemer 2004 Brief Description of the Service: Chippings is a detached house situated in a residential area of Horley. The property is owned by Gresham Care, who have a number of similar homes in the area. The home is registered for six service users with learning disabilities, aged between 18 and 45 years. The home was fully occupied at the time of the inspection by six male service users. All accommodation is provided in single rooms and set out on two floors. The care home has a large lounge, a kitchen adjoining a dining room, and there is a large enclosed garden to the rear of the property with a swing. Other communal facilities consist of two bathrooms on the first floor and a shower room on the ground floor. The home also benefits from its own snoozelam room upstairs, which other Gresham care service users access at times.. The home is very close to the centre of Horley with its facilities including a railway station and the larger towns of Crawley and Redhill are also close by. Chippings H58-H09 S13601 Chippings V234309 070705 Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place on one day over a period of five hours. Part of the focus for the inspection was in response to a complaint that had been received about the home, regarding damage to an external boundary, damage to property, lack of supervision of service users, safety concerns and lack of garden maintenance. Four elements of the complaint were upheld and one was partially upheld. The home has had to cope with some changes during the last ten months. The previous manager has moved on elsewhere within the organisation, which has resulted in a new manager being appointed. During this period, there have also been changes to the service user group at the home and other staff changes. The home manager was present for the visit and the home -owner for a short period. All six service users were seen during the visit, although were taking part in activities during the day. The home had a lively and busy atmosphere. A tour of most of the premises took place that included the gardens. Records were viewed including complaints documentation, care plans and risk assessments. Due to the communication difficulties that the individuals living in this home have, their direct views could not be obtained. Observations indicated that they were confident in their approaches to staff and that staff could understand some of their speech. Makaton, a form of sign language was seen being used by both some of the individuals and the staff to assist in communication. On arrival at the home, one individual was in the office using the home’s computer to compile the menu for the week. A group of three service users were about to go swimming with staff and two others were going into Horley with a staff member to have their hair cut and go for a drink afterwards. No staff interviews were held on this occasion Positive comments were received from one relative stating the ‘home has a caring home environment,’ other positive comments from the same source cannot be documented as they may identify the service user concerned. Feedback from another relative indicated that they would like the home to provide more information about what is happening day to day with their relation, without having to ask staff. They suggest weekly or monthly information being provided. A third set of relatives feedback stated they ‘were delighted with the standard and quality of care received at Chippings’ and named a staff member as being ‘particularly helpful and supportive’. Feedback received from a care manager indicated that they were satisfied with the level of care provided to the service user/s they are involved with. One set of feedback from a relative indicated they were not welcomed in the home by staff/owner at all times, but no further detail was provided.
Chippings H58-H09 S13601 Chippings V234309 070705 Stage 4.doc Version 1.30 Page 6 What the service does well: What has improved since the last inspection? What they could do better:
The change to the new care plan format needs to be completed, as there was evidence from the manager that some updating and addition to information is being put on ‘hold’ pending this change. An example given was clearly documenting service users emotional needs, which is planned for the new format. This will benefit service users but is not as clear as it could be on existing care plans. Additional risk assessments on one service user, identified to the manager during the visit are needed and a requirement was made regarding this. A recommendation was made that when completing risk assessments, the action taken to minimise the risk occurring should be expanded. Chippings H58-H09 S13601 Chippings V234309 070705 Stage 4.doc Version 1.30 Page 7 Requirements were also made in the area of the environment and health and safety of service users, which were connected to the complaint that was being investigated. These were regarding the need to include the garden in the regular health and safety audit; the ensuring of adequate supervision of service users when out at the front of the home, particularly one identified individual; that guidelines are in place for the supervision of service users in the back garden, particularly one identified individual; that staff are vigilant in identifying and removing objects from the garden, that could be thrown into adjoining properties. These requirements will help tighten the home’s existing guidelines and working practices and minimise the risk to individuals and others of their safety being compromised. A requirement was also made regarding the malodour still present in the downstairs toilet/shower room. This has previously