Inspection on 01/12/05 for Cromwell Avenue (9)

This inspection was carried out on 1st December 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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Cromwell Avenue (9) 11/04/07

Cromwell Avenue (9) 01/06/05

Similar services:

Chesham House

Argyll House

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

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

CARE HOME ADULTS 18-65 Cromwell Avenue (9) 9 Cromwell Avenue Cheshunt Herts EN7 5DJ Lead Inspector Tom Cooper Unannounced Inspection 3.30 1 December 2005 st Cromwell Avenue (9) DS0000061442.V265291.R01.S.doc Version 5.0 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 Cromwell Avenue (9) DS0000061442.V265291.R01.S.doc Version 5.0 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. Cromwell Avenue (9) DS0000061442.V265291.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Cromwell Avenue (9) Address 9 Cromwell Avenue Cheshunt Herts EN7 5DJ 01992 622032 01992 622032 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) Residential Community Care Services Ltd Care Home 4 Category(ies) of Learning disability (4), Mental disorder, registration, with number excluding learning disability or dementia (4) of places Cromwell Avenue (9) DS0000061442.V265291.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 1st June 2005 Brief Description of the Service: 9 Cromwell Avenue is a care home first registered in August 2004, providing personal care and accommodation for four young adults with learning disability and associated mental disorder. The home is owned and operated by Residential Community Care Services (RoCCS), a private organisation. This is the third home RoCCS has established in Hertfordshire within the past four years. The home consists of a four bedroom terraced house situated in a residential street in Cheshunt, next door to the GP’s surgery and across the street from a small grocery shop. It is in walking distance of other local shops and parks, and close to public transport. All the homes bedrooms are single, with en-suite facilities. The garden contains a patio and grass area, with a pond protected by a small fence, and a gravelled area that can be used for ball games. Cromwell Avenue (9) DS0000061442.V265291.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second unannounced inspection for the current inspection year and took place on a weekday in the late afternoon and evening. The main focus of the inspection was to check compliance with the statutory requirements and any action taken in respect of the recommendations made at the last inspection as well as evaluating the service users’ experience of living in the home. Discussions were held with the registered manager, staff on duty the four service users in residence and a visiting relative. Documentation checked included two service users’ care plans, records of activities, risk assessments, fridge/freezer temperature records, medication records, the complaints procedure and proprietor. A tour was made of the premises. The staff and residents were very friendly and welcoming. The inspection indicated that the home was running well with the service users clearly enjoying their lives in the home and forging very positive relationships with staff. Requirements have been made in respect of medication recording, a matter of fire safety and the proprietor’s monthly reports on the conduct of the home. What the service does well: All four residents were present during the inspection and were keen to show off their rooms, their possessions and to talk about their current routines and activities. The relationships observed between staff and residents were natural and vibrant and there was a lively atmosphere in the home. The four residents are very active and demand considerable attention from staff, who know how to respond appropriately and offer support and guidance in a sensitive way. The residents said they really liked living at the home and explained how they were able to make decisions for themselves in virtually all areas of their lives, supported by staff as necessary. Staff are very aware that their principal role is to assist the residents to develop and maintain as much independence as possible, with the result that the establishment is very much the residents’ home. A visiting parent of one of the residents said that she was very happy with the service provided and commented on the excellent progress made by her son since his admission. Cromwell Avenue (9) DS0000061442.V265291.R01.S.doc Version 5.0 Page 6 Thorough and detailed assessments were made for each resident prior to admission. From these, care plans have been drawn up that are detailed and practical, providing clear overviews of individual needs and the actions agreed with the resident to meet the goals and aspirations set. Staff continuously monitor individual progress and review and update care plans accordingly. Staff have good access to relevant training opportunities and said they felt very well supported and supervised. The manager, who is very experienced in social care, sets the tone for the team and provides strong leadership. What has improved since the last inspection? What they could do better: Residents and staff both expressed great satisfaction