Inspection on 21/03/07 for Forestview

This inspection was carried out on 21st 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 found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Forestview 17/03/09

Forestview 09/03/06

Forestview 09/11/05

Forestview 02/02/05

Forestview 10/11/04

Forestview 10/02/04

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 Forestview 60 Cherry Orchard Marlborough Wiltshire SN8 4AS Lead Inspector Pauline Lintern Key Unannounced Inspection 21st March 2007 10:00 Forestview DS0000028676.V331348.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 Forestview DS0000028676.V331348.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. Forestview DS0000028676.V331348.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Forestview Address 60 Cherry Orchard Marlborough Wiltshire SN8 4AS 01672 512464 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) White Horse Care Trust Mrs Allyson Kim Read Care Home 8 Category(ies) of Learning disability (8), Learning disability over registration, with number 65 years of age (2) of places Forestview DS0000028676.V331348.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The maximum number of service users that can be accommodated at any one time is 8 No more than 2 service users with a learning disability, aged 65 years and over may be accommodated at any one time The difference in age between the youngest and oldest service users must not exceed 45 years 9th March 2006 Date of last inspection Brief Description of the Service: Forest View is a spacious bungalow situated in a residential area of Marlborough. The home is registered to provide care to eight people who have a learning disability. The home is managed by the White Horse Care Trust and is one of a number of care homes run by the Trust. The house is furnished in relation to service users needs and offers a number of communal areas in the form of a spacious lounge, separate dining room and breakfast area within the kitchen. Service users access various outreach services and day sessions and the home has its own transport. Forestview DS0000028676.V331348.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Service users are referred to as clients at Forestview and will be referred to as such throughout this report. The unannounced key inspection took place over seven hours. The manager Mrs Read was available to assist the inspector throughout the day. At the time of the inspection five clients were at home and three were attending college or at the Jubilee day centre. The inspector was able to obtain the views of two clients. Four staff, including the manager were on duty in the morning and three staff in the afternoon. The inspector met with two members of staff. One client’s relative visited the home during the inspection and was able to meet with the inspector. Prior to the visit, we sent out survey forms to eight clients of which two were returned, eight to relatives, of which three were returned and six to staff, of which five were returned. Survey forms received were generally all of a positive nature and included comments such as: I feel the staff always support the clients. I would like all clients to get more day services. I have always enjoyed working at Forestview -I feel that I have full support from my manager and have no problems approaching her. To be fair there isn’t anything that I would change, maybe having the garden on a flat surface. They do everything well. Everything is really good-very professional. The home provides a homely environment and treats all clients as individuals, adhering to O’Brien’s principles. As part of the inspection process various records and documents were examined. These included two care plans; individual and generic risk assessments, complaints records, health and safety records, and staff recruitment files and staff supervisions. The fees charged at Forestview start at £906 per week but vary according to the individual care package. What the service does well: Many of the clients at Forestview find that making choices can be difficult for them, however the manager and the staff team encourage and empower them to do so where possible. Each client has a ‘choice’ book, which has pictures and information for the reader on how the client can be supported to make decisions. The home is further developing person centred planning. Staff are currently receiving training in this subject at team meetings and supervisions. When clients’ behaviours that are challenging increase, staff members access professional advice and guidance from various healthcare professionals. Relatives confirm that communication channels are very good. Forestview DS0000028676.V331348.R01.S.doc Version 5.2 Page 6 There is a comprehensive induction available for all new staff and an ongoing staff training programme for the year. There is evidence to show that staff are recruited following the correct procedure. Care plans and risk assessments are regularly reviewed. Health and safety is taken seriously and there are regular health and safety audits. The home has measures in place to monitor quality assurance. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Forestview DS0000028676.V331348.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 Forestview DS0000028676.V331348.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 2 Quality in this outcome area is good. The home has a statement of purpose. At present each client does not have an individual service user guide, although there is a copy available in the office. This document does not include all the relevant information as stated in the NMS. Each client has their care needs assessed to ensure that the home is able to meet them. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a statement of purpose, which provides information about the service and their philosophy. There is a service user guide, which is kept in the office. The contents of the service user guide do not cover the criteria set by the NMS. Each client should have an individual copy of the service user guide in a format that makes sense to him or her. We discussed ways of summarising the inspection report to enable it to be included in the service user guide. Obtaining the views of clients so that they can also be included in the service user guide is covered later in this report. Evidence suggests that prospective clients have a needs assessment carried out before they are admitted to the home. There is a holistic assessment, which covers accommodation, personal support, finances, education, social Forestview DS0000028676.V331348.R01.S.doc Version 5.2 Page 9 skills, culture, faith, health care needs, communication, and mobility and risk assessments. The two case files examined showed that a community nursing assessment was carried out. Each file has a pictorial contract and a copy of the clients’ charter. The files explain how confidential information about the client will be stored. Forestview DS0000028676.V331348.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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 8 and 9 Quality in this outcome area is good Each client has an individual care plan, which reflects his or her assessed needs and is kept under review. Staff members support clients to make decisions about their lives. Each care plan includes individual risk assessments, which are generally reviewed regularly. It is recommended that the manager increases the frequency of a risk assessment relating to challenging behaviours that take place. This judgement has been made using available evidence including a visit to this service. EVIDENCE: As part of the inspection process two care plans were sampled. Each reflected the clients’ needs, which were identified at the assessment stage. They include information on likes and dislikes, mobility, behaviours, culture, communication, activities and health and safety. Evidence shows that care plans are kept under review. Care plans inform the reader of the clients’ strengths and needs. One plan states that the client would like to have a holiday arranged for them. The plan Forestview DS0000028676.V331348.R01.S.doc Version 5.2 Page 11 explains what actions need to take place to enable this to happen. Identifying the person responsible for making it happen, a review of progress and also the outcome is documented. Each client has a ‘life book’, which contains information, which is important to the person. They also include photographs of family, special events, holidays and various pictures. Key workers are designated to each client to provide consistency. Person centred planning is currently being further developed. The manager explained that she has recently attended training in this area and is discussing with the staff team how they can actively promote this way of working into the home. The manager explained that each client has a ‘choice’ book. This explains how the client makes choices and this information is also documented in the client’s care plan. Some clients are able to make choices verbally, others by using gestures or by physically pointing to the object they want. One care plan records that the client will choose which daily tasks they wish to do. Where needed there are behaviour management support plans in place. The manager reported that these plans are regularly reviewed to take into account any changes. Care plans evidence that relatives, key workers, health care professionals and the client have the opportunity to attend the review meetings when they take place. Survey forms returned to us confirm that relatives are kept informed of important matters affecting the client and that they are consulted about their care. Some clients have an advocate who can support them to make decisions. One the day of the inspection one client’s advocate was visiting and met with the inspector. They confirmed that they are “very happy with the care provided” and that the manager is “super”. The manager confirmed that staff members would support clients to make appropriate choices. One sampled care plan states that staff members should provide guidance, advice and promote independence, choice and dignity. The manager gave an example of how she is offering a choice of new carpet for a client. She plans to obtain various sample squares so that the client can see how it feels and choose the one of their choice. There is evidence that risk assessments are kept under review. Due to the increased behaviours of one client, it is recommended that the manager ensure that the risk assessment relating to the management of behaviours is reviewed more frequently (every month) to safeguard the client and others. The case file shows that the risk assessment was last reviewed in November 2006; however there have been regular review meetings to monitor the changing situation. Forestview DS0000028676.V331348.