Inspection on 15/06/06 for Douglas Jackman House

This inspection was carried out on 15th June 2006.

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

Douglas Jackman House 29/10/07

Douglas Jackman House 18/01/06

Douglas Jackman House 12/05/05

Douglas Jackman House 18/03/05

Douglas Jackman House 10/08/04

Douglas Jackman House 02/02/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Douglas Jackman House 1 Weymouth Avenue Dorchester Dorset DT1 1QR Lead Inspector Sally Wernick Key Unannounced Inspection 15th June 2006 09:15 DS0000032030.V300383.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address DS0000032030.V300383.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. DS0000032030.V300383.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Douglas Jackman House Address 1 Weymouth Avenue Dorchester Dorset DT1 1QR 01305 251598 01305 268972 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) Dorset County Council Gillian Caroline Joslin Care Home 14 Category(ies) of Learning disability (14) registration, with number of places DS0000032030.V300383.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Staffing levels must be those determined in accordance with guidance recommended by the Department of Health. To accommodate up to a maximum of 1 service user in the category of LD (E) at any one time. 18th January 2006 Date of last inspection Brief Description of the Service: Douglas Jackman House is registered to provide accommodation and care to 14 adults who have a learning disability. The home provides for long-term and 1 short-term placements. It is situated in the town of Dorchester, within easy walking distance of the shops, restaurants, pubs and leisure facilities. The accommodation comprises of several communal areas and has a garden to the rear of the property, which has patio seating and a summerhouse. It is a three storey house, with bedrooms on the ground, first and second floors. There is no lift. Staff is provided 24 hours a day. The majority of service users attend Day Centres during the week. Staff support service users with their personal care, social, and emotional needs. Staff have experience in communicating with adults who have a learning disability, and the homes philosophy includes aiming to increase the service users independence skills and community integration. The fees charged in the care home are £522.00 per week. DS0000032030.V300383.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection visit was unannounced and began at 9:15am on Thursday, 15 June 2006. This was a ‘key inspection’ where the homes performance against the key National Minimum Standards was assessed alongside progress in meeting requirements made at the last inspection. A senior carer assisted the inspector, as did other members of care staff. Methodology used included a tour of the premises, review of records and discussions with service users and staff. The inspector also reviewed the contact sheet for Douglas Jackman House. The Commission for Social Care also sent questionnaires to the home for them to distribute amongst residents, relatives and visiting professionals. At the time of writing 30 have been returned. A Pre-inspection questionnaire was also sent to the manager in order that information could be provided prior to the inspectors site visit. That information where relevant will be included in the main body of this report. What the service does well: Douglas Jackman house provides a very good service for adults with learning difficulties in a well decorated comfortably furnished house. The home has a positive and relaxed atmosphere and service users are clearly at ease. The home is well organised and the care and contentment of those who live there is central to the way the home is run. Service users are supported by professional, well-trained staff, which ensures they are respected and cared for in a safe and comfortable environment. A very good pre-admissions procedure ensures that only people whose needs can be met are offered places at the home. Prospective residents and their supporters have the opportunity to visit and stay at the home to see if they like it before they move in. Information is available about what the home has to offer to help people make their choice. Thorough assessments and good individual care plans are in place and are regularly reviewed. Daily notes provide evidence to show the way that care is delivered and there are very good links with healthcare providers and other community stakeholders. Opportunities are provided for service users to take part in everyday living tasks and they are encouraged to make decisions and choices. Service users were observed to access the local community during the inspection with staff DS0000032030.V300383.R01.S.doc Version 5.2 Page 6 supporting them in a variety of ways. Staff spent all of their time with service users and it was clear that good relationships had been formed. Service users are encouraged to pursue their own choice of activities and staff facilitate this. Activities are informal and responsive to what service users choose to do. Residents through their key workers and their supporters as well as community health providers had returned thirty written survey forms to the commission for social care. Without exception all expressed satisfaction with the home. What has improved since the last inspection? What they could do better: Douglas Jackman house provides a very good standard of care to service users living at the home and this is reflected in the lack of requirements as a result of this inspection. There are some good practice recommendations one of which were not reviewed from previous inspections and have therefore been carried forward. The home continues to explore ways in which service users can be supported in enjoying holidays away from the home and is supporting increasing numbers of service users to shop, prepare and cook their own meals. Whilst training is available on autism it has not yet been delivered to all staff and should be relatively advanced in content to accommodate the needs of service users currently living at the home. The home’s quality assurance system should be developed further to include supporters and stakeholders and results provided to service users in a format, which is easily understood. DS0000032030.V300383.R01.S.doc Version 5.2 Page 7 It would be good practice to provide paper towels in communal washing areas. 