Inspection on 06/03/07 for Elm Tree House

This inspection was carried out on 6th March 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Elm Tree House 22/03/06

Elm Tree House 16/06/05

Elm Tree House 16/11/04

Elm Tree House 27/04/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Elm Tree House 8 Chandag Road Keynsham Bath & N E Somerset BS31 1NR Lead Inspector Paula Cordell Key Unannounced Inspection 6th March 2007 09:45 Elm Tree House DS0000008164.V310604.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 Elm Tree House DS0000008164.V310604.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. Elm Tree House DS0000008164.V310604.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Elm Tree House Address 8 Chandag Road Keynsham Bath & N E Somerset BS31 1NR 0117 9867791 0117 9867791 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) Treehome Ltd Mr Stephen Charles Wilkins Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Elm Tree House DS0000008164.V310604.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. May accommodate up to 8 persons aged 18 - 64 years with Learning Disabilities 22nd March 2006 Date of last inspection Brief Description of the Service: Elm Tree is a registered care home owned by Treehome Ltd a subsidiary of Craegmoor Healthcare (Parkcare No 2 Ltd). Mr Wilkins manages the home on a day-to-day basis. Elm Tree is registered with the Commission for Social Care Inspection to provide accommodation and personal care to eight people with a learning disability aged between 18-64. Elm Tree House is a two-storey property situated in a residential area of Keynsham. Local amenities include a leisure centre, shops and recreational park. Transport to Bristol and Bath and other areas can be accessed by rail or bus. Due to the accessibility of the building the home is unable to provide a service to people with a physical disability or for those people who use a wheelchair. All residents are provided with a single bedroom. The fees at the time of publishing this report are in the region of £990-£1500 per week depending on the care needs of the individual as detailed in the assessment of need drawn up by the placing authority. Elm Tree House DS0000008164.V310604.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection following the visit in March 2006. The purpose of the visit was to monitor the quality of the care provided to the residents accommodated at Elm Tree House. There were no previous requirements. There have been no additional visits conducted by the Commission of Social Care Inspection during this interim period. The home has one resident vacancy. The visit was conducted over a period of five hours, which included the lunch time period. The inspector had an opportunity to meet with six of the residents, three members of staff including the manager and to read a random selection of records. The inspector viewed three of the eight bedrooms and the communal areas. What the service does well: From examining individual records and ‘case tracking’ it is evident that the residents benefit from an individualised care package. Staff were aware of the care needs of the residents and it was evident that positive relationships have been forged. The environment was comfortable and homely and residents’ bedrooms were individualised and decorated in a way that reflects their personality. The home has built good relationships with the local community learning disability team in supporting the needs of the individuals living in the home complimenting the skills of the staff. All residents spoken with described a high level of support and satisfaction from living in Elm Tree House. It was evident that they were involved in making decisions about their care and the home does this well. There is a commitment to ensuring that staff are skilled and have the relevant training to be able to fulfil their roles within the home. Staff spoken with were aware of their roles and responsibilities and the manager ensures that this is reviewed through regular supervision sessions. Elm Tree House DS0000008164.V310604.R01.S.doc Version 5.2 Page 6 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. Elm Tree House DS0000008164.V310604.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 Elm Tree House DS0000008164.V310604.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and their supporters have adequate information made available to ascertain the quality of service provision. Prospective residents also have enough information to make a decision about where to live. Residents can be confident that there assessed and changing care needs are being met. EVIDENCE: At the last inspection the home demonstrated that each resident had been given a copy of the service user guide and that the home has a statement of purpose, which meets the National Minimum Standards and the Care Homes Regulations. Elm Tree House DS0000008164.V310604.R01.S.doc Version 5.2 Page 9 Copies of letters were seen in individual care folders informing relatives of the updated statement of purpose and service user guide. It also informed them of the web site details for Craegmoor Healthcare contact and information and the service they can expect from the home. The home has one resident vacancy. The home has policies and procedures to guide staff on the admission of a new resident and this is included in the statement of purpose. A member of staff stated that a new resident has visited the home and is planning to move shortly for a trial period. A resident confirmed this evidencing that they had been involved. The manager stated that the visits have been tailored to the individual. The visits were to enable the prospective resident and the manager to make a decision on whether Elm Tree House would be a suitable place for them to live. The home was in receipt of the placing authorities assessment and care plan and it was evident that the home had commenced the process of drawing up an initial care plan. This is good practice in anticipation of the person moving to the home. In addition the bedroom is being redecorated and new carpeting was being ordered. Evidence at this inspection was that the home was meeting the changing care needs of the individuals in the home. All residents spoken with described a high satisfaction with their home and the support of staff. Elm Tree House DS0000008164.V310604.