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16 and 17 Quality in this outcome area is good Evidence demonstrates that clients are able to take part in appropriate leisure activities both in the local area and in the wider community. Clients’ are able to have appropriate relationships with family and friends. Staff members were observed being respectful to clients. There is a healthy balanced meal menu provided for the clients at the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager reported that five clients attend Wyvern College where they participate in various activities. Every fortnight two clients attend a drumming session, which the manager confirmed that they really enjoy. Other activities available are visits to the Jubilee Rooms, an art group and a snoozlem. During the inspection clients were seen to be keen to have a massage from the visiting aromatherapist. The home has an electric organ, which it was reported both staff and clients play. There is evidence to show that the staff team supports clients to visit places of particular interest to them. For example one Forestview DS0000028676.V331348.R01.S.doc Version 5.2 Page 13 client is interested in horses and other animals and their life book shows photographs of them with staff members at Longleat, Monkey World and at wildlife parks. The manager confirmed that there are plans to return to Center Parcs for this year’s holiday, as it was such a success last year. She explained that, as there are many different activities available there it allows clients to participate in things they particularly enjoy. The fact that last years chalet was located by the lake meant that the clients had ducks coming up to the front door and as this was so enjoyed the manager has requested the same chalet this year. The manager reported that the afternoons tend to be one of the busiest times at Forestview as clients like to do various activities such as playing dominoes, jigsaws, singing, sewing, knitting, looking at books, watching cartoons or listening to music. She added that usually clients like to ‘chill out’ during the evening. One client attends Marlborough Resource Centre where they are able to maintain old friendships, which they had made at a previous placement. The home has a vehicle available to them, which is used to access the community. Clients are encouraged to help with domestic chores around the home. During the inspection a client’s relative arrived to take them out for the afternoon. Staff members were observed being courteous and welcomed them into the home. The relative commented to the inspector that they are always made to feel welcome at the home. Clients’ were observed being asked by staff members if they wished to go to their bedrooms to rest after lunch. Staff members were observed treating clients with respect and involving them in conversations. Two clients commented that they enjoyed the food at the home. One client reported that they really enjoy “chocolate ice ream and lollypops”. Mealtimes are flexible to allow for activities and appointments. Meals appear to be well balanced and varied. Forestview DS0000028676.V331348.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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good Support with personal care is delivered in a way that clients prefer. Clients’ physical and emotional needs are met and advice and guidance is sought from external healthcare professionals when needed. There are safe systems of administration of medication for clients in place. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Care plans sampled detail clear guidelines for the delivery of personal care. One care plan states that the person needs 1-1 support with bathing and teeth cleaning but can dress themselves with encouragement from staff members. There is evidence that gender issues with personal care support have been considered and documented in the care plan. Another care plan states that the client needs the bath chair hoist to access the bath safely and that they prefer to take a bath in the morning. Toiletries and razors are now risk assessed and securely locked away to ensure the safety of the clients. The home now has a Parker bath installed, which some clients prefer to use. Clients are encouraged to choose which clothes to wear, although staff members will support them to make appropriate choices. Forestview DS0000028676.V331348.R01.S.doc Version 5.2 Page 15 Case files evidence that clients are supported to attend regular healthcare check ups and appointments. The manager explained how she had made a few simple changes to the use of certain sheets, which had made it easier for the client to be able to complete their morning routines safely. Where emotional support is needed the home seek guidance and advice from healthcare professionals. There are regular visits from the Consultant Psychiatrist and the Community Nurse to assess clients changing needs. The manager reported that one client might need to go for further assessment as their needs are changing and this is being discussed with them. The manager added that the client has some understanding of what will be involved in the assessment, however may not fully understand the length of time this may take therefore she is exploring ways to rectify this if possible. A multi disciplinary team are involved in discussions around this issue. All clients have an annual OK health check to ensure their well-being. There are safe systems in place relating to the administration of medication. Medication administration records were examined and indicate that they are completed correctly. All ‘as required’ (PRN) medication is recorded when administered on yellow sheets to clearly identify them. There are protocols for the use of PRN (as required) medication on each clients file if used. Patient drug information sheets are available to provide information and advise of any contraindications that may arise. All medication, including any controlled drugs are securely locked away as required. All staff receive training in the safe handling of medication before they are authorised to administer it themselves. It is recommended that the manager arrange for photographs of each client to be placed on the front of their medication record, which will clearly identify them. Forestview DS0000028676.V331348.