Inspection on 10/05/05 for Gardiner Close

This inspection was carried out on 10th May 2005.

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

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

Other inspections for this house

Gardiner Close 22/05/07

Gardiner Close 10/10/05

Gardiner Close 14/06/04

Gardiner Close 19/02/04

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

CARE HOME ADULTS 18-65 Gardiner Close 2 Gardiners Close Dagenham Essex RM8 2XG Lead Inspector Roger Farrell Unannounced 10 May 2005 14:20 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Gardiner Close G55_S27900_Gardiner Close_V222398_100505_Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Gardiner Close Address 2 Gardiners Close, Dagenham, Essex, RM8 2XG Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 0208 592 3616 Outlook Care Mr Allan Douglas Ball CRH - Care Home 7 Category(ies) of LD - Learning Disability - 7 registration, with number of places Gardiner Close G55_S27900_Gardiner Close_V222398_100505_Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: Gardiners Close is registered to to accommodate and supprt seven people who have a learning disability. Date of last inspection 14 June 2004 Brief Description of the Service: Gardiners Close is a registered care home providing care and support to up to seven people who have a learning disability. It is operated by Outlook Care, a not for profit organisation who operate a range of support services for vulnerable adults in North East London and Essex. The home was purpose built in 1996, and is on a generous plot at the end of a cul de sac. All residents have their own bedrooms, and share spacious and well-maintained communal rooms. The building is owned by London and Quadrant housing trust, which are responsible for maintaining the property.Five of the residents moved in together when the home opened in March 1996, having lived together in an older style home that was being closed. The age range is 51 to 66 years. One person moved in December 2002 and quickly became established as a member of this settled household group. The seventh person joined the group in February 2004. Gardiner Close G55_S27900_Gardiner Close_V222398_100505_Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place on Tuesday 10 May 2005 between 2.20 and 4.40pm. The manager was not at the home, but both staff on duty were established permanent workers, one having been at the home since it opened. Another permanent worker arrived at 4pm and was gave help with details about holidays and outings. They were able to answer most questions and show the inspector the paperwork he asked to see. This visit included being given an update on the help each resident needs, the contact they have with their families and health care workers, and how they spend their time. This included looking at personal files, and how staff assists with, and record contact with doctors and other health care workers. The inspector looked at the main parts of the building. Only one resident was at home, who was unwell, but others arrived back towards the end of the visit. The inspector is grateful for the helpful way that staff dealt with his enquiries. What the service does well: The manager and staff team continue to provide a very good service to this group of residents who have a wide range of needs and abilities. Since April 2002 inspectors have been using the same checklist to see how well staff do their job, to make sure the building is okay, and to find out whether residents get the right sort of help. If inspectors think things need to be done better, they say so in their reports. For the third year running inspectors are saying that they are happy with what they find at Gardiners Close. As with last year’s main report, they have not picked out any areas needing improvement. All areas tested get the pass mark, with the ‘top score’ being given for looking after the house so well, including keeping it fresh and clean. Outlook Care are good at keeping up with what is expected, and helping managers and staff stay up-to-date on the best way of doing things. As well as having files that use pictures and other ways of making sure that residents can be involved in planning their lives – staff keep extra files where they write down the help people need with their physical and mental health. These are being well used, saying what additional help is needed as residents get older. Other people who visit the home, such as nurses, tell inspectors that this is a good home. The last time an inspector told the home there was to be a visit a number of people sent him comments. One relative wrote – “Excellent. I can’t fault the home in any way.” Another said - ”We are satisfied with the care [our daughter] gets. We are informed by the home if any problems arise. We would like to thank the staff for the care and attention they give.” Gardiner Close G55_S27900_Gardiner Close_V222398_100505_Stage 4.doc Version 1.20 Page 6 What has improved since the last inspection? What they could do better: This home continues to be a success despite there being some problems keeping the staff team up to strength. Julie Wilson used to be the part-time deputy. The original manager went to look after another Outlook Care home over two years ago. For a long time he was expected back, but he has now retired. This means that Julie Wilson has been in charge at Gardiners Close since January 2003, working full-time hours. She has now been confirmed as the permanent manager, and was waiting for a registration certificate with her name on it. Since she took over she has never had the help of a deputy – though attempts to find the right person are continuing. It is also