with the service and the standard of care provided and made no suggestions for improvements. Care must be taken by staff always to sign on the medication administration record (MAR) sheets for doses of medication given to residents as two gaps were found in the records checked. Fire doors must not be held open by the use of door wedges or armchairs. Suitable door holding devices should be fitted if it is felt desirable for doors to be kept open. Following on from the last inspection, some minor amendments have been recommended for the policies on confidentiality, infection control and physical intervention so that they comply with current good practice. Cromwell Avenue (9) DS0000061442.V265291.R01.S.doc Version 5.0 Page 7 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. Cromwell Avenue (9) DS0000061442.V265291.R01.S.doc Version 5.0 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Cromwell Avenue (9) DS0000061442.V265291.R01.S.doc Version 5.0 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 the following standard(s): 1, 2, 3, 4, 5 Full information about the philosophy of care and operation of the home is available to prospective and current residents. Admissions are made on the basis of detailed assessments of the individuals’ needs and aspirations so that it is clear that the home can provide a suitable service. The home also has good arrangements to enable new residents to familiarise themselves with the home prior to moving in. EVIDENCE: The home has a statement of purpose and service user’s guide that contain the required information. These documents are available to prospective and current residents. The occupancy agreement lists the services to be provided as well as the rights and responsibilities of the residents. A simplified version in ‘Widget’ has been produced. A fourth resident had moved in to the home since the last inspection. She explained how she had visited the home prior to admission and was very enthusiastic about her new situation. Detailed assessment information was held on file, which had enabled the manager to determine the suitability of the placement and this had formed the basis of her care plan, covering personal and health care needs, information on relationships, domestic skills, community activities and behaviour. An independent living skills questionnaire is completed for each resident to provide a snapshot of individual abilities at the time. Cromwell Avenue (9) DS0000061442.V265291.R01.S.doc Version 5.0 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 the following standard(s): 6, 7, 8, 9, 10 Comprehensive care plans including relevant risk assessments are in place detailing all the residents’ personal and health care needs. These ensure that staff are aware of individual needs and aspirations and can deliver a consistent standard of care. Staff support residents to make decisions and choices in all areas of their lives, including taking responsible risks. This leads to the development of increasing independence. EVIDENCE: Care plans are in place for each resident that describe the person’s needs, likes and dislikes, personal and healthcare requirements, independence abilities and so on, with corresponding actions to be taken to meet the needs and goals indicated under each topic. Keyworkers complete monthly progress reports, updating each care plan goal and setting fresh objectives for the next month. Relevant risk assessments have been carried out, with carefully considered control measures noted, covering activities and behaviour, for example going out alone and crossing the road, behaviour management and relationships. The care plans constitute valuable working tools for staff and the residents Cromwell Avenue (9) DS0000061442.V265291.R01.S.doc Version 5.0 Page 11 indicated strongly that they had been fully involved in devising them. In order to provide stronger evidence of service user involvement in a person-centred care planning system, since the last inspection the manager has introduced a new activities record form that has space for recording what has taken place and the resident’s reaction to it. Residents said they were able to make decisions for themselves, for example in respect of activities and meals. A current innovation was an activities wall chart for two residents placed in their bedrooms, using pictures and symbols to help the residents choose what they would like to do. Residents’ files are kept in a locked filing cabinet in the utility room. The home has a policy on confidentiality that provides for the sharing of information on a need to know basis. The subject of confidentiality is covered during the induction of new staff. Cromwell Avenue (9) DS0000061442.V265291.R01.S.doc Version 5.0 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 the following standard(s): 11, 12, 13, 14, 15, 16, 17 Staff support service users to engage in a wide range of stimulating social, educational and leisure activities, making use of community facilities and acting as independently as possible within their assessed capabilities. This ensures they have the opportunity for genuine personal development, can develop and maintain new and existing relationships and can lead rewarding lives. Staff work with service users to exercise their rights and