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. DS0000032030.V300383.R01.S.doc Version 5.2 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 DS0000032030.V300383.R01.S.doc Version 5.2 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): 2 Quality in this outcome area is good. This judgement has been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. Information provided about the home and a very good admissions procedure enables prospective residents and their supporters to make informed decisions about admission to the home and ensures that only service users whose needs can be met by are offered places there. EVIDENCE: Only one service user had been admitted to the home since the last inspection. The file demonstrated that a very thorough pre-assessment had been undertaken with the service user having the opportunity to meet residents and staff, to have overnight stays and to enjoy some of the activities arranged by the home. The file presented a very clear picture of the individual outlining specific needs, likes and dislikes and how all identified health and social needs could best be met. There was evidence of good liaison with care managers, family and previous providers and detailed risk assessments, which promoted independence and extended the range of activities enjoyed. The assessment was sensitive and enabled detailed care planning of a high standard. There was evidence that the service user had been consulted throughout and that the assessment was ongoing ensuring that needs had been properly identified particularly during the six-week trial period. DS0000032030.V300383.R01.S.doc Version 5.2 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 & 9 Quality in this outcome area is good. This judgement has been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. There is a very good care planning system in place to ensure that staff and service users know assessed and changing needs and personal goals are clearly reflected. The home encourages service users to make decisions in their daily lives with effective use of advocacy services to facilitate independence and choice. An individual approach to risk taking ensures service users are able to responsible risks in order to enjoy an independent lifestyle. EVIDENCE: The care plans of three service users were examined. An establishment task list was in place for each individual detailing preferred methods of communication, self care, eating, drinking, likes and dislikes health social and therapeutic activities alongside goals and aspirations. Each care plan presented an individual account of the service user and there was evidence of liaison with DS0000032030.V300383.R01.S.doc Version 5.2 Page 11 service users, family friends advocates and health care providers. Daily care reports are cross- referenced with the care plan and there is a further activity plan, which covers a four-week period. Key-workers are allocated and the inspector observed that there was a high level of interaction between staff and service users with good supportive relationships formed. Care plans included individualised procedures for service users who may at times demonstrate challenging behaviour. Knowledge of individuals was good with a responsible balanced approach, which recognises the difficulties that service users face in their daily lives. Care plans are regularly reviewed to ensure that they are upto-date and there was evidence of very good liaison with stakeholders and health care providers. There was evidence during the inspection that service users were encouraged to make decisions in their daily lives. For example observed practice during the inspection showed that service users were asked what they preferred to do during the morning most chose to go shopping two were supported in preparing their own lunch another in going to the local park for a picnic. The home is also able to demonstrate where they have made use of advocacy services for example in managing finances and for one resident arranging a holiday. The home has monthly residents meetings where residents are encouraged to provide feedback on the home and areas, which may require improvement. Risk assessments are in place for a range of activities such as horse-riding and swimming the content evidenced that the home in line with the assessment process promote and encourage service users to take responsible risks and fulfil their aspirations. This year all service users are supported in having an overnight stay away from the home in a caravan funded by a voluntary organisation. Residents have also been risk assessed regarding the use of front door keys and there are other assessments in place to safeguard and promote the health, safety and welfare of residents. DS0000032030.V300383.R01.S.doc Version 5.2 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): 12,13,15,16 & 17. Quality in this outcome area is good. This judgement has been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. Increased staffing hours means that the home is able to offer a greater range of activities, which has given service users more flexibility and choice increasing access to the local community. Service users are supported to maintain links with family and friends and to enjoy a range of activities and responsibilities. Service users are supported to plan and prepare their own meals in a safe environment, which meets individual preferences. EVIDENCE: Service user Activity Plans identify what they like to do and how they wish to spend their time. Most of the residents at the home attend at day centres this is out of choice something the inspector observed whilst conducting the site visit. There is a range of day centre providers one service user currently DS0000032030.V300383.R01.S.doc Version 5.2 Page 13 attends at college. The home does have its own mini-bus which is used for a variety of day trips and some individual activities enjoyed by service users include visits to theme parks, Swanage railway, caravanning, horse-riding, swimming, shopping, cinema, bowling, meals out and trips to the pub. Activities are very much person centred, age appropriate and based on individual choice in line with a requirement at the previous inspection. There is evidence that families are consulted and liaised with. Some residents continue to enjoy holidays with their relatives who along with friends are very much welcomed at the home at times which are suited to service users and their guests. For those residents who choose to stay at home during the day they were observed to be supported by staff in their choice of activity which involved going out into the local town and community. Friendships between residents are sensitively supported and where two residents enjoy spending time together was assisted in shopping and preparing their own lunch. Staff was seen to be flexible and sensitive and to demonstrate a good knowledge of residents likes and dislikes. The atmosphere within the home was calm and positive and service users needs and preferences are the priority. Service