taking a long time to fill vacancies for support workers. At this visit three of the six posts were vacant – two full-time and one part-time. The inspector has since spoken to the manager who said that she was hoping two full-time people would start Gardiner Close G55_S27900_Gardiner Close_V222398_100505_Stage 4.doc Version 1.20 Page 7 once she receives certificates saying they are okay to work in a care home. In the meantime other staff have been covering extra shifts, and they have been able to rely on a couple of well-known stand in workers. Recently the manager told the inspector that the service has been kept going through the dedication of the core group of staff – calling them “an extremely good bunch”. Not having permanent staff has resulted in some draw backs, one staff member saying – “We have managed to cope because we are able to do extra, and have some good bank staff. However, if there are bank staff on, this can cut back on the chance of going out at times.” Also, last year the home got a new minibus that it shares with another home. The other home has had the full benefit, as this team is so short of drivers. The inspector believes that all reasonable steps have been taken to try to keep this team up to strength, so no requirement has been set. However, Outlook Care must pay attention to doing all it can to have a stable staff team given the changing needs of some of the residents who live at this home. Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Gardiner Close G55_S27900_Gardiner Close_V222398_100505_Stage 4.doc Version 1.20 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Gardiner Close G55_S27900_Gardiner Close_V222398_100505_Stage 4.doc Version 1.20 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1; 2; 3; 4; 5. The headings covered in this section are all rated as satisfactory. The most recent person to join this group just over a year ago had a successful move-in. The paperwork covering this transition shows a well-planned approach to assessment, including good coordinated liaison with carers and health workers who knew the resident well. This service can show that it uses a methodical approach to helping new people become part of this resident group. EVIDENCE: At his last visit the inspector looked at the ‘assessment folder’ of the most recent resident, who had moved in five months earlier. This contained a good range of information, including – a seven page ‘care plan’ and profile done by the key worker at the person’s previous home; a detailed referral assessment and update completed by a social worker; and the additional assessment and tracking notes done by the manager. There was also a detailed pre-admission review. There had been a series of day visits with the new resident being accompanied by her existing carers, followed by an overnight stay. Details on the ‘assessment folder’ had additional information that showed a methodical approach – including progress reports of each introductory visit, and a meeting with the community learning disabilities nurse who has known the service user for many years. Suitable attention was paid to matching needs and consideration of compatibility with the established household group. At this visit it was found that the relevant elements had been carried forward onto the current file. An advocate had been involved with the second last resident to move-in who is a person that cannot express himself verbally. Gardiner Close G55_S27900_Gardiner Close_V222398_100505_Stage 4.doc Version 1.20 Page 10 The inspector saw the signed ‘Licencee Agreement’ issued to each person by the landlord housing trust, and the organisation also use a pictorial version. Files contain letters regarding rent accounts and adjustments. The inspector was shown the ‘statement of purpose’. Items that need to be included are set out in Schedule 1 of Regulation 4 (1)(c). The front index sheet and contents of the home’s version correspond with this expectation. A service-users’ guide is also available and has been put together in a way that makes it understandable to the residents, including using pictures and some photos. Copies are available in the entrance hall, along side a photomontage of the residents with their views on the service. Barking and Dagenham Council sponsor all residents, and a signed copy of the standard contract of residency is also on files. Gardiner Close G55_S27900_Gardiner Close_V222398_100505_Stage 4.doc Version 1.20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6; 7; 8; 9; 10. The way practice files are kept in this home is a positive reflection on the way the team continue to take fully into account individual needs and choices. Staff are able to judge the means by which each person communicates their views, and the extent to which they are willing and able to participate in activities like household tasks. As appropriate, there is good involvement from relatives and an advocate. Staff are also alert to the extent that some residents may have a decreasing ability to concentrate. EVIDENCE: The inspector looked at the personal files for two residents. This included ‘person centred planning (‘pcp’) files’; the ‘health care files’; and the ‘daily diaries’. The main sections of the ‘pcp files’ are designed to fully involve the resident in planning their support and how they spend their time. The examples seen had been kept up-to-date, showing that the planned sixmonthly reviews were taking place. These contain a ‘health care checklist’ and a ‘health care year planner’. There is good cross-referencing to the ‘health care files’. There was also a good range of individual risk assessment forms. As stated earlier, a priority for this team is to be