negotiate with them to recognise their individual and collective responsibilities. Service users have a healthy and well balanced diet and work together with staff to enjoy their mealtimes. EVIDENCE: Residents were keen to explain the life choices they habitually made, particularly in respect of activities, and household responsibilities. It was evident that staff support them to make realistic choices and help them participate in shopping, cooking, socialising, formal activities such as college and day centre activities and so on. The aim is to maximise the opportunities to act independently. Staff understand the importance of patiently assisting Cromwell Avenue (9) DS0000061442.V265291.R01.S.doc Version 5.0 Page 13 residents to do things themselves rather than staff doing them for them. For example the residents look after the rabbits and guinea pig that live in the shed at the bottom of the garden and assist with housework, laundry, menu planning and cooking. Two of the residents are learning how to stay safe when alone outside the home, going to the shops. Some attend a local college, others go to a day centre or follow planned activities in the home. Some household chores are carried out by the residents on a rota basis, with the rotas displayed on individual bedroom walls. The manager said that one project planned for the winter was to put a computer generated “Simpsons” mural up in the kitchen, which would complement the existing décor nicely. All the residents said they enjoyed a good social life and a variety of activities and outings, many of which they decided upon collectively. One resident said she particularly liked walking, another was very fond of music and using the computer, another enjoyed working in the woods as part of a college course. A visiting relative commented that there was always something interesting happening and praised the quality of life on offer. Residents have two holidays each year as part of the placement contract. The residents said that they were able to choose their food and take part in meal preparation with staff assistance. During the inspection the residents ate their evening meal together and enjoyed a pleasant social occasion. Two friends who live at another RoCCs home nearby were in the home for a routine “social evening” accompanied by support workers. Mutual visits take place frequently to expand the residents’ social networks and everyone seemed to get on well and be happy spending time together. Residents expressed great satisfaction with their lifestyles. Cromwell Avenue (9) DS0000061442.V265291.R01.S.doc Version 5.0 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 the following standard(s): 18, 19, 20 Staff treat the residents with respect and sensitivity and provide a high standard of personal care and healthcare, taking into account individual emotional and behavioural needs and circumstances. The home has sound policies and procedures for the safe handling and administration of medication that protect service users’ interests. However staff must take care always to sign for medication administered to residents. EVIDENCE: Care plans contain comprehensive details of the residents’ personal and healthcare needs and the actions agreed to meet them. A high standard of recording was noted in the daily records. Staff have good knowledge of each resident’s personality and specific needs and demonstrated a consistent approach to dealing calmly with the various behaviours presented during the inspection, when two of the residents were quite boisterous and demanding. Staff were adept at encouraging appropriate behaviour without excessive strictness. All the residents have experienced improvements in their general health and social skills since moving into the home. Medication is supplied by the local pharmacist in weekly dosette containers and is stored securely in a locked cabinet in the office. All movements of medicine in and out of the home are clearly recorded, although two signature gaps were Cromwell Avenue (9) DS0000061442.V265291.R01.S.doc Version 5.0 Page 15 noted on one MAR sheet. The system is basically sound but staff must always sign for every dose administered or explain in writing on the MAR sheet the reason for any non-compliance with the GP’s prescription. A requirement has been made to that effect in this report. Cromwell Avenue (9) DS0000061442.V265291.R01.S.doc Version 5.0 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 the following standard(s): 22, 23 The home has appropriate policies and procedures for the protection of service users, who feel confident that staff will listen to their concerns and try to resolve them. The home also has up to date policies and procedures on adult protection in place. Staff understand the basic principles of adult protection and are aware of their individual responsibilities to protect the residents. This means that residents should be protected from abuse. EVIDENCE: The home has a complaints procedure that contains the required information and a simplified version in Widget format is included in the service user’s guide. No complaints have been received since the home opened. A copy of the Hertfordshire inter-agency adult protection procedure is in the home and the company’s policy describes the