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Inspection on 11/04/07 for Gilead Foundations Charity

Also see our care home review for Gilead Foundations Charity for more information

This inspection was carried out on 11th April 2007.

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 found no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

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

What the care home does well

The manager and staff, who live on the premises, provide 24 hour care and support to students in a sensitive and respectful, but disciplined way while they withdraw from drug and alcohol dependency. They are dedicated to helping students build trust within a family environment, whilst `always looking at what they`re doing to improve long term outcomes`. Students said: "The heart of this place is good" and "It`s the best place for atmosphere". Students are treated with respect and their diverse needs are understood. Students appreciated the amount of freedom the farm environment offers. There was also special praise for the food, much of which is locally produced. The atmosphere at the home is warm and welcoming. All the staff and managers are helpful and showed a sincere willingness to learn and improve their care services.

What has improved since the last inspection?

Staff felt that the training provided them was improved. They were also enthusiastic about the home`s new approach to the therapeutic work. This is being changed to a `Grace based` approach instead of a `disciplinary approach`. This change is being delivered with the help and advice of a senior drug and alcohol advisor recently arrived to work at the home. This approach encourages students to take responsibility for their lives, showing them ways in which this can be achieved.The home`s handling of medicines is now more professionally managed, providing a safer system, so that service users can feel confident they will be given the correct medication. The bungalows, long awaited so as to replace elderly caravans, are now being built, but remain some months off completion.

What the care home could do better:

The standard of accommodation continues to be a concern. Whilst the reasons for this are fully understood the completion of the first bungalow, following which the caravan accommodation will cease, must be a major priority. In the mean time students must have comfortable beds in which to sleep. The current pre admission information needs review and improved clarity. In particular, it is not clear that the detoxification regime takes place with no medical specialist or nursing staff on the premises. It must also state the correct age of students allowed admission to the home. Recruitment practice is not sufficiently robust to ensure people unsuitable to work with vulnerable adults are not employed. Although many staff have been known to the organisation, thorough checks on all staff are still necessary. Staff training needs should be reviewed and a system put in place to confirm staff competence. This applies in particular to first aid and emergencies, which might be associated with a detoxification regime. To this end staff should also receive regular one to one supervision and support, so that their concerns and training needs can be identified. Students, who may not have previously had the opportunity to explore a variety of leisure activities, should have the opportunity to do. They should also feel confident that complaints are heard and dealt with, however minor they may appear. Abuse and whistle blowing policies should state that, following any allegation, the Local Authority adult protection team must be contacted and provide those contact details to make this easy.

