Inspection on 06/06/07 for Elizabeth House [Gloucester]

This inspection was carried out on 6th June 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Elizabeth House [Gloucester] 06/03/06

Elizabeth House [Gloucester] 18/10/05

Elizabeth House [Gloucester] 25/02/05

Elizabeth House [Gloucester] 23/09/04

Elizabeth House [Gloucester] 22/03/04

Similar services:

The Vicarage

7 Hyde Road

5 Seafield Road

Trevaylor Manor

12 Orchard Mews

Stallcombe House

Stepping Stones

Cornerstones

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

CARE HOME ADULTS 18-65 Elizabeth House Denmark Road Gloucester Glos GL1 3HW Lead Inspector Mrs Eleanor Fox Unannounced Inspection 6th June 2007 09:30 Elizabeth House DS0000016429.V336490.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 Elizabeth House DS0000016429.V336490.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. Elizabeth House DS0000016429.V336490.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Elizabeth House Address Denmark Road Gloucester Glos GL1 3HW 01452 782960 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) National Star College Mrs Julie George Care Home 24 Category(ies) of Physical disability (24) registration, with number of places Elizabeth House DS0000016429.V336490.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. That a member of the Management Team of Elizabeth House holds a current qualification as a Registered General Nurse. 6th March 2006 Date of last inspection Brief Description of the Service: Elizabeth House is one of two residential homes providing off site accommodation to students from the National Star College. The college owns the property, which was converted and fully refurbished into accommodation for 24 students with a physical disability almost 6 years ago. Situated in a residential area, the home provides easy access to the centre of Gloucester. Most students have single accommodation, some with en-suite facilities, which include a shower. There are three double rooms and sufficient bath/shower rooms and toilets. An independent living flat and training kitchen are also provided. Students have access to a spacious and comfortable lounge and a dining room. The home has two mini buses and students also use taxis and local transport systems. The provider supplies information about the service, including the most recent CSCI report, to students and their advocates on request. The current scale of charges is maintained within the Learning and Skills Council matrix. Elizabeth House DS0000016429.V336490.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The judgements contained in this report have been made from evidence gathered during the inspection, which included a visit to Elizabeth House and takes into account the views and experiences of people using the service. One inspector undertook this unannounced inspection over one day in June 2007. During the visit, she chose the care of three of the students for particular scrutiny. She spoke to each of these young people, read their care records, visited their bedrooms and, where possible, observed their interaction with members of staff. In two cases, she also observed their participation in personal development activities. The inspector had discussions with a group of students and a group of staff about their experiences at Elizabeth House. The inspector walked around the property and observed the service of a mid day meal during her visit. She also spoke with a member of the nursing team who explained the processes for the administration of medications and provision of any required medical interventions. Records relating to staff training were provided for inspection. The provision of quality assurance processes was also inspected. The inspector had the opportunity to talk to the Manager and to her deputy, particularly in relation to general management issues. Both were open and most cooperative in providing information as requested. Particular thanks is due for the production of an extremely well presented and detailed ‘Annual Quality Assurance Assessment’, which was provided to the Commission for Social Care Inspection prior to the visit. During an earlier visit to the National Star College the inspector read selected personnel and recruitment records. She also looked at the recorded evidence of the maintenance of equipment in use in the building. CSCI surveys were distributed to the students living at Elizabeth House. Nineteen were returned from students, some of which had been completed for them by a named member of staff; many of their comments and opinions are reflected in the content of this report. Elizabeth House DS0000016429.V336490.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? Since the last inspection the manager has been interviewed and registered by the Commission for Social Care Inspection. There have been improvements in the maintenance of care records at Elizabeth House. An enclosed attractive garden has been created for the students’ use. An additional lift has been installed in the residence, providing the students and staff with an alternative means of accessing all parts of the building. Elizabeth House DS0000016429.V336490.R01.S.doc Version 5.2 Page 7 There have also been improvements in the health and safety measures in place. These include the training of staff in First Aid processes; improved fire prevention processes and improved records. 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. Elizabeth House DS0000016429.V336490.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 Elizabeth House DS0000016429.V336490.