been addressed by the home, but needs further attention for the benefit of all service users. It was recommended that the hedge in the rear garden be cut. Recommendations were made regarding the manager organising to meet relevant parties to discuss a situation about one individual identified on the visit. The outcome from this meeting should also address safety concerns identified on the visit for this individual. A recommendation was made that the advice of a dietician be sought, particularly for the benefit for one individual with dietary issues. This will ensure that staff receive professional guidance in managing the situation, which will in turn benefit the service user concerned. As the dietician will look at the meals eaten at the home, the rest of the service users will also benefit from having the menus nutritional content checked. A requirement is made regarding the need for more staff to enrol for NVQ training, to meet minimum government targets for 2005. This will also ensure that staff have the knowledge to underpin the care they are giving to the benefit of service users. It was also recommended that new staff attend training in the protection of vulnerable adults.Two recommendations previously made have yet to be addressed and are included again in this report. These are that the training needs for the home as a whole need to be identified for the year and that the home develop local policies, involving service users in this. It is evident that individuals at this home could contribute to this process and would then ‘own’ the policies they have helped to develop. These were discussed with the manager and the inspector concluded that the change in management had contributed to delays in addressing these matters. 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. Chippings H58-H09 S13601 Chippings V234309 070705 Stage 4.doc Version 1.30 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 Chippings H58-H09 S13601 Chippings V234309 070705 Stage 4.doc Version 1.30 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) None of these standards were assessed on this visit and will be looked at on the second statutory inspection later in the year. EVIDENCE: Chippings H58-H09 S13601 Chippings V234309 070705 Stage 4.doc Version 1.30 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 & 9. Care plans were in place and risk assessments formed part of the care planning process. These are updated as needed to reflect changes in service users needs, but this process is currently affected by the home’s move to a new form of care plan yet to be completed. EVIDENCE: The home manager explained that the home are in the process of changing to a new form of care planning. When this occurs, each individual in the home will have a key worker amongst the staff team, who will take the lead in working to meet their particular needs. There was evidence that care plans are being reviewed regularly and the documentation for a review that had taken place recently was seen. Service users emotional needs are not currently identified on care plans, but in discussion with the home manager he offered the opinion that the new format would naturally address this. It was recommended that this is ensured. It appeared through discussion with the manager, that putting some updated information to paper is waiting until use of the new care plans is commenced. No date was given for when this might be, a recommendation was made that this be completed as soon as possible. Risk assessment documentation was in place and was sampled. The manager was in the process of reviewing and updating all risk assessments for
Chippings H58-H09 S13601 Chippings V234309 070705 Stage 4.doc Version 1.30 Page 11 individuals, evidence for this could be seen in some that were part completed on the computer. A recommendation previously made regarding the amount of detail recorded, regarding actions to be taken to reduce the given risk had been addressed. However, the inspector concluded that this area would still benefit from further expansion, which was discussed with the home manager on the visit. One individual’s risk assessments were viewed in detail. Although there were a number recorded, given the behaviours that this service user has, requirements were made that further specific risk assessments were put in place. Chippings H58-H09 S13601 Chippings V234309 070705 Stage 4.doc Version 1.30 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) 12, 13, 16 & 17. The home shows attention to promoting a fulfilling lifestyle for the service users living there. Activities are varied with some individuals attending college and two having part time jobs. Involvement in meal planning and preparation is promoted and could be seen taking place during the visit. EVIDENCE: Five of the service users living at the home attend college, with the number of days per week varying according to needs and appropriate courses being offered. This helps these service users to continue with their education and gives some structure to the day. The manager explained that finding the type of course appropriate to an individual can be a challenge, but this is crucial to ensuring that they will both enjoy and obtain benefit from college. At the time of this visit it was the college holidays, so the home had arranged some additional activities for service users to enjoy. Two individuals work part time locally, with one being supported by staff to do this. Service users are known within their community and are able to use the facilities offered such as the library, shops, pubs, cafes, horse riding, leisure centre and public transport. Staff were observed to be respectful of service users rights during the visit. A staff member was heard knocking before entering an individual’s room and
