CARE HOME ADULTS 18-65
East Wheal Rose Farmhouse St Newlyn East Newquay Cornwall TR8 5JD Lead Inspector
Lowenna Harty Announced 05 July 2005 09:30 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. East Wheal Rose Farmhouse D52-D04 S9099 East Wheal Rose V229416 050705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service East Wheal Rose Farmhouse Address St Newlyn East Newquay Cornwall TR8 5JD 01872 510750 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) Spectrum Mrs Sharon Waterton Care Home 3 Category(ies) of Learning Disability (3), Mental disorder, registration, with number excluding learing disability or dementia (3) of places East Wheal Rose Farmhouse D52-D04 S9099 East Wheal Rose V229416 050705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: Service users to include up to 3 persons aged 16 to 25 years with a Learning Disability (LD) and/or Mental illness (MD) Date of last inspection 06.01.05 Brief Description of the Service: East Wheal Rose Farmhouse is a home providing accommodation and personal care for up to three service users aged 16-25 years with a learning disability and/or mental disorder. The registered provider is Spectrum, an organisation that provides specialist care for adults with autistic spectrum conditions. Spectrum employs a manager and a team of staff to run the home on a day-today basis. The home is situated on the outskirts of the village of St. Newlyn East, in a very rural location, but within a short driving distance of Newquay. The home is set in its own grounds and offers privacy for service users. Spectrum supplies vehicles to enable service users to make full use of community facilities in the local area. The house is a spacious, two-storey building. Service users are provided with single bedrooms, which are on the first floor. There are two bathrooms, also on the first floor. Downstairs there is a kitchen, large lounge and separate dining room. There is also a dedicated office. The property has gardens to the front and the rear of the building with ample car parking space. The home does not have specific access facilities for people with physical or sensory disabilitites although there is some scope for adaptation of the building if required. East Wheal Rose Farmhouse D52-D04 S9099 East Wheal Rose V229416 050705 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an announced inspection as part of the home’s annual inspection programme, which took place on 5 July 2005. The inspection lasted for nearly 6 hours and consisted of the following activities: 1. Inspection of records, including assessment information and care plans 2. Discussion with the registered manager on how it operates on a day-to-day basis 3. Inspection of the premises 4. Interview with a member of staff 5. Interviews with both of the service users currently in the home with assistance from staff and in the communal areas of the home. 6. Input from a relative of a service user, who supplied the commission with information prior to the inspection. This indicated that they are satisfied that service users are well cared for in the home. 7. Pre-inspection information supplied by the registered manager of the home 8. Observation of the daily life of the home with particular regard for the interaction between staff and service users. Overall the home provides service users with a good standard of care, which encourages them to develop their skills and independence, although the environment requires extensive re-decoration and modernisation. There are plans for the service users to move on to an alternative property within the Spectrum organisation, so much of the inspection was focused on the planned move. The inspector would like to thank the registered manager, staff, relatives and service users for their kind assistance in the conduct of this inspection. What the service does well:
The service users currently in the home have lived there for some years. There are plans in progress for them to move on to another property within the Spectrum organisation. There were no plans to admit any further service users at the time of the inspection. Current service users have been given good information, in appropriate formats on this home and the home they will be moving on to, in addition to the home’s more detailed statement of purpose. There is detailed assessment information to ensure that they and their
East Wheal Rose Farmhouse D52-D04 S9099 East Wheal Rose V229416 050705 Stage 4.doc Version 1.40 Page 6 representatives can be confident that their future needs have been fully identified. There are plans for the staff working with them at this home to move with them, so that they will continue to be helped by people who know them well. Service users are helped to make decisions and are offered choices, for example about what they want to do during their free time. There is written information about their preferences and favourite activities to guide staff and they are helped to develop their independent living and communication skills. There are detailed risk assessments to guide staff so that they are able to help service users to take safe risks so that they are not unduly restricted, but they and other people are protected. Personal information about them is held securely so that they and their representatives can be assured that it is confidential. Service users enjoy active lives, in and out of their home and are helped to develop their skills and interests individually. They attend a local college, at different times and are encouraged to undertake a range of tasks in the home according to their individual abilities. There is appropriate consideration of their cultural and faith needs. Staff assist them with personal care tasks and take pride in helping them to appear fashionably dressed and well groomed. There are sufficient staff to support service users and they are all qualified or undergoing training to achieve qualifications. They have good access to ongoing training and the home’s recruitment records show that they employed on the basis of fair, safe and effective recruitment and selection processes. The home is generally well managed for the benefit of the service users. The registered manager is very committed to ensuring their future needs are well met and complied with all the requirements set at previous inspections that she has control over. Immediate requirements were complied with immediately. She is in the process of completing an annual quality assurance check by sending out questionnaires to service users’ relatives and representatives and providing service users themselves with questionnaires in appropriate formats to enable them to state their views about the quality of the care provided to them. The home’s environment requires considerable attention, but service users have spacious accommodation with individual bedrooms, a choice of communal areas and a large garden. The home’s location is very rural but Spectrum provides vehicles and sufficient drivers on the staff team to enable service users to make full use of local community facilities and resources. What has improved since the last inspection?
