Inspection on 26/09/05 for Esher House

This inspection was carried out on 26th September 2005.

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

Esher House 11/02/09

Esher House 17/08/07

Esher House 29/06/06

Esher House 06/04/05

Esher House 09/11/04

Esher House 05/05/04

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

CARE HOME ADULTS 18-65 Esher House 16 Cabbell Road Cromer Norfolk NR27 9HU Lead Inspector Dot Binns Announced 26 September 2005 9.30am The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Esher House I55 S27339 Esher House V245290 260905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Esher House Address 16 Cabbell Road Cromer Norfolk NR27 9HU 01263 512533 01263 512533 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Prime Life Limited Ms Sara Doherty Care Home 13 Category(ies) of Mental Disorder (13) registration, with number Mental Disorder - over 65 (1) of places Esher House I55 S27339 Esher House V245290 260905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 6 April 2005 Brief Description of the Service: Esher House provides accommodation for up to 13 adults with mental health problems. The philosophy of the home is centred on helping service users to regain/develop social skills with a view to ‘moving on’ if this is possible. All service users have their own room to which they can retire at any time. Communal accommodation is spacious and one lounge is designated a ‘smoking room.’ Service users private rooms are located on the first, second and third floors.Service users are encouraged to participate in all aspects of the life of the home and to develop links with the local community if they wish. In this respect the home is well situated: both the town centre and the seafront are just a few minutes walk away. Maintaining and developing contacts with family and friends is seen to be an important aspect of the service users overall pattern of care and at their invitation family members and friends are welcome at all times. The home does not provide accommodation for highly dependent service users and all those in residence have to be fully ambulant as there is no lift. Esher House I55 S27339 Esher House V245290 260905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine announced inspection of the home lasting 6.5 hours. Two inspectors of the Commission attended and the manager of the Home was supported by an official from the organisation’s head office. Discussions took place about the previous inspection and whether progress had been made on the improvements required. Records and policies were examined. The care staff on duty talked to the inspectors individually and in private and four service users were also seen in their rooms. The activities of the service users in the communal rooms were observed as the day progressed. In addition survey forms were sent from the Commission to the Home to be distributed to the service users to enable them to express their views about the Home. Five replies were received and those views were taken into account when writing the report. What the service does well: What has improved since the last inspection? There have been remarkable changes since the last inspection largely due to the enthusiasm and leadership qualities of the new manager who has settled well in the job. She has excellent organisational skills and despite difficulties has turned the home into a much livelier place which both staff and service users have noticed and are enjoying. Esher House I55 S27339 Esher House V245290 260905 Stage 4.doc Version 1.40 Page 6 It has helped that she has stabilised the staff group and now has two support staff on duty at all times until 8pm. Lack of staffing had been a concern at the last inspection. This enables her to see that the home functions well and she can get on with bringing fresh ideas into the home and dealing with management tasks. Another noted improvement is the introduction of more activities and outings. Staff are more proactive in organising activities in the home and some individual outings have been arranged. This not only changes the atmosphere in the home but is helping to give service users more confidence and fun. Even employment and education are being found and considered. Communication is better in the home with staff and resident meetings, meetings between shifts and individual sessions between staff and manager. This helps to make everyone feel they know what is going on, are being supported and can work to the same aim. The medication systems have improved with appropriate record keeping and locked facilities. The meals have improved with much more fresh ingredients used and home baking. The care records outlining how best to support the service users are more detailed and better written ensuring staff have all the information they need. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. Esher House I55 S27339 Esher House V245290 260905 Stage 4.doc Version 1.40 Page 7 The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Esher House I55 S27339 Esher House V245290 260905 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Esher House I55 S27339 Esher House V245290 260905 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1 and 2 The information given out to service users could be improved with a more cohesive guide. Information obtained by the Home as part of assessing whether service users can be accommodated is detailed and helpful, ensuring that service users can be supported satisfactorily. EVIDENCE: The statement of purpose was in place though the service users guide continues to be rather disjointed with separate bits of paper making up the information rather than a cohesive document. There was some discussion during the inspection about the contents of the guide and whether all the information was included as outlined in regulation 5. A recommendation is made to review the guide. The care records of three service users were chosen at random and the information scrutinised to see what kind of information had been obtained to help the home know what assistance to give the service users. There were full details relating to all aspects of the person’s needs and abilities showing where they might need support and where they were independent. Social workers were involved in the assessment process with the service user. Esher House I55 S27339 Esher House V245290 260905 Stage 4.doc Version 1.40 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 standard(s) 6,7 and 9 The service users can be assured that their needs and expectations are recorded well in their care plans, helping staff to support them effectively. Service users make as many decisions as they are able with advice from staff but the way their savings is looked after should be made independent of the service. Service users are supported in areas of risk as part of the support for an