Inspection on 26/07/05 for Hampshire House

This inspection was carried out on 26th July 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

Hampshire House 14/01/10

Hampshire House 27/09/07

Hampshire House 01/06/06

Hampshire House 12/01/06

Hampshire House 23/02/05

Hampshire House 10/05/04

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

CARE HOME ADULTS 18-65 Hampshire House & Redsteps The National Society For Epilepsy, Chesham Lane, Chalfont St Peter Gerrards Cross, Bucks SL9 ORJ Lead Inspector Mike Murphy Announced 26th July 2005 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. Hampshire House & Redsteps Version 1.10 Page 3 SERVICE INFORMATION Name of service Hampshire House & Redsteps Address The National Society For Epilepsy, Chesham Lane, Chalfont St Peter, Gerrards Cross, Bucks, SL9 ORJ 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) 01494 601427 01494 871927 The National Society for Epilepsy Mr John Peter Windley Care Home 20 Category(ies) of Physical disability registration, with number of places Hampshire House & Redsteps Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 23rd February 2005 Brief Description of the Service: Hampshire House and Redsteps provide a rehabilitation service for people with epilepsy. The service is based in two separate buildings located at the National Society for Epilepsy (NSE) centre in Chalfont St Peter, Buckinghamshire. Hampshire House is an older building which has been extended and provides 14 places in single rooms on two floors. Redsteps is a conversion of two buildings, two semi-detached former staff houses, on the periphery of the NSE site about 400 metres walk from Hampshire House. Together the service can accommodate up to 20 younger adults with epilepsy.The home’s aims include the development of service users independence. The home is an integral part of the NSE and benefits from a wide range of support services provided by the organisation. Hampshire House & Redsteps Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was conducted by one inspector over two days. Although for organisational purposes Hampshire House and Redsteps are managed as one service, they are in fact quite different in character. The 14 residents of Hampshire House have higher needs and the nature and level of activity is variable. Staffing levels take account of this. Redsteps offers a quieter and more stable environment and in many ways has the characteristics of a supported living environment. This disparity within a single registered service can affect the rating of individual standards which assess the service as a whole. The findings in each service are summarised in the narrative to each standard. The methodology of the inspection included consideration of a pre-inspection questionnaire, discussion with the manager and staff, discussion with service users, consideration of comments cards completed by relatives and professionals in touch with the homes, reading relevant documents, a walk around the homes and observation of activity. In summary this inspection finds that Hampshire House and Redsteps are providing a valued service to residents with complex needs. Staffing has improved in both homes and staff are supported by an ongoing programme of training and development (which includes supervision and appraisal). Because of its size, staff in Redsteps are not able to make full use of this and it is recommended that the registered manager address this with the deputy manager for Redsteps. The changes to the catering arrangements seem to be appreciated by residents but a number of food safety matters needs to be addressed. The environment in both homes has improved since the last announced inspection but some problems with water temperatures and a section of hot pipe need to be addressed by the registered manager. What seemed particularly evident on this inspection was a sense of change in Hampshire House. It would appear that in future it is to provide care for residents with higher levels of dependency. It is expected that this will be a planned and managed process taking account of the needs of all stakeholders and it is hoped that this will be the case. On this inspection the home had residents needing one to one care as well as residents whose care manager feels that more rehabilitation could be carried out in the wider community. Meeting the needs of residents with such a diverse range of needs in a 14 place home will present challenges to staff and managers. The inspector would like to thanks residents, the manager, deputy manager and staff for their time and hospitality during the inspection and everyone who took time to complete and return comment cards. Hampshire House & Redsteps Version 1.10 Page 6 What the service does well: What has improved since the last inspection? What they could do better: Hampshire House should achieve a higher level of compliance with good practice in food safety in the kitchen. These may still be early days as far as self catering is concerned and it may be difficult to achieve consistently high standards at first but it must achieve a higher level of performance than found on this inspection. The advice of an Environmental Health Officer, acquisition of relevant publications (both paper and online (such as through the Food Standards Agency website (www.foodstandards.gov.uk)) and a review of staff and resident training would help achieve this. Hampshire House & Redsteps Version 1.10 Page 7 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. Hampshire House & Redsteps Version 1.10 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 Hampshire House & Redsteps Version 1.10 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 The statement of purpose, updated in the summer of 2005, provides information, which, together with