Inspection on 25/04/07 for Heathcotes Care (Sawley)

This inspection was carried out on 25th April 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Heathcotes Care (Sawley) 08/10/08

Heathcotes Care (Sawley) 23/04/08

Heathcotes Care (Sawley) 22/08/06

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Heathcotes Care (Sawley) 1 Bradshaw Street Sawley Nottingham Nottinghamshire NG10 3GT Lead Inspector Helen Macukiewicz Unannounced Inspection 25th April 2007 09:30 Heathcotes Care (Sawley) DS0000064327.V337252.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 Heathcotes Care (Sawley) DS0000064327.V337252.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. Heathcotes Care (Sawley) DS0000064327.V337252.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Heathcotes Care (Sawley) Address 1 Bradshaw Street Sawley Nottingham Nottinghamshire NG10 3GT 01159 636379 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) enquiries@heathcotes.net www.heathcotes.net Heathcotes Care Ltd Gemma Simpkins Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Heathcotes Care (Sawley) DS0000064327.V337252.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22nd August 2006 Brief Description of the Service: Heathcote Care Home is situated in a quite residential area of Long Eaton and lies on the Derbyshire and Nottinghamshire boarder. The home is a purpose built provision for six adults with Learning Disabilities and Changing Behaviour. The home comprises of two floors with each floor having three spacious bedrooms with en-suite facilities. The communal areas include the dining area, lounge, kitchen, bathroom and two showers. The home is within a few minutes walk of local shops and amenities and within easy reach of the cities of Derby and Nottingham. The Manager confirmed that the current range of fees are between £1100.00 and £2200.00 per week. Heathcotes Care (Sawley) DS0000064327.V337252.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This Inspection was unannounced and lasted 7.5 hours over 1 day. Prior to this, Computer held records of all contact between the Home and the Commission for Social Care Inspection since the last Inspection were referred to in the planning of this visit. During the Inspection five people living at the home completed written questionnaires and the Manager submitted a preinspection questionnaire that she had started to complete. Discussion with service users, relatives and a transitions coordinator from social services took place. Time was spent in discussion with the Registered provider, Manager and one member of staff. Two service users care files were looked at in detail and their care was examined to see how well records reflect care practices within the home. Relevant records belonging to the home were also examined such as complaints and policy documents. A brief tour of some areas of the home took place. What the service does well: What has improved since the last inspection? What they could do better: The assessment processes pre-admission need to be kept in the home and staff need to consider length of time they allow to assess new service users in between further admissions to ensure people will settle in well with each other. Heathcotes Care (Sawley) DS0000064327.V337252.R01.S.doc Version 5.2 Page 6 Management of violent incidents in the home needs reviewing to ensure safety of service users and staff. Recording of complaints also needs to be reviewed to ensure service users rights are upheld. The care plans need to provide clearer direction for staff and include all areas of service users needs. The induction and supervision of staff needs to be improved to ensure staff are equipped to deal with service users needs. 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. Heathcotes Care (Sawley) DS0000064327.V337252.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 Heathcotes Care (Sawley) DS0000064327.V337252.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): Standards 1 and 2. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People who may use the service and their representatives have the information needed to choose a home although admission procedures do not fully ensure peoples needs will be met. EVIDENCE: A copy of information about the home, including complaints procedures was included in each service users file that was looked at. These were written in normal type and symbol form to ensure they were in a format suitable for the needs of the service users and the Registered provider had clearly invested a lot of time in producing these documents. These guides were quite lengthy and the terminology used was quite complex. They would benefit from being simplified. Relatives confirmed that they had received written information about the home before admission and this also included a C.D. about the home. The Registered provider and Manager confirmed that service users have a comprehensive assessment of needs before a decision is made to admit them to the home. Relatives confirmed that they had a visit to the home with the Heathcotes Care (Sawley) DS0000064327.V337252.R01.S.doc Version 5.2 Page 9 service user to see if they liked it before admission. Relatives also said that staff asked them a lot about the service users likes, dislikes, personal preferences, routines etc. However, in 3 care files that were seen none had a pre-admission needs assessment recorded and one file did not have an assessment by the placing authority either. The Registered provider confirmed that assessments had been carried out but could not explain why these were missing from files. A discussion also took place with the Registered Provider and Manager regarding how they assess whether someone will ‘fit in’ with the existing service user group; therefore ensuring relationships between service users are positive. And whether any formal assessment of this is made. This was in light of the fact that there had been several admissions to the home within a short space of time, and it was unclear from records how long service users undergo assessment of their behaviours and needs prior to the admission of the next person. Due to the fact that this is a long-term home, and the challenging needs of some people who live in the home, this is essential to ensure the safety and wellbeing of service users. Comments from one social worker were that this was a good placement for their client and that they have found the home to be good. Heathcotes Care (Sawley) DS0000064327.V337252.