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Inspection on 23/11/06 for Evelyn Wright House

Also see our care home review for Evelyn Wright House for more information

This inspection was carried out on 23rd November 2006.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Residents can be confident that once residing at Evelyn Wright their needs can be met, as comprehensive assessments are carried out prior to the commencement of a trial period. Residents benefit from a service which meets their individual needs, and supports them in maintaining their independence, through the development of tailored care plans, which are developed in conjunction with the resident and records their views and wishes. Residents have the opportunity to take part in various activities organised within the home. Residents live in a well maintained home that is clean and homely. Residents receive care from a group of staff that are qualified in the delivery of care, and have training relevant to their individual needs, with specialised training in Dementia Care. Residents actively contribute to the day-to-day running of the home, with formal processes in place for obtaining their views. The home is well managed by the management team who have specific areas of responsibility.

What has improved since the last inspection?

Residents now benefit from a structured activity programme, which reflect the wishes of residents, whose views have been sought. Environmental and safety improvements have been made which include the provision of additional emergency lighting. All care plans now follow the new format, which is detailed and specific to each resident, and promotes independence and choice.

What the care home could do better:

This was a positive inspection overall of the service. The Registered Manager and the staff demonstrated enthusiasm and passion towards providing a quality service to the people requiring care. The evidence from the inspection suggested that the service is well managed and look to improving the service by continuously consulting with the residents, their relatives and staff trained to support the residents.