The home’s statement of purpose has been revised and updated so that service users and their representatives now have information on confidentiality and the circumstances under which information may be shared so that they can be assured of the security and privacy of their personal information. The home’s registration certificate was on clear display at this inspection so that visitors to the home are immediately aware of its legal status. The registered
East Wheal Rose Farmhouse D52-D04 S9099 East Wheal Rose V229416 050705 Stage 4.doc Version 1.40 Page 7 manager has drawn up a training plan for the team as a whole, which can be used to identify staff training needs and prioritise training so that service users are protected by staff with the necessary skills to work with them effectively. The registered manager has commenced work on drawing up an annual development plan for the home, although plans for current service users have changed and they will be shortly moving on to alternative accommodation within the Spectrum organisation. There are improved facilities for correct hand washing and documentary evidence of staff having undergone training in basic food hygiene so that service users and their representatives can be more confident that they are protected from the risks of infection. The main improvement relates to record keeping in the home. There are now full records in the home to demonstrate that the staff working there are fit to do so and safe to work with vulnerable adults, which is important for service users’ wellbeing and protection from abuse. A staff member interviewed at the inspection said that both the service users have benefited from their structured care plans. She has noticed that their concentration spans are longer, particularly at college and there are fewer incidents of negative behaviours that place them at risk. What they could do better:
The service users are shortly due to move on to an alternative placement within the Spectrum organisation. Their future needs have been assessed and identified and now they need written care plans to reassure them and their representatives that they will be properly met. This needs to include consideration of their long-term plans and what their wishes would be in the event of their becoming seriously ill, for example. This is important now that plans for the move at are an advanced stage and prospective moving dates are being considered. Whilst the home’s manager and staff have initiated ways of helping service users to maximise their communication skills, they may benefit from specialist input in this respect and local options for this should be explored. Spectrum is in the process of reviewing and updating all its policies and procedures for guiding staff in working safely and effectively with service users. This work needs to be completed and some written procedures should be prioritised, particularly written guidance on medicines management, to reduce the risks of medication errors. Staff should be provided with safe handling of medicines training to enhance the training they receive during their induction to the home to further reduce the risk of errors and storage facilities for some medicines need to be improved so that they are fully secure. Other written policies, which should be prioritised, are those relating to staff handling service users’ money to provide them with sufficient detail on how to properly manage and account for it in their best interests and written policies to guide staff on the protection of vulnerable adults from abuse. Staff should also have ready access to copies of local multi-agency procedures for the protection of vulnerable adults and procedures from each of the service users’ placing
East Wheal Rose Farmhouse D52-D04 S9099 East Wheal Rose V229416 050705 Stage 4.doc Version 1.40 Page 8 authorities so that they know how the various agencies work together in this respect. The registered manager would benefit from access to local multiagency training, which should then be communicated to staff so that everyone is fully aware of what to do should they suspect that a service user has been abused, and takes the right action to protect them. The home’s environment, whilst spacious, is in need of extensive re-decoration and modernisation to make it homely, comfortable and attractive for service users. Spectrum has been asked to provide the Commission with its plans for undertaking the necessary work for the benefit of future service users who may be admitted. The kitchen, in particular, should be modernised so that service users can safely access and use it to develop their skills and independence. The laundry should be located away from the kitchen, where food is prepared and served to reduce risks of infection in the home. Staff should also be provided with training in infection control to better protect service users in this respect. Finally, the home’s annual development plan, which the registered manager has started to work on, needs completion, based on the analysed results of the current quality assurance exercise. 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. East Wheal Rose Farmhouse D52-D04 S9099 East Wheal Rose V229416 050705 Stage 4.doc Version 1.40 Page 9 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 East Wheal Rose Farmhouse D52-D04 S9099 East Wheal Rose V229416 050705 Stage 4.doc Version 1.40 Page 10 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 The home has good information on the service for prospective service users. Admission is on the basis of a detailed assessment of their needs. EVIDENCE: The home has a statement of purpose, which provides detailed information about the service to inform prospective service users and their representatives about what it provides. There is also a service users’ guide, which has been provided to service users in a pictorial format so that they can understand it. This also acts as a contract for their placement in the home. The statement of purpose has recently been updated and improved so that it now contains information on confidentiality and sharing of information to reassure service users and their representatives that their personal information will kept private. The correct registration certificate for the home is now on visible display to inform visitors of the legal status of the home. There are currently two service users living in the home, who have been resident there for several years. There is assessment information available in relation to both of them and they have recently undergone a process of detailed re-assessment with a view to their moving to an alternative property within the Spectrum organisation. Plans for them to move on are at an advanced stage and it has been planned that the staff working with them will accompany them to their new home. This will provide them with the continuity they need. There are no current plans to admit any further service users at the present time.