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 and 4 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Students choose to be relocated to Elizabeth House once they have adequate information about the establishment and assurances have been given that their assessed needs may be met while they are accommodated at the residence. EVIDENCE: Very thorough assessments are undertaken for each student prior to their arrival at the National Star College. These are then reviewed and updated throughout their stay. Usually towards the end of their first year, students are offered a choice of where they will spend the rest of their College placement. Due consideration is given to their particular needs and preferences before any person is offered a place at Elizabeth House. If it then transpires that the placement is not appropriate, alternative arrangements elsewhere on the College campus will be made. Elizabeth House DS0000016429.V336490.R01.S.doc Version 5.2 Page 10 Students are provided with the opportunity to visit the available facilities before they make their choices. Some come over to Elizabeth House to have tea there; others may even stay for few days if there is an available bed. Where possible the new key worker visits the student in his or her current residence prior to relocation. Each person who spoke to the inspector was very happily settled in the accommodation and commented that they would be most sorry to leave at the end of term. Four students did comment in their surveys that they would have liked to have known more about Elizabeth House before they moved to the residence. This issue has already been identified in the unit and is now being addressed with the development of additional written information about the accommodation. Elizabeth House DS0000016429.V336490.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, and 9 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. There are comprehensive care planning systems in place, including risk assessments, which give detailed information to ensure that students’ health, personal and social needs are met. Students are supported to have autonomy over their individual life styles. EVIDENCE: Clearly detailed plans to address all areas of the student’s care and life style are documented and reviewed appropriately. Students participate fully in this process and where possible sign the completed records. This information is also recorded electronically to improve communication of information between the different sites throughout the college campus. Personal development profiles and clearly detailed target action plans are also agreed with each student and developed throughout their stay at the College. Elizabeth House DS0000016429.V336490.R01.S.doc Version 5.2 Page 12 These are also reviewed and updated with the full involvement of the student concerned. During conversation with the students it was evident that the young people are supported and encouraged to make decisions and choices about all aspects of their daily lives. Students are facilitated to manage their own personal monies as far as possible. Detailed risk assessments are undertaken on each person to assess their ability to undertake as independent a life style as is possible. These are reviewed and updated appropriately and cover all aspects of their college life. Any necessary restrictions are discussed and agreed with the individual concerned. Signed agreements were seen in their individual files. Elizabeth House DS0000016429.V336490.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): 11, 12, 13, 14, 15, 16 and 17 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. Students are facilitated to live as full and independent a life as possible. Good opportunities are provided for varied and stimulating activities to occupy the students and thus improve their quality of life. Students are supported to maintain any links they wish with family, friends and the local community, thus adding interest to their lives through social contact. An good standard and variety of nutritious food is provided for students living at Elizabeth House EVIDENCE: Elizabeth House DS0000016429.V336490.R01.S.doc Version 5.2 Page 14 While staying at the College, students are given support and are facilitated to achieve their documented personal development goals. On this visit, one person was developing catering skills; another was planning a trip into Gloucester. One student showed the inspector photographic evidence of his achievements throughout this year. Recently students entertained a group of residents from a local home for elderly people. The students did all the planning, from delivering invitations to getting the shopping. They made afternoon tea, which they then served while they entertained their guests. The students participate in college educational activities at the main campus and at Elizabeth House. Facilities and equipment are provided to suit their wide variety of needs. The students are supported to participate in local community life as much as they wish and are able. During conversation they described their trips to local clubs, sports centres and pubs; many also enjoy shopping in Gloucester City. They use college transport or alternative methods with staff support, if appropriate. The young people have numerous opportunities to take part in a wide variety of activities at the College. These include sports, creative pursuits, drama, and other special interest groups. In addition various entertainments are arranged at Elizabeth House; the students were due to have a barbeque shortly. Recently some of the young people have been on trips to London and to the Forest of Dean. Some of the students prefer to watch television, listen to music or enjoy alternative pursuits of their own choice. Students are supported to meet people and to develop friendships as they wish. The girlfriend of one student has been a weekend residential visitor on a number of occasions recently. At the beginning of each College year, students living at Elizabeth House meet and agree the self regulated Student House Guidelines, within which they will live. Throughout the inspection members of staff were seen addressing the students’ in a friendly but respectful manner. They appear to have developed good interpersonal relationships. The majority of the students spoke positively about the standard and variety of food served to them. They confirmed that they are offered choice and are given guidance in eating a healthy diet. Food for students with particular dietary needs, medical or ethnic, are prepared as required. The students also have access to their own cooking facilities and sometimes prefer to eat ‘take away’ meals for a change. Elizabeth House has recently been given ‘5 Stars’ ‘Scores on the Doors Award’ by Cotswold Council, a commendable achievement. Elizabeth House DS0000016429.V336490.