Inspection on 31/03/08 for Forton House

This inspection was carried out on 31st March 2008.

CSCI found this care home to be providing an Good service.

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

Forton House 20/06/06

Forton House 08/02/06

Forton House 21/07/05

Forton House 09/03/05

Forton House 27/07/04

Forton House 24/02/04

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 27/09/2008.

CARE HOME ADULTS 18-65 Forton House 3 St Johns Road Exmouth Devon EX8 4BY Lead Inspector Rachel Doyle Unannounced Inspection 31st March 2008 09:30 Forton House DS0000021938.V359677.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 Forton House DS0000021938.V359677.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. Forton House DS0000021938.V359677.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Forton House Address 3 St Johns Road Exmouth Devon EX8 4BY 01395 222621 01395 222621 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) Premier Living (Devon Partnership NHS Trust) Mr Huw Francis Lewis Akiba-Jones Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Forton House DS0000021938.V359677.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Age range 18 to 40 years Date of last inspection 20th June 2006 Brief Description of the Service: Forton House is registered to provide residential care for up to 3 younger adults who have a learning disability. The property is a detached family style house situated in a residential suburb of Exmouth. There is ample parking on site, and good-sized gardens. There are 3 bedrooms on the first floor, one of which is used as an office. There is also a bathroom and separate toilet. On the ground floor there is a lounge, separate dining room, a bedroom, and a kitchen. Fees are around £76,000 per year per service user. Additional costs, not included in the fees are transport costs, toiletries, magazines and personal items. Inspection reports are available to service users, families and staff upon request and are displayed in the home’s office. Forton House DS0000021938.V359677.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This unannounced inspection took place over 3.5 hours on a weekday. The manager was unavailable during this time but staff on duty were very helpful. We spoke to the manager a few days later to clarify some information. The majority of service users living at Forton House have a limited ability to communicate verbally and were therefore were unable to contribute fully to the inspection process. Time was spent with the people living at the Home before they went out for the day and observations of their care were made throughout the inspection. Staff were consulted on the day and their views on the service discussed. Staff were sent surveys prior to the inspection, two were returned. Comment cards were sent to outside professionals, including a GP, care managers and other professionals involved in the home. None were returned. Surveys were also sent to all relatives but no responses were received. The manager completed a questionnaire prior to the inspection, this provided the Commission with required information about staffing, people living at the Home, staff training and policies and procedures. We looked at a number of records during the course of the inspection and a tour of the property took place. What the service does well: The ethos and atmosphere of the home is relaxed, friendly and person centred. Some of the staff have worked at the home for a long time, giving service users a familiar group of carers who know them well. Service users’ relatives have a good relationship with the staff who help the people at the Home keep in close contact with their family and friends as they wish. People’s needs are carefully identified and the home works in close liaison with relatives and community professionals. Staff work hard to support and maintain service users’ independence, provide choices for them and enable them to lead an active and meaningful life. People’s safety, welfare, health and care needs are well met and fully protected with a caring, respectful and committed staff team. Forton House DS0000021938.V359677.R01.S.doc Version 5.2 Page 6 The manager ensures staff are provided with excellent information about each person prior to admission and while living at the home. This ensures peoples’ needs are met safely and consistently. People are offered a varied and health diet that takes into account their preferences and choices. They are supported to make their own food and drinks whenever possible and enjoy being involved in food shopping. Activities in and out of the house are planned around peoples’ choice, preferences and abilities. They lead a busy life and use public transport and local facilities. Relatives and service users are listened to and any concerns raised or unhappiness observed is always acted upon. The home has a complaint’s procedure in formats suitable to peoples’ communication needs, which are easily accessible. People living at the Home are fully protected from abuse with good recruitment practices, well-trained staff, excellent recording systems and good policies and procedures that staff understand and use. The environment is clean, safe, relaxed, bright and homely and meets the needs of people living at the Home. The home is well run with a committed and caring manager who provides staff with a clear sense of direction. He continues to have an excellent philosophy in relation to person centred care and peoples’ rights and staff say that they feel well supported in their roles. What has improved since the last inspection? What they could do better: When decisions are made in the best interests of service users’ safety, but infringe on some of their rights of privacy, freedom of movement and spending their monies appropriately, discussions and agreements should be reached within a multi-disciplinary setting, for example a Good Practice Committee. This will ensure such restrictive practices are reviewed regularly and are Forton House DS0000021938.V359677.R01.S.doc Version 5.2 Page 7 discussed and agreed with a wide range of professionals, in an open and transparent forum. If this discussion has taken place records should be kept and regularly reviewed. Further and more formalised developments are needed in how the manager audits the home to ensure service users are receiving the best service. 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. Forton House DS0000021938.V359677.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Forton House DS0000021938.V359677.