other information and a visit, forms a sound basis on whether to accept residence in the home. The home’s assessment procedures, which include obtaining comprehensive information from referring agencies and professionals, aim to ensure that it can meet the assessed needs of residents. EVIDENCE: The statement of purpose for Redsteps and Hampshire House have been reviewed in June and July 2005 respectively. Most of the content is identical with the exception of the staffing of the two houses. The documents include reference to most of the information required under Schedule 1 of Regulation 4(1)(c) but does not actually contain all of this information. On one detail the Chief Executive is the ‘responsible individual’ and not the registered provider as mentioned in the documents. The reader is referred to other documents. It is however a well written and reasonably concise document which will be helpful to current and prospective residents and their families and to prospective referring agencies. This is a medium to long term service which has had one admission since the last inspection. A review of care records showed that the home obtained comprehensive information at the referral and assessment stage prior to Hampshire House & Redsteps Version 1.10 Page 10 admission. An initial care plan was drawn up on admission and following a further period of assessment was reviewed and amended at six weeks. A further review and update took place after three months. Additional training was provided for staff to ensure that the particular needs of the resident could be met. Hampshire House & Redsteps Version 1.10 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 & 9 Residents needs are carefully assessed taking into account information provided by referring agencies and information supplied by the resident. This ensures a comprehensive assessment on which to base a plan of care. Care staff work closely with residents in drawing up care plans. This ensures that care plans take account of residents’ needs and wishes. Risk assessments cover a wide range of activities and aim to allow residents to lead an independent lifestyle as far as possible. EVIDENCE: Resident records consist of a personal file (containing key information, contracts and other papers), a daily report, a medical file and a care plan. Prescription sheets have a photo of the resident. Together, this maintains a comprehensive record for each resident. A care plan was in place for each resident. Care plans examined were comprehensive and detailed and included periodic reviews of residents needs (at least every three months). Key workers are responsible for ensuring that care plans are drawn up with the involvement of the resident. The content of the daily records examined varied – some brief and with little reference to the care plan, others much more detailed giving a Hampshire House & Redsteps Version 1.10 Page 12 full account of the resident’s day. Some loose filed typed sheets did not have the name of the resident on every page and it is strongly recommended either that space for the name be included on each page or that an automatic ‘footer’ with the name be inserted. Care plans contained relevant correspondence and reports from other agencies. The registered manager said that the home was to develop’ Person Centred Care Plans’ (PCPs) over the next year or so. Staff encourage residents to participate in decision making and provide whatever support and information is required. The home can put residents in contact with ‘Peoples Voices’ advocacy organisation as required. Residents manage their own money wherever possible. At the time of this inspection the Director of Finance was the appointee for twelve of fourteen residents. Risk assessments include an assessment of a resident’s ability to manage money. Risk assessment processes are well developed and cover a very wide range of activities. In one file for example, risk assessments covered (among others) use of sharp instruments, using the cooker, working in the kitchen, possession of keys, use of locks on doors, use of public transport. Staff respect the choice of individual residents to take risks (such as not wearing protective headwear). There is a policy and procedure governing staff action when responding to unexplained absences by residents. Residents expressed satisfaction with the care in Hampshire House and Redsteps. Residents have had holidays in Wales and Tenerife. Staffing in Redsteps has now improved and the deputy manager responsible for the service is keen to make greater use of facilities in the community. Efforts in this respect in both Redsteps and Hampshire House would be supported by at least one professional respondent who in completing a comment card said ‘Promotion of independence needs reviewing at NSE. I have a service user who is able to work outside of centre, however, my attempts to implement this have been continually frustrated by Centre’. Other professional respondents expressed satisfaction with the service with comments such as ‘I am very impressed with the quality of services and staff at Hampshire House’. Another said ‘I have had little contact over the past year as the staff have worked effectively to promote [name] self confidence and independence skills…’. Hampshire House & Redsteps Version 1.10 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) Standards in this section were not assessed on this inspection. They will be assessed in the unannounced inspection which will take place before the end of March 2006. EVIDENCE: Hampshire House & Redsteps Version 1.10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) Standards in this section were not assessed on this inspection. They will be assessed in the unannounced inspection which will take place before the end of March 