Chippings H58-H09 S13601 Chippings V234309 070705 Stage 4.doc Version 1.30 Page 13 enquiring whether he wanted lunch yet, as others were about to have theirs. When he declined, this was accepted as his right to wait until he was ready to eat. A previously made recommendation regarding the reasons for non issue of room keys to service users has been met. Two individuals do hold their own keys and are able to lock their room doors. All service users can freely access communal areas of the home, although the front garden has restricted access via the front door for service users safety. This as the front of the home is not a secure area. The home’s menu is planned a week in advance and service users are involved in this process. The home have a box of photographs of food and meals, thus enabling those who might lack the ability to give a verbal choice to express their opinions. The home’s main meal is eaten in the evening, when service users and staff sit down to eat together. One individual needs some assistance to eat. Breakfast and lunch times are flexible, according to when individuals get up and what activities might be talking place. Four service users are able to get their own breakfast. Some assist with the preparation of the main meal and this was seen on the day of this visit when a service user was observed assisting with peeling vegetables with staff. Snacks are reported to be available to individuals at any time if they are hungry. One service user has some issues around food and managing his dietary intake can be a challenge for the staff. It was recommended that the advice of a dietician be sought, so that the home can ensure that his nutritional needs are being met. Chippings H58-H09 S13601 Chippings V234309 070705 Stage 4.doc Version 1.30 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) 19. The health care needs of service users in this home are well met, with evidence of both routine and specialist appointments being sought where needed. The home needs to document service users emotional health needs as part of their care plan, to ensure that these are then met. EVIDENCE: There was evidence of attention to health needs of service users living in the home. Routine type appointments are arranged such as the optician and dentist. Annual ‘well man’ checks are arranged with the GP for all service users, apart from other visits that may be needed during the year. Some individuals have input from other medical professionals, such as the occupational therapist and specialist nurse for some specific conditions. There was evidence that the manager pays attention to ensuring staff understand the specialist needs of service users health. This by providing accessible information for them to read and arranging visits from professionals to talk to them about various conditions. The monitoring and recording of specific symptoms associated with one individual’s condition was seen. This is then available to the nurse when they visit, as a means of monitoring the service user’s condition. Chippings H58-H09 S13601 Chippings V234309 070705 Stage 4.doc Version 1.30 Page 15 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. The home works to the Gresham Care complaints procedure, which is robust in it’s content. Copies of any complaint made are held on site at the home. Service users are protected from abuse by the measures in place at the home. EVIDENCE: Part of the purpose of this visit was to investigate a complaint that was made to CSCI regarding damage to an external boundary, lack of supervision for service users, damage to private property, lack of garden maintenance and safety concerns. Some elements of this complaint were upheld and one element was partially upheld. Some requirements and recommendations have been made as a result of this investigation and are included in this report. This will improve care practices by staff, which are already judged to be good at this home. A previous complaint had also been made to the home, regarding some damage to a boundary. There was documentary evidence on site at the home of the complaints and correspondence entered into regarding these. Both the manager and deputy manager have attended the multi agency training on protecting vulnerable adults. This should ensure senior staff at the home are particularly clear about responsibilities and actions required, in respect of ensuring service users at the home are protected from abuse or neglect. The remainder of the staff access other external training. The manager reported that some new staff have yet to attend this, it is recommended that this is booked for those requiring this as soon as possible. The home has Gresham Care procedures in place regarding protecting service users, which includes reference to the Department of Health guidance’ No Secrets’. The manager reported that occasionally two