different forms of abuse that may occur. In addition the home has a written whistle-blowing policy that includes information on contacting outside organisations such as the CSCI. All staff are made aware of the policies during their induction training. Staff spoken with during the inspection had a fair awareness of the basic principles of adult protection and understood their duties in responding to allegations or suspicions of abuse or neglect. RoCCS has a policy on physical restraint that stipulates that restraint should only be used as a last resort. None of the current residents exhibit behaviour that would necessitate the use of restraint and most of the staff team have not had restraint training. As a safeguard for residents and staff the policy should Cromwell Avenue (9) DS0000061442.V265291.R01.S.doc Version 5.0 Page 17 be amended to state that restraint should only be practised by staff who have been trained safe restraint techniques. This was recommended at the last inspection but has not yet been done, so the recommendation has been repeated. Cromwell Avenue (9) DS0000061442.V265291.R01.S.doc Version 5.0 Page 18 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 the following standard(s): 24, 25, 26, 27, 28, 30 The building is homely, comfortable, reasonably spacious, well maintained and safe, providing a suitable domestic environment that suits the service users’ needs and allows adequate privacy. The staff maintain a good standard of cleanliness and hygiene. EVIDENCE: The building is an ordinary double fronted mid-terrace house, furnished and decorated in domestic styles that produce a homely, comfortable environment that allows the residents to relax and feel very much at home. The small office is located unobtrusively under the stairs. The residents all have their own rooms, arranged and decorated to reflect their particular interests and tastes. The two ground floor bedrooms have en-suite toilets and sinks with a separate shower room, The two first floor bedrooms have en-suite bathrooms. The lounge and kitchen are domestic in style and are comfortably furnished and well equipped. There is a ‘sensory’ room on the first floor, which provides a useful space for relaxation. Laundry facilities are adequate, with good hygiene policies and practices followed. Staff assist the residents to varying degrees to do their own laundry. The garden is a fair size for a midterrace property, is easily accessible (with a patio) and securely fenced. There Cromwell Avenue (9) DS0000061442.V265291.R01.S.doc Version 5.0 Page 19 is a shed at the end of the garden, in which the residents’ pet animals are kept, including a guinea pig and three rabbits. There is also a pond protected by a small fence. All the facilities and equipment in the home are well maintained and suitable for the residents’ use. Heating, lighting and ventilation were effective on a dark and cold evening. Apart from two doors being held open on the ground floor, no health and safety hazards were noted. Cromwell Avenue (9) DS0000061442.V265291.R01.S.doc Version 5.0 Page 20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 36 Staffing levels are adequate to provide the attention that the service users require and to achieve the aims of the home. Members of staff are enthusiastic, knowledgeable, experienced and well trained to support service users effectively and meet their needs. Staff are well supported and receive regular supervision. This means that the service users receive consistent support and guidance. EVIDENCE: The manager confirmed that the staff rota includes two support workers on duty throughout the day shifts, with one on duty at night. Numbers may be increased to provide extra support if required to facilitate residents’ activities. This is planned in advance to maximise flexibility. The support worker’s job description prioritises working with residents towards increased independence as well as contributing to care planning and reviews. Staff have clearly come to know the residents very well and have developed strong relationships with them based on mutual trust and respect. Several staff, including the manager previously worked at other RoCCs homes and brought with them directly relevant experience. The deputy manager previously worked at the day centre. Three staff have achieved NVQ2 qualifications and the deputy is working towards NVQ3. The manager, who already has relevant care qualifications, has started the Registered Manager’s Award course. Cromwell Avenue (9) DS0000061442.V265291.R01.S.doc Version 5.0 Page 21 Staff spoken with described communications and teamwork in the home as good and said they felt well supported by the manager and company. Team meetings are held every two months and formal one to one supervision takes place, although the frequency should be increased to meet the standard of six sessions per year. The manager may consider simplifying the supervision format to make the process more efficient. Cromwell Avenue (9) DS0000061442.V265291.R01.S.doc Version 5.0 Page 22 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 40, 42 The home is well run, with service users benefiting from the support and guidance of the manager and the committed and enthusiastic staff team. The manager is experienced and qualified