2006. EVIDENCE: Hampshire House & Redsteps Version 1.10 Page 15 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 & 23 The home’s complaints procedures ensure that service users or others making complaints will have the complaint investigated by the registered manager and senior managers. The home’s procedures and staff training on the protection of vulnerable adults (POVA) mean that staff are aware of the subject and of local reporting arrangements and that service users are protected from abuse. The home’s investment in training on challenging behaviour will develop staff knowledge and skills and help to ensure that residents who present such behaviour on occasions are treated appropriately. EVIDENCE: The home conforms to NSE policy and procedure. The complaints policy and procedure was reviewed in May 2005. The policy outlines in detail the process to be followed by staff and includes references to other procedures (such as the grievance, disciplinary and whistleblowing procedures). The procedure is summarised in a flowchart which includes timescales and is on display in picture form in Hampshire House. The procedure is at variance with standard 22.3 by not stating that a complainant may refer a complaint to CSCI at any stage should they wish to do so and not only when dissatisfied with the outcome as stated in 9.7. It is noted that the procedure states that a complainant may refer their complaint ‘as appropriate’ to the Charity Commission (as well as the CSCI and Health Services Commissioner). Two complaints had been received since the last unannounced inspection. Five of nine relative respondents completing comment cards said that they were not aware of the home’s complaints procedure while three of the nine respondents Hampshire House & Redsteps Version 1.10 Page 16 had made a complaint. Five of seven professional respondents had not received complaints about the home. As with complaints the home conforms to NSE policy and procedure. A social worker has lead responsibility for co-ordinating investigations into allegations. Managers respond promptly to allegations of abuse and establish multi-agency procedures for investigating such events. The registered manager had attended recent training sessions on the subject run by Buckinghamshire County Council Social Services. The home plans to cascade training to all staff over the course of the year which supplements POVA training offered by the training department. Staff interviewed during this inspection were aware of abuse and procedures for its investigation. Training on challenging behaviour is offered at a number of levels including induction, and by external trainers, PACT (Personal Awareness Consultancy & Training), on a two day programme and a four day programme. Policies and procedures are in place for the ‘security and control of residents cash and valuables’ (last reviewed in May 2005). Hampshire House & Redsteps Version 1.10 Page 17 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 & 30 Both Hampshire House and Redsteps provide a comfortable environment for residents. Weaknesses in some health & safety aspects in exposed pipework and in the detail of food safety in the kitchen may expose residents to risk. EVIDENCE: Hampshire House and Redsteps are located on the NSE site. Hampshire House is an older building which has been modernised and adapted for its current use over the years. It is quite a spacious building which accommodates 14 residents in single rooms. Communal areas consist of the games room, lounge, dining room and a small quiet room. The kitchen has been thoroughly refurbished since the last inspection, a shower room has had new flooring, tiling and wall units fitted, exposed hot pipes have been covered (although about 5 cms of uncovered pipe in a shower room remains a hazard), the lounge and games room has been redecorated by residents, and the residents telephone is now in a booth (which provides more privacy). Weaknesses in the detail of food safety procedures in the kitchen (outlined in more detail under standards 37-43 below) expose residents and staff to risk. Hampshire House & Redsteps Version 1.10 Page 18 The lounge, games room and dining room are bright and well ventilated. There is an outdoor seating area outside of the games room. The home provides a television, stereo, billiards and computer with games programmes. The laundry is intended for general use. Any soiled laundry goes to the central laundry elsewhere on the NSE site. A heat detector has been installed since the last inspection. The sluice room is sufficient for general needs. The environment in this home may experience a higher level of wear and tear than other areas and the home requires an ongoing maintenance budget to reflect this. Two rooms were viewed in the company of residents. These were comfortable and well furnished and both residents had personalised their rooms with posters, photographs and other objects and had installed TVs. DVDs and music systems. Both were quite happy with their accommodtion. Redsteps is a conversion of two 1950’s semi-detached houses and provides single room accommodation for six residents. It has a small front garden which leads on to the main road to the front of the house and a good sized garden at the rear which leads to the rest of the NSE site. New windows have been fitted since the last inspection and the installation of a new shower on the first floor had been approved (this will also need a new blind and light fitting when the work is completed) and work was to commence in August 2005. The lounge looked rather dull and in need of redecoration. The arm of a chair had been damaged and either needed repairing or replacing. It was reported that the aluminium patio door stuck at times. The kitchen is sufficient for the present