CARE HOME ADULTS 18-65 Gilead Foundations Charity Risdon Farm Jacobstowe Okehampton Devon EX20 3AJ Lead Inspector Anita Sutcliffe Key Unannounced Inspection 11th April 2007 09:00 Gilead Foundations Charity DS0000061096.V330780.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 Gilead Foundations Charity DS0000061096.V330780.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. Gilead Foundations Charity DS0000061096.V330780.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Gilead Foundations Charity Address Risdon Farm Jacobstowe Okehampton Devon EX20 3AJ 01837 851240 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) Gilead Foundation Charity Miss Beth Rosanna Samuel Care Home 10 Category(ies) of Past or present alcohol dependence (10), Past or registration, with number present drug dependence (10) of places Gilead Foundations Charity DS0000061096.V330780.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. 6. The first of the three new bungalows must be completed and available for occupation by Service Users by 31st October 2006 The Farmhouse modernisation and extension programme must be completed by the 30th April 2007 The mobile homes/caravans must be removed from the site once the 3 new bungalows are occupied. (as per planning application) Upon completion of the first bungalow, no more than 2 service users may be accommodated in the Farmhouse. No more than 10 service users undergoing a detoxification programme for substance abuse may be accommodated at any one time. Upon completion of the first new bungalow, service users must only be accommodated in this bungalow and the Farmhouse. 23rd June 2006 Date of last inspection Brief Description of the Service: The Gilead Foundation, previously registered as Risdon Farm, is a Registered Charity. The home provides care services and supported living in an extended family community, which follows the principles of Christianity. It is registered to provide care and accommodation for people who wish to recover from drug and alcohol dependency. The current registration allows for the admission of up to 10 service users, referred to as students, of both sexes between the ages of 18 and 65. Care is divided into phases, phase one known as detoxification and stability and lasting four to six weeks. This is the part for which the home is registered. The home is part of a working dairy and livestock farm, which provides opportunities for work and an income to support the charity. It is set in a rural area near the town of Okehampton in Mid Devon. Female students are accommodated in the farmhouse and male students in temporary static caravans, which are to be replaced with three large bungalows with modern amenities and single rooms. Communal areas are provided in the caravans, farmhouse and the community centre. Currently the fee for phase one is £550 per week. This covers care, support, accommodation, food, basic toiletries, personal protective clothing (for use in the dairy), study materials and skills training. The most recent report is displayed in the office and the report summary is included in the pre admission material sent to prospective students. Gilead Foundations Charity DS0000061096.V330780.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was to check the home’s compliance with the National Minimum Standards for Younger Adults, using the Commission’s guidance on how those standards relate to drug and alcohol addiction. Prior to the inspection the home provided current information on the service. The Commission anonymously sought opinion from the people (known as students) living at the home, and all staff. A GP completed a comment card. We did one unannounced and one announced visit. We also observed a staff and student group meeting. Two students were spoken with at length; care records were examined. Two staff (known as house parents) and the registered manager Beth Samuels provided information. Various records and policies were examined. What the service does well: What has improved since the last inspection? Staff felt that the training provided them was improved. They were also enthusiastic about the home’s new approach to the therapeutic work. This is being changed to a ‘Grace based’ approach instead of a ‘disciplinary approach’. This change is being delivered with the help and advice of a senior drug and alcohol advisor recently arrived to work at the home. This approach encourages students to take responsibility for their lives, showing them ways in which this can be achieved. Gilead Foundations Charity DS0000061096.V330780.R01.S.doc Version 5.2 Page 6 The home’s handling of medicines is now more professionally managed, providing a safer system, so that service users can feel confident they will be given the correct medication. The bungalows, long awaited so as to replace elderly caravans, are now being built, but remain some months off completion. 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. Gilead Foundations Charity DS0000061096.V330780.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 Gilead Foundations Charity DS0000061096.V330780.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&2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Students are unable to make a fully informed choice as to whether Gillead Foundation is suitable for them. Prospective students have their needs and aspirations fully assessed. EVIDENCE: Although professionally produced, and in a useful format, Gillead’s pre admission information lacks some detail which is relevant. This includes the structure of management and qualifications of manager and staff; also that nursing is not provided. However, most information, including the Christian ethos and structure of the students’ week, is clearly defined. The manager says the information is currently being reviewed. Students receive verbal information about the home, plus written copy of how they are expected to behave. This is explained to them before they sign it. One student mentioned these expectations several times during discussion. He confirmed that students were closely involved in the admission arrangements, but also adding that the drug and alcohol illness reduces the ability to do this. One student, describing why he had chosen the home said: Gilead Foundations Charity DS0000061096.V330780.R01.S.doc Version 5.2 Page 9 I had been before and really found the environement to be family like. All student surveys confirmed that students received enough information about the home to decide if it was the right place for them, but assumptions may have been made regarding information not included. The assessment records of three students were examined. There was sufficient detail in them for staff to be able to plan the student’s care very well. They also showed that students had been involved in the assessment. Appropriate contacts and other enquiries were made with outside agencies (health and social professionals also working with the person/student). This helped to ensure the student’s specific needs could be understand on admission and reduce any risk associated with admission. Gilead Foundations Charity DS0000061096.V330780.