Inspection on 01/06/05 for Cromwell Avenue (9)

This inspection was carried out on 1st June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

Other inspections for this house

Cromwell Avenue (9) 11/04/07

Cromwell Avenue (9) 01/12/05

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 Cromwell Avenue Cheshunt Hertfordshire EN7 5DJ Lead Inspector Claire Farrier Announced 10:00 on 1 June 2005 st 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. Cromwell Avenue I52 s61442 cromwell avenue v219861 010605 stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service 9 Cromwell Avenue Address 9 Cromwell Avenue Cheshunt Hertfordshire EN7 5DJ 01992 622032 01992 622032 mbhconnors@aol.com Residential Community Care Services Ltd 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) Care Home 4 Category(ies) of LD Learning Disability - 4 registration, with number MD Mental Disorder - 4 of places Cromwell Avenue I52 s61442 cromwell avenue v219861 010605 stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: There are no additional conditions of registration. Date of last inspection This is the first inspection Brief Description of the Service: 9 Cromwell Avenue is a care home providing personal care and accommodation for four young adults with learning disability and associated mental disorder. It is a new home, first registered in August 2004. The first residents were admitted in September 2004. The home is owned by Residential Community Care Services (RoCCS), which is a private organisation. This is the third home that they have established in Hertfordshire within the past four years. The home consists of a four bedroomed terraced house. It is situated in a residential street, next door to the GP 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 ensuite 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 I52 s61442 cromwell avenue v219861 010605 stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first inspection since the home opened, and it was carried out over one day. The majority of time was spent observing and talking to residents and staff, and discussions were held with the home’s manager. Some time was also spent in the office looking at records, care plans, risk assessments, complaints, staff training and staff files. Two residents took the inspector on a tour of the premises. Comment cards were received from all three residents and three relatives, all with positive comments. The staff and residents were very welcoming. This was a very positive inspection, and the majority of the standards were met. The provision of healthcare was assessed to be commendable. Two immediate requirements were made in relation to health and safety concerns, and a further requirement for the proprietor’s monthly monitoring report to be sent to CSCI. What the service does well: The home has made a very good start, and there are no major concerns about the management and the provision of care. All the residents took part in the inspection, talking to the inspector and conducting a tour of the house. They are all happy and well settled. They have all made improvements in their health and their quality of life since moving into the home. One resident has improved so much since moving into the home that an ongoing health condition is no longer a concern. A letter from the GP states that this problem has resolved since moving into the home, and in a Learning Disability Service Review the consultant psychiatrist stated that there have been improvements in all aspects of the person’s life. The atmosphere is very much that this is the residents’ home. They were very keen to show the inspector their home and their rooms, and they spoke about their involvement in decisions, such as choosing their own activities and meals. The manager has established an efficient system for maintaining clear and accurate records. Thorough and detailed assessments are carried out before the residents are admitted to the home, which lead to care plans that provide clear and accessible information on all the residents’ needs, with regular monitoring and reviews. Cromwell Avenue I52 s61442 cromwell avenue v219861 010605 stage 4.doc Version 1.30 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Cromwell Avenue I52 s61442 cromwell avenue v219861 010605 stage 4.doc Version 1.30 Page 7 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 Cromwell Avenue I52 s61442 cromwell avenue v219861 010605 stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,3,4 and 5 The home has good arrangements for residents who are moving into the home. Written information is provided in the Service Users’ Guide and the Statement of Purpose. Prospective residents are encouraged to visit the home and get to know the staff and the other residents. The residents and their families who were contacted for the inspection feel confident that the staff can meet their needs. EVIDENCE: Two residents moved into the home in September 2004 and one in February 2005. A fourth resident is making visits to the home in preparation for moving in. One resident described how she visited the home before she moved in and met the staff. She said that she wanted to move in because she liked the home and she has been very happy living there. Comprehensive assessments were seen in the residents’ files, containing full details of their personal care and health care needs, as well as information on relationships, domestic