East Wheal Rose Farmhouse D52-D04 S9099 East Wheal Rose V229416 050705 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7, 9 & 10 Service users have detailed written care plans but they need to be updated to reflect their current situations, which are changing. Service users are helped to make decisions about their lives, but would benefit from further help with this. There are detailed risk assessments in place, which are appropriate to their needs. All information is held securely and confidentially. EVIDENCE: There are detailed written assessments for both service users in relation to their proposed move to an alternative property within Spectrum. They have also been given pictorial information and have visited the property, as part of the assessment and care planning process. Plans to move them were at an advanced stage at the time of the inspection and detailed written care plans need to be drawn up in consultation with them and their representatives. Service users’ current care plans and their assessments take account of their abilities to make decisions and describe ways in which care staff help them to make informed decisions. Daily care records, which service users help to prepare, back them up. Residents are assisted to maximise their communication skills using pictorial symbols and signs. They do not currently have specialist input in relation to developing their communication skills and
East Wheal Rose Farmhouse D52-D04 S9099 East Wheal Rose V229416 050705 Stage 4.doc Version 1.40 Page 12 this should be considered, so that they are able to maximise their abilities to communicate their choices and preferences. Service users’ current care plans and updated assessment documents take full account of risk factors involved in helping them to maximise their skills in independent living so that they are helped to make progress in as safe a way as possible. The home has a lockable office with lockable filing cabinets for the storage of personal information about service users. There is also a statement in the home’s statement of purpose on confidentiality and the circumstances in which information may be shared. East Wheal Rose Farmhouse D52-D04 S9099 East Wheal Rose V229416 050705 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13 & 16 Service users benefit from taking part in a range of activities in accordance with their needs and preferences. They are helped to safely access the local community and take responsibilities in their daily lives according to their individual abilities. EVIDENCE: Service users daily records and activity plans demonstrate that they both undertake a wide range of activities in and out of the home. These are mainly done individually and special account is taken of any risks involved in taking them out into the community. There are sufficient staff to help them access local facilities and both attend a local college at different times. Their care plans consider their religious and cultural needs and their preferences. Both are encouraged to help with household tasks in the home and have free time built into the structured daily routines that they need, according to their care plans and risk assessments. There are records in the home to demonstrate how their care plans have been successful in helping them to extend their skills and abilities in positive ways. East Wheal Rose Farmhouse D52-D04 S9099 East Wheal Rose V229416 050705 Stage 4.doc Version 1.40 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, 20 & 21 Service users are appropriately supported in all aspects of their personal care. The home’s policies, procedures and practice in respect of management of medicines need improvement. The wishes of service users in the event of their ageing, illness and death are currently being elicited. EVIDENCE: Service users’ care records and re-assessment documents fully account for their needs in relation to they ways in which they are supported with their selfcare, washing, dressing and grooming. They are encouraged to make choices about their personal appearance and staff help them to appear fashionably dressed and smart. The home’s written policies for medicines management need to be updated to ensure that staff receive adequate guidance and appropriate storage facilities for controlled medicines is needed. Staff handling medicines need full training to reduce the risk of medication errors. Service users’ current care plans do not specifically address their needs and wishes in the event of their serious illness or death but the registered provider is currently following this up with their relatives and representatives so that staff have guidance on what they should do in these situations. East Wheal Rose Farmhouse D52-D04 S9099 East Wheal Rose V229416 050705 Stage 4.doc Version 1.40 Page 15 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 23 Systems in place to protect service users from abuse, neglect and self-harm would benefit from improvement. EVIDENCE: There have not been any recorded instances of service users being subject to abuse whilst in the home. They appeared to be content and well looked after by a team of staff, who work together and rarely in isolation. Staff undergo some training as part of their induction on how to recognise abuse and protect vulnerable adults from it. There are records in the home to demonstrate that staff have undergone checks to determine their suitability to work with vulnerable adults. Spectrum needs to update its written policies and procedures for