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents assessed and changing care needs are being met. Residents are supported to take risks as part of every day living, which do not curtail their independence. Residents are consulted on and participate in all aspects of life in the home. EVIDENCE: Three residents were ‘case tracked’ and records were examined in respect of them. Information relating to their care and support was also gained from the appropriate key-worker or other staff members. Information was person centred and individualized and was being reviewed at the appropriate intervals. It was evident that the assessed and changing needs of individuals were being met. Elm Tree House DS0000008164.V310604.R01.S.doc Version 5.2 Page 11 One staff member was able to describe her role as a key-worker. Residents stated that they had been involved in the allocation demonstrating that choice had been given. One resident stated that they liked their key worker and had similar interests and were planning a trip away. A resident stated that they had a meeting with their key worker in January to determine what they wanted to do, this included social activities, college courses and involvement in the home. This had been translated into the plan of care and it was evident that the staff were supporting them with their goals, with a monthly progress records being maintained. The home reacts positively to the changing needs of individuals and risk assessments are put in place accordingly. Where behaviours that may be seen as challenging are identified this is adequately recorded and managed. There are ABC charts in place to identify the antecedent, behaviour and the consequence to the behaviour. This informs the action plan and associated risk assessment. There was evidence that the home seeks support from the occupational therapist and physiotherapist and other healthcare professionals where necessary. Residents described how they were involved in the running of the home, including attending meetings, completing questionnaires as part of the quality audit tool making decisions about activities and the décor of the home. A resident stated that they attended a conference on service user involvement with Craegmoor Healthcare another resident had requested that they attend a manager’s meeting. The manager stated that this had recently been facilitated. Elm Tree House DS0000008164.V310604.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,1,5,16,17, Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents lead active lifestyles based on choice maintaining contact with friends and family. Residents have available a good balance diet based on choice. EVIDENCE: Residents were keen to share information about their activities that they were undertaken during the day. This included college, day centres and activities organised by the home. Elm Tree House DS0000008164.V310604.R01.S.doc Version 5.2 Page 13 Residents stated that they were able to choose how to spend their time and were involved in accessing information about college courses, social events and the organising of the annual holiday. All residents have access to an annual holiday. Two residents have only recently returned from a 70s weekend at Butlins. The manager stated that a further break will be organised later in the year for the two individuals. Opportunity plans and daily statements demonstrated that the individuals were supported in their chosen pursuits. A resident stated that there are plenty of opportunities to go out and about in the community. However, the individual acknowledged that they often refuse to participate preferring to spend time on their own. Care documentation included information on how the staff were supporting individuals with social, emotional, communication and independent living skills. Many of the staff have attended training in professional relationships and all the team have attended a course in adult protection. This is good practice. Training was planned for the team on supporting individuals that challenge for the week of the inspection. The manager stated that training on equality and anti-discriminatory practice is now mandatory training and forms part of the home’s induction for new staff, in addition to the values training. From talking with the manager and the staff it was evident that the residents would be supported to do what ever they chose and individuals would not be discriminated against because of their learning disability. This is good practice. Residents stated that staff in the home support them to maintain contact with relatives including transportation and regular social gatherings in the home. A resident stated that they are able to use the telephone to make contact with friends and relatives. Some of the residents spend weekends with their relatives as evidenced in care documentation, conversations with residents, staff and the manager. Residents stated that the food available to them was good and that they could choose alternatives and make suggestions to the weekly menu. A menu was displayed in the kitchen. A resident stated that they are supported to make choices and pictures are used of different foods that are available. Members of staff on duty were observed to be socially interactive with the residents clearly understanding their behaviour and individual characteristics. Staff were aware of their roles and the plans of care in place. A member of staff stated that social activities are organised on a daily basis. Elm Tree House DS0000008164.V310604.