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, 7 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Student’s benefit from clear and informative individual plans and the expectations and restrictions placed upon them. EVIDENCE: A student said: “There’s lots of support and staff do try. If you’re willing they’ll try very hard”. Individual plans showed that goals were set and readjusted as students progressed through the detoxification and support programme. Written records were detailed. A score system is used to evaluate success or not and the care is closely monitored by the ‘house parent’, supported by the manager, said to be available whenever needed. Risk is managed more through the ‘family’ support system, including twentyfour hour care regime, than through formal assessment and management. This would be improved if more areas of risk were assessed. It should also be Gilead Foundations Charity DS0000061096.V330780.R01.S.doc Version 5.2 Page 11 a formal part of the individual’s care planning. This would ensure any risk had been completely thought through. Students are aware of restrictions and expectations placed on them. One felt they were too harsh and difficult to achieve. They form an integral part of the care delivered and there is a clear policy of how difficulties with this should be managed. Staff understood their duty of care to the student as they work toward achieving self-discipline. The manager said that the restrictions and expectations (Code of Practice) is regularly reviewed and updated. Students are expected to work on the farm, in the kitchen and in the office dependent upon their abilities, health and preferences. This is seen as part of the therapeutic approach for recovery. Regular meetings take place. Students were observed being encouraged to voice their opinions. One said through survey: Two evenings a week we are commited to family night and devotions. I work every Saturday. On Sunday we have church and sometimes I milk the cows. Gilead Foundations Charity DS0000061096.V330780.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 & 17 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The structured routine helps to promote a positive working lifestyle but the leisure and social activities available are not fulfilling social or creative need. Food is very much enjoyed at the home. EVIDENCE: Spending time employed constructively around the farm and home is an important part of the care regime and timetabled into the day. A student said: “Work gives you a structure”. Where basic literacy, numeracy or IT skills are lacking students have the opportunity to develop these when well enough to do so. Students are initially restricted from using a mobile phone, leaving the premises unsupervised and having visitors unless part of planned care; when Gilead Foundations Charity DS0000061096.V330780.R01.S.doc Version 5.2 Page 13 they are less vulnerable. Intimate relationships between students are also discouraged for the same reason and also because of the Christian ethos of the Gillead Foundation. These restrictions are understood and agreed when students are admitted. Students, staff and volunteers of all ages and religions participate in Christian worship. Pre admission information makes this expectation clear and the two student assessments examined showed a positive desire for a Christian environment. Students were very positive about the amount of country space and “freedom” which that provided. They were quite negative about the leisure choices available, one stating he needs to learn how to fill leisure time that would previously have been filled through drugs or alcohol misuse. They confirmed that when activities are arranged students often ‘back out’. Leisure preferences are currently being sought but this may not take into account the previously limited experiences of some students. Staff, however, are aware of this. The manager said funding was currently affecting the options they could provide. When asked what the home does best a student said: “Very good food here”. A second student agreed. They said food is organically grown and local. The menu is varied and healthy. There is a separate vegetarian menu equally varied. Gilead Foundations Charity DS0000061096.V330780.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): 18, 19 & 20 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Students receive a ‘whole person’ approach to their mental and physical health care. Medication is well managed. EVIDENCE: Students consent to having their health care and medication needs dealt with by staff when they are admitted and most vulnerable. Their files show that, following a thorough assessment, their care is planned, delivered and reviewed in a structured way. It is a ‘whole person’ approach with frequent individual and group support and counselling. A staff member said: We offer a quality recovery program for those who want to change. It is proving effective for long term users. The home liaise with practitioners, from where the student is admitted, who prescribe any detoxificatin schedule. A local General Practitioner ensures other Gilead Foundations Charity DS0000061096.V330780.R01.S.doc Version 5.2 Page 15 medical care needs are met. However, there has been frequent recent change, outside the home’s control, which introduces a risk. The manager is trying to source consistent ‘GP’ cover from somebody with specialist knowledge in substance misuse. A GP with current knowledge of the home said: Gillead clearly suits many people who are happy to accept a religious approach to dealing with their problems”. The handling of medication at the home has improved. The manager now checks that records of correctly recorded. Full audit, to ensure medicines are handled safely, is achievable. One student commented that at this home he has choice as to when one tablet is given, which he has found beneficial. No staff member handles medication without having completed a training course and pharmacy advice has been followed. Gilead Foundations Charity DS0000061096.V330780.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): 22 & 23 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Students are protected from abuse, though the home’s own policy in this area is inadequate. Issues raised by students are not always perceived or responded to as complaints. EVIDENCE: Each student surveyed said they knew who too take concerns to and how they could make a complaint. Staff are fully aware of the vulnerability of students and this knowledge informs some restrictions imposed, such as separate living quarters for men and women. Complaints and prevention of abuse policies are easily accessible. The system of support – senior students, support staff, house parents and manager – ensure there is always somebody to talk over concerns with. Students voiced ‘grumbles/dissatisfaction’ during the house meeting and discussion with inspector, yet no complaints have been recorded. This was discussed with the manager who said they would review ‘what is a complaint’ in view of improving the quality of their service. The Commission have received no complaints about the home. Policies connected with prevention of abuse and whistle-blowing do not comply with the expectation that any allegation should be reported to the Local Gilead Foundations Charity DS0000061096.V330780.R01.S.doc Version 5.2 Page 17 Authority Adult Protection team, and only dealt with according to their instruction and advice. Gilead Foundations Charity DS0000061096.V330780.