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager ensures the home is able to meet people’s needs prior to admission and provides them and their families with information about the home. EVIDENCE: The three people living at the home have done so for a number of years. The carers spoken with have been working at the home after these people were admitted but said the information provided about each person ensures that they are able to understand their individual needs. Assessments and care plans which are no longer used are filed and these show that the Home would have had good information to be able to assess people prior to them moving in ensuring that their needs would be able to be met on admission. In addition to documents about people’s individual needs, background information about each person living at the Home is available in detail and although not all staff had read this they were aware of each person’s general Forton House DS0000021938.V359677.R01.S.doc Version 5.2 Page 10 history. There is also summarised information for agency staff to ensure that they can meet people’s needs when working on a shift-by-shift basis. Trust Residential Services, who operate the home, have good admission procedures. Forton House DS0000021938.V359677.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is excellent information available to enable staff to meet service users’ needs and goals safely. Small improvements are still needed in relation to decision-making and health care records. EVIDENCE: We case-tracked all three people living in the home, which enables us to gather information about their experiences living there. All three care plans were excellent and a picture of the three people’s needs has been carefully built up over time. These are known as Essential Lifestyle plans and were started in January 2007. These plans ensure that people are able to live their lives how they would like to. Maintaining independence is a goal throughout the plans and staff were seen to promote this ethos during the inspection. People living at the Home and their relatives are involved in the care planning process resulting in clear information showing staff exactly how to meet individual needs safely. Plans are written in the first person and include clear Forton House DS0000021938.V359677.R01.S.doc Version 5.2 Page 12 instructions on behaviour, triggers to avoid, preferences, aggression minimisation and daily routines. Daily notes reflect the aim of the plans in a consistent way. Additional information on autism and epilepsy are included. Staff were very knowledgeable about how they care for people living at the Home and it was clear that this is delivered in a person-centred way showing understanding. Staff were seen to communicate very well with people living at the Home using objects of reference and appropriate language and body language. Communication is addressed within the care plans such as ‘I will always say no first, be patient’ and ‘I need to know what is happening next’. Visual photograph cards are also used to help one person understand timescales. Care was seen to be given exactly as the care plans indicated and people were asked what they would like to do. One person liked a particular activity and staff were arranging an outing to accommodate this preference. In general the Home ensures that people living at the Home are able to make decisions about how they live their lives. However there are some issues, which need to be clearly recorded to show that the decisions involving restrictions and rights have been made following good practice. The home uses a listening device for one service user at night. Staff said this was because of their complex needs and the need to ensure they remained well and safe. The listening device was introduced when staff slept in at night. The home now provides a waking-staff at night; therefore the use of the listening device should be reviewed. Staff said that relatives had been involved in the decision making process but this needs to be clearly recorded. This is particularly important to ensure privacy is respected as much as possible. Any decision that may infringe upon someone’s privacy should be discussed and agreed within a multi-disciplinary setting. These issues were discussed with the manager during the previous inspection. The manager and staff team have worked hard to enable service users to have free access to all areas of the home with their support. However, the front gate to the house remains locked with a coded padlock. This was introduced after a serious incident had occurred and was discussed with the Commission at the time. The gate opens onto a fairly busy road. However, the use of the padlock should be regularly reviewed, discussed and agreed within a multi-disciplinary setting. This would ensure it is in the best interests of service users to have this restriction and the decision is made with other professionals. These issues were discussed with the manager during the previous inspection. The manager encourages people at the Home to use their own keys to come and go as they wish and there is a front door key easily accessible. People then need staff to open the front gate. The outside space is well used including places for people to go if they want peace and quiet and staff and people at the Home are going Forton House DS0000021938.V359677.R01.S.doc Version 5.2 Page 13 to start on a project to make a static caravan in the garden a nice place to relax. Any hazards within the home or with individuals are assessed and any action needed to minimise risks to service users is recorded. This ensures staff have the information they require to keep service users safe. Staff demonstrated an excellent awareness of individual risks. An area of the garden has recently been closed off due to an unsafe wall and this needs to be included in risk assessments and the problem addressed. A full premises risk assessment needs to be updated from 2006. Plans clearly show what each person’s individual risks are and how to minimise these. People living at the Home sometimes enjoy visiting staff homes. A policy should be considered relating to this to ensure the welfare of people living at the Home and staff safety. Other guidelines and assessments of risk provided staff with excellent information to ensure service users remain safe whilst out or completing any activities in the home. Forton House DS0000021938.V359677.R01.S.doc Version 5.2 Page 14 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, 15, 16, 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People living at the Home benefit from respectful staff, accessing the local community, engaging in appropriate activities; and are supported in maintaining good relationships with relatives. People living at the Home benefit from a varied and healthy diet. EVIDENCE: People at the Home have a weekly activity plan, which