and provides strong leadership to the team. The home is operated so as to maximise the service users’ control over their lives within a risk assessment framework. The home has a full range of policies and procedures that safeguard service users’ interests. However the policies on infection control and physical intervention should be amended to reflect current good practice. Overall the home is safe to live in, with only one fire safety hazard noted. An immediate requirement was made that fire doors must not be wedged or held open. Cromwell Avenue (9) DS0000061442.V265291.R01.S.doc Version 5.0 Page 23 EVIDENCE: The home is succeeding in meeting its statement of purpose, in that it is run in such a way that the residents largely control their day to day routines and have the opportunity to lead fulfilling and stimulating lives. The manager is very involved and approachable, working alongside the other staff on the rota and carrying out her management duties when the residents are out at their daytime activities. Staff spoken with indicated that they were encouraged to put forward ideas to improve the lives of the residents. The manager is very experienced in social care. She was previously manager of another RoCCS home, has a relevant care qualification and is studying for the Registered Manager’s Award. The home has all the necessary policies and procedures in place to ensure good care practices in the home. Recommendations were made in the last inspection report to amend three policies: the confidentiality policy should specify the access to files that residents’ families will have; that on the use of physical restraint should state that restraint should only be used by staff who have been trained in the relevant techniques; the infection control policy should include appropriate guidance on hygiene and infection control in a care home setting. This has not yet been done therefore the recommendations have been restated in this report. The home has appropriate policies for monitoring health and safety, including regular fire drill and a monthly review of the premises. No hazards were noted apart from the office and lounge doors being held open by a lump of wood and a chair respectively. This practice must cease as it compromises fire safety. If the doors need to be kept open, suitable devices must be fitted that release the doors on activation of the fire alarm. See requirements. Some copies of the proprietor’s monthly reports on the conduct of the home were available for inspection. These must be produced each month and sent to the CSCI. Cromwell Avenue (9) DS0000061442.V265291.R01.S.doc Version 5.0 Page 24 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 3 3 3 3 3 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 3 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score 3 3 3 X X 2 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Cromwell Avenue (9) Score 3 4 2 x Standard No 37 38 39 40 41 42 43 Score 3 3 X 2 X 2 x DS0000061442.V265291.R01.S.doc Version 5.0 Page 25 Are there any outstanding requirements from the last inspection? yes 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 YA39 Regulation 26 Requirement Timescale for action 31/07/05 2. YA20 3. YA42 The proprietors make regular monthly monitoring visits to the home, but the reports have not been sent to CSCI. The proprietors must ensure that reports of the monthly monitoring visits to the home are sent to the CSCI. [Outstanding from the last inspection report] 17(1)(a) All doses of medication 01/12/05 Sch 3(3) administered to service users must be recorded on the MAR sheets. 23(4)(c)(i) Adequate arrangements for 01/12/05 containing fires must be made i.e. the office and lounge doors must not be held open by wedges or chairs. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Good Practice Recommendations DS0000061442.V265291.R01.S.doc Version 5.0 Page 26 Cromwell Avenue (9) Standard 2. YA40 The homes confidentiality policy mentions sharing information on a need to know basis. It is recommended that it should be more specific about the access that the residents families may have to their files and other personal information. The homes current residents do not have behaviours that may require the use of physical restraint, and the staff have not been trained in the techniques of physical restraint. The policy on physical restraint should state that restraint should only be practised by staff who have been trained in the techniques. RoCCS policy on infection control contains only information on blood borne viruses. The policy on infection control should include appropriate guidance on control of infection and hygiene control in a care home setting, such as the importance of hand washing and the appropriate use of gloves Suitable door clasping mechanisms should be fitted to the lounge and office doors, either magnetic clasps or DorGards, that are activated by the fire alarm to close the doors.l 3. YA40 4. YA40 5. YA42 Cromwell Avenue (9) DS0000061442.V265291.R01.S.doc Version 5.0 Page 27 Commission for Social Care Inspection Hertfordshire Area Office Mercury House 1 Broadwater Road Welwyn Garden City Hertfordshire AL7 3BQ 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. 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