CARE HOME ADULTS 18-65
Douglas Jackman House 1 Weymouth Avenue Dorchester Dorset DT1 1QR Lead Inspector
Marion Hurley Key Unannounced Inspection 29th October 2007 10:00 Douglas Jackman House DS0000032030.V353297.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 Douglas Jackman House DS0000032030.V353297.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. Douglas Jackman House DS0000032030.V353297.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 g.joslin@dorset-cc.gov.uk www.dorsetforyou.com Dorset County Council 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) Gillian Caroline Joslin Care Home 14 Category(ies) of Learning disability (14) registration, with number of places Douglas Jackman House DS0000032030.V353297.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection June 15th, 2006. Brief Description of the Service: Douglas Jackman House is registered to provide accommodation and care to 14 adults who have a learning disability. It is situated on the edge of the County 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 one ground floor bedroom and the others on the first and second floors. There is no lift. Staff are 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 £650.00 per week. Douglas Jackman House DS0000032030.V353297.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. Information about the home was collected in a number of different ways. Prior to the inspection the manager provided the Commission for Social Care Inspection with written information about the home in their annual quality assurance self assessment (AQAA). Verbal feedback was received from health and social care professionals associated with the service. The inspection was conducted over two days one visit commencing at 09:30 and other at 15:00; this ensured a range of staff and residents were met. The manager was available to provide information and answer questions, as were staff. The inspector spoke both formally and informally to staff and enjoyed meeting residents over the tea time period on the second day. Assessment of the care provided was undertaken through direct observations, sampling records and most importantly seeking the opinions of residents and staff. Other documentation was read and this included health and safety records, staff recruitment, supervision and training and the overall management and maintenance of the home. A tour of the premises was conducted and some residents’ bedrooms were viewed. The inspector would like to thank all the residents, staff and manager for their help and hospitality during the course of this inspection. What the service does well:
There is a happy, friendly and welcoming atmosphere at Douglas Jackman House. This was observed and confirmed by comments received from visiting professionals who said: “Douglas Jackman House is a very open environment. Visits are always welcome even if not arranged in advance. The atmosphere is friendly”. “I always find the staff pleasant and helpful”. “The residents are well looked after”. “Nice atmosphere”. People living at Douglas Jackman House are supported to lead full and active lives and their choices are respected. On the first day of the inspection one person was going out with their family and another was going into town shopping, others had chosen to go the Social and Educational Centre and one person was at College. On the second visit a group were off to the Firework Display at Weymouth. It was evident from the reactions and observations of the residents that they enjoy themselves getting out and about but are equally happy to be at home in the company of each other and the staff. Staff are provided with good leadership, are motivated and provide good care that meets residents’ needs. Safe systems are in place to ensure residents receive their medication as it is prescribed and to minimise risk of error. This
Douglas Jackman House DS0000032030.V353297.R01.S.doc Version 5.2 Page 6 promotes the health and safety of residents and simultaneously safeguards their welfare. Without exception all residents indicated that staff treat them well. The service is very good at planning and delivering individual services and care. There is a supportive and encouraging approach toward people who live at Douglas Jackman House and one that promotes independent lifestyles. The home has very good documentation available to introduce new residents to the home although new admissions are not planned in the future. Good recruitment procedures are in place and a comprehensive staff training and development programme available. There are well-developed links established with community health and social care teams and specialist health personnel. Staff are very committed and focused in their provision of care and do this in a sensitive, encouraging and friendly manner. Detailed documentation is available about the services and care provided. Positive steps are taken to make these appropriately accessible to people. The manager and staff have the best interests of people in mind throughout their work. As one relative commented “the care is excellent and I am made to feel at home when I visit”. Staff are keen to improve means of interpersonal communication and enhance the lives of people in the home, and the manager and staff seek the views, advice and skills of other related professional personnel to achieve this. Staff training and development programmes are comprehensive and kept up to date. The manager and staff work very hard to maintain a comfortable and safe home and do so with the best interests of the residents in mind. The outcomes for the people living at Douglas Jackman House are judged to be good. What has improved since the last inspection?
The care planning system used in the home is being developed and will, when completed, reflect a genuine person centred approach for planning the services and support each person requires to ensure a safe and stimulating lifestyle. Since the last inspection a considerable amount of work has been completed to the environment and some of this remains on going, e.g. new fire safety sprinkler system.
