Inspection on 18/12/07 for Eastbank

This inspection was carried out on 18th December 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Eastbank 16/12/08

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

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

CARE HOME ADULTS 18-65 Eastbank 26 Ledbury Road Hereford Herefordshire HR1 2SY Lead Inspector Jean Littler Key Unannounced Inspection 18th December 2007 01:30 Eastbank DS0000070047.V347937.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 Eastbank DS0000070047.V347937.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. Eastbank DS0000070047.V347937.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Eastbank Address 26 Ledbury Road Hereford Herefordshire HR1 2SY 01432 266177 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) Mr Russell Vance James Mr Russell Vance James Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Eastbank DS0000070047.V347937.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide care and accommodation for service users of both sexes whose primary care needs on admission to the home are within the following categories: Learning Disabilities (LD) 6 The maximum number of service users to be accommodated is 6. This is the first inspection since the change of ownership. 2. Date of last inspection Brief Description of the Service: Eastbank is registered to provide personal care for up to six adults with learning disabilities. The Home is situated in a residential road in Hereford within walking distance of the city centre. The house is four storeys with a garden and comprises of six single bedrooms, staff facilities, a kitchen, laundry, bathrooms, a lounge and a dining room. Information about the Home is available from the provider on request. The weekly fees are currently £367 per week. The residents are expected to pay for personal services such as haircuts and chiropody and personal items such as clothes and some toiletries. They also have to pay for holidays, transport costs and social activities. Eastbank DS0000070047.V347937.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out over 3.5 hours. The new owner was on duty and helped with the process. The inspector looked around the house and spoke with four of the residents. Some records were looked at such as care plans, medication and money. The residents and their relatives were asked their views in surveys before the visit. The owner sent information about the Home to the inspector before the visit. What the service does well: The residents are supported to access local health care. There are supported to follow their chosen lifestyles and take part in activities they enjoy. The residents are supported to have friends and stay in touch with their families. The residents live in a homely and safe house as a family group. They have nice single bedrooms. They are supported to be independent and go out without staff. The residents are asked for their views and chose the staff who work in the home. The residents like the staff and because the staff team is small they get to know each other well. Eastbank DS0000070047.V347937.R01.S.doc Version 5.2 Page 6 The residents choose the menu and like the food. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Eastbank DS0000070047.V347937.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Eastbank DS0000070047.V347937.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 4. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Prospective residents would be given information about the service and have their needs assessed. They would be enabled to visit the service, and if suitable, move in on a trial basis. EVIDENCE: The new provider, Mr James, has developed a Statement of Purpose and Service User’s Guide. The Guide could be developed into a more accessible format for people with a learning disability e.g. with the information written more clearly in plain English with visual prompts. Mr James has developed a new Terms and Conditions of Residency document and plans to issue this to the residents. There have not been any vacancies for over two years. Mr James has however written an admissions procedure that lays out how any prospective residents would have their support needs assessed. If judged to be suitable they would be enabled to visits and spend time with the residents and staff. If a place is offered the person would move in on a trial three month period and they, their representatives and the other residents would be consulted before the placement became permanent. Eastbank DS0000070047.V347937.R01.S.doc Version 5.2 Page 9 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, 8, 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents basic support needs are detailed in their care plans. They are being supported to make daily decisions about their lives and take reasonable risks as part of living a fulfilling life. EVIDENCE: All residents have a care plan that contains some basic details about their needs. Mr James has started the process of reviewing the residents’ support needs. He reported in the AQAA (the annual quality assurance assessment that providers are asked to complete) that he aims for each resident to have person centred support plan that they have been fully involved in developing and can understand. Better records are being made about each resident’s wellbeing. When residents take a bath is still being recorded in a communal book. This old fashioned and impersonal system should be ended. Care reviews have been held both internally and with the residents’ representative such as social workers. The member of staff spoken with felt that the needs of the residents were known and staff worked in relatively consistent ways even though they often Eastbank DS0000070047.V347937.R01.S.doc Version 5.2 Page 10 work alone. She had not attended a staff meeting but felt because the team is small she