can be flexible depending on preferences. These are based on knowledge of what people like to do and when. For example one person needs to be kept occupied but with clear rest times. People are also encouraged to be independent in occupying themselves. Staff were seen to be very knowledgeable about each individuals likes and were inventive in thinking of different things to do. Activities are very varied and include walks to the beach, individual hobbies, farm shop, picnics, Forton House DS0000021938.V359677.R01.S.doc Version 5.2 Page 15 train rides, sports, bus trips and meals out. One person had asked if they could go out again and this was accommodated by staff. During the inspection people were getting ready to go out or listening to music in their rooms. One person likes to have noise in the background and this was observed. Staff enable people at the Home to go out and do what they want to do every day and daily records showed a wide variety of events. One person living at the Home showed us around their room, which was personalised cleverly to ensure that there were no dangers for that person. Another room was full of things that the person obviously liked. Including photographs of family. The Home promotes good relationships between people at the Home and their family and friends. People are regularly taken to visit their families, and staff keep in contact with them by telephone. The food provided in the home is varied and healthy. Menus confirmed a healthy diet; including fresh fruit and vegetables are always on offer. Breakfast and lunch is down to individual choices. Staff were observed supporting service users in their choices and helping them to prepare food and drinks safely. One service user particularly enjoys going out and helping with food shopping. Forton House DS0000021938.V359677.R01.S.doc Version 5.2 Page 16 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People’s dignity and privacy is respected in the Home. The people living at the Home have their health needs well met. EVIDENCE: The ethos and atmosphere of the home is very much about giving people choice, respecting their rights and providing a relaxed and respectful atmosphere. Staff had a gentle, caring and respectful manner when talking about the people in the Home and when communicating with them. This was observed throughout the inspection and there was obviously a good rapport between staff and people living there. People responded well to staff and appeared relaxed and happy. Care plans described how people preferred to be spoken to, supported and called. Plans were very detailed describing individuals’ health care needs and medical records showed that medical assistance is sought appropriately. It would be good practice to record specific health care issues separately from daily records as the information is at risk of getting lost within day-to-day records Forton House DS0000021938.V359677.R01.S.doc Version 5.2 Page 17 which staff might miss. Action and progress relating to some health care needs was difficult to follow and could result in needs not being met such as constipation and chiropody. Generally records were excellent. People living at the home currently do not have any manual handling needs but a risk assessment should be carried out to record this and to include staff actions that might be needed in the incidence of a fall due to a seizure. This would ensure that people living at the Home and staff remain safe. All staff including agency staff have received training on epilepsy, the administration of emergency medication and the safe administration of medicines. This training included staff being observed whilst administering medicines and assessed for competencies. A self-directed study book is the final part of this training. One agency staff member on duty confirmed this. Medication is kept in a suitable locked cupboard in the kitchen. A controlled medication cupboard is also provided upstairs. Medication is supplied through a monitored dosage system. Records were well kept and clear and there was good organisation of important drugs. When people living at the Home go out for the day or home for visits, medication is re-dispensed into “medi-wallets” including individual emergency drugs. The wallets have strips for each day, which are divided into sections for morning, lunchtime, evening and night-time. These are checked before each shift and include identification cards. Forton House DS0000021938.V359677.R01.S.doc Version 5.2 Page 18 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at the Home and their representatives are assured they are listened to and complaints are dealt with appropriately. People living at the Home are fully protected from abuse. EVIDENCE: The complaints procedure is displayed in the hallway and in the rear lobby. This has been drawn up using both words and symbols and has also been explained to people living at the Home. A copy of this within the Service Users’ Guide is also available in each person’s room. Staff demonstrated an excellent knowledge and understanding of Adult Protection issues. They clearly described forms of abuse, including infringing on people’s rights and choices; and knew what to do should they suspect any abuse. The home also has policies and procedures and local guidance on abuse awareness and what to if it is suspected. Forton House DS0000021938.V359677.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People live in a clean, safe & homely environment. EVIDENCE: Forton House is a detached house situated in a residential area of Exmouth. There are good-sized gardens and car parking on site. The property has been regularly maintained and decorated throughout. Each person living at the Home has their own bedroom that is decorated and furnished according to individual interests, needs and preferences. Each of the bedrooms is bright, attractive and comfortable. Decorations, pictures and possessions displayed in the rooms reflected the interests and tastes of each service user. The lounge and dining rooms appeared comfortable, stylish and homely. Forton House DS0000021938.V359677.R01.S.doc Version 5.2 Page 20 There is a bathroom and separate toilet on the first floor and a toilet on the ground floor. These rooms were in good decorative order including the outside laundry room. All areas of the home were clean and free from any odours. The hot tap in the bathroom is thermostatically controlled. Staff have access to liquid soap and paper towels to promote good infection control. Forton House DS0000021938.V359677.