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 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Although some minor improvements are required in the medication administration processes, in the main, students’ medical care needs are addressed appropriately, ensuring that they receive the healthcare support they require. EVIDENCE: Each student has a named key worker for the duration of his or her stay at Elizabeth House. If at all possible this is normally of the same gender as the student although, at present, there have been difficulties in recruiting enough male staff at the residence. There is also a qualified nurse on duty throughout the day and night to address any medical requirements. Detailed care plans have been prepared for each young person identifying all their care needs and also identifying any associated risks. The records provide clear guidance for the staff providing that care. All the students who were questioned, strongly confirmed that they are involved in any decisions about the care they receive; the completion of consent documentation further confirmed this. Elizabeth House DS0000016429.V336490.R01.S.doc Version 5.2 Page 16 Mechanical aids and hoists are provided, maintained and reviewed as necessary to assist the students to live as independently as possible and to assist staff when care procedures are undertaken. Nursing staff maintain close contact with the students checking and maintaining records on their general health and well being on a daily basis. Students are supported to manage their own health needs including accessing medical care, dental care, chiropody and other specialist assistance as required. Students are also supported to take responsibility for their own medication administration as far as is possible; this is done on the basis of a documented risk assessment process, which is kept under regular review, and is normally introduced on a phased basis. Observation of the medication administration records showed that medicines had been administered correctly; photographs had been provided for each person to aid identification. However, where medications were prescribed as ‘as required’, there were no associated care plans to provide an explanation as to when these should be administered. Other medications were no longer being administered although they had not been discontinued on the medication administration records. Medication administration processes are currently being totally reviewed and a ‘monitored dose system’ will be introduced at Elizabeth House at the start of next term. However, it was observed that currently a large stock of drugs was being stored in a non-pharmaceutically approved cupboard in the nurses’ room. This is unsafe practice although it is appreciated that there will be no need to maintain such a large amount of medications when the new systems are introduced. Elizabeth House DS0000016429.V336490.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 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A satisfactory complaints system enables students and their families to feel assured that their views would be listened to and acted upon. Students are offered a good level of protection against abuse. EVIDENCE: There is a published complaints procedure for Elizabeth House, the details of which are displayed for the students and their advocates. Each person who responded to the surveys was well aware of the procedures to follow, if necessary. Most students were content to discuss any concerns with their key worker. One person wrote, “ I speak to my key worker and she deals with it for me”. There have been no formal complaints recorded since the last inspection. The number and content of any concerns and complaints are closely monitored by the National Star College. Discussions with a group of staff during the inspection revealed that they all had a good understanding of abuse issues and had undertaken appropriate training on these subjects. Elizabeth House DS0000016429.V336490.R01.S.doc Version 5.2 Page 18 The College has developed policies to address all forms of abuse. These are readily available for members of staff to read. Whistle blowing procedures are also included in this documentation. Elizabeth House DS0000016429.V336490.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, 25, 26 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Students are provided with a good standard of clean comfortable accommodation, some of which would benefit from redecoration. EVIDENCE: During a walk around the property it was evident that the accommodation had been adapted to suit the needs of the students living there. Bright cheerful colours and furnishings had been chosen throughout the building. However, there were a number of areas, particularly in the corridors, which were scratched and damaged, requiring decorative and maintenance attention. Recruitment for a dedicated maintenance person for Elizabeth House is currently being undertaken. Assurances were given that, once an appointment has been confirmed, ongoing decorative and maintenance needs would be addressed in a more timely fashion. Elizabeth House DS0000016429.V336490.R01.S.doc Version 5.2 Page 20 Since the last inspection a new garden has been created, which is particularly popular with the students living at Elizabeth House. The bedrooms for those students selected for case tracking were visited on this occasion. All were of a good size to suit the students’ needs. It was observed, however, that screens provided in one double room would give only limited privacy although this does not cause any difficulties at the current time. However, consideration should be given to replacing the material used in this equipment. Each bedroom had been individually personalised with treasured possessions, posters, televisions and musical equipment. The rooms had been equipped with appropriate furniture and furnishings to suit the special needs of the young people living there. The entire property appeared reasonably clean and free from any offensive odours. Appropriate laundry facilities are provided and there are clear protocols in place to address all laundry requirements. Clinical waste is managed correctly. Students are supported to undertake their own laundry arrangements, as appropriate. Elizabeth House DS0000016429.V336490.