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can feel satisfied that their changing healthcare needs will be reassessed and the appropriate healthcare professional will be accessed. Safe practices in the administration of medication protect residents. EVIDENCE: Care documentation provided evidence that the resident’s personal and health care needs were being met. These were being reviewed on a monthly basis and updated or amended as required. Residents told the inspector that there was no fixed time for getting up and going to bed and this was service user led. This was documented in daily records. Elm Tree House DS0000008164.V310604.R01.S.doc Version 5.2 Page 15 Records were maintained of appointments with health professionals and the action taken. Care records demonstrated that the home liaised with a number of professionals, complimenting the skills of the staff team in supporting individuals in the home. The home was keeping the Commission for Social Care Inspection informed of incidents that affect the wellbeing of the individuals and where actions had been discussed these had been undertaken by the home. Staff records provided evidence that first aid training is given to all staff and is updated on a regular basis. The medication system was inspected and found to be satisfactory. Staff have received training in the safe administration of medication and this has included completion of a distance learning pack on the safe administration of medication and training from the pharmacist on the particular system in the home. In addition staff competence is regular assessed by the deputy manager. Policies and procedures are in place as seen at the last inspection. Elm Tree House DS0000008164.V310604.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23, Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Robust procedures and policies protect residents. Residents are confident that they complaints would be listened too and appropriate action taken to resolve them. EVIDENCE: The home has a robust procedure for residents and their representatives to use in the event of a complaint. A resident stated that they would tell staff if they were unhappy. Resident meetings were used as a forum where resident’s views were sought on the care provided and it was evident that residents were empowered to discuss all aspects of the running of the home, before it came to being a complaint. The home was able to demonstrate that complaints would be listened to and responded to in an appropriate manner. The home has had one complaint in the last twelve months from a neighbour. The manager stated that this related to the fencing having come down due to recent weather conditions between the two properties. This has now been responded to. The home has policies and procedures on protection and what to do if an allegation of abuse occurs including a whistle blowing policy. Elm Tree House DS0000008164.V310604.R01.S.doc Version 5.2 Page 17 The manager stated that all staff would be attending updates on abuse to protect the residents living in the home. All staff have attended training on abuse with the manager and the deputy attending an investigatory course organised by the local Social Services Department. The manager stated that it is Craegmoor’s policy for abuse training to be updated for all staff every two years. This is good practice. In addition all staff are either in the process or have gained a National Vocational Qualification and a member of staff stated that abuse is discussed as part of the assessment process. It was clear from discussions with staff that they had a good understanding both of what constitutes abuse and the procedure to follow if abuse is suspected. The home has good financial procedures to ensure the protection of resident’s finances. Good clear records were being maintained in relation to incoming and outgoing finances, including signature of the resident and or two members of staff. A designated member of staff checks finances at frequent intervals. Resident inventories of their belongings had recently been updated. In conclusion the home was able to demonstrate how they were protecting the individuals living in the home. Elm Tree House DS0000008164.V310604.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26,27,28,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have access to specialist equipment where needed to maximise their independence. Residents live in a comfortable, homely, safe environment. EVIDENCE: Elm Tree House is a two-storey property in keeping with the local area. The home is close to services and amenities in Keynsham and there is regular transport to Bristol and Bath. The home has undergone a major refurbishment programme over the last three years. This has included an overhaul of the electrics, new windows, Elm Tree House DS0000008164.V310604.R01.S.doc Version 5.2 Page 19 making the garden safe, new kitchen, refurbishment of the laundry and bathroom facilities, new windows to the communal areas and the decorating all communal areas and most of the bedrooms. In addition a walk in shower has been created to the ground floor. These changes have positively transformed this home. The home is now homely and comfortable. All areas seen were clean and free from odour. The office has moved downstairs into a vacant bedroom leaving a larger room on the first floor to become the vacant bedroom. This will allow the prospective resident more space. The manager stated that there is a plan for part of the downstairs lounge to be made smaller to provide staff with a separate office and sleep in room. Whilst the manager and the staff see this as a positive step, there were no formal plans or exact measurements of the changes to the premises to determine if this would be satisfactory in relation to the National Minimum Standards on spatial requirements. All residents are provided with a single bedroom. The vacant room was being redecorated during this inspection. The manager stated the new service user has been involved in the planning of the colour scheme. The manager has a programme of redecoration in place and is able to control part of the budget ensuring smaller items can be purchased quickly. There are handrails situated appropriately and residents have use of a toilet seat raiser should they need it. Staff members spoken to were aware of the personal care needs of residents and knew how one resident in particular liked to be supported in the shower. Two residents stated that they liked spending time in their bedrooms. It was noted that these were comfortable and contained personal effects, music centres and televisions. Another resident stated that they had chosen the colour scheme including the carpet. Residents had access to all parts of their home. The manager stated that the home has completed a fire risk assessment assisted by an external company. A recommendation was made that the home should install an automatic opener to the front door. So that in the event of a fire this would automatically open without the need for a key, as the front door is locked at night. The manager stated that this is being undertaken and residents would be taught how to use the code to exit the building where this is dictated by the individuals risk assessment. The manager confirmed that once this has been completed that this would be clearly documented both in the individual’s risk assessment and the statement of purpose. Presently three residents access the community independently and the manager confirmed that this would not restrict residents or curtail their independence. Elm Tree House DS0000008164.V310604.