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at the Home are protected by robust recruitment procedures. People living at the Home are supported by a trained, experienced and caring team of staff. EVIDENCE: On the day of the inspection three staff were consulted and observed, one agency staff member. It was clear they were experienced and skilled in their knowledge of each service user’s needs, preferences and goals. The home provides almost one to one staffing during the main parts of the day. The level of staffing ensures that people’s complex needs can be met safely and they are able to lead a busy, meaningful and active life. The home uses some agency staff, which means that they cannot be left alone in the Home without a regular staff member. This then means that at times people living at the Home cannot go out as early as their needs describe. The Home are not able to recruit staff at present due to a decision by the Provider but do always have the numbers of staff to provide a good service other than the above. Forton House DS0000021938.V359677.R01.S.doc Version 5.2 Page 22 Three staff files were inspected and found to have the required recruitment documentation to ensure service users are fully protected. Files included good induction training and showed encouragement from the Provider to attend further specialist training. All staff have received a good range of training that helps them to understand and meet peoples’ needs, the training includes, mandatory health & safety training, protection of vulnerable adults, medication administration, epilepsy, autism, safe holding techniques, conflict resolution, gentle teaching and total communication. Some staff have completed the Learning Disability Award Framework (LDAF) induction or are on the waiting list. These are standards expected to be achieved by staff that working with people with a learning disability. The work completed with LDAF also goes towards achieving National Vocational Qualification (NVQ) qualifications. One staff member has achieved NVQ level 2 and 8 are working towards this qualification. Staff said that they recommended doing the training and that they had enjoyed it saying that ‘Gentle Teaching has come into its own with one particular person’. Forton House DS0000021938.V359677.R01.S.doc Version 5.2 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at the Home benefit from good leadership and home management focussing on their best interests. EVIDENCE: Although the manager was not on duty during the inspection all the staff at the Home were very helpful and felt supported by the manager. They said that they enjoyed their work, one commenting that they loved working there. Two staff survey responses were returned. These were both very positive. One said that the Home ‘provides day activities with good monitoring of health needs. They felt that the service offered excellent support for people living there to maintain family relationships. The manager has worked to ensure that the service focuses on helping the people living there to communicate exactly what they wish to do and to work Forton House DS0000021938.V359677.R01.S.doc Version 5.2 Page 24 in a person centred way. As a result people are more assertive and assured that their needs will be listened to and met. The manager has completed the National Vocational Qualification in Care Level 4 and the Registered Managers’ Award. They have 17 years experience in complex care and the deputy has 15 years experience. Both work within a stable staff team using agency staff who know the home if necessary. Health and safety issues are well managed. Fire records are up to date including fire drills and training. The questionnaire sent in by the manager helps us to ensure that policies and procedures are up to date and reviewed. This was seen to be the case during the inspection. Trust Residential Services also complete regular visits to the home to ensure it is running well. However, the manager does not have a formalised quality assurance plan that includes, time scales for work to be completed, who is responsible for completing these checks and action plans to improve the services. This would ensure that all work relating to checking the quality of services would be highlighted, recorded, include time scales and people responsible. A quality assurance plan would ensure the work is completed in the manager’s absence and provide a formalised monitoring system. This was discussed during the previous inspection. People living at the Home appeared happy and confident. One person smiled a lot and said ‘yes they liked it here’. Staff seemed comfortable in their roles and there was a lovely calm atmosphere during the inspection. Forton House DS0000021938.V359677.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 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 X 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 4 2 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 4 14 X 15 3 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 2 3 X 3 X 2 X X 3 X Forton House DS0000021938.V359677.R01.S.doc Version 5.2 Page 26 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. 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. 1. Refer to Standard YA7 Good Practice Recommendations Any practices that may infringe upon service users privacy and freedom of movement should be discussed and agreed within a multi-disciplinary setting, such as a Good Practice Committee and records kept and reviewed regularly. (This refers to the use of a listening device, the locking of the front gate) This is carried over from the previous inspection. You should consider drafting a policy relating to when people at the Home visit staff homes to ensure peoples’ welfare and safety. A risk assessment of the building needs updating from 2006 and should include the fenced off area in the garden. Health care records should be clear and ensure that any health alerts are able to be easily identified by all staff and that progress and actions can be followed. All people living at the Home should have a Manual Handling risk assessment to include actions needed in the event of a fall due to a seizure. DS0000021938.V359677.R01.S.doc Version 5.2 Page 27 2. YA9 3. YA19 Forton House 4. YA39 The manager should develop and formalise the home’s quality assurance system further to ensure the home is being run in the best interests of service users. This is carried over from the previous inspection and the manager assured us that this was in progress. Forton House DS0000021938.V359677.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection South West Region Colston 33 33 Colston Avenue Bristol BS1 4UA 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 Forton House DS0000021938.V359677.R01.S.doc Version 5.2 Page 29 - 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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