users were observed to be treated with respect and kindness at all times. The home has good links with a local voluntary agency and as a result has access to a caravan at a nearby holiday park. This is a facility enjoyed by all residents and this summer it is anticipated that all will have at least one night away to enjoy the parks resources. The home has not yet been able to arrange extended holidays for all service users, as funding and staff resources are limited. The home continues to explore potential opportunities to facilitate this as part of resident’s contracts. A training kitchen is available at the home to enable service users to prepare their own meals a facility, which some residents use on a regular basis. The senior carer who assisted in the inspection stated that the majority of residents eat lunch out whilst dinner is prepared by a dedicated cook. A tour of the kitchen evidenced a good choice of quality food -stuffs with fresh food and vegetables and a choice of healthy well-balanced menus. The home remain committed to supporting service users to shop, prepare and cook their meals at times which are regular and flexible. DS0000032030.V300383.R01.S.doc Version 5.2 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 Quality in this outcome area is good. This judgement has been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. The home provides personal guidance and support according to assessed need and in line with resident’s preferences and wishes. Policies and procedures relating to the health care needs of service users promote good practice and ensure physical and emotional needs are met. Medication held at the home is very well managed to ensure that service users medication needs are met and they are protected through the policies, procedures and practices within the home. EVIDENCE: Care plans clearly outline service users preferences, where guidance and support is needed for care and how this must be provided in line with service uses wishes. Residents are supported in deciding what they wish to wear, personal hygiene and there was evidence on files examined of appropriate referrals to occupational therapists, psychiatry, psychological services, dentists and chiropodists. The home clearly has good working relationships with community health professionals and liaises regularly with other community DS0000032030.V300383.R01.S.doc Version 5.2 Page 15 staff and stakeholders to ensure continuity and consistency of support is given. A dedicated key worker system further strengthens this and where a need may be identified additional support is sought through independent advocacy. Each resident has his or her own medication file with clearly recorded MAR sheets. During the inspection and as part of a pilot programme initiated by the primary care trust a Boots pharmacist visited the home. Each medication file was reviewed and residents at the home spoken to about the medication prescribed to them. One resident expressed a preference for soluble medication, which the pharmacist was able to prescribe. Correct dosage and administration is reviewed as are possible side effects and the pharmacist confirmed that everything was up to date and accurate. This was an excellent example of good practice. It provided the opportunity for consultation with service users and ensured that they were receiving the medication that was right for them. There are no service users at the home that are currently selfmedicating. DS0000032030.V300383.R01.S.doc Version 5.2 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 Quality in this outcome area is good. This judgement has been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service The home has a satisfactory complaints system in place with some evidence that service users are promoted to raise concerns and their views are listened to and acted on. Service users are safeguarded by staff’s knowledge of adult protection procedures and written policy. EVIDENCE: The home has a clear complaints procedure in place and through monthly residents meetings residents are asked to air any concerns they may have about care and facilities in the home. Minutes of meetings are provided in widget (picture form) and in addition a “grumbles sheet” to enable service users to express dissatisfaction about daily issues which may be important to them. Only three of these had been received and staff will be ensuring that these are regularly audited. A complaints book is in place and although there have been no complaints during this inspection period there is evidence of review. The key worker system and collaboration between staff and service users means that staff are aware of how individuals express themselves and ways in which they satisfaction and dissatisfaction. Staff, were observed to be sensitive to individuals and to understand ways in which needs were being communicated. DS0000032030.V300383.R01.S.doc Version 5.2 Page 17 Adult protection procedures are in place and up to date and there is evidence that some but not all staff has received up to date training in the protection of vulnerable adults. Recently the manager from the adult protection team visited the home to discuss and provide guidance on incidents where action must be taken. There are plans for further training in the future. DS0000032030.V300383.R01.S.doc Version 5.2 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 & 30 Quality in this outcome area is good. This judgement has been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service The home provides service users with a comfortable well-maintained and homely environment, The home was clean and hygienic with procedures in place to protect service users from the spread of infection. EVIDENCE: Douglas Jackman house is a large comfortable home, which is well maintained. Bedrooms are big, personalised, bright and cheerful as are communal areas. It is well situated close to the local town and amenities and has an attractive spacious garden. A decoration and renewal programme means that the home is well maintained and meets the requirements of the local fire and environmental health departments. There are up to date infection procedures and staff has received relevant training. It is recommended however that in communal bathrooms and washing areas paper towels be provided to prevent the risk of infection. DS0000032030.V300383.R01.S.doc Version 5.2 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 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): 32,33,34 & 35. Quality in this outcome area is good. This judgement has been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. Residents are protected by the employment procedures and the staff, training programme, which is comprehensive