skills, community activities and behaviour. An independent living skills questionnaire is completed for each resident when they move in, which provides a number score for their abilities. This will be reassessed after a year in order to monitor each resident’s progress towards independence. Cromwell Avenue I52 s61442 cromwell avenue v219861 010605 stage 4.doc Version 1.30 Page 9 The staff demonstrated through discussion, observation and record keeping that they understand the service users very well and that they have the skills and experience to meet their needs. The Statement of Purpose and Service Users’ Guide are RoCCS documents, and provide information on the services provided by the home. The Service Users’ Guide has recently been updated, and now includes photographs of the residents taking part in activities in the home and in the local community. The occupancy agreement covers the services provided by the home and the rights and responsibilities of the residents, and a simplified version has been produced in widget format. Cromwell Avenue I52 s61442 cromwell avenue v219861 010605 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) 6,7,8,9 and 10 The residents’ care plans contain detailed information on all their personal care and health care needs. Comprehensive risk assessments related to each individual, which enable the staff to provide a good quality of care. The staff were observed to treat the residents with respect and to assist them to make choices about their lives, but the care plans do not reflect this involvement. EVIDENCE: Detailed case tracking was carried out through the files of two residents. The care plans are well written, with a pen portrait for each person and good details of all the residents’ likes and dislikes, strengths and needs, based on their assessment (see Standard 2). A detailed care plan provides full information on all the listed needs, with objectives and the action needed for each topic. The key workers complete monthly reviews with an update of each care plan goal and new objectives are set for the following month. Appropriate risk assessments are in place related to the care plans, for example for one resident crossing the road to go alone to the local shop and for another to prevent dependence on a member of staff. Cromwell Avenue I52 s61442 cromwell avenue v219861 010605 stage 4.doc Version 1.30 Page 11 The care plans provide a commendable framework for providing appropriate information on each resident’s needs and for monitoring their progress. It was reported that the care plans are discussed with the residents, but there is no indication of their involvement. The format could provide a basis for a person centred planning (PCP) approach, which should focus on the person being totally at the centre of all planning, and the key workers could assist and enable residents to write and monitor their own monthly objectives. The manager is aware that this is an area for development, and she and the deputy manager are looking at ways to achieve the involvement of all the residents, including the use of photographs. The residents said that they make decisions together about their lives in the home, including what activities they do and what meals they eat. One resident looks after her own personal money. Accurate records are kept for the other residents. There is information in the home on advocacy services. Residents’ files are stored in a locked filing cabinet in the utility room. The home has a clear policy on confidentiality, which mentions that information may be shared on a need to know basis, but it is not specific about the access that the residents’ families may have to their files and other personal information (See Standard 40). Cromwell Avenue I52 s61442 cromwell avenue v219861 010605 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) 11, 12, 13, 14, 15, 16 and 17 The ethos of the home is that the residents are living in their own home, supported by the staff. Personal development opportunities are encouraged for all residents ensuring good relationships with their families and with the local community, and that individual rights and responsibilities are recognised and supported. EVIDENCE: It is evident from talking with the residents and staff that 9 Cromwell Avenue is the home of the residents and that the staff have the role of assisting them to live as independently as possible. One of the residents explained with some pride that she takes responsibility for her own cleaning and laundry, and that she now goes on her own to local shops. She attends a local college four days a week. The other residents attend a day centre or have programmed activities in the home. The residents said that they enjoy a range of activities and outings, and they decide together what they want to do. Cromwell Avenue I52 s61442 cromwell avenue v219861 010605 stage 4.doc Version 1.30 Page 13 One resident particularly likes going swimming, and everyone has a walk every day, in the local park and neighbourhood. The residents talked about visits they have made to the seaside, the zoo and a local farm. One resident was looking forward to a visit by his family. They have two holidays each year, and in September they are going to Butlins, which they all enjoy. The residents said that they choose what they want to eat, and take part in shopping and preparing the food. The evening meal was cooked during the inspection and was a