information is effectively shared in other ways. A communication book is used and a diary. Mr James has begun to review and develop the risk assessments and the arrangements in place to help residents stay safe while enjoying life. He has been pro-active about this e.g. going into town with residents to assess their road skills. Some minor changes have been agreed with the residents to increase their safety e.g. a staff member crossing the road outside the Home with them each morning. One resident is reluctant to accept a change in route after dark that Mr James feels is sensible but the resident appeared under pressure to conform. Mr James must remember that as this resident has the capacity to make this decision he must respect the resident’s right to take risks. Clear records can be kept of how safety information has been provided and of Mr James’ views. The residents and their relatives gave positive feedback about how the residents are being supported and enabled to make choices. Mr James said he is consulting the residents about their daily routines and all have personalised lifestyles. He has removed some restrictions that came to light such as not taking drinks into the lounge. The member of staff said residents continue to go to their rooms to watch television or listen to music after their 9pm supper drinks out of habit rather than returning to the lounge. All go out independently, some walking and using public transport others using taxis to go to their day activities or jobs. Residents meetings continue to be held each week where the residents make decisions that affect them. Examples of these are group plans about social activities and holidays. The care worker said she had observed a meeting and this was chaired in a very open and democratic way. Consideration should be given to residents chairing the meetings and accessible minutes being provided. Around the house the residents choose how to spend their time and they seek out staff support when they feel they need it. Mr James and the member of staff both gave examples of when residents make choices, such as to not attending planned activities. Eastbank DS0000070047.V347937.R01.S.doc Version 5.2 Page 11 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): 11, 12, 13, 14, 15, 16, 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents have a good quality of life and take part in appropriate activities and work. They integrate with the local community and are supported to maintain links with their families and friends. They are provided with a balanced diet and they enjoy their mealtimes. EVIDENCE: Unless unwell all the residents go out each weekday. Each resident has a busy personalised routine and these include day centre sessions, part and full time employment and work experience. One resident enjoys a gardening group so Mr James plans to start a gardening project at the house that this resident can be central to. All the residents were positive about their lifestyle and said they can choose how to spend their time. One reported that she can go to town when she likes to see what is going on. Some take part in leisure activities e.g. swimming, badminton, dance classes. Mr James said staff are more involved in evening activities. A new social club is being tried and recent trips out for music evenings and a carol concert have been enjoyed along with a trip to the coast to see an electric carnival. A car has been provided by Mr James and he Eastbank DS0000070047.V347937.R01.S.doc Version 5.2 Page 12 drives them to some activities and appointments. Some residents get about by walking, using public transport or taxis. The residents are encouraged to be independent in many areas e.g. most go out alone, they have front door keys, some keep their own money, one works full time and others are supported to work part time or on a voluntary basis. At home they get involved in daily tasks such as setting the table, drying up and tidying their own bedrooms. Relationships are appropriately supported between family, friends and partners. Mr James said some residents stay in touch by phone and others visit regularly. Survey feedback from day centre staff was positive. Examples include: all the residents still seem to be happy with their care under the new ownership; I have been kept fully informed and feel the high standards remain and the residents continue to be respected. They all do different things at different times; the service provides a real sense of home where the residents are supported to follow their interests and enthusiasms. The meals are prepared fresh by staff on a daily basis. The residents reported that they like the meals and make suggestions for the menu. There is usually only one main meal choice is provided which Mr James may want to review. He reported that choice is promoted, for example residents are being encouraged to choose their own packed lunch contents rather than everyone copying each other. Longstanding staff know the residents’ preferences but Mr James plans to develop a record of residents’ likes and dislikes. New food recording sheets have been introduced and these showed a reasonably balanced diet is being provided. The member of staff said there seems to be a realistic food budget. Most of the residents are involved in food shopping. . Eastbank DS0000070047.V347937.R01.S.doc Version 5.2 Page 13 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. Suitable arrangements are in place to meet the health needs of the residents and they receive personal care in the way they prefer. Medication is being safely managed. EVIDENCE: The residents are supported with their personal care needs in different ways, as they all need different levels of support. The only female resident has the top floor bedroom, which helps providers her with some privacy. She has been using one of the bathrooms with a toilet and the men have been using