Douglas Jackman House DS0000032030.V353297.R01.S.doc Version 5.2 Page 7 The car parking area to the rear of the property has been increased and resurfaced. A new conservatory/dining area has been created and this has also increased office space. New flooring has been laid in the kitchen. The home has achieved a five star rating for the food hygiene standards and quality of meals served from the main kitchen. Some members of the staff team have completed training in person centred planning and are very enthusiastic to commence working side by side with residents to genuinely implement this method of identifying residents’ interests, aspirations and practical needs. Consultation forms have been developed with residents to ensure their views are collated and form the basis of the quality assurance system for the home. 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. The summary of this inspection report can be made available in other formats on request. Douglas Jackman House DS0000032030.V353297.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 Douglas Jackman House DS0000032030.V353297.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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has good procedures, paperwork and care practices in place to ensure the needs of individuals are assessed, promoted and appropriately acted upon. The manager and staff were very clear that no one would be offered a place unless their needs had been assessed and their suitability to complement the existing group of residents carefully considered. EVIDENCE: The information available to prospective residents, their family and or representative is well documented. The Statement of Purpose and Service User Guide are regularly reviewed and are currently being updated. Both documents are accessible and available to family and representatives. The home’s use of photos and symbols in their documentation is being developed and this will provide alternative methods for residents to increase their decision making and involvement residents in everyday events in their life and will ensure that all residents are positively included in all aspects of their lives. Douglas Jackman House DS0000032030.V353297.R01.S.doc Version 5.2 Page 10 Assessments of people’s needs are comprehensively detailed as is the care planning documentation in use. Records show that a very holistic approach is taken in planning for people’s care, their needs, wishes and aspirations and written evidence illustrated how these are achieved. The last person to move to Douglas Jackman House benefited from a series of respite stays and was therefore well acquainted with other residents and the staff before being supported to make a decision to move in permanently. Despite being well known to staff the full admission procedures were completed and well documented; these included a new admission checklist, record of all visits, help list, pre-admission assessment and the distribution of the Welcome Pack which contains information about the home, local advocacy services and how to raise a concern. Douglas Jackman House DS0000032030.V353297.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager and staff are very focused on achieving individual outcomes for people. These are carefully monitored through a developed system of care planning. Staff know how to meet people’s needs and there is evidence that people living at Douglas Jackman House are supported to make choices in their day-to-day lives. Risk taking is well managed and a good balance is achieved between promoting independence and ensuring the well being and safety of people. EVIDENCE: The manager and staff have developed individual care plans for people. Individual ways of communicating are included and staff are constantly seeking ways of furthering people’s involvement in their daily lives. Information is kept up to date and very person centred.
Douglas Jackman House DS0000032030.V353297.R01.S.doc Version 5.2 Page 12 The care planning in the home is maintained with the use of daily records and staff “handing over” and “sharing information” from one shift to another. The care plans identified people’s needs and their abilities. Some people have complex needs and can present behaviour, which can be difficult for other people living and working at the home to understand. Discussions with staff showed that they are familiar with residents’ needs and how to individually meet the person’s needs and preferences. Staff were observed adhering to safety measures put in place to minimise risk The care planning system is currently being strengthened and developed into a comprehensive person centred planning approach. Several staff have completed the relevant training and the documentation, which will be used with each person to develop their service plan, is excellent. The manager and staff are very keen to start work with each person arranging planning meetings and then further time to work with them to convert all their ideas into achievable service plans and the practical ways staff will support and guide people to their achievements and goals. Risk assessments have been undertaken and are integrated into the everyday life experiences of people living at Douglas Jackman House. The format of the risk assessments are being reviewed and will become an integral part of the person centred planning. This practical approach encourages and supports people to be appropriately involved in events in their lives in a safe manageable and balanced manner. Staff were observed being very diligent about ensuring people were comfortable and their physical and emotional needs attended to. A health professional told CSCI “staff have a good rapport with residents and awareness of individual needs.” Douglas Jackman House DS0000032030.V353297.R01.S.doc Version 5.2 Page 13 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents lead busy and interesting lives pursuing activities of their choice. People’s rights are promoted and their individuality respected. Meal times are catered for on an individual basis both in the home and through using community facilities. EVIDENCE: People’s leisure and community involvement are detailed in their personal records and staff are very encouraging and supportive of people’s participation. Staff attended to these in a manner that respected people’s individuality and planned people’s inclusion with this in mind. Staff said that residents go out most days, the cinema, restaurants, shopping or attendance at the local Social and Educational Centre. It was good to learn that both the home and day