alert to the changing needs of a number of residents as these may be linked with the onset of dementia. Reviews carried out in-house, and by supporting agencies demonstrate good attention to detail, including seeking the views service-users and their Gardiner Close G55_S27900_Gardiner Close_V222398_100505_Stage 4.doc Version 1.20 Page 12 relatives. An advocate from Mencap has a meeting with the service users once a month. Some residents use a stamp to acknowledge the entries in their individual diaries that are used to record day-to-day events. These are written in the first person. There is little evidence of the need to have restrictions, beyond everyday safety matters that are well covered by risk assessments. All residents like to be accompanied when away from the building. The front door has a discreet alarm to let staff know when a resident opens the door to a caller. The inspector was shown the main risk assessment file covering a range of general areas, such as use of parts of the building. These were currently being updated. At present no resident is assessed as capable of managing their own money without help. No individual staff member acts as an appointee for residents benefit claims. Cash held in the safe for residents is generally limited to £50, and the inspector saw how this is checked at each hand-over. The consultant who carries out the ‘monthly visits’ also checks cash accounts. No discrepancies have been found over the past year Staff described the level of involvement in domestic planning and routines. One resident is generally resistant to helping but other established residents assist with a range of tasks, some exercising quite high levels of independence using their self-help skills. The inspector saw the minutes of the monthly residents’ meeting which all service users attend. This covers a good range of household topics, such as building issues like planning the new kitchen. The organisation hold service user consultations and invitations are made known to service users, but none of this group wish to attend. Each file has a completed ‘missing-person’ form with a photo attached. There is a procedure to follow if someone is unaccounted for. The inspector has seen the policies covering confidentiality and data protection. This issue is covered in the induction programme, including the shorter version used for bank staff. Personal information is kept in a locked filing cabinet in the office. Each person has ready access to their ‘pcp’ file and their day-to-day diaries. Gardiner Close G55_S27900_Gardiner Close_V222398_100505_Stage 4.doc Version 1.20 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11; 12; 13; 14; 15; and 16. This home is continuing to support residents to enjoy varied and individually appropriate social and leisure activities. This includes going on holiday, though it is recognised that two residents now probably find going away too stressful if this involves being around crowds and children. As some residents get older and dependencies increase it is proving harder to find suitable organised activities, though the manager is exploring options. Arranging lifeskills training at home is helped by having an activities organiser one day a week. EVIDENCE: The inspector looked at a range of records covering planned weekly activities. This included each person’s ‘How I like to spend my week’ section in the ‘pcp’ files. He also saw the ‘what I have done this month’ sheets. This shows that residents have regular scheduled programmes, generally going to outside venues on weekdays. The resident at home at this visit has the least outside commitments, but still has a structure to the week. Most residents are out most days – in particular two residents who use the Riverside Centre, four people attending sessions at the Bethel Hall Centre on Mondays, including the drama group, craft classes and music sessions. Four residents go to the Gardiner Close G55_S27900_Gardiner Close_V222398_100505_Stage 4.doc Version 1.20 Page 14 Dagenham Church Club on Tuesdays. Regular activities are set out on a chart in the office, including some short college courses. An activity organiser comes to the home each Thursday, and activities include improving the garden, personal shopping and cooking. Up to four residents go to the Monday evening club. One person attends church. Following the visit the inspector spoke to the manager, and she is keen to find options suit the age of residents. Some options, such as college courses need greater one-to-one support than can be managed at present. She was due to meet a new advisor from within the organisation who is looking at day opportunities. Staff described social events that have happened over recent months. This included all residents going on a caravan holiday in Dorset last September, and five people having a long weekend at a holiday camp in March. Leisure activities include bowling, a monthly disco, pub trips and lunch out, and music shows. There is a home delivery video service. All residents need to be accompanied away from the house, with one person having some mobility restrictions and decreasing mental ability. The home has a vehicle, but its use is very limited at present as only the manager can drive. Staff described each person’s links with their families, and the regularity of contact and whether they attend reviews. In general, all but one person has regular contact, varying from weekly visits, to once every couple of months. One resident recently met with his sister who was visiting from the USA. All residents are understood to have used their postal votes for the recent general election. Relationships with the immediate community were described as