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): Standards 6, 7 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Individuals are involved in decisions about their lives and play an active role in the care and support they receive although better identification of care needs would ensure more individualised care. EVIDENCE: Care plans were personalised although they lacked specific details and clear instructions for staff in certain areas. One care plan for a younger service user covered many areas of need. However, there was no reference to the particular communication needs of the person, social needs, wishes and preferences, educational aspirations, specific health needs or any particular friendships or relationships that need to be maintained given the young age of the person. There was a lot of emphasis on daily living skills. There was a Heathcotes behaviour scale in each set of care records seen; this was based on a recognised model of behaviour management. Each one was Heathcotes Care (Sawley) DS0000064327.V337252.R01.S.doc Version 5.2 Page 11 individualised and focused on a non-invasive approach. Care records in files had all been signed by staff to confirm that they had read them. All contained a review date. Although some reviews were slightly overdue, most had been done. Service users had signed to agree their care plans and one service user was aware of what was in his care plan. Service users confirmed that they are able to make decisions affecting their lives within the home. All service users had some form of Advocacy services appropriate to their needs, although not all advocacy was fully independent. However, two people were on a waiting list with Derbyshire Advocacy Services. There was evidence that people living in the home are allowed to take risks in order to further their independence, using a controlled approach. The Manager said one service user is being assisted to undertake independent travel in agreement with their social worker. Another service user said that they were being allowed to go to the shops alone and that staff were monitoring the time they took to return to the home. The service user was hopeful that this would help them towards moving on to a home where they would be given more independence. Heathcotes Care (Sawley) DS0000064327.V337252.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): Standard 12, 13, 14, 15, 16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use this service are able to make choices about their lifestyle and are supported to develop their life skills. Social, educational and recreational activities mostly meet individuals’ needs. EVIDENCE: 3 people living in the home have placements with the forestry commission, where they are employed to undertake routine grounds maintenance with park rangers. One service user said he enjoyed this work and had been working there on the day of this Inspection. One service user said that they were planning to undertake a College course in September. One service user said that they regularly went to the local pub and karaoke nights, which they joined in. They had friends at the pub and one relative of Heathcotes Care (Sawley) DS0000064327.V337252.R01.S.doc Version 5.2 Page 13 another service user said that she was going to join him in the pub to watch him and provide support. The Registered provider and one service user confirmed that a holiday had been planned for later on in the year. Two service users also said that individual camping trips were being organised for them and had pictures of previous camping trips. Two service users said that they would like more to do in the daytime. They said that they could not do as much as they liked as there were not enough drivers for the transport and also that staffing affected what they did. Discussion took place with the Manager regarding these comments during this Inspection. The people who live in the home have links with their immediate Community. Neighbours call in from time to time, and they also receive visits from a Community Police Liaison Officer. One relative said that staff always make them feel welcome, and that ‘staff and the people living here are like my family’. Service users have their own meetings to discuss issues relating to the home as a whole although there were only minutes of the last meetings available as the Manager said that the last record book had been accidentally destroyed. Most service users had their own bedroom door keys, service users were observed to be locking and unlocking their own rooms and moving freely around the home. Staff were interacting well with service users. One service user confirmed that staff treat them with respect and that they had enough privacy in their bedroom. One service user gave a tour of the grounds and said that they were assisting in building a barbecue and had been painting the perimeter fencing with other people over the weekend. They appeared to have enjoyed doing both these things. Individual care plans clearly described the housekeeping tasks performed by service users, with the support of staff. Service users said that they do their own laundry, cleaning and cooking. One service user said ‘I like cooking’. On Saturday nights service users have a take-away of their choice, which is funded by the home. Service users were making their own meals with staff support during the Inspection. Staff record the choices that service users make in relation to meals. A review of these records did show that service users were not incorporating much fruit and vegetables into their diet. Heathcotes Care (Sawley) DS0000064327.V337252.