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): 24 & 30 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Students’ lifestyle is adversely affected by the standard of accommodation provided. Cleanliness and hygiene are adequate maintained. EVIDENCE: Students live in either static caravans or in the farmhouse pending the building of three large bungalows in the grounds, the completion of which is far over due because of funding difficulties. Although the accommodation is old, worn and difficult to maintain, the caravans and farmhouse were warm and homely. No inspection surveys from students indicated that they were unhappy with the accommodation, but the homes’ own quality surveys from students and staff mention it as a problem. We were informed that at least one student is longer than his bed, causing discomfort. Gilead Foundations Charity DS0000061096.V330780.R01.S.doc Version 5.2 Page 19 Each person in the caravans has a small single bedroom and some quite small bedrooms are shared in the farmhouse. Students confirmed that they are involved in the cleaning of accommodation, the standard of which they considered satisfactory. Students said they enjoyed the freedom the farm and farmlands provide. The shared community areas are somewhat worn but homely, but some spaces are not always available and a broken television has not yet been replaced. No specific environmental health and safety concerns were identified during the visit and accommodation is for short-term use. However, the poor standard of the indoor space does impact on the students. Gilead Foundations Charity DS0000061096.V330780.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, 35 & 36 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Students’ benefit from a staff committed to undertaking their work in a caring and professional way. Training, recruitment and staff support need to be improved. EVIDENCE: Students said: “There’s lots of care and support. Staff do try. If you’re willing they’ll work very hard” and There is a lot of pressure surrounding you in a rehab. The staff generally cope very well. Most staff surveys report that there were sufficient staff available, but this was not always repeated during the visits; shortage of staff was given as the reason for reduced leisure activities. One staff member wrote: Were in the process of change. This is exciting. Were asked to fulfil many roles but some are not able to do things as well as others and we need more staff. Staff feel that training has improved and is good. They understand the use of Gilead Foundations Charity DS0000061096.V330780.R01.S.doc Version 5.2 Page 21 individual plans and clearly understand the needs of the students and are enthusiastic about the new approach to their work. They receive regular health and safety training such as food hygiene and fire safety. However, staff knowledge of first aid proved a concern when a house parent was unclear what to do if a seizure/fit occurred, something of special importance in this setting. Staff training includes that relevant to drug and alchohol misuse; National Vocational Qualification (NVQ) qualifications are aligned with specialist standards in the subject. Most staff at the home are volunteers many known to the organisation for many years or through the Christian connections. The manager is fully aware of the importance of robust recruitment. Recruitment records of four staff/volunteers show that not all checks, to ensure they are suitable to work with vulnerable people, were complete, including Criminal Record Bureau (CRB) and references. However, no new staff were unknown prior to recruitment. Surveys report that staff feel sufficiently supported in their work, but staff spoken with said more “de briefing” would be appreciated, especially through the period of change. Staff do not receive one to one ‘formalised’ supervision but add: “advice is always available, but that is not the same as a set time to discuss things”. Gilead Foundations Charity DS0000061096.V330780.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 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Students’ benefit from the commitment of management and staff and the caring culture at the home, which is generally well run. Health and safety are understood and managed. EVIDENCE: The registered manager demonstrates a good understanding of her responsibilities and a commitment to the students, staff and organisation. She has good insight where improvement is needed and is keen to raise standards. Gilead Foundations Charity DS0000061096.V330780.R01.S.doc Version 5.2 Page 23 Students, staff and others associated with the home have the opportunity to comment on the service through anonymous survey. Other tools, accepted in the field of substance misuse as good indicators, are used to evaluate the standards achieved. The registered manager is not currently informing the Commission when a student leaves the home prior to completing their detoxification programme, but is now aware this must be done. The homes’ policies and procedures reflect and guide the practice seen and were available to staff and the students as appropriate. They are regularly reviewed and updated. Health and safety are well managed and take into account risk associated with work at the farm. Although far from ideal, the accommodation is maintained as safe. Gilead Foundations Charity DS0000061096.V330780.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 2 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 2 23 2 ENVIRONMENT Standard No Score 24 1 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 2 35 2 36 2 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 2 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 Gilead Foundations Charity DS0000061096.V330780.R01.S.doc Version 5.2 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 YA1 Regulation 4, 5 Requirement Written information about the home must provide clear detail about what therapy is and is not provided and who is and is not involved in providing it. All the information, described in Schedule 1, must also be included so that there can be no doubt as to what the home provides. Student accommodation must be of solid construction, meeting building regulations and national minimum standards so that they are safe and comfortable during their time at the home. Students must have available to them a bed of sufficient length that they can sleep in comfort. Persons employed at the home must have their fitness to do so fully established through pre employment checks, which include: identity, employment history, all criminal convictions or cautions and two named references. This will ensure students are protected from persons unsuitable to work with them. DS0000061096.V330780.R01.S.doc Timescale for action 30/06/07 2 YA24 23(2) 30/09/07 3 4 YA24 YA34 23(2) 30/04/07 30/04/07 19 Gilead Foundations Charity Version 5.2 Page 26 5 YA35 18(1)(a) Staff must be trained and competent to deliver first aid safely. This will protect students should an accident or health care emergency occur. 30/04/07 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 YA2 YA22 YA23 Good Practice Recommendations A variety of leisure activities should be available to students so that they can explore areas, which might prove of interest to them. What is or isn’t a complaint should be reviewed so that students’ are empowered to make their feelings known. Prevention of abuse and whistle blowing policies should clearly state that the Local Authority adult protection team should be contacted in the event of an allegation. Contact details should be included. This will better protect students from abuse. Staff should have recorded supervision meetings at least six times a year so that they are able to receive the support they would like. 4 YA36 Gilead Foundations Charity DS0000061096.V330780.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Gilead Foundations Charity DS0000061096.V330780.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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