CARE HOMES FOR OLDER PEOPLE Evelyn Wright House 32 Badby Road Daventry Northants NN11 4AP Lead Inspector Mrs Linda Clarke Unannounced Inspection 09:45a 23 November 2006 rd X10015.doc Version 1.40 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 DS0000034870.V307333.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 Older People. 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. DS0000034870.V307333.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Evelyn Wright House Address 32 Badby Road Daventry Northants NN11 4AP 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) 01327 703140 01327 312775 www.northamptonshire.gov.uk Northamptonshire County Council Mrs Sharon Alma Towers Care Home 29 Category(ies) of Dementia - over 65 years of age (14), Old age, registration, with number not falling within any other category (29), of places Physical disability over 65 years of age (4) DS0000034870.V307333.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. No person falling within the category OP can be admitted where there are already 29 persons of category OP already in the home. No person falling within the category DE(E) can be admitted where there are 14 people of category DE(E) already in the home No person falling within the category PD(E) can be admitted where there are 4 people of category PD(E) already in the home To be able to continue to accommodate the named person of category MD(E) who was accommodated in the home prior to registration in 2002 Total number of service users in the home must not exceed 29 Date of last inspection 1st December 2005 Brief Description of the Service: Evelyn Wright is a care home providing personal care and accommodation for up to twenty-nine persons, who may have associated conditions, which may include dementia and physical disabilities. The home is easily accessible by private or public transport, and is located closed to the town centre of Daventry. The twenty-nine single bedrooms are without en-suite facilities. All accommodation is provided on the ground floor, communal areas include a lounge and dining room in addition there are three distinctive areas named, The Willows, The Brambles and The Laurels each catering for individuals with similar needs and benefit from having a dedicated communal and bedroom facilities. The home has a patio and garden area with mature plants and shrubs. Information is located on site detailing the range of services offered, which includes the Statement of Purpose, Quality Assurance Audit and a copy of the Commission of Social Care Inspections, Inspection Reports, which are located on a table in the entrance lounge. The maximum weekly fee is £406.00, which was provided in documentation submitted by the Registered Manager prior to the Inspection. There are additional costs for individual expenditure such as Chiropody, Optician and hairdressing services, and the fee will depend on the services received. DS0000034870.V307333.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection process consisted of pre-planning the inspection, reviewing the last inspection report and the reviewing of the Pre-Inspection Questionnaire and Comment Cards/Surveys distributed to service users, their relatives and General Practitioners by the Commission for Social Care Inspection (CSCI) along with the reviewing of significant events. Ten Comment Cards were sent out to service users, twenty to relatives/friends and eight to General Practitioners. The unannounced site visit commenced on the 23rd November 2006 and lasted 1 day. The focus of the inspection is based upon the outcomes for the service users. The method of inspection was ‘case tracking’. This involved identifying service users with varying levels of care needs and looking at how these are being met by the staff at Evelyn Wright. Four service users were selected and discussions were held with two of them and one resident who was not part of the ‘case tracking’ process. The method of case tracking included the review of service users’ individual care records, discussions with staff of various delegated responsibilities within the home and reviewing the records, training records and the minutes of service user and team meetings. Of the Comment Cards sent out to service users, 70 were returned. The comments received were complimentary about the care. Comments incorporated within Service User Comment Cards included: • • • • • • • • • • • I’m happy living here, the staff are nice to me. I see my doctor when I’m sick, I also see the optician and chiropodist every time they visit. I like the food, the only thing I don’t like is the kippers. I try to do things myself, the staff are very nice and help me when I need help. I trust the staff, they listen to me. The activities are good, so is the entertainment. I enjoy joining in. My mum was unwell a while back and the home was brilliant. Mum feels this is her home, a place of security, warmth and loving care. There is a family feel to the place and the staff are friendly and affectionate to the residents – also welcoming to family and visitors. This is a wonderful place. Mum benefits from living here and her quality of life is better than hoped for. She is very happy and has made a lot of friends – residents and staff. Mum has lived at Evelyn Wright for about a year, she is very happy and receives all the support she needs to live comfortably and as independently as she can. DS0000034870.V307333.R01.S.doc Version 5.2 Page 6 Of the Comment Cards sent out to General Practitioners, 37 were returned. Comments incorporated within General Practitioner Comment Cards. No additional comments were recorded, however all indicated positive responses to the questions asked, for example are you satisfied with the overall care provided to service users within the home. Of the Comment Cards sent out to relatives/friends, none were returned. What the service does well: What has improved since the last inspection? DS0000034870.V307333.R01.S.doc Version 5.2 Page 7 Residents now benefit from a structured activity programme, which reflect the wishes of residents, whose views have been sought. Environmental and safety improvements have been made which include the provision of additional emergency lighting. All care plans now follow the new format, which is detailed and specific to each resident, and promotes independence and choice. 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. DS0000034870.V307333.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection DS0000034870.V307333.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 and 3. Standard 6 is not applicable. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Detailed information is available as to the services offered by the home, and prospective residents care needs are well assessed before they move into the home to ensure their needs can be met. EVIDENCE: Individuals considering residential care at Evelyn Wright are provided with detailed information in a document referred to as The Statement of Purpose, the document provides a brief description of the services provided, including the accommodation, information as to the number of staff employed including information as to qualifications and training. The document also details the number of places provided and relevant information as to the quality assurance process and complaints procedure. The Statement of Purpose is available upon request; a copy is on display at all times in the reception lounge. DS0000034870.V307333.R01.S.doc Version 5.2 Page 10 The records of four residents were viewed, and all were found to contain a ‘Homes Agreement’, which outlines the terms and conditions of occupancy including information as to the fees. The resident or their representative and the Registered Manager sign the agreement. Prior to admission to Evelyn Wright a representative of Northamptonshire County Council known, as the Care Manager will undertake a comprehensive assessment of an individuals need, and produce a document to reflect their findings. The Social Care and Health Care Management Assessment will then be forwarded to the Registered Manager of Evelyn Wright, upon receipt of this document; she will undertake an additional assessment arranging to meet the prospective resident at their current address. The type of assessment undertaken will be dependent upon the needs of the individual. The Registered Manager will then be able to make an informed decision as to whether the staff of Evelyn Wright can meet the person’s needs, before offering a trial placement. The assessments of the four residents files that were ‘case tracked’ contained detailed assessments undertaken by a Care Manager and the Registered Manager of Evelyn Wright. Assessment tools were reflective of the individuals needs, including an assessment of the individual’s cognitive abilities using a specific assessment form. Standard 6 is not applicable, as the Evelyn Wright Homes does not provide intermediate care. DS0000034870.V307333.