social occasion with the residents. One resident said that she had made a fruit salad on her own, and she described the food as “lovely”. Cromwell Avenue I52 s61442 cromwell avenue v219861 010605 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) 18, 19 and 20 The staff provide good quality personal care and treat the residents with sensitivity and respect. The provision of healthcare is commendable, with praise from healthcare professionals on the improvements that have been achieved. The residents have all seen improvements in their health and their social skills since moving into the home. EVIDENCE: The care plans that were inspected provide comprehensive details of the residents’ personal care and health care needs (see Standard 6). A good relationship was observed between the staff and the residents. Behaviour guidelines were seen for some of the residents, the staff follow these sensitively, encouraging appropriate behaviour without seeming to impose rules on the residents. Detailed recording of each resident’s health care includes health notes for hospital visits and contact with GPs and other medical professionals. The house is situated next door to the GP surgery, and the GP as been very supportive and available to offer advice when needed. One resident has improved so much since moving into the home that an ongoing health condition is no longer a concern. A letter from the former GP states that this problem has resolved since moving into the home, and in a Learning Disability Service Review the consultant psychiatrist stated that there have been improvements in all aspects of the person’s life. Cromwell Avenue I52 s61442 cromwell avenue v219861 010605 stage 4.doc Version 1.30 Page 15 Medication is supplied in nomad monitored dosage boxes for each service user. The procedures for administering and recording medication are followed appropriately. Cromwell Avenue I52 s61442 cromwell avenue v219861 010605 stage 4.doc Version 1.30 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 23 The home has appropriate policies and procedures for the protection of the residents. There is a simplified complaints policy in widget format for the residents. Appropriate policies and procedures concerning adult protection that follow the guidelines given in the Hertfordshire County Council adult protection procedures are in place. EVIDENCE: The home has comprehensive procedures for complaints. The Service Users’ guide contains a simplified complaints policy in widget format. No complaints have been recorded since the home opened. The procedures on prevention of abuse contain information on the different forms of abuse, and follow the guidelines given in the Hertfordshire County Council adult protection procedures are in place. There is a clearly written whistle blowing policy that includes information on contacting outside organisations, including CSCI. All the staff are made aware of the policies during their induction training. RoCCS has a policy on physical restraint, which states that physical restraint should only be used as a last resort and never as a matter of course. None of the residents of 9 Cromwell Avenue need the use of restraint to manage their behaviour, and most of the staff have had no training in the techniques, although the deputy manager is doing a course for training others in restraint techniques. As a safeguard for the residents and the staff the policy should state that restraint should only be practiced by staff who are trained in the techniques (See Standard 40). Cromwell Avenue I52 s61442 cromwell avenue v219861 010605 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, 25, 26, 27, 28 and 30 The home provides a comfortable and well maintained environment for the residents. The staff maintain a good standard of cleanliness and hygiene. The manager and staff have created an environment that the residents can feel is their home. EVIDENCE: The building was inspected as part of the registration process, but at that time it was not fully furnished or occupied by residents and staff. It is a double fronted mid terrace house and looks no different to other houses in the street. The atmosphere is that it is the home of the residents. The office is very small and situated in an unobtrusive position under the stairs. Each resident has their own room, which they have decorated with their own possessions. The two ground floor bedrooms have en-suite toilet and washbasin, with a separate shower room. The two first floor bedrooms have en-suite bathrooms. There is a comfortable furnished lounge and dining room, with TV and CD player, and this room is also home to the budgie that one of the residents owns. Cromwell Avenue I52 s61442 cromwell avenue v219861 010605 stage 4.doc Version 1.30 Page 18 The kitchen is spacious, and was seen to provide a centre for social interactions between the residents and staff while the evening meal was prepared. On the first floor there is a snoezelem room, containing soft furnishings and lighting for relaxation. It also contains a computer for the residents to use, and a programme on the computer can provide relaxing sounds and visual effects. This was demonstrated during the inspection, and experienced as calming and relaxing! 