independent lifestyle and the home monitors these carefully. Esher House I55 S27339 Esher House V245290 260905 Stage 4.doc Version 1.40 Page 11 EVIDENCE: Three care records were seen at random. They were found to contain a full assessment of each service user with a plan for the care of that person. There were full details setting out what assistance they needed and individual care procedures to suit each service user. The service user was involved in the process and knew about their care plans. Each service user had a key worker to monitor how they were getting on and regular reviews took place and were recorded. Social workers and community psychiatric nurses were seen to attend these reviews and where there were changing needs these were taken note of. The Home too reviewed the day to day care on a regular basis. The documents were well completed by staff who wrote daily entries about the health and activities of the service users. They were also well organised and overseen by the manager. Four service users were seen in private and they confirmed that they felt they were able to make decisions about their lives and were not forced to do anything. They found the staff very helpful and willing to listen. Some needed help to manage their finances and two records were selected at random to check how these were managed. They were properly recorded showing the deposits and withdrawals with both staff and service user signing the transaction. The records were checked against the cash held and found to be correct. The one area for consideration is the policy where due to the lack of a bank account the organisation deposits any savings of the service users into a company account. This is done to save the service user having large amounts of cash in the home but does not offer any interest for the service user. It is strongly recommended that the service users are enabled to have their own bank accounts and that an independent advocacy service is sought to enable the advice and account to be independent of the service. It is required that interest on their savings whilst in the company bank account is provided to the service users. Risk assessments were in place covering a range of situations. The assessments weighed up any difficulties and showed what action needed to be taken to ensure the safety of the service user. Risk assessments seen in the care records included the response to a fire alarm, the use of a kettle, and difficulty with eating. Esher House I55 S27339 Esher House V245290 260905 Stage 4.doc Version 1.40 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 standard(s) 12,13,14,16 and 17 The opportunities for education and employment are only just beginning to be explored but the manager has made a start. Some service users make good use of the community and can go out and about by themselves. More effort is now being made to ensure that those who need support to access community facilities are able to have it. Appropriate leisure activities are now being offered and are providing a livelier atmosphere in the Home. There is still more to be done but there has been a big improvement in this area. Service users feel they are well treated by staff and respected in their views. The food offered to service users is healthy and varied and service users enjoy their meals. Esher House I55 S27339 Esher House V245290 260905 Stage 4.doc Version 1.40 Page 13 EVIDENCE: The area of education and employment for service users has not in the past been given a high priority as many of the service users feel too unwell to cope with a job. Recently however the staff have been able to link one service user with a part time job which is going well. This has provided a good opportunity for the service user and is to be encouraged. The manager is hoping to find more opportunities for education and sheltered work in the future. Most of the service users are able to use the community by themselves without the support of staff. Service users told the inspectors of the visits they made to shops, library or pub or how they went out for a walk every day. Two service users told how they regularly go out to the theatre and travel to Norwich on the train. The care plans also recorded when service users went out. There is a system in the home where if staff have been driving for three years they are authorised to take service users out in their car and some of the outings were recorded eg to car boot sales and shopping. Not all service users can go out by themselves and efforts are being made to ensure that those who need support are able to go out with staff. One service user told the inspector that staff took her out as she was not confident on her own. Whilst this progress needs to be ongoing, there is no doubt that staff are now talking more about supporting people outside the home and that there are now enough staff on duty on a regular basis for this to happen. Service users reported that there were more leisure activities offered in the Home and staff talked enthusiastically about this. On the day of the inspection a painting session was taking place and some service users had displayed their work in the hall. Not all service users want to join in and nothing is imposed but there is no doubt that opportunities for activities even for only one or two people at a time, liven up the home and make it more stimulating. Service users spoken to at the inspection felt that the manager was making an effort to make the home better. One staff thought the improvements were making the service users more confident. While this is an area that can still be developed further especially in relation to releasing staff to take service users out or provide an activity, this is an area where the manager is making progress and the home felt livelier because of it. Esher House I55 S27339 Esher House V245290 260905 Stage 4.doc Version 1.40 Page 14 Service users are able to keep to their own routines with some staying in bed quite late and others getting up early All the service users are able to deal with their own personal care so have a bath or shower as they like. They have keys to their rooms and can spend time in them as they like so long as there is no reason to worry about this. Service users were clear about their responsibility for keeping their rooms clean and the system enables their key workers to support them in this task once a week. Rules on smoking are clear with a specific lounge dedicated to smoking. All the service users spoken to felt they were properly treated and respected by staff. The menus provided for the inspection showed that service users are offered a choice at the main meal and that the choices looked varied and nutritious. On the day of the inspection, staff were observed circulating amongst the service users to find out their choice for the day which was between spaghetti bolognaise and