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): Standards 18, 19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health and personal care that people receive is based on their individual needs. EVIDENCE: Service users said that they knew who their key workers were. One confirmed that he could choose another key worker if he wanted. Staff were observed assisting service users with their personal hygiene, whilst respecting their individuality and preferences regarding personal appearance. Service users were unable to say whether they could see the G.P. unaccompanied but said that their privacy is respected in the home. The Manager confirmed that there are good links with community nursing services and specialist community learning disability teams as well as specialist medical advice. The community nurse provides support with person centred care planning, family planning and general health promotion programmes. Heathcotes Care (Sawley) DS0000064327.V337252.R01.S.doc Version 5.2 Page 15 Comments from one transitions co-ordinator were that communication between themselves and staff in the home was good. Management of medication within the home was good. Care records contained a lot of specific detail about the individual medication needs of service users. The Medication Administration Record (MAR) sheets seen were all completed in full. Heathcotes Care (Sawley) DS0000064327.V337252.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): Standards 22 and 23. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People who use the service are able to express their concerns. The management of physical aggression and adult abuse policy and procedures do not adequately safeguard people living there. EVIDENCE: There have been 5 complaints made to the home since the last Inspection; these were all recorded in a complaints book. From the Managers feedback and written records it appeared that all complaints had been resolved satisfactorily. One issue was ongoing at the time of this inspection. The way in which complaints were recorded did not allow for confidentiality, and did not provide a complete picture of the investigation that took place. The Registered provider confirmed that the Company have better forms and would provide some for the Manager to use. The Manager said that worries and concerns are also raised in service users meetings. All people living in the home, who were asked about complaints, said they would speak to their key worker or the Manager if they had problems, and were happy that things would get sorted. One service user said that if their issue was not sorted out by the home, they would speak to their social worker. None of the people living in the home, or relatives knew about the role of the Commission for Social Care Inspection in complaints. Heathcotes Care (Sawley) DS0000064327.V337252.R01.S.doc Version 5.2 Page 17 There was a written complaints procedure in the foyer, in service users files, and in the policy documents. This was also written in symbol form. However, some information was out of date and it was quite complex and therefore may not be fully understood by all people in the home. A simplified version was sent electronically to the Commission for Social Care Inspection, after this inspection. There have been 2 adult protection investigations since the last inspection. The Manager, in the pre-inspection questionnaire, supplied this information. There were Derbyshire Area Adult Protection Procedures in the office. Staff training records indicated that they had received training on adult protection. However, there were no internal procedures available to instruct staff on how to deal with allegations, which include names both internally, and externally of who to notify and giving timescales for responses. These were also unavailable at the last Inspection in August 2006. The Registered provider confirmed that within the Company, there were procedures, which should have been in the home. He sent a copy to the Commission for Social Care Inspection following this Inspection. Staff had received training on adult protection through an internal programme. There had been 3 incidents within April, which had resulted in personal injury to staff or a person living at the home. The Commission for Social care Inspection and social services had been notified appropriately. One incident involved 2 service users. The care plan had since been updated for one service user so that it contained instructions to staff on how to prevent further incidents. However, there was no safeguarding plan in the other service users file providing instructions for staff on how to keep them safe. There was incomplete record keeping in 1 service users file regarding an incident of a physical nature. The accounts of staff at the time of entry into the daily log omitted one incident that was reported on the untoward incident sheet. There was no evidence written anywhere in records to support that persons involved in the incidents had been given the right to make a complaint to the police and also have a medical examination within 24 hours. The Manager verbally confirmed that both these rights were upheld in all cases. In one service users file staff had made reference to use of SKIP methods to control the