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. The utility room contains a domestic style washing machine and tumble drier, and the staff assist the residents in varying degrees to do their own laundry. The home appeared to be clean and hygienic. RoCCS policy on infection control contains only information on blood borne viruses such as HIV and hepatitis B. It should be reviewed, with the addition of appropriate guidance on control of infection and hygiene in a care home setting, such as the importance of hand washing and the appropriate use of gloves (See Standard 40). Cromwell Avenue I52 s61442 cromwell avenue v219861 010605 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, 34, 35 and 36 The residents benefit from a staff team of experienced support workers who are appropriately trained to meet their needs, and supported by regular supervision. The staff team are enthusiastic and appear to take pride in the service that they provide. EVIDENCE: The staffing rotas show that there are two support workers on duty throughout the day, and one during the night. When the home is fully occupied, the daytime levels may be increased. The job description for the support workers includes working with the residents to increase their independence, and contributing to their care plans and reviews. It also states that staff may be asked to work at other RoCCS homes from time to time. The three RoCCS homes support each other, during the inspection a resident and staff from one of the other homes made a visit. Many of the home’s support workers came from the other RoCCS homes and brought the benefit of their experience to the new home. This has provided a stable and confident staff team for the new home. The manager was previously manager at one of the other RoCCS homes and the deputy manager previously worked with some of the residents at the day centre. Cromwell Avenue I52 s61442 cromwell avenue v219861 010605 stage 4.doc Version 1.30 Page 20 The staff spoken to are enthusiastic about their work, they are encouraged to have ideas for further developments. They receive regular supervision, and they said that they feel supported by the manager and each other in their work. New staff complete an induction programme that includes all the basic policies and procedures, and RoCCS has a training programme that complies with TOPSS (Training Organisation for the Personal Social Services) guidelines. Three of the six support workers have now completed NVQ2 in care, and the deputy manager is working towards NVQ3. The staff files of three members of staff were inspected. They contained all the required information, including references, proof of identity and evidence of satisfactory CRB (Criminal record Bureau) disclosures. A thorough recruitment procedure is followed, including following up all references by telephone. Cromwell Avenue I52 s61442 cromwell avenue v219861 010605 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) 37, 38, 39, 40, 41, 42 and 43 The home is well run by a competent manager who leads a dedicated and enthusiastic staff group. The residents are at the heart of the home, and the management and staffing structure support and enable them to contribute to decisions about their home. There were two health and safety issues for which immediate requirements were made, concerning window restrictors and the use of door wedges. These were actioned within 24 hours of the inspection. EVIDENCE: As described previously (see Lifestyle and Environment) the ethos of the home is that the residents are living in their own home, supported by the staff. Good procedures are in place for supporting the staff, and the manager is involved and approachable. She works alongside her staff on the rota, and carries out her management duties at times when the residents are at their daytime activities. Both staff and residents are encouraged to make their views known, and to have creative ideas for improving the life of the residents. Cromwell Avenue I52 s61442 cromwell avenue v219861 010605 stage 4.doc Version 1.30 Page 22 The manager was previously manager of another RoCCS home, and her skills and experience have enabled the new home to provide a stable and supportive environment for the residents in the short time since it opened. She is studying for the Registered Managers Award. The manager is responsible for the home’s daily budget, for food and other requirements for the home, and any other expenses are met by the company. RoCCS has an annual development plan, and the manager has addressed the priorities for 9 Cromwell Avenue of staff consistency and educational knowledge. There is a system in place for monitoring the quality of the service, including consultation and questionnaires for the residents, families and professionals, which will be implemented when the home has been opened for a year. The proprietors carry out monthly monitoring visits. Reports of the visits were seen during the inspection, but they are not currently also sent to CSCI when the visit is completed. There is a high standard of record keeping, and all the records inspected were up to date and easy to understand. RoCCS has policies and procedures that cover all aspects of the home. The complaints policy has also been written in widget format for the residents. The policies are provided to staff as part of their induction when they start work. The policies on confidentiality, infection control and physical intervention should be reviewed to comply with current good practice. • The policy on confidentiality is not specific about the access that the residents’ families may have