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 and 35 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. Care is provided by a stable loyal care team, which is subject to robust recruitment processes and has access to very good training opportunities, ensuring that the students are fully protected. EVIDENCE: Students who spoke to the inspector and/or completed survey forms described the staff in most positive terms. One person commented, “I find the staff approachable, easy to talk to and friendly”. And another said, “They’re great”. Almost all the staff have completed a National Vocational Qualification, Level 2 or are working towards achieving the award. Recruitment processes are managed centrally at the National Star College. During a visit to the Human Resources Department the inspector saw that each applicant for a post had completed an application form providing a full employment history. Medical details were checked. POVA (Protection of Vulnerable Adults) and CRB (Criminal Record Bureau) screening had been completed. Two written references were provided for each applicant. There Elizabeth House DS0000016429.V336490.R01.S.doc Version 5.2 Page 22 was also documented evidence that each person had been inducted to his or her respective post. One member of staff who had been recently appointed at Elizabeth House described the processes undertaken in her case; they had been completed correctly. Members of staff who spoke to the inspector also confirmed that they have the opportunities to undertake a wide variety of training to assist them in their roles. Records of attendance are maintained in Elizabeth House and were provided to the inspector. Elizabeth House DS0000016429.V336490.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, 38, 39 and 42 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The effective implementation of the College’s policies and procedures ensures that Elizabeth House is well managed and the students’ rights upheld. There is also evident commitment to improve the services for the benefit of the students living there. EVIDENCE: Since the last inspection, the Manager of Elizabeth House has been interviewed and registered by the Commission for Social Care Inspection. She has extensive experience in the care of young physically disabled people and has a Elizabeth House DS0000016429.V336490.R01.S.doc Version 5.2 Page 24 National Vocational Qualification, Level 4 in care and management. Her deputy and her assistant, a qualified nurse, support her in her role. There are clear lines of responsibility within the team; members of staff who spoke to the inspector confirmed that they received good support from the senior staff. Regular meetings are arranged for the students and the staff, giving them all the opportunity to raise matters for discussion as required. When questioned they all appeared most content living and working at Elizabeth House. The National Star College has a published commitment to equal opportunities. Excellent quality improvement processes are in place at the College. Every year self-assessment and quality improvement processes are undertaken. Key strengths and areas for improvement are identified. Action plans are then developed to resolve any issues within agreed time scales. The previous year’s published report was provided to the inspector. Any complaints, accidents or adverse incidents are all monitored and audited centrally. The College holds the Investors in People and Investor in Students Careers Awards. There are good protocols in place to ensure that all routine maintenance of equipment is undertaken in a timely fashion. The planned checking of water temperatures at all outlets was undertaken on the day of the inspection. Records were available to show that all electrical appliances are checked appropriately. Good fire prevention processes are in place; the fire risk assessment has recently been reviewed and updated. Since the last inspection a dedicated ‘fire escape’ shaft lift has been installed. Members of staff receive training and updates in manual handling techniques. There were records to show that this was addressed correctly. Each of the nursing staff has a qualification in First Aid and the majority of the rest of the employees have had training in the processes. Security is also addressed well at Elizabeth House. Elizabeth House DS0000016429.V336490.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 3 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 3 26 3 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 4 33 x 34 3 35 4 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 4 x 3 x LIFESTYLES Standard No Score 11 4 12 4 13 4 14 4 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x 3 4 4 x x 3 x Elizabeth House DS0000016429.V336490.R01.S.doc Version 5.2 Page 26 No 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 YA20 Regulation 13(2) Timescale for action When medications are prescribed 30/06/07 as, “As required”, there must be a care plan available to provide administration guidance to the person responsible for administering medicines. All medications must be stored in 31/10/07 pharmaceutically approved storage cupboards. Repair and redecorate damaged 31/08/07 woodwork and plaster throughout the residence but particularly on the first floor corridor. Requirement 2 2 YA20 YA24 13(2) 23(2)(d) 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 YA25 Good Practice Recommendations Improved screens should be provided in double bedrooms to promote dignity and privacy. Elizabeth House DS0000016429.V336490.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Unit 1210 Lansdowne Court Gloucester Business Park Brockworth Gloucester GL3 4AB 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 Elizabeth House DS0000016429.V336490.R01.S.doc Version 5.2 Page 28 - 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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