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users are well cared for having their tailored health and daily care needs met. EVIDENCE: The care plans and records of four residents were viewed as part of the ‘case tracking’ process. The care plans were very detailed and highlighted all aspects of daily living, for example the time a resident wished to get up or go to bed, the likes and dislikes of the resident with regards to meals and the type of cutlery preferred by the resident and the level of support if any was required. Care plans covering aspects of physical care and support provided information as to the resident’s abilities, which ensures that residents are supported to maintain their independence, whilst appropriate support is provided in the way the resident prefers. Care plans also focus on emotional wellbeing, memory and mental health this has particular relevance for those residents with memory loss or Dementia as DS0000034870.V307333.R01.S.doc Version 5.2 Page 12 it enables staff to provide the appropriate reassurance and support. Care plans reflected the choices, which residents have made, for example the frequency of bathing; their preferred term of address, and their decision as to whether they wished to be responsible for the administration of their medication. Care plans were also in place for care throughout the night, these included residents views as to the frequency that night staff carried out ‘checks’ to ensure they were well. Care plans are regularly reviewed and signed by the resident or their representative. Care plans are supported by the life history document which is in place for each resident, this enables staff to appreciate the residents life prior to their admission to Evelyn Wright and enables them to offer a continuity of care, for example aspects of daily living, likes and dislikes, hobbies and interests. The life history documents detail information as to family and friends, occupation, childhood and memorable experiences, hobbies and interests, pets and wartime experiences. Records evidence that residents have access to health care, such as General Practitioners, District Nurses, Community Psychiatric Nurses, Specialist Consultants, Opticians and Dentists. Activities are in place within the home to promote the health of resident’s well-being through exercise and mental stimulation. Risk assessments have been undertaken for all aspects of a residents health which require monitoring to ensure health and well-being, for example, falls, nutrition - including the monitoring of a residents weight and pressure care relief to help prevent sores in those residents who are not able to mobilise. Medication and medication records were viewed, for three residents all were found to be in good order. Staff that have received the appropriate training administer medication. Residents spoken with all confirmed they were very happy with the care they received, and that should it be necessary they access to a health care professional. “Absolutely wonderful.” “Everyone is ready to help.” All residents have a named ‘keyworker’ who is responsible for additional tasks, to support the resident. Staff spoken with confirmed that their views were ascertained when care plans were reviewed. Staff spoke positively of the care plans, confirming that they contained a good level of information, enabling them to provide good and effective care. DS0000034870.V307333.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above 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, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users continue to make choices about daily living and are offered a variety of meals and social activities of interest. EVIDENCE: Residents benefit from a flexibly run home, which enables them to make choices as to their daily lives. The life history documents provide staff with information as to resident’s preferences, hobbies and interests, which are then incorporated into their daily social activities. Residents have recently completed a questionnaire, which was devised to gain their views as to the types of entertainment they wish to have provided at Evelyn Wright, the results of these questionnaires have been used to develop a programme of activities. The management team are currently developing further activities for residents who have Dementia, advice has been sought from professionals in the field of Dementia, and individual plans will be produced. DS0000034870.V307333.R01.S.doc Version 5.2 Page 14 Records are kept of resident’s involvement in activities, which included board games, jigsaw, flower arranging, bingo, and an external shopping and boat trip. A Halloween party was recently held by the home. Residents spoken with confirmed that the activities provided were good, the clear favourite being bingo. Relatives and friends are encouraged to visit; Evelyn Wright has an open door policy, placing no restrictions on visiting. There are three Church services held within the home every month, these services are facilitated by the United Reformed Church and the Church of England, one service being Holy Communion. Residents spoken with said that they were satisfied with the meals, and confirmed that choices were available for all meals. In addition residents have choose as to where they wish to eat their meals, either from sitting in the smaller dining room attached to their accommodation, eating in the central dining room or in their own room. Residents confirmed that drinks and snacks are available upon request twentyfour hours days. “Meals are very good, and we usually have a choice, there’s always plenty”. “Wonderful meals”. The Registered Manager advised that a local firm each year for Christmas organises the decoration of the home and provides the decorations, this takes place free of charge, a date for December had been set for this year. DS0000034870.V307333.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are protected by a robust and accessible complaints procedure and by staff trained in safe guarding adult processes. EVIDENCE: Service users when asked were confident that should they have any concerns, whom they should speak with, in addition there is a written complaints procedure, and information as to how to contact advocacy services. Care staff spoken with had a good understanding of their responsibility and procedures to follow in relation to safeguarding adults and were confident to whistle blow on poor or bad care practices. Staff files examined contained evidence to show that staff have received training in safe guarding adults as and as part of attaining a National Vocational Qualification (NVQ) in Care. The Registered Manager of Evelyn Wright confirmed she has not received any complaints since the last Inspection. The Commission for Social Care Inspection has not received any expressions of concern with regards to Evelyn Wright. DS0000034870.V307333.