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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good Residents are able to raise any concerns if necessary and know that they will be listened to. Protocols are in place to ensure that clients are safeguarded as far as possiblefrom any form of abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a complaints policy and procedure, which is available in a pictorial format. There is a copy in the service user guide and in the homes’ statement of purpose. The Trust provides each client with a pre-addressed postcard, which they can post directly to the Chief Executive. Both of the relatives surveys returned to us confirm that they have never had to make a complaint. Clients who met with the inspector reported that they knew who to talk to if they were unhappy. The home has a complaints log, which was examined and showed that there were no complaints recorded. The manager confirmed that there has been one adult protection investigation carried out since the last inspection. This was fully investigated using the correct procedures and was found to be unsubstantiated. The home has a ‘whistle blowing’ policy, which enables staff to feel confident to raise concerns without incrimination. Staff members informed the inspector that they would feel happy to raise any concerns following the Wiltshire and Swindon guidance ‘No Secrets’. They confirmed that they have been provided with a copy of the guidance. All staff members receive training in the use of physical intervention and attend regular refresher courses. The manager explained that she has arranged for the trainer to come to the home to devise a management programme specific to the needs of one client. When this has been completed Forestview DS0000028676.V331348.R01.S.doc Version 5.2 Page 17 she reported that she will develop a form to record when and which particular intervention has been used. She has confirmed that she will forward a copy of this to the inspector. Although physical intervention has increased with one client, it is mainly used to support them and not to restrict them in any way. The manager will continue to report this to the inspector and will indicate if physical intervention has been used and at what level. The manager will monitor any further changes and will keep the inspector informed of the situation. The Trust acts as the appointee for client’s finances however two clients are subject to Power of Attorney. Records are kept of all clients’ personal allowance transactions. Forestview DS0000028676.V331348.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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. Forestview provides clients with a homely, comfortable and safe environment. The home is kept clean and hygienic. This judgement has been made using available evidence including a visit to this service. EVIDENCE: At the time of the inspection the inspector found the home to be clean and tidy with no unpleasant odours. The bungalow has a large kitchen/diner, which was clean and tidy. There is also a spacious lounge, which is cheerful, light and homely. Bedrooms are appropriately decorated and well furnished. They are individualised with personal possessions. The gardens are well tended and secure. The home has a gardener and keep a maintenance manual where they record identified jobs to be completed. The home is wheelchair accessible throughout. Clients can listen to music or watch television in their rooms if they wish. One client had a typewriter, which they explained they liked to use occasionally. Each client who spoke to the inspector confirmed that they are happy with their bedroom. Forestview DS0000028676.V331348.R01.S.doc Version 5.2 Page 19 The manager reported that they have made arrangements to have a laser alarm fitted in the home to ensure clients safety at all times. All toxic materials are securely locked in the large garage along with other domestic appliances such as the freezer and a tumble drier. There is also a laundry, which houses the washing machines and another drier. This area was found to be clean and hygienic. Staff members receive training in infection control and the home has a copy of Wiltshire’s guidance on infection control. There is the provision of protective clothing such as aprons and gloves. Antibacterial hand wash is available at all hand washing facilities. Forestview DS0000028676.V331348.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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 Quality in this outcome area is good. Staff members have the qualities and competencies to meet the clients’ needs. Records show that clients are protected, where possible by the homes’ recruitment procedure. There is a comprehensive training programme in place to ensure that clients’ needs are met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During the inspection two staff members’ recruitment files were examined. There is evidence to show that staff members complete an application form, provide proof of identity and proviide two written references prior to appointment. Checks are carried out with the Criminal Records Bureau (CRB) and Protection of Vulnerable adults (POVA) list to safeguard the clients. Staff members are provided with a contract and a statement of employment. Staff members confirmed that they received an induction