a separate gents only toilet, however Mr James is reviewing this arrangements as he feels it is institutional. The residents are able to follow their own preferred routines and make choices about who assists them. The newest worker said that although a bath book is kept that outlines a plan of bath days no pressure is put on residents who decline the offer to bath that evening. Mr James reported in the AQAA that the residents are supported in they way they prefer but that the care plan information needs to be developed. The residents and relatives gave positive feedback about how physical care needs are met. Very little evidence was provided in the AQAA about how health needs are met but Mr James has said that Health Prevention care plans will be developed. He Eastbank DS0000070047.V347937.R01.S.doc Version 5.2 Page 14 did report at the inspection that a chiropodist now visits the Home and that the residents are offered the opportunity to be weighed more frequently. One resident who has a tendency to gain weight is being encouraged to be more physically active e.g. walking into town. The previous provider had made arrangements for the residents to have annual general health checks with their GP. One resident’s records showed he had visited the dentist during the year and had an eye appointment booked for 2008. One resident has epilepsy and he has attended his annual appointment with a specialist. The newest member of staff had been shown a training video to prepare her to respond to a seizure. She was sensibly keeping her own mobile phone with her so she could stay with him while calling for assistance if needed. Mr James said a mobile handset is also available. The resident has an alarm to press for staff assistance at night if he has a seizure. This assumes he will be unhurt and able to call for attention. Mr James should consider informing the resident about the epilepsy alarms that are now available so he can make an informed choice about his safety. A purpose built cabinet has been purchased to store the medication in. A key safe is on order to improve security arrangements. A relatively small amount of medication is held and the office door is also kept locked. The records were clear and up to date showing that medication doses had been checked on arrival and given as prescribed. The supplying pharmacy has completed an audit and a returns book has been set up. Mr James reported that he had returned all medication that was not currently in use when he took over. Mr James reported that he has developed the medication policy and has attended accredited medication training in October 07. Other staff have not yet attended this training but some have many years relevant experience. The newest worker is not being asked to administer medication until she has attended a course. Mr James may wish to forward the policy to Mr Jones, one of the pharmacy inspectors, for comment. Eastbank DS0000070047.V347937.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The residents feel their views are listened to. They feel safe at Home and are being protected from abuse. EVIDENCE: Mr James reported in the AQAA that he listens to the residents’ views and has developed an open culture. He is consulting them more formally at their care reviews and the weekly residents meetings. There is a complaints procedure but the information on display is out of date and not accessible to the resident who cannot read. Mr James is planning to revise this and make the information more accessible. Residents reported in their surveys that they felt staff listened to them and they knew how to make a complaint. No complaints have been received by the service or the Commission since the change of ownership. Mr James showed evidence that adult protection had been covered during the newest worker’s induction. The worker confirmed she was aware of her duty to report any concerns. Other staff have attended adult protection training in the past. Mr James has reinforced the need to protect residents since his arrival and plans to improve the level of training provided in this area. A protection policy is in place, which reflects the local multi-agency Vulnerable Adult guidelines, but Mr James plans to improve this. No adult protection issues have been reported since the last inspection. The residents continue to report that they feel safe at home and are able to tell staff of their problems and concerns. Mr James believes the residents look out for each other’s welfare and would raise concerns on each other’s behalf if needed. Eastbank DS0000070047.V347937.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28, 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The residents live in a clean and comfortable Home that is reasonably well maintained. They have personalised single bedrooms. EVIDENCE: The Home is situated on a busy road in easy walking distance of the city centre. The rooms are spread over four floors. The staff facilities are located in the basement, the communal rooms are on the ground floor and these include the kitchen, laundry, lounge and dining room. The communal areas are large enough and the furnishings and fittings are of good quality and suitably domestic in style. The single bedrooms are spread between the ground and first floors. The residents have personalised their bedrooms over the years and they are supported to keep them clean. None have en-suite facilities but there are two bathrooms and a separate toilet. The laundry is situated in an area adjoining the kitchen and is only accessible through the kitchen or from an external door. This is obviously not ideal but very little soiled laundry is managed and Mr James reported in the AQAA that there is an infection control policy and he has improved practice in this area. Eastbank DS0000070047.V347937.R01.S.doc Version 5.2 Page 17 The house and garden continue to be kept