cordial, with contact limited to exchanging greetings. The standard covering meals was not fully tested. Resident are asked to make a choice a day ahead, and staff have a good knowledge of individual’s likes and dislike, one person saying – “People prefer straight forward meals, meat with two veg, though we do get a take-away occasionally.” One person now has liquidised food, and a daily record of intake is kept. There was a good range of food stocks in the kitchen, including fruit and fresh vegetables. Gardiner Close G55_S27900_Gardiner Close_V222398_100505_Stage 4.doc Version 1.20 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 17; 18; 19; 20; and 21 This home is able to demonstrate that it has good systems to promote residents’ well being, and respond when problems occur. This is true when signs of changing needs to do with aging appear, including loss of mental abilities. They can show how they link in with health services, and adjust their support to meet residents’ current needs. Gardiner Close G55_S27900_Gardiner Close_V222398_100505_Stage 4.doc Version 1.20 Page 16 EVIDENCE: The age span of residents is from early fifties to one person now over sixtyfive. Two other residents will be sixty-five this year. There is a separate ‘Need To Know’ file that has pen-picture profiles on each person. This includes the level of support and prompting that each person needs to maintain their personal care. This is also covered in the appropriate sections of the ‘pcp’ files. In general residents have good levels of self-care skills. However, over the past year one resident has developed higher dependency needs, with a further two people also needing increased supervision with personal care. The underlying cause of these changes are tentatively being associated with decreasing mental ability due to aging. The highest dependency resident is undergoing tests as the signs indicate the development of dementia. She has been referred for a specialist scan. Further, the inspector was told that two other residents were also being referred for initial cognitive tests, including looking at hormonal balance and possible depression. These changes call for more detailed observation by staff. Consequently, the introduction of the ‘health care files’ is essential – providing a monitoring framework for physical and mental signs and symptoms – and showing contact with doctors ad other health care workers. These files have sections on medical consultations and tracking sheets; observation sheets that have good detailed entries; reports from others such as occupational therapists and speech and language therapists; entries by community learning disability nurses; monitoring charts, such as for blood tests and weight; and older medical reports that have been carried forward. Also, to guide staff they contain fact-sheets on conditions relevant to that resident. The file of the most recent resident had a chronological resume of her medical contacts extending back over ten years that the manager had researched. This is a good example of how this service comprehensively covers the ‘carry-forward’ of information to assist continuity in such a key area. Routine visits by community learning disability nurses have been phased out, though they were seeing one resident on request. Additionally, a community nurse visits twice each day to give one resident her insulin injection. Another person is also being monitored for a condition with treatment provided as necessary. The inspector observed the duty staff brief a visiting nurse on the condition of the resident who was unwell and who had been in hospital recently. At each visit over the past two years visiting nurses have made favourable comments about the quality of care and liaison. This service had to provide increased physical care to one of the original residents before she moved onto a nursing home. Plans were being put in place to increase the care arrangements for the current high dependency resident, and this included introducing pressure relieving equipment and a toilet frame. Gardiner Close G55_S27900_Gardiner Close_V222398_100505_Stage 4.doc Version 1.20 Page 17 The inspector noted that all three residents he met were again very well presented, including the quality of clothes care. Medication is provided weekly in ‘Nomad’ boxes supplied by a local pharmacist, with printed mar sheets. A good safety innovation is that these pillboxes have a photo attached. There are two metal medicine cupboards fixed to the office wall, which were neatly arranged. Other satisfactory conditions found at this visit included - the administration records; individual medication profiles; guidance on when to give ‘as and when necessary’ medication; double checks on deliveries; a homely medicines list approved by the GP; and a wall display on the changes in name for some medications. The Commission’s pharmacy inspector carried out a more detailed audit on 20 January 2005 and a separate report was provided. Compliance with the advice set out in that report will be followed up at a later visit. There is a policy on guiding residents to consider their wishes regarding illness and dying, with a corresponding section in the ‘pcp’ files. Gardiner Close G55_S27900_Gardiner Close_V222398_100505_Stage 4.doc Version 1.20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 23. There have been no complaints or protection issues reported at this home over the past year. The information available, and awareness of staff positively indicates that the expected action would be followed if concerns were raised, including calling on the help of an advocacy service. EVIDENCE: There is good guidance on complaints available, including – the