when they are trained in aspects of health and safety practices and have the opportunity to learn about the client’s needs and policies and procedures. One member of staff commented, “ I received an excellent induction”. Another staff member reported that they shadowed a more experienced member of staff when they Forestview DS0000028676.V331348.R01.S.doc Version 5.2 Page 21 commenced work and added, “ I am well supported by the manager and other members of staff”. The manager reported that the Trust has introduced development portfolios for all staff to enable their personal development and identify any training requirements. There is a staff training programme in place, which includes manual handling, fire awareness, safeguarding adults, first aid, the ageing process, infection control, drug competence, O’Brien’s principles, communication, sign along, person centred planning, health and safety, physical intervention, bi-polar disorder, basic food hygiene and risk assessments. Staff members have the opportunity to complete their National Vocational Award (NVQ). One member of staff commented on how nice it is to work at the home, as there is plenty of staff to ensure that clients can go out. They added that they feel happy with the care that the home provides to the clients. There is evidence that staff are regularly supervised and that team meetings take place. Forestview DS0000028676.V331348.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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Quality in this outcome area is good. The manager is competent and qualified to ensure that the home is well run. Mechanisms are in place to ensure that the views of clients and their relatives are sought and listened to. The health, safety and welfare of clients are promoted and protected where possible. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager of the home is competent and qualified to ensure that the home is well run. She has a nursing qualification and has achieved her Registered Managers award (RMA). The manager reported that she has attended management training in disciplinary and grievance procedures and facilitator training. Forestview DS0000028676.V331348.R01.S.doc Version 5.2 Page 23 There are effective quality assurance systems in place. Survey forms have been sent out to all relatives and the majority of the responses were generally positive. The Trust holds a ‘residents consultation meeting’ on a regular basis where residents are supported by staff members to share their views. The last meeting took place on 20/11/06. The manager explained that she is planning to re-introduce ‘client’ meetings within the home. She commented that when she had previously held client meetings they had not been successful. Since she has attended person centred planning training she has decided to re-introduce the meetings. The meetings will include the client, key worker and the manager. She explained that she hopes that the key worker or a member of their circle of friends will be able to ‘ speak’ for the client and have their ‘best interests’ when making decisions. We discussed observing body language, facial expressions and gestures to help ascertain how the client is feeling or what they wish to do. It is recommended that these meetings are recorded and the extracts could be added to the service user guide to demonstrate how people felt about the service. The home has a development plan, which is a result of the responses to the survey forms. The home are currently holding an ‘Investors in People’ award for their commitment to staff development. Health and safety audits are regularly completed. The homes’ health and safety representative carried out the last ‘in house’ audit in February 2007. Fire awareness is taken seriously with regular checks completed on fire fighting equipment, fire alarms and the emergency lighting system. The home has a fire risk assessment, which was reviewed on 15/11/07. Staff members receive instruction in fire awareness and carry out regular fire drills. A current certificate is at the home for gas safety and the testing of portable electrical appliances. Bath hot water temperatures and the fridge freezer temperatures are recorded regularly. Records show that any accidents or incidents are recorded appropriately. Forestview DS0000028676.V331348.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 X 26 X 27 X 28 X 29 X 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 X 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 Forestview DS0000028676.V331348.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? No 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 YA1 Regulation 5(1) Requirement The registered person must ensure that each client has a copy of the service user guide and that it contains all the information as set out under Regulation 5. Timescale for action 21/06/07 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. 3. Refer to Standard YA9 YA20 YA39 Good Practice Recommendations It is recommended that during periods of increased behaviours the associated risk assessment relating be kept under more frequent review. It is recommended that each medication record has a photograph of the client on the front to identify them. It is recommended that comments from the client meetings are included in the service user guide. Forestview DS0000028676.V331348.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Chippenham Area Office Avonbridge House Bath Road Chippenham SN15 2BB National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Forestview DS0000028676.V331348.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!