the protection of vulnerable adults from abuse so that staff have clear guidance on what to do should they suspect it is happening. In addition to this the registered manager should obtain copies of the local Council’s procedures for multi-agency working to protect vulnerable adults and copies of the procedures of each of the service users’ placing authorities. This is because of the need for all staff to be clear about the need for different agencies to work together in a clear and co-ordinated way when there is an allegation that a vulnerable adult has been subject to abuse. The registered manager should undergo multi-agency training available locally and cascade it to staff to enhance their knowledge of the local procedures. East Wheal Rose Farmhouse D52-D04 S9099 East Wheal Rose V229416 050705 Stage 4.doc Version 1.40 Page 16 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, 26, 28, 30 The home’s environment is in need of considerable redecoration and modernisation throughout, to make it comfortable for service users. They currently have single bedrooms and sufficient communal space to meet their needs. Further improvements are needed to maintain hygiene in the home. EVIDENCE: Extensive work is needed on the property, particularly in relation to decoration, as several parts have very worn and tatty paintwork. The kitchen is in need of modernisation to make it safe and suitable for service users to develop their skills and independence. There should also be a laundry separate to the kitchen, to fully protect staff and service users from risks of infection. There is plenty of space for the service users. They have a choice of communal spaces and both have single bedrooms and a bathroom for their personal use. At present, plans for them to move to an alternative property within Spectrum are at an advanced stage and there are no immediate plans to admit any further service users to the home. Most of the staff have training in basic food hygiene but none has training in infection control and they should be provided with this. There are now hand drying facilities in the staff bathroom and service users’ recent assessments account for their needs in relation to
East Wheal Rose Farmhouse D52-D04 S9099 East Wheal Rose V229416 050705 Stage 4.doc Version 1.40 Page 17 protecting them and others from the spread of infection. The home’s laundry area is in the vicinity of the kitchen but equipment is provided for the safe transport of laundry. The environmental health officer conducted a satisfactory inspection of the premises last year. The Commission has requested an action plan from Spectrum regarding its intentions for the improvement of the building before any further service users are moved into it. East Wheal Rose Farmhouse D52-D04 S9099 East Wheal Rose V229416 050705 Stage 4.doc Version 1.40 Page 18 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) 32, 34, 35 Staff are either qualified or undergoing training to obtain qualifications to demonstrate their competence to work with the service users in the home. They are well trained and have good access to ongoing training. Recruitment of new staff is fair, safe and effective. EVIDENCE: Information required to show that staff are safely and fairly recruited, properly trained and qualified to work with service users is now available in the home, which is a great improvement. Service users and their representatives can now be more confident that the staff working with them are fit and suitable to undertake the work they are employed to perform. Spectrum has introduced a computerised record system to safely and securely store personal information relating to the recruitment and selection of staff. The information checked at this inspection showed that new staff are selected on the basis of a written application, formal interview and provision all the information required by law to demonstrate their fitness to work in a care home. There are written records of new staff inductions to work in the home to prove that they have the basic skills they need to safely work with the service users and the registered manager has drawn up a whole house training plan for the home so that staff training needs can be easily identified and prioritised. East Wheal Rose Farmhouse D52-D04 S9099 East Wheal Rose V229416 050705 Stage 4.doc Version 1.40 Page 19 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, 39, 40 & 41 The home is well managed for the benefit of the service users. Their views and wishes are considered as part of the home’s ongoing development but the home’s written annual development plan lacks detail. The home’s written policies and procedures need to be reviewed, revised and updated but record keeping has much improved. EVIDENCE: The registered manager is experienced in managing the home and is currently undergoing training towards achieving NVQ level 4 in management. She runs the home for the benefit of the service users and ensures that requirements arising out of inspections are complied with to the extent of her individual control. This includes immediate requirements set at the time of the inspection. Quality assurance questionnaires have been sent out to service users’ relatives and representatives and a questionnaire using a pictorial format is currently being drawn up for the service users. One of them has an independent advocate and both have families that are closely involved in their ongoing care, one of them sent back a comment card that indicated service