Douglas Jackman House DS0000032030.V353297.R01.S.doc Version 5.2 Page 14 services work co-operatively ensuring a flexible approach with reference to the residents’ attendance at day services. Family members are encouraged to be involved in the home and it was very evident that residents are supported to maintain contact with friends and family and staff are to be commended for the ways in which they support residents where it is difficult for relatives to maintain contact by visiting the home. Staff confirmed that fresh food stocks are always available and that meals are of a good quality. The home employs two cooks and discussions with one during the course of the inspection described a range of residents’ dietary needs and how each person’s requirements are met. Mealtimes are clearly arranged to meet individual needs whether this is in the home or community. An evening meal was observed and residents where needed were discreetly supported. Residents and staff sat together for their meal, which was a calm and socialable occasion with staff discreetly supporting residents. The meal was healthy, colourful and generous in portion. A choice is available at every mealtime or an alternative meal if they wish. Throughout the visits staff were observed encouraging people to make their own decisions and their rights and choices were clearly being recognised and promoted. It is clear that this is one of the underpinning values of Douglas Jackman House. Residents have enjoyed summer holidays, some with their families and some with staff accessing the locally based Mencap caravan, a stay at Centre Parcs, Longleat. Even though staffing is provided by the home Dorset County Council still does not fund residents’ holidays and this good practice recommendation is repeated for the second time having been previously identified in other inspections. Douglas Jackman House DS0000032030.V353297.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Healthcare matters are well managed and documented. Residents’ personal care preferences and health needs are known and changes are responded to. An appropriate importance is placed on the health and safety of people. Medication systems are in place to promote people’s health and to minimise the risk of error. EVIDENCE: Personal care preferences are included in plans of care and are known to staff. Staff were able to describe for example whether residents preferred a bath or shower, what time they liked going to bed or getting up and this information cross referenced with the written care plans. Where required, moving and handling was assessed with safe procedures in place supported by the availability of appropriate equipment such as a manual hoist for use in one bathroom. Staff have a very good understanding of people’s healthcare needs and work positively with local health care professionals and the records showed that as
Douglas Jackman House DS0000032030.V353297.R01.S.doc Version 5.2 Page 16 well as regular routine health screening prompt attention is given to any change in a resident’s physical and emotional needs. Records showed that any changes are carefully monitored. A health care professional said, “If there are any issues staff contact health professionals and have regular clinic appointments and GP visits. Staff support residents to ensure all appointments are kept.” The care planning, which is being developed, includes healthcare matters and recording the outcomes in a progressive and positive manner. Douglas Jackman House has benefited from a consistent staff team that are both experienced and knowledge and have a good understanding of people’s healthcare needs. Policies and procedures for medicine management are in place and these are well organised. Medication records, protocols and storage were all checked and no specific areas for improvement were identified. Residents are receiving their medication as prescribed. Douglas Jackman House DS0000032030.V353297.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The service is managed in the best interest of people who live at Douglas Jackman House. There have been no complaints or concerns since the last inspection. Where vulnerabilities are evident action is taken to minimise risk to those living at the home. The home has a system for safely managing people’s financial arrangements and these are monitored regularly. EVIDENCE: Meetings with residents take place approximately every month and are minuted. There is a detailed complaints policy and procedure and a semi pictorial version available and displayed. The home has not received any complaints and CSCI is not aware of any. Adult protection policies and procedures are available and the manager and staff are experienced at identifying and reporting incidents/allegations through the appropriate channels to ensure that vulnerable adults are protected. The training records showed that all staff have received training in safeguarding adults and those spoken to displayed a sound knowledge of the appropriate action to take and importantly a good understanding of how to avoid behaviours escalating.
Douglas Jackman House DS0000032030.V353297.R01.S.doc Version 5.2 Page 18 Residents’ financial records were checked and reconciliation systems were discussed with staff who felt that the system for managing residents’ monies as “absolutely robust” and “every penny is accounted for”. The reconciliation system was checked and all receipts and accounts were signed off and checked. If staff are required to sign on behalf of a resident then two staff are required to sign for these transactions. Douglas Jackman House DS0000032030.V353297.R01.S.doc Version 5.2 Page 19 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The clean, homely, environment is well maintained. Changes are made where necessary to ensure that the home and the physical environment continues to meet people’s needs. EVIDENCE: The premises are spacious, clean and well equipped. People competent to do so have carried out assessments and their advice is acted upon to ensure that the premises and equipment continue to meet the needs of people living at Douglas Jackman House. All arrangements are in place for the general health, welfare and safety of people living and working in the home. Guidelines and procedures are followed regarding environmental health and fire safety. Bedrooms are comfortable, personalised and pleasant environments and staff are instrumental in making these as individual and personal as possible.