Chippings H58-H09 S13601 Chippings V234309 070705 Stage 4.doc Version 1.30 Page 16 service users may display aggressive tendencies. Risk assessments were reported to be in place with regard to this and the manager explained that known strategies usually worked to diffuse the situation. It is planned that all staff will have training in working with those who have behavioural difficulties, three staff members are reported to have undertaken some specialist training in case of the need to use restraint to protect service users. Chippings H58-H09 S13601 Chippings V234309 070705 Stage 4.doc Version 1.30 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, 28, 29 & 30. The environment is a comfortable one for the service users who live in the home. However, requirements are made some of which relate to health and safety and need to be complied with in view of this. The home was clean and hygienic on the day of the inspection, although one area needs further attention to fully address an odour that persists. EVIDENCE: The home was observed to be clean and comfortable on the day of this visit. Work is planned for later in the year to the kitchen and ground floor bathroom to upgrade these areas to better meet the needs of service users. New flooring had been laid in one of the bedrooms, landing and in the bathrooms since the last inspection, which has helped these areas look clean and fresh. Shared spaces in the home are accessed by all service users. The home is fortunate in having a sensory room on the first floor, which service users can use. This is also utilised by other Gresham Care individuals, but is booked in advance and limited to certain times to prevent too much intrusion into the home by outsiders. One of the service users living at the home will readily damage areas of paint work and plaster, particularly in his room. The manager explained that they have a system whereby he is now expected to assist to repair or repaint damage with staff as it occurs. This involves staff being
Chippings H58-H09 S13601 Chippings V234309 070705 Stage 4.doc Version 1.30 Page 18 vigilant and responsive and seems to be working well. Some aids were seen to have been installed since the last visit. These include banisters to both sides of the stairs, and an extension to safety rails on the landing area. These are for the benefit of one service user in particular and a change to the ground floor bathroom is also planned to benefit this same individual. There was a malodour present in the downstairs toilet/shower room, which had been raised at the time of the last inspection visit. Although action had been taken to address this, there was still a problem apparent, which needs to be addressed and a requirement was made in regard to this. This needs to be completed so that individuals using this room do not have to do so in unpleasant conditions. Outside and part of the reason for the complaint, damage was evident to areas of hedging to the front of the property. This is being addressed by the home owner who is planning an alternative to the hedge. To the rear, the hedge to one side would benefit from cutting and this was recommended to the home manager. A quote for new fencing adjoining the hedge has also been obtained. Please also see comments made in section 37-42 under health and safety and requirements made. Chippings H58-H09 S13601 Chippings V234309 070705 Stage 4.doc Version 1.30 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 & 35. The staff team at the home are competent to meet the needs of the service users. The home has had some staff changes, including a change in manager during the past year. More staff need to achieve NVQ level two, to ensure that the home is meeting the government’s minimum training requirements. EVIDENCE: The manager spoke about ensuring staff understand the role of being a key worker, which will form part of the change to the new system of care planning. He is planning training for staff on this. Staff are informed about their role and other differing roles within the home and organisation as a whole during their induction, which either the manager or deputy are responsible for. This ensures they fully understand the aims of the organisation and home. Each staff member has a job description in place. There were adequate staff on duty in the home to meet service users needs on the day of the inspection. There are a minimum of three staff on duty during the daytime, but this may be as many as six depending on what activities are happening. This ensures service users have the support they need at all times to attend the activities scheduled for them. At night there is one waking staff and one sleeping in. The manager reported that staffing numbers are sufficient to cover the needs of the home. Four staff are new to the home and there is still one vacancy being recruited to. Any gaps in the rota are filled by permanent staff, or those from other
Chippings H58-H09 S13601 Chippings V234309 070705 Stage 4.doc Version 1.30 Page 20 Gresham Care homes, which means service users always know the staff who are supporting them. No agency staff are used. Two staff have achieved their NVQ level 2, with a further one being part way through this. Another was reported to have stopped part way through, due to external problems with the support available. The home manager must ensure that more staff enrol onto NVQ courses, to ensure that staff have the knowledge to underpin the care they are giving. It was acknowledged that there are four new staff members, but a requirement was made in respect of this. Some staff training needs were discussed with the home manager, who advised he has service specific training planned in; person centred planning, working with behavioural difficulties and epilepsy. The new staff have mandatory training needs, which the manager is planning for. A previously made recommendation remains regarding producing an overall training needs plan for the home. Please also see recommendation made under standard 23 in respect of new staff accessing vulnerable adults training. Chippings H58-H09 S13601 Chippings V234309 070705 Stage 4.doc Version 1.30 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) 40, 41 & 42. Policies and procedures are in place and there is evidence of good record keeping at this home. There is attention to health and safety, but requirements have been made in this area. EVIDENCE: The home has Gresham Care policies and procedures in place. The manager reported that these have just been updated by the organisation’s general manager, who consults with all the home managers during this process. This ensures that staff work to current and relevant policies, that are workable in practice. This in turn is to the benefit of service users at the home. A previously made recommendation remains regarding involving service users in developing some local home policies. Appropriate records were seen to be kept by the home for its effective operation and for the well being of service users. This included any notification made to relevant statutory bodies under regulation 37 of The Care Homes Regulations 2001. The home has a designated member of staff who takes the lead within the home on matters of health and safety. A weekly audit is undertaken of the
Chippings H58-H09 S13601 Chippings V234309 070705 Stage 4.doc Version 1.30 Page 22 home, but a requirement was made that this be extended to include the garden area. Checks should be made of communal boundary areas so that any damage sustained is identified and attended to early on. The home manager reported that staff undertake visual checks of the home daily in order to identify potential safety and welfare issues. A requirement was made that this must include the identification of and removal of any objects lying in the garden, that could be thrown by one particular service user. A requirement was also made that guidelines for staff regarding the level of supervision for individual service users when out in the back garden are in place. One identified individual must be supervised when out in the garden. This is for the welfare of all those living at the home, as well as those living in adjoining properties. Maintenance requests are attended to by the organisation’s maintenance man, with external professionals brought in as necessary. Both the home manager and deputy are fully qualified in first aid, with other staff attending annual basic training in this. This ensures that when needed, service users in this home will receive prompt medical type attention from staff appropriately trained to do this. Sharp knives are in a locked drawer in the kitchen based on a risk assessment for the protection of service users. Necessary fire checks were seen to be being carried out, with a practice monthly evacuation of service users. Documented guidelines were seen to be in place for staff to follow in the event of any service user refusing to evacuate the home. Chippings H58-H09 S13601 Chippings V234309 070705 Stage 4.doc Version 1.30 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 x x x x x Standard No 22 23
ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10
LIFESTYLES Score 3 x x 2 x
Score Standard No 24 25 26 27 28 29 30
STAFFING Score 2 x x x 3 3 2 Standard No 11 12 13 14 15 16 17 x 3 3 x x 3 3 Standard No 31 32 33 34 35 36 Score 3 2 3 x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Chippings Score x 3 x x Standard No 37 38 39 40 41 42 43 Score x x x 3 3 2 x H58-H09 S13601 Chippings V234309 070705 Stage 4.doc Version 1.30 Page 24 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 9 Regulation 13(4)(b) Requirement That additional risk assessments must be put in place in respect of getting into and out of the home’s vehicle and on returning from visits home for one identified individual As part of the regular health and safety check of the home, the garden area including fences and hedges must be checked. Staff must be vigilant in observation and immediate reporting of any damage noted. The home manager must ensure that all staff are vigilant in removing items from the back garden, that may be thrown into adjoining gardens. There must be further attention to dealing with the malodour present in the downstairs toilet/shower room More staff must be enrolled for NVQ training in order for the home to meet 2005 training targets. That the home manager ensure that necessary guidelines for staff supervision of individual service users when they are in the back garden, are in place. Timescale for action 7/8/05 2. 24&42 13(4 c) Immediate 7/7/05 3. 24&42 13(4)(b) Immediate 7/7/05 4. 30 23(2)(d) 7/8/05 5. 32 18(1)(a) 7/10/05 6. 42 13(4)(b) Immediate 7/7/05 Chippings H58-H09 S13601 Chippings V234309 070705 Stage 4.doc Version 1.30 Page 25 One service user identified must be supervised when out in the back garden. 7. 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. 2. Refer to Standard 6 9 Good Practice Recommendations That the change to the new form of care planning is completed as soon as possible and that emotional needs are identified within these. That the home manager meet with all interested parties including the care manager, in respect of one identified individual to best plan how to manage the situation discussed on the visit. That within risk assessment documentation, there is further expansion of actions to be taken to minimise the risk from occurring. The advice of a dietician should be sought for one individual with dietary issues to ensure nutritional needs are being fully met. All new staff should attend protection of vulnerable adults training as soon as possible. The hedge to the rear of the home should be cut as part of routine maintenance. There should be a general training plan for the home. Some local policies should be developed with the input of service users. 3. 4. 5. 6. 7. 8. 9 17 23 24 35 40 Chippings H58-H09 S13601 Chippings V234309 070705 Stage 4.doc Version 1.30 Page 26 Commission for Social Care Inspection The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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