shepherds pie. The menu was also displayed in the dining room. The meal was later seen being served. The food had improved since the previous inspection with fresher foods being used and menus being home cooked. The manager said that the survey carried out by the previous manager about what food the service users liked had been taken into account. Home baking was also carried out. Service users spoken to felt the food was very good and all those replying to the survey said they liked the food. Two diabetic diets are catered for with sugar free products. Esher House I55 S27339 Esher House V245290 260905 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19 and 20 Service users are mobile and self caring but are receiving the support they need from staff in terms of their mental health and wellbeing. Both physical and mental health needs are monitored well and actions taken to see that they are met. Service users are protected by the home’s procedures on medication and the records and staff show that the system is well organised. EVIDENCE: Service users are all mobile and do not need physical support from staff. However one service user did say she would like more help in the bath and this was passed on to the manager. Service users decide on their own routines and choose their own style of dress or makeup. Staff are organised into the key worker system to give individual support and advocacy to each service user. This is still being developed but is on its way and enables the key worker to get to know and help all staff to support what is best for the individual. Esher House I55 S27339 Esher House V245290 260905 Stage 4.doc Version 1.40 Page 16 The care records showed plenty of references to the health needs of the service users and the actions taken to see that they were attended to. The records showed visits by community nurses, visits to doctors and liaison with mental health social workers. In addition one record showed staff making an effort to persuade a service user to see an optician and the outcome of this. Another showed that weight was being monitored and that blood tests were done. Hospital appointments were recorded and there were links to the Mental Health trust. Staff in the daily progress reports recorded observations on sleep patterns, mood, eating habits and any distress. Overall the evidence was that both physical and mental health needs of the service users were monitored. The medication systems in the home were in place and appropriately organised. A monitored dosage system is used where the medicine is pre packed by the pharmacist. Medicine is kept in a locked cupboard with a double lock for controlled drugs. The medication records were checked and found to be properly recorded. Staff confirmed that they had received training on the safe handling of medication. One service user is self medicating and the home has written guidelines for assessing this. Esher House I55 S27339 Esher House V245290 260905 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 23 The service users do feel staff listen to them and that their concerns will be acted on. The service users are protected from abuse by the homes policies and staff are aware of the need to report allegations of abuse. However further local training is recommended. EVIDENCE: The complaints procedure is in the service users guide and posted in the hall for the service users and their visitors to see. A complaints record is kept and from the recordings it looked as if the manager was listening to the service users and trying to deal with things at an early stage. No complaints have reached the Commission. Policies regarding how the home will protect service users from abuse and what actions it will take are in place. A whistle blowing policy encourages staff to speak up. Of the two staff seen in private at the inspection, one had received training and the other had not although the training department of the organisation does carry out some training. However as so many local courses are now available to ensure that providers and their staff are aware of the local protocols regarding adult protection, it is recommended that outside training is supported. Esher House I55 S27339 Esher House V245290 260905 Stage 4.doc Version 1.40 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 standard(s) 27 The hot water system is working successfully and has been improved since the last inspection. EVIDENCE: Most of the premises were not inspected but a tour was made of the bathrooms and toilets to see whether there was sufficient hot water. A problem had been identified at the last inspection and a requirement had been made for improvement. The supply of hot water seems to be more consistent. When first tested the water on the second floor was not running hot and one resident said he did not always find it hot. It did become hot later in the day. The manager said that it would be checked on a regular basis to ensure that service users were properly served. Esher House I55 S27339 Esher House V245290 260905 Stage 4.doc Version 1.40 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,34,35 and 36 Service users are benefiting from the improved organisation of staff and the development of the role of key worker. They receive more help and feel this has improved the home. Service users are well supported by competent staff but more of them need to study for their NVQ. The numbers of staff now on duty each day is providing much more support to service users. The recruitment procedure of the home is not rigorous enough and does not offer as much protection to the service users as it might. Staff are well served by in house training which helps them to give a better service to staff. Staff are well supported and supervised and this benefits the service users. Esher House I55 S27339 Esher House V245290 260905 Stage 4.doc Version 1.40 Page 20 EVIDENCE: When discussing their work, staff did describe a large part of their work as catering and cleaning the home. They were clear about their key worker role however and described how assisting their key service users with cleaning their rooms was working out and more organised, making a cleaner house. They also felt able to spend more time with the service users and initiate more activities. They had not taken service users out very much – this seems to fall more to a member of staff who can drive – but this is an area which should continue to develop. Staff seen at the inspection had worked in the home for some time and were respectful and interested in the service users. Service users confirmed that they thought a lot of staff, found them helpful and felt well looked after. In house training is plentiful but none of the support staff have yet completed their NVQ though 2 are nearly finished. The standard of 50 of staff trained by 2005 will not be met and more training at this level