generally well maintained and the house was clean and warm. The bathrooms need refurbishment. Mr James plans to do this as soon as funds allow. The previous owner did not permit the residents to run their own baths because the hot taps are not fitted with thermostatic temperature control devices. Mr James should have these fitted to increase the protection for residents whilst enabling them to be as independent as possible. The residents gave positive feedback about their home and were observed to move freely around the house in a relaxed manner. No hazards were seen and Mr James is ensuring residents keep the fire escape routes clear. He organised a fire safety inspection and has given approval for the recommended third fire break-glass to be fitted. He reported in the AQAA that the electrical appliances and heating have not been tested or serviced at the recommended frequency. He is taking action to address these matters. Eastbank DS0000070047.V347937.R01.S.doc Version 5.2 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 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35, 36. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The residents are being supported by a committed group of staff who they like who are reasonably well trained and supported. The recruitment procedures are helping to protect the residents. EVIDENCE: The residents reported in their surveys that they like all the staff. They were observed to interact positively with the worker on duty. The staff team is made up of the provider and four support staff. Only one worker is usually on duty at any one time to support the residents. This is judged to be sufficient as the residents are independent in many areas. During the week the shifts are a 3pm start, sleep-in duty and morning shift until 9am. Mr James or the senior is on call while the Home is empty in case one of the residents needs to return from their day activities. At the weekends the shifts are sometimes long with one worker covering between Friday afternoon to Monday morning with two sleep-in duties. Longstanding staff have worked these pattern for many years. This type of shift pattern is not considered good practice as staff can become tired and isolated so Mr James should try to phase this out. The work is often not pressurised and no poor outcomes have been reported as a result of the arrangement. Eastbank DS0000070047.V347937.R01.S.doc Version 5.2 Page 19 Mr James reported that he hopes to increase the staff team to seven. This should make the team more able to respond to staff sickness and turnover and more flexible in meeting the residents’ needs. One worker left after the change of ownership, however Mr James and another worker are covering these hours. Two staff are now being rostered on duty on occasions. This is allowing residents more choice about whether to go on a group activity or stay at home with a worker. The residents have also benefited and enjoyed some day trips and evening activities out with staff. The newest worker started in November 07. The recruitment records showed an application form had been completed and the applicant had been asked about gaps in employment dates. A CRB check was received prior to employment starting. Only one reference was on file and this was not dated to show when it had been received. Mr James said two references had been received prior to appointment and the second one was on his computer. He agreed to ensure all evidence was on the file. Three residents assisted in the interview process, which they had enjoyed. The applicant had looked around first but was already known to the residents, as she is a relative of an existing worker. Mr James had completed an induction check for this worker, which was dated and all but three sections had been signed off as complete. The outstanding areas of responsibility such as medication and residents finances he wanted to cover fully after the holiday period. He had accessed the Skills for Care Council’s common induction standards and planned to support the worker to complete these in the new year. She had already attended some core training courses and others were planned. The worker confirmed she had felt very well supported and had worked as an extra person for four shadow shifts before being left to work alone. She had found the training appropriate and helpful. She had not had a supervision session yet while the induction sessions were taking place but said she saw Mr James regularly and felt able to raise any issues or questions. Mr James reported in the AQAA that he plans to provide staff with regular supervision sessions and introduce an appraisal system. Staff meetings are not held regularly however handover meetings take place as staff change over at the weekends and during the week. These are recorded and a communication book and diary are also used to ensure good communication and planning. Training records are in place for each worker and Mr James is aware that training needs to be developed to be in line with the nation minimum standards. Only two of the staff have a relevant qualification and another is working towards gaining an NVQ award. Eastbank DS0000070047.V347937.R01.S.doc Version 5.2 Page 20 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, 38, 39, 40, 41, 42. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The residents are benefiting from a home that is being run in their best interests. The new provider is aware that shortfall in some areas need to be addressed. EVIDENCE: The Home changed ownership in July 2007 and Mr James became the provider. It is his only care home and he also manages the service. He has relevant experience but has not been a registered manager or provider before. He has gained the NVQ 4 in Care and the Registered Managers Award. He is working on shift regularly and has made good efforts to get to know the residents well. The feedback in residents and relatives’ surveys was positive. One resident said we are very happy with Russell and Kate James the new owners. The worker spoken with said the staff worked well for him and he is encouraging the residents’ personal development. The residents seemed very Eastbank DS0000070047.V347937.R01.S.doc Version 5.2 Page 21 relaxed and were enjoying secretly discussing buying him a Christmas present. The findings of this inspection indicate that Mr James is reviewing the service and implementing positive changes in a paced manner. This could be formalised by a plan being developed with aims and timescales. The residents and staff can then be fully informed of the plans and can contribute where possible. Mr James reported in the AQAA that he is consulting the residents as part of the quality assurance process during the regular meetings and through pictorial questionnaires. He has improved several areas such as staffing and record keeping and he knows the systems and policies need to be further developed. Once the standards are improved across the board it would be beneficial if a more structured approach to monitoring were introduced e.g. an annual programme of reviews that cover all areas of the service. The findings from this process can be used to provide better factual evidence in future AQAAs to back up Mr James’ assessment of the service. A sample of residents’ financial records were seen. Mr James has taken over appointeeship for all of the residents. Currently the residents only have savings accounts so Mr James has arranged for their benefits to be paid into a central Eastbank account. Their personal allowance cash is then brought into the Home for them to have access to. Regulation 20 indicated that residents’ personal money should not be paid into a central account unless it is in the residents’ names or separate from the business accounts of the Home. Mr James agreed to support the residents to set up current accounts to enable them to receive their own benefits and then pay Mr James their fees by cheque. He also agreed to review the necessity for most of the residents to keep their money in the office. No health and safety hazards were noted during the inspection. As mentioned fire safety has been reviewed along with risk assessment, infection control and the servicing of equipment. Mr James is aware that an over-riding health and safety policy needs to be developed along with COSHH risk assessments, an accident procedure and an emergency plan. First aid arrangements are going to be improved as all staff are going to take the four day full qualification course. Eastbank DS0000070047.V347937.R01.S.doc Version 5.2 Page 22 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 2 2 3 3 X 4 3 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 2 28 3 29 x 30 2 STAFFING Standard No Score 31 X 32 2 33 3 34 3 35 2 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 2 x LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 2 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x 3 3 2 2 2 2 x Eastbank DS0000070047.V347937.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? NA 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 Refer to Standard YA5 YA1 Good Practice Recommendations The statement of purpose should contain information about the size of the rooms in the care home. Provide information about the service in a format that is more accessible to the residents and any prospective residents with learning disabilities. Issue the new terms and conditions to the residents. Enable them to access independent support with this process if required. 2 YA6 Develop the care planning system so all residents have a person centred plan that reflects their support needs, goals and aspirations. Provide the residents with accessible information about how to raise concerns and make complaints. 3 YA22 Eastbank DS0000070047.V347937.R01.S.doc Version 5.2 Page 24 The residents’ representatives should be provided with a copy of the complaints procedure that reflects the change of ownership. 4 YA27 YA42 Carry out plans to refurbish the bath and shower facilities. Fit baths and the shower facility with thermostatic temperature control devices and then enable residents to bath more independently. 5 6 YA20 YA35 YA42 YA19 All staff who administer medication should attend an accredited training course. Review the arrangements in place at night for a resident who has epilepsy and consult the resident about the options available to help keep him safe. Review lone working arrangements and accessibility of a telephone in emergencies. 7 YA33 YA11 Review the shift working patterns and phase out the practice of staff working excessively long shifts. Continue to develop the flexible use of staffing to enhance the opportunities offered to the residents. 8 YA34 Ensure the recruitment policy fully reflects the current legislation including the need to establish from previous employers why an applicant left work with vulnerable adults or children. Ensure all recruitment information is held on the staff member’s file and available for inspection 9 10 YA39 YA40 YA41 Develop a clear plan of how the service is going to be developed and consult stakeholders about this. Make alternative arrangement so the residents’ personal monies are not being paid into a central bank account that is used by the provider. (Reference regulation 20). Develop a health procedures. and safety policy and associated 11 YA42 Eastbank DS0000070047.V347937.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Shrewsbury Local Office 1st Floor, Chapter House South Abbey Lawn Abbey Foregate SHREWSBURY SY2 5DE 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 © 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 Eastbank DS0000070047.V347937.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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