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Adequate and competent staff supports residents. There is a commitment to providing staff with relevant training to enable them to support the residents. EVIDENCE: The duty rota provided evidence that there was adequate staffing to support the residents individually and as a group. Staff were supporting residents with day care throughout the inspection either taken to college or their day centres and one individual was supported with dog walking. Other residents were seen relaxing around the home and engaged in conversations with staff. The manager stated that generally there is four staff in the mornings to support with day care and two staff in the evenings with one member of staff sleeping in. This reduces at the weekend to two staff as some of the residents spend the weekend with relatives. Staff spoken with during this visit stated that staffing was adequate to meet the care needs of the residents. Elm Tree House DS0000008164.V310604.R01.S.doc Version 5.2 Page 21 However, a member of staff stated that a third member of staff is being rostered in the evenings to enable residents to go out. The manager stated that this would be in place within the next two weeks when the new resident moves to the home. The manager stated that the home has 2.5 staff vacancies, which are presently being advertised. From discussions with the manager they were aware of the legislation and their responsibilities to ensure competent staff are employed ensuring the protection of the vulnerable adults living in the home. The manager said that some residents have taken part in the interview process but others are not interested. Recruitment information was viewed for two staff most recently employed. The home was able to demonstrate that a robust and safe procedure was followed in the recruitment of staff and all the appropriate records were in place in accordance with the National Minimum Standards and the Care Homes Regulations. The home has a comprehensive induction and training package for new staff. Competent and trained staff support residents. The manager was able to demonstrate that there was a commitment to ensure that 50 of the staff team have undertaken or are undertaking a National Vocational Award at either level 2 or 3. Staff confirmed this. There was a strong commitment for staff training and the manager was able to demonstrate that staff had undertaken training relevant to their roles and the care needs of the individuals living in the home and further courses were planned throughout the year. The manager stated that the home has accessed training on management of aggression for all staff and this was planned in March 2007 for all staff. Elm Tree House DS0000008164.V310604.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,38 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s benefit from a well-managed and safe service. EVIDENCE: Mr Wilkins is the registered manager. Mr Wilkins is the registered manager and has been in post since November 2003. Mr Wilkins has successfully completed the Registered Managers Award and the deputy manager was in the process of completing this. Elm Tree House DS0000008164.V310604.R01.S.doc Version 5.2 Page 23 A member of staff stated that the home was managed well and the manager and the deputy have an open door policy. The manager organises monthly resident and staff meetings. Records of the meetings demonstrated that matters relating to the running of the home were discussed, giving staff and residents further opportunities to air their views. Quality Assurance audits were seen involving the residents and their relatives in the form of questionnaires. Comments were positive. In addition the manager completes audits on the environment, staff training and care audits. From this information the manager and the staff develop an action plan to address the shortfalls. This is good practice. The inspector focused on the fire records in relation to health and safety. Fire records were found to be satisfactory, demonstrating that the staff were receiving appropriate fire training and the equipment was being checked routinely as per the fire officer’s recommendations. The manager stated that they receive regular supervision from an area manager and budgets and financial monitoring is discussed during these regulation 26 visits. Records of these visits were not seen on this occasion. Lines of accountability within the home and with the external management team are clearly understood by staff. Lines of accountability are also detailed in the statement of purpose. Residents and relatives are also made aware and residents said they find the manager approachable. Elm Tree House DS0000008164.V310604.R01.S.doc Version 5.2 Page 24 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 3 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Elm Tree House DS0000008164.V310604.R01.S.doc Version 5.2 Page 25 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. 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. Refer to Standard Good Practice Recommendations Elm Tree House DS0000008164.V310604.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos BS32 4RG National Enquiry Line: 0845 015 0120 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 Elm Tree House DS0000008164.V310604.R01.S.doc Version 5.2 Page 27 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!