needs to be offered. At the last inspection there had been concerns about the level of staffing. This has been attended to with two staff on at all times and the manager extra to the care staff on 4.5 days a week. The rota received for four weeks confirms this structure. Staff have to perform all tasks as there are no ancillary staff but the hours provided are satisfactory allowing the manager to support the staff and see that the home functions well overall. Staffing is now stabilised and there is a mixture of male and female, older and younger staff. This staffing is making a big improvement to the function of the home and is a welcome improvement from the last inspection. Three staff files were inspected at random to look at recruitment procedures. There were clear gaps in the process in the past with references and criminal records check carried out after recruitment. Amendments had been made to fill the gaps and all documents are now in place on those files. A new starter’s file however showed a similar situation with the person starting work before checks had been completed. This is not acceptable and a requirement has been made. Whilst it is now acceptable for a new recruit to commence supervised work before the CRB check has been received (providing the POVA First has been received) all the other documents must be in place. Staff do receive contracts and a code of practice. Staff training files showed that appropriate induction and foundation training had been carried out and that staff were trained in fire, food hygiene and safe working practices. An overall training plan showed what training staff had received and where the gaps were. Most of the training is in house though outside courses are being considered. Esher House I55 S27339 Esher House V245290 260905 Stage 4.doc Version 1.40 Page 21 The manager has now developed a system of supervision where staff have an individual meeting with their manager at regular intervals. Staff confirmed this was in place and they had had sessions with their manager. An annual appraisal system is also used. Staff files also showed documented evidence of these meetings. Esher House I55 S27339 Esher House V245290 260905 Stage 4.doc Version 1.40 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,38,40,41 and 42 The manager brings ideas and good organisation to the Home which is benefiting the service users. She is providing strong leadership and good management skills. The service users feel the Home is better run and has improved. Policies and procedures are in place and the required records are in place and well maintained. This framework helps service users to be protected. The health and safety of service users is protected with policies and training. Esher House I55 S27339 Esher House V245290 260905 Stage 4.doc Version 1.40 Page 23 EVIDENCE: The registered manager has been in post for less than a year but had had supervisory experience in a care setting prior to her appointment. She is currently studying for her NVQ4. She has responsibility for the home but has a framework of support from the head office of the organisation. The evidence at this inspection showed that the manager has worked very hard to bring about changes in the home and put it onto a more positive footing. She communicates a clear sense of direction and has put in place communication channels which have clearly benefited the service. Staff feel that they all communicate better and it is easy to see why. There are handover meetings, staff meetings and supervision sessions for staff to air their views and discuss their work and to be guided into a common aim. Service users have residents meetings and are much clearer about who their key worker is. Such strategies are paying off. The home is a livelier place and service users and staff feel that things are being done to improve the home and benefit the service users. This manager has made an excellent start and had a positive impact on the Home. In terms of policies and procedures, these are in place and provide a framework for the organisation of the home. The majority of records were seen at the inspection and were appropriately maintained. The home has well organised procedures for keeping service users safe with appropriate checks and services on fire systems, gas and electrical appliances and water temperatures. Fire drills are held regularly for all service users and staff. Records and up to date certificates were seen. Staff also receive training on fire, moving and handling, emergency aid and food hygiene. The accident record is kept. Esher House I55 S27339 Esher House V245290 260905 Stage 4.doc Version 1.40 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 3 x x x Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 2 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score x x x 3 x x x Standard No 11 12 13 14 15 16 17 x 2 3 3 x 3 3 Standard No 31 32 33 34 35 36 Score 3 2 3 1 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Esher House Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 4 x 3 3 3 x I55 S27339 Esher House V245290 260905 Stage 4.doc Version 1.40 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. 1. Standard 34 Regulation 19(1) Requirement The registered person must not employ a person to work in the care home until all checks listed in paragraphs 1 - 7 in schedule 2 are completed. The registered person must ensure that interest is paid on any savings deposited in a company account by a service user. Timescale for action 15.10.05 2. 7 20(1) 31.10.05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard 1 7 Good Practice Recommendations It is recommended that the service users guide is reviewed and that the contents include the items in regulation 5. It is recommended that every effort is made to enable individual service users to open their own bank accounts and if necessary have independent advocates to help them. The home has made a lot of progress on looking at the social opportunities for service users. This needs to be consolidated so all staff are involved and are given time to participate in activities or move off the premises. It is recommended that staff are offered the opportunity to I55 S27339 Esher House V245290 260905 Stage 4.doc Version 1.40 Page 26 3. 12,13,14 4. 23 Esher House 5. 32 attend local courses on adult protection. It is recommended that more training to NVQ level is offered to staff. Esher House I55 S27339 Esher House V245290 260905 Stage 4.doc Version 1.40 Page 27 Commission for Social Care Inspection 3rd Floor, Cavell House St Crispins Road Norwich NR3 1YF 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 Esher House I55 S27339 Esher House V245290 260905 Stage 4.doc Version 1.40 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. 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. 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