to their files and other personal information (see Standard10). • The policy on physical restraint should state that restraint should only be practiced by staff who are trained in the techniques (see Standard 23). • The policy on infection control should include appropriate guidance on control of infection and hygiene control in a care home setting, such as hand washing and the appropriate use of gloves (see Standard 30). The home has appropriate procedures for monitoring health and safety, including regular fire drills and a monthly review of the premises. However, three potential hazards were noticed during the inspection. • In the pre-registration report a requirement was made for a risk assessment to be carried out on all first floor windows, and in particular for the window that could provide access to a flat roof. Window restrictors have been fitted to this window and to the landing window, but not to the other first floor windows, in the snoezelem room and a resident’s bedroom and bathroom as this could be a possible risk to service users. An immediate requirement was made that window restrictors must be fitted to all first floor windows and a risk assessment put in place for each resident until the work is completed. Following the inspection it was reported that window restrictors were fitted to all first floor windows within twenty four hours. Cromwell Avenue I52 s61442 cromwell avenue v219861 010605 stage 4.doc Version 1.30 Page 23 • • All the internal doors are fitted with hinges that close automatically, and a variety of objects were utilised to hold them open, including a wedge, a chair and a lump of wood. An immediate requirement was made to consult the fire authority about the safety of this practice. Following the inspection it was reported that the fire authority had advised that door release mechanisms should be fitted. The record of fridge temperatures showed regular measurements of 8ºC and 10ºC, which is above the limits of 0ºC to 5ºC that are recommended for the maintenance of food hygiene. This may be due to the time of day when the temperatures are recorded, and it was recommended that the night staff should record the temperatures when the fridge has been closed all night. Cromwell Avenue I52 s61442 cromwell avenue v219861 010605 stage 4.doc Version 1.30 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 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 N/A 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Cromwell Avenue Score 3 4 3 x Standard No 37 38 39 40 41 42 43 Score 3 3 2 2 3 2 3 I52 s61442 cromwell avenue v219861 010605 stage 4.doc Version 1.30 Page 25 N/A 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 39 Regulation 26 Requirement 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. A requirement was made in the pre-registration report for a risk assessment to be carried out for all the first floor windows. Window restrictors have been fitted to two first floor windows, but for the safety of the residents the other windows also need restrictors. Window restrictors must be fitted to all first floor windows, and a risk assessment must be put in place for each resident until the work is completed. The manager confirmed that window restrictors were fitted to all first floor windows within twenty four hours of the inspection. The registered person must consult the fire authority concerning adequate precautions against the risk of fire, in Timescale for action 31 July 2005 2. 42 13(4)(a) & (c) From 01 June 2005 and henceforth 3. 42 23(4)(c) (iii) Cromwell Avenue I52 s61442 cromwell avenue v219861 010605 stage 4.doc Version 1.30 Page 26 particular with regard to the use of door wedges, and take action on any subsequent recommendations. The manager confirmed that door release mechanisms will be fitted as advised by the fire authority. 4. 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 6 Good Practice Recommendations The care plans contain comprehensive information on all aspects of the residents life, but there is no evidence that the residents are involvd in writing and reviewing their care plans, in line with PCP. It is recommended that the staff should encourage and enable reidents to provide a realistic input into their care plans and reviews, for example by setting their own targets or monitoring their own progress. 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 practiced by staff who are 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 impotance of hand washing and the appropriate use of gloves The record of fridge temperatures showed regular measurements of 8ºC and 10ºC, which is above the limits of 0ºC to 5ºC that are recommended for the maintenance of food hygiene. I52 s61442 cromwell avenue v219861 010605 stage 4.doc Version 1.30 Page 27 2. 40 3. 40 4. 40 5. 42 Cromwell Avenue It was recommended that the night staff should record the temperatures when the fridge has been closed all night. Cromwell Avenue I52 s61442 cromwell avenue v219861 010605 stage 4.doc Version 1.30 Page 28 Commission for Social Care Inspection Mercury House 1 Broadwater Road Welwyn Garden City 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. Extracts may not be used or reproduced without the express permission of CSCI Cromwell Avenue I52 s61442 cromwell avenue v219861 010605 stage 4.doc Version 1.30 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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