Douglas Jackman House DS0000032030.V353297.R01.S.doc Version 5.2 Page 20 A tour of the premises showed that they are safely managed. Staff are aware of general infection control principles and personal protective equipment is provided. Since the last inspection a considerable amount of work has been completed in the home and to the grounds and some of this remains on going, e.g. new fire safety sprinkler system. The car parking area to the rear of the property has been increased and relaid. A new conservatory/dining area has been created and increased office space. New flooring has been laid in the kitchen. The home has achieved a five star rating for the food hygiene and quality of meals served from the main kitchen. The two cooks should be commended for their high standards and positive attitude ensuring residents enjoy and benefit from good healthy eating. Douglas Jackman House DS0000032030.V353297.R01.S.doc Version 5.2 Page 21 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. There is a motivated and committed manager and staff team that are focused on meeting people’s needs. Staff ensure outcomes for residents are good and residents speak highly of staff with whom they have a good rapport. EVIDENCE: Staffing levels are suitable and an assessment of the rota shows that staffing ratios are being maintained. The service has developed its own bank of staff which are experienced workers and who are equally aware of the needs of the residents. Supervision records of staff were randomly selected and found to be up to date. Staff reported that they felt well supported on a day-to-day basis and continue to benefit from a comprehensive training and development programme. In addition staff are encouraged to identify any specialist training needs to help them understand residents’ individual needs and aspirations.
Douglas Jackman House DS0000032030.V353297.R01.S.doc Version 5.2 Page 22 The manager and staff are well informed of the needs of residents and demonstrate a great commitment to placing these needs first and ensuring each resident benefits from positive life experiences. Staff are continually looking at ways to make information user friendly and more accessible and consider this is an on going process; this commitment reflects good practice. Staff continue to study for National Vocational Qualifications (NVQ). Staff recruitment files were comprehensive and all records, references and statutory checks had been completed prior to staff commencing employment at the home. Douglas Jackman House DS0000032030.V353297.R01.S.doc Version 5.2 Page 23 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is clean and orderly. Outcomes for residents are good. Management systems are in place to minimise potential risks to residents. Residents continue to benefit from a service that places their personal well being first and where they are importantly valued as individuals. EVIDENCE: There are heath and safety policies and procedures available in the home and staff are informed of these matters. The records assessed on the day of the inspection were accessible and confidentially stored. Douglas Jackman House DS0000032030.V353297.R01.S.doc Version 5.2 Page 24 The manager is very focused in her responsibilities and is working to implement and maintain records and documentation systems in the home that benefit and enhance residents’ lifestyles. The manager stated that she felt well supported by senior management and in turn staff reported feeling well supported by the manager, describing her as “professional” but “one of us” and able to protect and drive the service forward. Detailed regulation 26 visit records were available and provide a good reflection of the daily life at Douglas Jackman House. Staff meetings are held regularly and are timed to enable the manager to feedback any organisational issues to the staff team following management briefings that she attends. Staff meetings are minuted and evidenced resident and care practices as the focus. Risk assessments of the premises based upon the vulnerabilities of residents are in place and these include a fire risk assessment. Weekly and monthly tests were all recorded and found to be current. Cold food storage, hot cooked food and water outlet temperatures are taken and recorded and action taken where temperatures do not comply with accepted safe ranges. Staff have successfully completed first aid training and basic first aid equipment was available. Moving and handling equipment, portable electrical appliances have all been serviced. The manager had comprehensively completed the AAQA (pre inspection information/ annual quality self assessment) and all information cross referenced with current records seen during the inspection visits. Arrangements in the home are very focused on meeting the needs, wishes and aspirations of the people living at Douglas Jackman House and these are balanced against the need to ensure their day to day well being and safety. Douglas Jackman House DS0000032030.V353297.R01.S.doc Version 5.2 Page 25 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 4 23 4 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 4 33 X 34 4 35 4 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 3 x 4 X 3 X X 3 X Douglas Jackman House DS0000032030.V353297.R01.S.doc Version 5.2 Page 26 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 YA25 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. It is recommended that a discreet screen is made available for the residents sharing a bedroom to ensure increased should they wish. (NB please note these two residents have shared a room for many years and enjoy each others company) It is recommended that all documentation used in the home refer only to Adults and not Children. The same standards of food hygiene achieved in the main kitchen should be achieved in the training kitchen. 3. 4 YA38 YA42 Douglas Jackman House DS0000032030.V353297.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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