number of residents and was very clean and tidy. However, it was noted that the melamine on some base kitchen units was damaged and needed replacing. The kitchen units did not appear robust enough to take the level of wear and tear in a home such as this. The laundry room is sufficient in size for the present number of residents. Cleaning and laundry materials left out in the kitchen and laundry should be risk assessed. Given the different nature of the service in Redsteps it would not be appropriate for everyday cleaning materials to be locked away. Both Hampshire House and Redsteps were clean and free from offensive odours. Hand washing facilities are situated satisfactory in each home. The organisation has a contract with Cannon Hygiene for the disposal of clinical waste. Hampshire House & Redsteps Version 1.10 Page 19 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) 33, 34, 35 & 36 Staffing levels at the time of this inspection were sufficient to meet the needs of residents. Concerns were expressed in both houses about the ability to sustain this in future given changes in resident dependency in Hampshire House and the vulnerability of a small establishment such as Redsteps to short term changes in staffing. The organisation of training provides staff with opportunities to develop their knowledge and skills which has potential benefits for the quality of care provided to residents. Staff meetings are held and staff receive personal supervision every six to eight weeks in Hampshire House. These provide staff with opportunities to consider their work in a group and confidential setting, to improve practice, and to influence the development of the service. Each of these has potential benefits for the quality of the service provided to residents. These need to be established on a regular basis in Redsteps if the same advantages for staff and residents are to be realised. EVIDENCE: Although the basic funded staff establishment had not changed in either home, the staffing position had improved since the last announced inspection. Five new staff had been appointed (including two transfers from other homes) and Hampshire House & Redsteps Version 1.10 Page 20 this been of particular benefit to Redsteps. Two residents on Hampshire were receiving special care (one member of staff to one resident) which was being funded by the relevant local authority. Two other factors were affecting staffing on Hampshire: firstly, the introduction of self-catering and the amount of supervision and support which residents required; secondly, an increase in the level of dependency of residents. In the view of the registered manager, the second of these, resident dependency, is likely to continue to increase over the next few years. This is due to a likely increase in the proportion of less able residents in the home as those who are less dependent move on to new services and models of care and rehabilitation in line with the strategy for the service as a whole. Redsteps appeared to be gaining particular benefit from the new staff and it was hopeful of now being in a position to provide the service to which it aspires. However, in view of its low staff numbers it is particularly vulnerable to change – even when one member of staff moves on. Staff meetings are being held every two months. The staff mix is international and includes individuals of English, Polish, Indian and Sri Lankan origin. Recruitment is subject to NSE policy and procedure. Staff files are now held in the human resources department and are available for inspection if necessary. The CSCI and NSE have agreed a checklist for home managers to complete confirming that key elements of the recruitment process have been followed and that documents are in order. This was discussed with the registered manager and was reported to be working well. In view of the relatively recent introduction of this system staff files were not examined on this inspection. The probationary period for new staff is six months. The NSE has a training department which runs training courses throughout the year. This includes a five day corporate induction programme. Mandatory training is given priority and the copy of the training programme provided for the inspection included basic life support, fire awareness, moving & handling, care principles, diversity, epilepsy awareness, first aid, infection control, personal care and tissue viability, POVA, keyworking, medication and food hygiene. A two and four day course on ‘The Prevention and Management of Behaviours that Challenge’ run by external trainers was also being offered. Annual appraisals include a review of training needs. Staff are undertaking NVQ courses at levels 2 and 3 and a deputy manager will be leading on NVQ training from the autumn of 2005. Supervision and appraisal is governed by NSE policy and practice. Supervision in Hampshire House takes place every six weeks. Supervision in Redsteps is taking place less often due to pressure on the deputy manager’s time. Sessions are recorded and copies retained by the supervisor and supervisee. Appraisals are held annually in both houses. Copies of all policies are available to staff in the offices in Hampshire House and Redsteps. Hampshire House & Redsteps Version 1.10 Page 21 Staff interviewed in both houses appeared very committed to their work. New staff in Redsteps confirmed that they had attended an induction programme and received mandatory and other training. Staff were aware of policy and practice with regard to abuse. In Hampshire House some concerns were expressed about the future direction of the service and the management of any changes. New staff in Hampshire expressed appreciation of the support of team leaders and again confirmed attendance on the induction programme. Hampshire House & Redsteps Version 1.10 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) 42 Performance with regard to health & safety matters is uneven and a number of weaknesses were identified in both homes which need to be addressed by managers. These pose a potential hazard to the safety of residents. EVIDENCE: The training department offers basic and update training in moving & handling, first aid, food hygiene and infection control. One member of staff is a moving and handling trainer. The home uses an NSE ‘Incident, Accident or POVA Report Form’ for recording accidents and incidents. Significant accidents are also reported to the Commission under Regulation 37 procedures. Accidents are monitored by a senior manager. Seizures are not reported as accidents unless an injury is sustained. A HSE poster was on display in the office. Both homes had been visited by a representative of the Health & Safety Executive (together with a CSCI inspector) in May 2005. COSHH data sheets are in place and materials locked away in Hampshire. Some cleaning materials are left out in Redsteps and given the different nature of this service this seem in order. The registered manager should, however, carry out a risk assessment of these. Hampshire House & Redsteps Version 1.10 Page 23 Windows in both home have restricted opening. One resident in Hampshire House complained that the installation of a restrictor in his room made him feel claustrophobic and was having an adverse effect on his well-being. It was agreed that it could be removed for that resident after a risk assessment had been carried out. Details of technical checks on gas, electricity, fire and emergency equipment and water were supplied in the pre-inspection questionnaire and those for Legionella and PAT electrical testing appeared a little overdue. A record of the most recent check of the electrical wiring in Redsteps could not be found at the time of the inspection. The office door in Redsteps needs to be propped open (it is a very small office) and the advice of the fire service should sought on this. Some weaknesses in safety procedures in both kitchens were observed. Hampshire House is now self-catering and this is a welcome development in a service with a rehabilitative element. Residents were very pleased with the development. Redsteps has been a self-catering kitchen for sometime. In Hampshire the temperature of the hot water was tested at 800 Celsius – dangerously high temperature in an area to which residents have access (an ‘Immediate Requirement’ was issued with regard to this and the registered manager dealt with the matter through the works and maintenance department). Waste bins were uncovered. Dead flies were noted in the light fitting. Open sauce bottles in the fridge had not been labelled. Apart from those observations the kitchen was clean and tidy. Food is now ordered online and is delivered by Tesco. While this ensures the safety of perishable foods in transit it has had the side effect of reducing opportunities for residents to go food shopping and gain the potential benefits of this. Redsteps kitchen is smaller. It was very clean and tidy and hot water temperatures were at a safe level. However some weaknesses in procedures were noted. Fish were defrosting at room temperature in a pan on a unit. Chicken and milk were on the same shelf in the fridge. Open sauce bottles and an open packet of cooked meat had not been labelled. Some doors of base units were split. The shower room room in Hampshire has been refurbished with new flooring and a new wall fitting. However about 5 cms of hot water piping is exposed and needs to be covered. Hampshire House & Redsteps Version 1.10 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. 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 x x x Standard No 22 23 ENVIRONMENT Score 2 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x x 3 Standard No 11 12 13 14 15 Hampshire House & Redsteps x x x x x Standard No 31 32 33 34 35 36 Score x x 3 3 3 2 Version 1.10 Page 25 16 17 x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score x x x x Standard No 37 38 39 40 41 42 43 Score x x x x x 2 x Hampshire House & Redsteps Version 1.10 Page 26 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 24 Regulation 13(4) Requirement The registered manager is required to ensure that exposed pipework carrying hot water is properly covered and does not pose a risk to residents. The registered manager is required to ensure that practice in the main kitchen in Hampshire House and in Redsteps meets current good practice with regard to food safety The registered manager is required to ensure that the temperature of the hot water in areas to which residents have access is close to 43 degrees Celsius Timescale for action July 30 2005 2. 42 13(4) November 30 2005 3. 42 13 (4) October 31 2005 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. Refer to Standard 6 22 Good Practice Recommendations It is recommended that the name of the resident be written in all loose filed sheets in care plans It is recommended that the complaints policy include reference to a residents right to refer a complaint to the Version 1.10 Page 27 Hampshire House & Redsteps 3. 36 CSCI at any stage as stated in 22.3 of this standard. It is recommended that the registered manager provide occasional support to Redsteps to enable it to hold staff meetings and establish a programme of personal supervision for staff. Hampshire House & Redsteps Version 1.10 Page 28 Commission for Social Care Inspection 8 Bell Business Park Smeaton Close Aylesbury Buckinghamshire HP19 8JR 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 Hampshire House & Redsteps Version 1.10 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. 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!