East Wheal Rose Farmhouse D52-D04 S9099 East Wheal Rose V229416 050705 Stage 4.doc Version 1.40 Page 20 users are well looked after in the home. The registered provider has drawn up an annual development plan for the home but it lacks detail and needs to be updated once the results of this year’s quality assurance exercise have been analysed. Spectrum is in the process of updating its written policies and procedures across the organisation. Procedures that currently lack detail or are in need of updating more immediately should be prioritised. This includes, for example medicines, protection of vulnerable adults from abuse and the management of service users’ personal finances so that staff have clear guidelines to work by and are less likely to make errors that negatively affect service users. Record keeping, storage and arrangements in respect of ensuring confidentiality of information have much improved so that service users are protected by staff who have the information about them that they need and can be confident that this is confidential. East Wheal Rose Farmhouse D52-D04 S9099 East Wheal Rose V229416 050705 Stage 4.doc Version 1.40 Page 21 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 x x x Standard No 22 23
ENVIRONMENT Score x 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10
LIFESTYLES Score 2 2 x 3 3
Score Standard No 24 25 26 27 28 29 30
STAFFING Score 1 x 2 x 2 x 2 Standard No 11 12 13 14 15 16 17 x 3 3 x x 3 x Standard No 31 32 33 34 35 36 Score x 3 x 3 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
East Wheal Rose Farmhouse Score 3 x 2 2 Standard No 37 38 39 40 41 42 43 Score 3 x 2 2 3 x x D52-D04 S9099 East Wheal Rose V229416 050705 Stage 4.doc Version 1.40 Page 22 yes 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 6 Regulation 15(2) 12(1) Requirement Timescale for action 15/09/05 2. 20, 40 13(2) 3. 24, 26, 28 & 30 12 (1)(a), 12 (4)(a), Service users care plans must be updated and reviewed to take account of their current needs and plans. These must demonstrate how their needs will be met with particuar reference to: communication skills and development of these; individual activity plans; maintenance and develolpment of their social skills and skills in independent living and continuity of current activities, which they value. The registered manager must 15/09/05 ensure that arrangements in respect of the management of medicines in the home are in accordance with the guidelines of the Royal Pharmaceutical Society of Great Britain (June 2003) and current best practice. This is with particular reference to written policies and procedures to guide staff; access to appropriate training for staff who are handling medicines and safe storage of controlled medications. The registered provider must 15/09/05 ensure that the homes premises
Version 1.40 East Wheal Rose Farmhouse D52-D04 S9099 East Wheal Rose V229416 050705 Stage 4.doc Page 23 13(3), 13(4)(a) 16(2)(g) 23(1)(a) 23(2)(b) 23(2)(d) 23(2)(o) are fit for its purpose. They must supply the Commssion with an action plan with timescales as to how and when this will be achieved. This is with particular reference to the internal and external decoration of the building, provision of a kitchen that is safe and suitable for service users to access and use, provision of suitable laundry facilities and completion of repairs. This requirement is renotified. Previous dates have been set for compliance by 30/08/04 and 01/04/05. The time scale has been re-set to reflect that the current service users are shortly due to move on from the property and there are no immediate plans to move any further service users. 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 7 Good Practice Recommendations Service users should be given access to specialist services to assist them to further develop their communication skills to enable them to fully participate in making decisions about the care and services provided to them. The individual wishes of service users and/or their representatives in the event of their becoming seriously ill or their unexpected death should be elicited sensitively and recorded as part of the care planning review process. The registered provider should improve arrangements for the protection of vulnerable adults from abuse by reviewing and revising the homes written procedures; obtaining copies of multi-agency procedures from the local authority in which the home is located and each of the service users placing authorities and providing staff with access to local multi-agency training. Staff should be provided with infection control training.
D52-D04 S9099 East Wheal Rose V229416 050705 Stage 4.doc Version 1.40 Page 24 2. 21 3. 23, 40 4. 30 East Wheal Rose Farmhouse 5. 40 6. 39 The homes written policies and procedures to guide staff should be reviewed and revised. Written procedures in respect of the handling of servcie users personal finances should provide sufficient detail to reflect actual practice and ensure a clear audit trail in respect of money handled on behalf of any service user. The homes annual development plan should be more detailed and be clearly based on the results of the quality assurance exercise currently in progress. East Wheal Rose Farmhouse D52-D04 S9099 East Wheal Rose V229416 050705 Stage 4.doc Version 1.40 Page 25 Commission for Social Care Inspection John Keay House Tregonissey Road St Austell Cornwall PL25 4AD National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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