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are provided with a warm, safe, clean, comfortable and wellmaintained environment suitable for their needs. EVIDENCE: The front door of Evelyn Wright opens onto the front lounge, a table is located on the left hand side whereby the homes Statement of Purpose, most recent CSCI Inspection Report, and Quality Assurance documentation can be found. The table also houses the visitors signing book. The front lounge gives access to the office areas, treatment room and laundry facilities. The front lounge provides comfortable seating for residents, who wish to observe the coming and going of visitors. DS0000034870.V307333.R01.S.doc Version 5.2 Page 17 The central dining room, leads into three areas referred to as The Brambles, The Willows and The Laurels, each of these in the main provides care to residents of similar needs and provides bedroom accommodation, a lounge and dining area, toilets and a bathroom. Two of the bathrooms having specialist equipment to meet the needs of residents with a physical disability. All accommodation being provided on the ground floor. The bedrooms of two residents were viewed, and were found to be clean and tidy, and decorated to a good standard, both residents expressed satisfaction with their room. The gardens surrounding the property are well maintained, with a range of mature plants and shrubs, in addition a patio area has been provided, which is surrounded by fencing providing a safe and secure area. All communal areas were viewed and were decorated to a good standard and were clean and tidy, residents confirmed that they sometimes use the lounge/dining areas to entertain their visitors. Staff have received training in Infection Control, and policies and procedures are in place to ensure the welfare of residents. DS0000034870.V307333.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Trained and qualified staff are employed following robust recruitment checks and are employed in sufficient numbers to meet the care needs of service users. EVIDENCE: The Registered Manager employs sufficient staff to meet the needs of service users. Currently in addition to the Registered Manager there are Residential Care Supervisors (RCS) and Senior Night Care Assistants who are all supported by care assistants and ancillary staff. Of the 22 members of care staff employed, 86 have attained a National Vocational Qualification at level 2 or 3, whilst the remaining staff are working towards the qualification. A clerk, cooks and domestic staff all of whom have attained a National Vocational Qualification in their areas of expertise support the Registered Manager and care staff. The provision of ancillary staff enables residents to receive uninterrupted and focused care from care staff. The Registered Manager submitted to the CSCI information as to the training staff have received prior to the Inspection, in addition training records were viewed on the day of the site visit. DS0000034870.V307333.R01.S.doc Version 5.2 Page 19 Staff have received training in all mandatory areas, including fire awareness, moving and handling, risk assessment and infection control. Specialised training has also taken place for a significant number of staff, which focuses of the care of adults with Dementia. The commitment of the Registered Manager and the staff in gaining qualifications and attending training ensures residents receive effective care from staff that who are knowledgeable and confident in their approach. Residents spoke positively of the care they receive, stating nothing was too much trouble, and confirmed that staff always respond promptly when they press their bell for attention. The recruitment and selection procedure in place is robust and is supported by a Human Resource Team in accordance with the local authority equal opportunity policy and guidance. The files of three care staff recruited since the last inspection were viewed. All files contained thorough pre-employment checks including the obtaining of a Criminal Record Bureau disclosure and protection of vulnerable adult check, a completed application form and two written references. Discussions with staff and the viewing of staff records confirmed that all newly recruited staff undertake a detailed induction and foundation training programme within the first six months of employment, the level of training provided is reflective of that which is expected by Skill Council. The programme of induction and foundation training covers five areas of expertise, focusing on the principles of care, the role of the worker within the organisation, maintaining safety at work, communication and recognising and responding to abuse or neglect. DS0000034870.V307333.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The Management of the Home continues to be effective and the Home is run in the best interests of the Residents. EVIDENCE: The Registered Manager has been in her current post for three years, and has attained the Registered Managers Awards and level 4 National Vocational Qualification in Care, in addition she has undertaken training specific to the care needs of residents residing at Evelyn Wright and training which enables her to be an effective manager. DS0000034870.V307333.R01.S.doc Version 5.2 Page 21 Residents spoken with were confident in the management team, and said they were able to discuss with them any issues affective themselves. The Registered Manager works a variety of hours ensuring residents have regular contact with her. Residents, relatives and stakeholders (General Practitioners, Nurses etc.) have all had the opportunity to take part in the quality assurance process, which took place earlier in the year, the Registered Manager asks that all parties complete a questionnaire, which she then collates producing a report of the results, a copy of the report is located on the table in the entrance lounge. Subsequently a letter is sent out to all those involved in the quality assurance process, answering questions arising from the audit and incorporating a plan of action detailing the continued development of the service. Northamptonshire County Council (NCC) has this month introduced a new monthly monitoring report, which will be in part the responsibility of the Registered Manager to complete. A member of the NCC Quality Team, will visit the home unannounced, visits will incorporate weekends and evenings to undertake an audit of the service being provided, which will include speaking with residents and relatives, viewing records, speaking with staff on duty, viewing the environment and following upon issues identified at the previous visit. Residents attend meetings, which are held regularly within the home, this enables residents to contribute to the day to day running of the home and be kept apprised of all events. Minutes of meetings are taken, which detail the comments and wishes expressed by residents. Residents financial affairs are managed either by themselves, relatives, friends or Solicitors, which is recorded within the residents care plan. Staff spoken with confirmed that they receive regular supervision sessions from members of the management team, one benefit of this is that staff who have ‘keyworker’ responsibility for residents, are able to discuss any issues of concern, and review the care plan ensuring that any changes in a residents care can be quickly addressed. All documentation viewed on the day of the site visit, was of a very high standard, both in content and presentation. Records were stored safely and securely consistent with the Data Protection Act 1998. The Pre Inspection Questionnaire submitted prior to the CSCI prior to the site visit detailed the regular maintenance of health and safety systems within the home, including fire systems and equipment, environmental health visits, central heating systems and emergency call systems. DS0000034870.V307333.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 DS0000034870.V307333.R01.S.doc Version 5.2 Page 23 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 DS0000034870.V307333.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Northamptonshire Area Office 1st Floor Newland House Campbell Square Northampton NN1 3EB 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 DS0000034870.V307333.R01.S.doc Version 5.2 Page 25 - 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!