behaviour of the service user. This is not a form of behaviour management that is recognised by the Home. The method of behaviour management adopted by staff is Nappi (Non-abusive psychological and physical intervention). Staff have been trained to level 1. This equips them to undertake de-escalation techniques and non-invasive guiding, as well as protecting themselves from injury. Staff in the home are not currently trained in restraint techniques and there is a policy of no restraint in operation. Heathcotes Care (Sawley) DS0000064327.V337252.R01.S.doc Version 5.2 Page 18 Given the homes’ aims to provide placement for people with challenging behaviours, and recent incidents resulting in personal injury, the Registered Provider will need to demonstrate how staff will be able to maintain the safety of themselves and of service users using this approach. Also, how this approach will be effective in reducing criminalisation of service users. Systems were in place to ensure the financial dealings made on behalf of service users are audited. Monies are kept individually in a secure area and purchases receipted. Service users confirmed that they could have access to their money at any time as agreed in their care plan. Heathcotes Care (Sawley) DS0000064327.V337252.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The physical layout of the home enables people who live there to be in a well maintained and comfortable environment, which encourages independence. EVIDENCE: All service users who were asked said they liked their bedrooms. Visitors confirmed that they brought in things from home for their relative and that the room had been painted in a choice of colour after consultation with the service user. The Manager’s pre-inspection questionnaire confirmed that a quite room had been decorated and sensory lighting fitted since the last Inspection. All parts of the home were clean and tidy. One service user, in their completed questionnaire said they felt the home needed redecorating, but that it was clean and tidy. In the last monitoring visit undertaken by the Registered Provider, they had put an action point in their Heathcotes Care (Sawley) DS0000064327.V337252.R01.S.doc Version 5.2 Page 20 report asking for the home to be redecorated when service users went on their annual holiday. Heathcotes Care (Sawley) DS0000064327.V337252.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 32, 34, 35 and 36. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staff in the home are trained and in sufficient numbers to support the people who use the service although better induction and supervision procedures would ensure that resident’s wellbeing is not put at risk. EVIDENCE: The Manager confirmed that 70 of the total number of care staff were completing qualifications to NVQ level II (National Vocational Qualifications) and had 3 units to finish before completing this. The remaining 30 had an NVQ level II or equivalent. Staff have also received training in specific areas such as non-physical intervention and behaviour de-escalation, and body mapping (to chart physical injuries following incidents). Comments from one social worker were that they had respect for the management of the home and staff. A member of senior staff described the training provided by the Company as good. One staff file documented an individual training plan. There was a staff Heathcotes Care (Sawley) DS0000064327.V337252.R01.S.doc Version 5.2 Page 22 training matrix available which showed that most staff have received training in mandatory areas such as fire safety and basic food hygiene. Training was also documented in areas such as Autism and Protection of Vulnerable Adults. The recruitment files for 2 staff were seen. These generally supported good recruitment practices with the exception of the fact that verbal rather than written references were obtained for one person and one needed updating to confirm that a CRB check had been obtained. There was a written record in 2 staff files of a 2 day induction programme. During the first few weeks staff are expected to sign to confirm that they have read through key policies and procedures, as well as service users care records. There was written evidence of this. The level of induction was difficult to assess as records had insufficient detail. In 1 service users file staff had used inappropriate terminology to describe a care practice they had carried out, this gave the impression that staff exercised inappropriate control over service users. In practice, there was nothing to suggest this was the case and that it was a training issue. Staff files did not provide sufficient detail to support the proper induction and ongoing supervision of staff. There have been a large number of staff employed recently, to meet the increasing number of people living in the home. Some staff have not worked in a care setting before and some have recently left education. In one staff file, a member of inexperienced staff had only one supervision recorded in the four months since they were employed. Supervision records did not fully detail points covered in standard 36.4 of the National Minimum Standards document. Heathcotes Care (Sawley) DS0000064327.V337252.R01.S.doc Version 5.2 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 37, 39, 40 and 42. Quality in this outcome area adequate This judgement has been made using available evidence including a visit to this service. The home is managed effectively although health and safety hazards create unnecessary risks to the welfare of people living in the home. EVIDENCE: The Manager has been registered with the Commission for Social Care Inspection since the last Inspection. She is undertaking a Registered Managers Award and confirmed that she has two modules left to complete. She