organisation’s policy and revised pack; clear and simple notices posted in the hall, including a pictorial version; and details in the ‘statement of purpose’, and ‘service users’ guide’ that tell residents there is a video available in the lounge on how to complain. The complaints log had no entries since December 2002. How to complain and report concerns is regularly on the agenda of the residents monthly meetings. The organisation’s policies relevant to these standard are available. This includes the ‘Management of Abuse and Suspected Abuse’; ‘Infringement of Service Users’ Rights Procedures’; ‘Whistle blowing’; and ‘Prevention of Bullying’. Also available in the hall was the pictorial ‘No More Abuse’ produced by Voice UK. The duty staff gave informed answers when asked about following procedures, including the whistle blowing guidance, and were aware of the GSCC’s Code of Practice. They confirmed that they had attended a course on adult protection. Gardiner Close G55_S27900_Gardiner Close_V222398_100505_Stage 4.doc Version 1.20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24; 27; 28; and 30. The inspector viewed all communal parts of the building and a consistently high standard of cleanliness was again found, including in the kitchen and laundry areas. In recognition of these exemplary conditions the household heading is scored at the highest ‘commendable’ level. This building continues to provide all its residents with a comfortable and safe living environment, including being alert to the needs of those residents who are growing more dependant. EVIDENCE: This well maintained property was purpose-built eight years ago, located on a plot at the end of a residential close. The house is well screened from the busy road to the rear, with double-glazing helping to reduce the noise. The building is in keeping with neighbouring houses that were built at the same time. There is a handy parade of shops nearby. The inspector again found the home safely arranged, comfortable, bright and clean. There is plenty of space for service users, including a generous central hall and landing, and an enclosed stairwell – that has the potential to accommodate a lift. All areas are suitably decorated, with good quality Gardiner Close G55_S27900_Gardiner Close_V222398_100505_Stage 4.doc Version 1.20 Page 20 furnishings and fittings. In February the kitchen was refitted, including new appliances. All service users have their own bedrooms that are above the minimum space requirements. There are two bathrooms and a shower room on the first floor. The ground floor has a large disability shower room, with an additional door making it accessible from the adjacent bedroom. There is also a separate a separate toilet at this level. All these facilities were found to be hygienic, adequately maintained, and have suitable locks. The lounge is well furnished, attractively decorated, and has a good range of home entertainment equipment. It is spacious enough to allow a section to be used for a snooker table. The dining room is also large, part of which is arranged as a lounge area, and can be used for visitors. There is a large garden, with patio area and garden furniture. A large sturdy decked area has been fitted. The standard of maintainance of the garden is much improved, including new furniture, planted borders and pots. The inspector was shown the birdbath made by some of the residents with the activities organiser. The staircase has an additional sturdy handrail. There is an assistance call system that is kept on, but is very rarely used. Gardiner Close G55_S27900_Gardiner Close_V222398_100505_Stage 4.doc Version 1.20 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 0 This set of standards was not covered at this inspection. In last year’s announced inspection report they were all rated as met. The inspector did speak with staff about current rota arrangements, including covering for the vacant posts. The normal pattern is two people on duty on both the early and late shifts (with varied starting and finishing times), and one person on sleepin duty. This does not include the manager’s hours. EVIDENCE: Gardiner Close G55_S27900_Gardiner Close_V222398_100505_Stage 4.doc Version 1.20 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 0 This group of standards were not checked at this inspection. Those looked at last year were all scored as met. EVIDENCE: Gardiner Close G55_S27900_Gardiner Close_V222398_100505_Stage 4.doc Version 1.20 Page 23 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. Where there is no score against a standard it has not been looked at during this inspection. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 3 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x 3 3 x 4 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score x x x x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 Gardiner Close Score 3 3 3 Standard No 37 38 39 40 41 42 43 Score x x x x x x x Version 1.20 Page 24 G55_S27900_Gardiner Close_V222398_100505_Stage 4.doc 21 3 Gardiner Close G55_S27900_Gardiner Close_V222398_100505_Stage 4.doc Version 1.20 Page 25 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard Regulation Requirement No requirements were set at this inspection. 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 Good Practice Recommendations Gardiner Close G55_S27900_Gardiner Close_V222398_100505_Stage 4.doc Version 1.20 Page 26 Commission for Social Care Inspection Ferguson House 113 Cranbrook Road Ilford, Essex IG1 4PU 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 Gardiner Close G55_S27900_Gardiner Close_V222398_100505_Stage 4.doc Version 1.20 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!