and covers all aspects of the statutory training. Substantial increases to staffing levels within the home have made a considerable difference to service users quality of life promoting their choice and opportunities for personal development. Robust recruitment procedures are in place to ensure the protection of service users living at the home. Regular supervision, support and professional guidance ensures that service users benefit from a confident, kindly staff team. EVIDENCE: The senior carer and two other members of the staff team talked confidently about the needs preferences and wishes of residents at the home. Demonstrating insight into different styles of communication. Brief observations made on the day of the inspection indicated how well staff and residents interacted which was positive and comfortable. Residents were DS0000032030.V300383.R01.S.doc Version 5.2 Page 20 unable to confirm this verbally but through individual communication and specific behaviour each would clearly indicate any negative feelings they might have towards staff - none were observed. Staff at the home continues to benefit from a range of up-to-date training although not all staff have completed courses on autistic spectrum disorder, which is planned for the coming year and would benefit service users considerable. Other courses planned include: extending good practice in autism, managing challenging behaviour and working with people with complex needs. NVQ’s remain ongoing as does LDAF induction and foundation. At the current time of the 18 care staff four have LDAF 1 and 2, two have LDAF 3 and 4, two have NVQ level 2 a further two members of staff are qualified at NVQ level 3. The inspector looked at the current rota’s, which showed that sufficient numbers of staff were on duty, and was supported by a senior member of staff. There are current staff vacancies although the current team and experienced relief staff cover these. Review of staff files demonstrate that in line with a previous requirement staff receive regular planned supervision and for those staff spoken to felt well supported. Good recruitment procedures are in place three staff files were examined and were all found to be in good order with the relevant documentation. The home demonstrates a commitment to providing a well-qualified staff team each staff member has an individual learning plan. A record is kept of all courses completed and training planned for the future demonstrates that staff undertakes courses linked to the specialist needs of residents. However as all staff have not yet received specialist training in autism it is a recommendation that this be undertaken and completed during this training year. DS0000032030.V300383.R01.S.doc Version 5.2 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 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): 37,39 & 42 Quality in this outcome area is good. This judgement has been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. The home benefits from an experienced manager and senior team whose roles and responsibilities are clearly defined, which ensures that all aspects of the home are well covered. The home does generally review aspects of its performance through a programme of self-review and consultation with service users and staff. The lack of an up to date quality assurance system however means that the home is not in a position to demonstrate that there is an on-going review of aims and outcomes for service users. There are well-organised procedures and practices in place in the home to ensure that the health and safety of residents and staff is promoted and protected. DS0000032030.V300383.R01.S.doc Version 5.2 Page 22 EVIDENCE: The registered manager has extensive experience of working with adults with learning disabilities and worked at Douglas Jackman house a number of years before she was promoted to manager. She has achieved NVQ 4 in management and is currently working towards NVQ 4 in care. There was evidence on file that she continues to keep her knowledge and skills updated by attending regular training courses. There is evidence in place that there are systems to monitor quality of provision within the home. Questionnaires had been completed by staff and residents but had not included families, friends other stakeholders and visiting professionals. Nor had information been collated and fed back to residents in a format, which could be easily understood. The home have recognised this however and are currently in the process of developing their quality assurance systems further. Sample records of safety checks, servicing and maintenance of equipment were examined and found to be up to date. All staff had undertaken fire safety training at the required intervals, and fire drills had included various scenarios. Staff had undertaken appropriate health and safety training including moving and handling and infection control. A tour of the premises demonstrated that routine maintenance and refurbishment work was being implemented. A recommendation made at previous inspections to monitor and maintain hot water temperatures close to 43 degrees has been fully and regularly implemented. DS0000032030.V300383.R01.S.doc Version 5.2 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 Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 x 32 2 33 3 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 4 x 3 X 3 X X 3 x DS0000032030.V300383.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard YA14 YA17 Good Practice Recommendations Service users should have as part of the basic contract price the option of a seven day annual holiday outside of the home. The opportunities for service users to shop, prepare and cook their meals should be regular and flexible. It was recommended that service users were formally consulted about their views about the home offering a respite service, e.g at a residents meeting, to provide written evidence that the service users felt there were benefits in continuing to offer this service. (Not inspected on this occasion and therefore carried forward) It is recommended that paper towels be provided in communal bathrooms and washing areas to prevent the risk or spread of infection. The home should provide training to all care staff on autistic spectrum disorder. The Registered manager should continue to develop quality assurance methods based upon seeking the views of service users and other interested parties, to ensure success in achieving the aims and objectives of the home. The outcomes of which should be provided to service users DS0000032030.V300383.R01.S.doc Version 5.2 Page 25 3. YA24 4. 5. YA30 YA32 6. YA39 in a format, which can be easily understood. 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