also undertakes periodic training in areas relevant to her sphere of work. The Manager confirmed that internal quality assurance monitoring is undertaken monthly, and had forms to record this on. Various questionnaires were seen that have been developed to send out to service users, relatives and Heathcotes Care (Sawley) DS0000064327.V337252.R01.S.doc Version 5.2 Page 24 professionals within the community. Some had been sent out recently but there had been none returned. The Manager intended to complete a report with all the results of these every 3 months. There was a comprehensive policy file, which include policies such as equal opportunities, personal allowances and safety. Staff had signed to confirm they had read and understood these. Measures had been put in place to ensure the safety of the service users environment. There was also a full risk assessment of the home. Safety data sheets were also kept in a COSHH file (Care Of Substances Hazardous to Health). It was observed that some of the ground floor fire doors had been wedged open. These areas were not constantly supervised, creating a risk to service users. A random check on service records showed that these were all up to date including portable appliance testing. The Registered Provider confirmed that all senior staff on shifts have first aid qualifications. However, training records for staff indicated that most other care staff have not had this training. The Registered Provider confirmed that training was being planned for all staff in this area. This will be of particular importance as two service users care files documented that they were at risk of choking on food. Heathcotes Care (Sawley) DS0000064327.V337252.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 1 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 1 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 2 35 2 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 x 3 x LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 3 3 x 2 x Heathcotes Care (Sawley) DS0000064327.V337252.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? YES 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 YA2 Regulation 14 Requirement There must be sufficient written information kept in service users files to support a full assessment of their needs prior to admission. Admission procedures must be able to demonstrate how the home ensures that the service user being admitted to the home will ‘fit in’ with the needs of the existing group of service users. Complaints records must be kept confidentially and contain sufficient information to support a thorough investigation and satisfactory outcome, to ensure resident’s are safeguarded. All service users must be informed that they can contact the Commission for Social Care Inspection regarding concerns to ensure their rights in this area are upheld. The home must have a policy and procedures on how they will safeguard service users from harm or abuse. This requirement had previously been given a timescale of DS0000064327.V337252.R01.S.doc Timescale for action 31/05/07 2. YA22 22 31/05/07 3. YA23 13(6) 31/05/07 Heathcotes Care (Sawley) Version 5.2 Page 27 30/9/06 that has not been met. The service user who did not have a safeguarding plan following the most recent incident must have one in their care file to ensure their safety. A clear account of all events must be maintained in written records to ensure issues relating to service users welfare can be properly audited and future safeguards put in place. Written records must support that persons involved in incidents resulting in personal physical injury had been given the right to make a complaint to the police and have a medical examination. The Registered Provider must provide a written response as to how staff will be able to maintain the safety and wellbeing of themselves and of service users. Staff must be appropriately 30/06/07 supervised to ensure service users wellbeing is safeguarded. Written records must be able to support that supervision is consistent with standard 36.4. Risk assessment of fire doors 31/05/07 being wedged open must occur to ensure safety of service users. All staff must be adequately trained to ensure the safety of the service user at risk of choking. 4. YA36 18(2) 5. YA42 13(4) Heathcotes Care (Sawley) DS0000064327.V337252.R01.S.doc Version 5.2 Page 28 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 YA1 YA6 YA14 Good Practice Recommendations The service user guide should be simplified to ensure service users with differing abilities readily understand it. Consideration should be given to wider and longer-term goals and aspirations within care planning to ensure that an institutional lifestyle is not re-enforced. The comments from a service user regarding lack of drivers for activities should be discussed with them and also as a group at the next service users meeting and appropriate action taken. Staff should encourage service users to maintain a healthy diet including fresh fruit and vegetables. The complaints procedure should be simplified and the displayed copy kept up to date with the Commission for Social Care Inspection details. Further staff training and oversight of the manager in terms of completing records should be undertaken. Recruitment of staff should include 2 written references and recruitment files kept up to date. Induction records for staff should be more detailed. 4. 5. 6. 7. 8. YA17 YA22 YA32 YA34 YA35 Heathcotes Care (Sawley) DS0000064327.V337252.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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 Heathcotes Care (Sawley) DS0000064327.V337252.R01.S.doc Version 5.2 Page 30 - 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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